Unemployment Essay Example | Topics and Well Written Essays - 1250 words

Unemployment - Essay Example There are two types of policies that an economy can apply to fine tune the economy to achieve required economic growth and employment levels, this include fiscal policies that include government expenditure which affect the IS curve, the other type of policy include the monetary policies which affect the LM curve. These factors include the change in the transaction demand for money, change in speculative demand for money and changes in money supply. There are factors that affect money supply and they include changes in open market operations, change in prices and changes in the reserve ratio. The IS curve joins together combinations of interest rates and national income at which the commodity market is at equilibrium, this is to say that the equilibrium expenditure equals output. Shifts in the IS curve are attributed to changes in government expenditure and changes in net exports. From the above discussion the factors that cause a shift in the LM and IS curve can therefore be used by the government and monetary policy makers to improve the state of the economy, those factors that lead to a shift in the LM curve which include money supply, changes in prices and reserve ratios can be used to fine tune the economy to reduce unemployment, also those factors that lead to a shift in the IS curve will also help in reducing unemployment and these factors include government expenditure and exports. According to Keynes, aggregate demand is equal to consumption plus investment plus government, this can be stated as Y = C + I + G for a closed economy and Y = C + I + G + (X –M) for an open economy, an increase in government expenditure therefore will increase aggregate demand. ... es expenditure then the level of employment will increase but the outcome will be inflationary, the diagram below shows the increase in government expenditure which in turn increases aggregate demand and the level of employment in the economy increases. The diagram shows an increase in government expenditure which results into an increase in aggregate demand from aggregate demand 1 to aggregate demand 2, as a result the equilibrium level shifts from y1 to y2, this in turn shifts the equilibrium level of the IS LM model, the IS curve shifts from IS curve 1 to IS curve 2. The economy is at a higher output level and for this reason there is higher employment level, however from our diagram this position brings about an increase in the interest rate level than it was originally was at, the interest rate level increases from I1 to I2. Therefore employment can be increased by the government through an increase in the level of government expenditure. This will however result to higher levels of interest rates as a monetary policy measure to avoid inflation caused by the government expenditure. From the above diagram it is clear that an increase in government expenditure will result to an increase in aggregate demand will result into increased income, the income level signifies the employment level in the economy and in our case it is clear that this results to higher employment level from y1 to y2. The LM curve on the other hand depict a policy measure by which an economy can reduce the level of unemployment, an increase in money supply will result into a downward shift in the LM curve, as a result the economy will be at a higher output level and therefore higher employment levels, the diagram below shows a the effect of an increase in money supply on the LM curve and

MRIs and Other Issues in Medicine Essay Example | Topics and Well Written Essays - 750 words

MRIs and Other Issues in Medicine - Essay Example An X-Ray is also used to image internal structures of the body, but opposed to an MRI, an X-Ray is a type of high-energy radiation. X-Rays are made of electromagnetic radiation with wavelengths between ultraviolet and gamma rays, and are most often used in low doses for making images of internal body structures and in higher doses for treating cancer. A CT Scan (CAT Scan) is again, another form of viewing the internal structures of a person's body. CT Scans are in fact a computerized series of X-Rays, which can reveal tumors and small strokes in the brain. A computer is used to generate a three dimensional image, which are then analyzed and displayed for diagnostic purposes. An MRI is most often used for studying nerves, muscles, ligaments, bones, and other tissues in the body. Problems such as a disc herniation in the spine or masses or tumors within soft tissues are seen well on an MRI image. MRIs are most helpful and most commonly used by orthopedic surgeons; an MRI is particularly helpful at diagnosing many common orthopedic problems. Therefore the most probable explanation as to why and MRI would be ordered is if orthopedic problems are perceived to exist in a patient. What Would it be an Appropriate Situation for an MRI not to be Done There are several proper explanations for why an MRI would not be ordered for a patient. Firstly, an MRI is not the most accurate test. Although an MRI is useful in the diagnosis of many conditions, it is not 100% accurate in all cases, which means sometimes the problem will not show up in the MRI. Another primary reason as to why an MRI might not be ordered is because an MRI is usually "not the first step." (Cluett, 2006). In other words, there are other steps which should be taken in an attempt to figure out the problem, rather than immediately ordering an MRI. Lastly but certainly no less importantly, is the fact that an MRI is only a diagnostic test, and not a treatment. "An MRI gives some people peace of mind, but will do nothing to change the symptoms of your condition." (Cluett, 2006). Are There any Limitations on an MRI Although MRIs have major technological advantages when compared to other imaging modalities, there are also certain limitations which are present. Disadvantages are there, such as the fact that because of the small bore of the magnet, some patients experience claustrophobia and often have difficulty cooperating in the study. As well, some obese patients cannot be studied by an MRI. Patient throughput is also slower than comparative imaging

Heart Failure Case Study

Heart Failure Case Study Sharon Heather Ferguson-Guy When it comes to Heart Failure the best form for a brighter future is to optimise the intervention with treatment goals that are vital for the patients’ health, well-being and gain a better chance of longevity. The benefits of obtaining a compatible medication treatment goal for the patient, is so to reduce the stress and anxiety for the patient, which in turn can minimise hospital admissions. Anyone that has other cardiovascular risks such as diabetes, smoking, excessive alcohol (with young adults; with excessive alcohol consumption, they may be susceptible to ‘holiday heart syndrome’ which it is also known as) (Sanders, et al. 2012, p.628) and elevated blood cholesterol levels. The following case study was given freely from a neighbour on his present health. I have changed his name to protect his confidentiality. Case study: Mr Lloyd is a 73 years old widower and has heart failure in the form of Atrial Fibrillation. He started to become breathless after riding his bike; that he did daily. He said that he also noticed excitable flutters in his chest, but did not take much notice as he thought it was because he had over exerted on an activity at his time of life and put it down to the aging process. He popped to his local General Practitioner with his experiences and was put on a low dose of Warfarin. After a couple of weeks he returned and told his General Practitioner that he was not feeling any better and did not feel right. His General Practitioner told him to continue his dosage for another week. Mr Lloyd enjoyed walking if he was not cycling, but, due to the weather he left the bike at home. While on his way he slipped on ice and banged his head on the pavement. He was taken to hospital for the rest of the day due to a possible concussion. At the point of leaving he complained he still had a headache. The doctor was not surprised as he had banged his head and prescribed pain relief and told him what to watch out for with head injuries (They were aware of his medication he was on at the time). After a week of pain relief he still did not feel right. His daughter took him to a different hospital. The doctor asked what medication he was on and told him that he was on still on the warfarin, they took him off it immediately, and replaced with a very low dose of aspirin. They immediately took him for a MRI (magnetic resonance imaging) scan that revealed that he had a haemorrhage on the brain; it had been there since the fall. History: There is not a family history of heart failure. Has not smoked for 50 years. Does not have any previous illnesses. Has never drank alcohol. Has worked away from home outdoors all of his working life until retirement. Admitted that his diet improved since his retirement, as with his previous job required him to be away from home quite a lot of the time and so his lifestyle then contained of hotels and bar meals. Has never been a big eater and portions were always small. Signs and symptoms: Feeling breathless on light activities, more so when cycling Feeling weak and more tired Dizzy after excursion Pale but not all the time. No sickness Heart beating too fast, rhythm was irregular No coughing Not confusion No weight gain as always active BP normal No depressive feelings or cognitive problems Tests done: Auscultated lungs for changes – non were found Blood test was taken Blood Pressure – high on his visit, but often fluctuated between normal and high Neck veins checked – no distension found ECG that read Atrial Fibrillation Electrocardiogram was performed for 24 hours No chest x-ray was performed Pitting oedema was slight at the end of the day Medication before fall: Warfarin – was later changed to Aspirin Salbutamol inhaler Furosemide (unable to remember dose) Cod liver oil 2 spoonful’s twice a day – home remedies (On further reading on drugs.com I was curious regarding his cod liver oil intake and the medication of warfarin he was taking that may interact due to it containing vitamin K, this reduces the effectiveness of the warfarin and flagged an air of caution) (drugs.com) Mr Lloyd still suffered tiredness and breathlessness. Medication after fall for 4 months: Aspirin Cod liver oil 2 capsules twice a day – home remedies Pravastatin 20mg – 1 daily (reduces the bad cholesterol) Salbutamol – when required Simvastatin 20mg – 1 daily (changed from pravastatin also reduces bad cholesterol) Spiro inhaler – when required (drugs.com) Mr Lloyd was told to weigh himself every morning as he got out of bed. This was so he could take part in his own progress on any weight gain or weight loss due to the change of medication and possible fluid retention. He noticed the frequency during the day and maybe once at night in going to urinate. With the changed medication Mr Lloyd still suffered tiredness and was breathlessness on light activities. After a review with a specialist his present medication treatment plan is: Apixaban 5mg – 1 x 2 daily (reduce the risk of stroke clots) Atorvastatin 10mg – 1 daily Cod liver oil 2 capsules daily home remedies (not spoonful’s anymore) Digoxin 125mcg – 1 daily (makes the heart beat stronger and a regular rhythm) Dutasteride 0.5mg – 1 daily (used with Tamsulosin, reduce risk of urinary blockage) Omerprazole 20mg – 1 daily (acid reflux) Spiro inhaler – when required Tamsulosin hydrochloride 400mcg m/r capsules 1 daily– muscle relaxant, ease flow of urine (drugs.com) This drug therapy is working well and clear from any adverse reactions and only visits the General Practitioner twice yearly. Blood pressure is stable at 110/75 bpm. His weight has not changed. Mr Lloyd still charts his input and output of fluids. With this, he is able to monitor and report to his now General Practitioner any noticeable differences, to which, there is not any. Current status: Even though Mr Lloyd had to endure some frustrating discomfort with tiredness and breathlessness from past medications, these just didn’t suit him, (It may have been a perfect combination for somebody else) and the time it had to take to get the correct treatment goals and drug therapy to his own body’s balance, Mr Lloyd is continuing his everyday activities without any problems of breathlessness or tiredness that have hugely decreased. He has decided with himself and with agreement from his General Practitioner that after about 17.00 he will start to slow down, and relaxes after food, and will potter in his garden instead of cycling. I have only ever known Mr Lloyd to cycle everywhere and all day. He tells me that he now enjoys seeing a television programme to the end instead of falling asleep half way through. His medication has slowed down his ventricular rate and that he will go for another review later on this year. Mr Lloyd said that he would not mind if the dose was lowered or none at all as he does not like to be reliant on medication. The specialist Doctor after reviewing Mr Lloyd advised him to attend a rehabilitation gym (sponsored by the British Heart Foundation) to monitor his exercise regime and to teach him how to keep fit in a healthy way for his age. They also educated him on a tasteful diet without the worry of blandness. He still goes to the gym, mainly because he has made many friends with similar conditions, and able to swap ideas. Mr Lloyd values the presence of the professional medical staff that are there for any health or heart concerns. Treating congestive heart failure with medication: To optimise the correct and suitable medication would be to find the patients correct balance. This will take a selection of medication over a period of time in order to reach the optimum goal of drug therapy. The reason for this is to make less strain on the heart by using the correct combination of drug and its correct dosage. We must try and increase the cardiac output so the blood can pump more blood every minute. This will in turn improve the pumping action of the heart and reduce the hearts workload. So medication or a medical intervention may be suggested, the severity or damage would be taken into consideration. If there is a valve problem, it may be fixed with a repair or a replacement. If a more invasive form of fixing is needed, surgical implants may be required. This may be a pacemaker. This is a ventricular assisted device that contains a pulse generator with one, two or three electrode leads that give off electrical impulses to and from the heart (British Heart Foundati on 2014, p.13)(Cleland 2006, pp.72-44). A more severe case may include a heart transplant which includes a recently deceased donor that is a match for the recipient. There are risks involved like any other surgery, but a heart transplant may be rejected due to rejection, infection or the new heart does not work properly. (Cleland 2006, pp.79-80) We need to take the effort off the workload on the heart by decreasing the fluid overload and reduce the blood pressure, so medication to reduce the heart rate and increase vasodilation (widen the blood vessels, by relaxing the smooth muscle cells). Diuretics would be one solution that would help with the fluid overload. This will increase the urine output and so in turn decreases the fluid overload. Different diuretics such as thiazide and loop diuretics that will cause a general loss of sodium and water from the body but also other electrolytes (minerals in the blood). This must be monitored for hypokalaemia (low potassium) because of sodium and water loss, potassium can be lost from the body in large quantities. (Cleland 2006, pp.54-63)(Class notes 2014/15) Another diuretic is a potassium sparing diuretic, it is an aldosterone antagonist (blocks the sodium retention effects of aldosterone in the kidney). This may cause a reverse problem, the potassium sparing diuretic can cause the body to retain too much potassium, so the patient must be monitored for hyperkalaemia (high potassium). An imbalance of hypokalaemia or hyperkalaemia in the body will be a risk of the electrical problems in the heart. By using diuretics the patient will be monitored for hypotension (low blood pressure) this is due to the fluid retention and the reduction of blood pressure medication. You must also monitor serum creatinine (waste product in the blood that comes from muscle activity and kidney function indicator). If the levels of this get too high, it will be an indication that the kidneys are having problems. (Class notes 2014/15)(Cleland 2006, pp.59-63) Other medications that will be help congested heart failure is to now focus on the blood vessels, the aim is to stimulate the function of the vasodilation that will rest the heart by slowing it down. The most used medication is called an ACE inhibitors (Angiotensin-converting enzyme) (Cleland 2006, pp.53-56) this will block the enzyme that forms angiotensin II also known as ARBs (angiotensin receptor blockers) (Cleland 2006, pp.56-57) this causes the vasoconstriction to raise the blood pressure. The ACE inhibitor will interrupt the cycle of angiotensin II, this will then decrease the blood pressure. The increase of vasodilation with the ACE inhibitors and vasodilation will lower the blood pressure and so helps to reduce the workload on the heart. There will be a drop in aldosterone (is a corticosteroid hormone that stimulates absorption of sodium by the kidneys) levels causing a decrease in fluid overload. A medication called ARBS (Angiotensin Receptor Blockers) reduce the activity of the angiotensin II in the blood. You would prescribe this if the patient is not able to tolerate an ACE inhibitor. (Class notes)(Cleland 2006, pp.56) Beta blockers block the binding of norepinephrine (neurotransmitter) to the beta receptors on the heart, this will cause a decrease in the heart rate. Which in turn will decrease the blood pressure and the workload of the heart. With such an amount of medication, it is advisable to monitor the patient for hypotension. (Class notes 2014/15)(Cleland 2006, pp.57-59) References: Bibliography British Heart Foundation (2014) Pacemakers. Chronic heart failure | introduction | Guidance and guidelines (no date) Available at: http://www.nice.org.uk/guidance/cg108/chapter/introduction (Accessed: 13 May 2015) Cleland, J. (2006) Understanding heart failure. London: Family Doctor Publications in association with the British Medical Association Prescription Drug Information, Interactions Side Effects (no date) Available at: http://www.drugs.com (Accessed: 14 May 2015) Sanders, M. J., Lewis, L. M., Quick, G. and McKenna, K. D. (2012) Mosby’s Paramedic Textbook [With DVD]. 4th edn. United States: Elsevier/Mosby Jems Citation (Chronic heart failure | introduction | Guidance and guidelines, no date) (Prescription Drug Information, Interactions Side Effects, no date) (Sanders et al., 2012, p. 628) (British Heart Foundation, 2014, p. 13) (Cleland, 2006, p. 56) (Cleland, 2006, pp. 57 – 59) (Cleland, 2006, pp. 57 – 59) (Cleland, 2006, pp. 56 – 57) (Cleland, 2006, pp. 53 – 56) (Cleland, 2006, pp. 59 – 63) (Cleland, 2006, pp. 54 – 63) (Cleland, 2006, pp. 79 – 80) (Cleland, 2006, pp. 72 – 74) Case study given freely by my neighbour. Font used – Calibri light. Size 11. Size 9 for references My draft copy was kindly read and checked by: The Clinical Manager and three different Clinical Supervisors at Yorkshire Ambulance Service.

The Strengths and Weaknesses of the DSM-IV Classification System for Di

The Strengths and Weaknesses of the DSM-IV Classification System for Diagnosing Psychopathology Introduction: DSM-IV as a system of diagnosis has been criticised on its very foundation that far from improving the clinical practice it claims to have prioritised. To assess its strengths and weaknesses, the essay critically examined the purpose of DSM-IV and how its practice and techniques have been practically found useful. As in the definition offered by Allen (1998) the concept stands for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. As a system, Allen (1998) added that, it ‘details the diagnostic criteria for nearly 300 mental disorders and nearly 100 other psychological conditions’. Stressing its strengths, many studies highlighted on its research focus that its authors have over-concentrated on its reliability which further led to its criticism. This criticism among other thing include the neglect some of the issues concerning clinicians, lack of precision in of its criteria, and bias that emanate from the technique that predetermine the patients di sorders. The essay, however, have survey literature based on the various issues raised as to its weakness and how these weakness to be overcome. Given the last points, comparative studies conducted on improvement measures to the clinical practices are examined. There are considerable issues to highlight in evaluating strengths and limitations of using DSM-IV as a method for diagnosing psychopathology. These are its emphasis on reliability and validity of it diagnostic criteria and classification methods and techniques. The strengths and limitations in the application of DSM-IV, as could be observed, depend on the technique and the purposes th... ...tent/full/156/11/1677 [accessed on 24th/11/2010] Ronald, C (2006), ‘Clinical calibrations of DSM-IV Diagnoses in the World Mental Health (WMH) Version of the World Health Organisation (WHO) Composite International Diagnostic Interview (WMH-CIDI)’. International Journal of Methods in Psychiatric Research, Vol. 13/2. Samuel, D. B. and Widiger, T. A. (2006), ‘Clinicians’ Judgements of Clinical Utility: A Comparison of the DSM-IV and Five-Factor Models’. Journal of Abnormal Psychology, Vol. 115/5. [Accessed on: 25/11/2010] Semiz UB, Basoglu C, Oner O, Munir KM, Ates A, Algul A, Ebrinc S, Cetin M. (2008), 'Effects of diagnostic comorbidity and dimensional symptoms of attention-deficit-hyperactivity disorder in men with antisocial personality disorder'. Aust N Z J Psychiatry, 42(5):405-13. Online: http://www.ncbi.nlm.nih.gov/pubmed/18473259 [accessed on: 24/11/2010]

Humanistic Theories of Organizations Essay

The relationship between the â€Å"boss† and the employee is an important one indeed. It is a relationship that can make or brake an organization. While classical theorist such as Fredrick Taylor (Scientific Management Theory), Henri Fayol (Administrative Theory) and Max Weber (Theory of Bureaucracy) (Modaff, Butler, Dewine 2012 p26.) emphasized the literal structure of an organization; i.e. worker productivity, chain of command and preserving organizational authority, they were not too concerned with an organizations social structure. However, â€Å"Human Relations Theory† (Modaff, Butler, Dewine 2012 p43.) builds more on an organizations social structure suggesting that an organization can benefit greatly from a positive social relationship between its supervisors and its employees. It is clear that there is a positive connection between â€Å"authentic leadership and employee voice behavior† (Hsin-Hua Hsiung 2012). Authentic Leadership, Employee Voice Behavior & the Hawthorne Studies Hsin-Hua Hsiung (2012) quoting Walumbwa et al. 2008, p. 94 writes that â€Å"Authentic Leadership† refers to ‘‘a pattern of leader behavior that draws upon and promotes both positive psychological capacities and a positive ethical climate, to foster greater self-awareness, an internalized moral perspective, balanced processing of information, and relational transparency on the part of leaders working with followers, fostering positive self-development’’. In the referred to article Authentic Leadership and Employee Voice Behavior: A Multi-Level Psychological Process (Hsin-Hua Hsiung 2012) the author discusses an investigative study of the â€Å"psychological process of how authentic leadership affects employee voice†. He suggests that the â€Å"theoretical model† of the study proposes that positive mood of the employees and, what he terms, the â€Å"leader–member exchange† or LMX quality mediate the relationship between authentic leadership and voice behavior, while the procedural justice climate moderates the mediation effects of positive mood and LMX quality (Hsin-Hua Hsiung 2012). This study ultimately revealed â€Å"the cross-level effects of authentic leadership†, and provided practical suggestions to assist employees expressing themselves and their opinions in the organization (Hsin-Hua Hsiung 2012). Ironically, the Hawthorne Studies (Mayo, Roethlisberger & Dickson 1939) in human relations had a similar conclusion. Among other implications these studies (Illumination, Relay Assembly Test Room, the Interviewing Program and Wiring Room Studies) collectively proposed that supervisors â€Å"pay attention to your workers to increase their satisfaction and productivity † (Modaff, Butler, Dewine 2012 p). Conclusion, Strengths and Weaknesses In conclusion, the article in my opinion was a fair explanation of a study that concluded that there are positive implications for social interaction between supervisors and employees. The strength and weakness of the article is the authors supporting research material. While he quotes several researchers and documents to validate his findings and his theory is supported by what the author terms â€Å"multi-level data from 70 workgroups of a real estate agent company in Taiwan†, he failed to research or mention the Human Relation Theory or the Hawthorne Studies (Mayo, Roethlisberger & Dickson 1939) which in my opinion would have further strengthened theory. References: Hsiung, H. H. (2012). Authentic leadership and employee voice behavior: A multi-level psychological process. . Journal of business ethics, 107 (3), 349-361. doi: 10.1007/s10551-011-1043-2 Modaff, D. P., Butler, J. A., & Dewine, S. (2012). Organizational communication: foundations, challenges, and misunderstandings. (3rd ed.). Glenview Illinois: Pearson

Beka Lamb Essay

Beka Lamb is the daughter of Mr. and Mrs. Lamb. She is an only child who lives with her parents in Belize. Beka is tall and slim built. She is fourteen years of age and is a very active and enterprising individual. Beka possesses very admirable qualities that are worthy of emulation. She demonstrates a sense of responsibility and maturity for an individual of such a tender age. One notices the growth and development of Beka’s character as the novel progresses. Initially, her relationship with her parents , especially her father is somewhat strained, but there is a notable improvement as the plot develops. Beka displays qualities of love, compassion and warmth for her mother , and there exists a bond of understanding between them. Of particular note, is Beka’s relationship with her friend ,Toycie. At the beginning of the novel, Beka is mourning her friend’s death, and eventually, one is informed as to why she is so profoundly affected by her friend’s death . Beka exhibits qualities of endurance and determination when she is confronted with challenging situations. Beka also displays a sense of naivete and innocence when she has to deal with apparently, insurmountable tasks. The author , Zee Edgill , presents her heroine Beka Lamb in demanding yet rewarding situations. Indeed, Beka is truly a character worthy of emulation and praise. Beka Lamb is the daughter of Mr. and Mrs. Lamb. She is an only child who lives with her parents in Belize. Beka is tall and slim built. She is fourteen years of age and is a very active and enterprising individual. Beka possesses very admirable qualities that are worthy of emulation. She demonstrates a sense of responsibility and maturity for an individual of such a tender age. One notices the growth and development of Beka’s character as the novel progresses. Initially, her relationship with her parents , especially her father is somewhat strained, but there is a notable improvement as the plot develops. Beka displays qualities of love, compassion and warmth for her mother , and there exists a bond of understanding between them. Of particular note, is Beka’s relationship with her friend ,Toycie. At the beginning of the novel, Beka is mourning her friend’s death, and eventually, one is informed as to why she is so profoundly affected by her friend’s death . Beka exhibits qualities of endurance and determination when she is confronted with challenging situations. Beka also displays a sense of naivete and innocence when she has to deal with apparently, insurmountable tasks. The author , Zee Edgill , presents her heroine Beka Lamb in demanding yet rewarding situations. Indeed, Beka is truly a character worthy of emulation and praise.

Potato chips Essays

Potato chips Essays Potato chips Essay Potato chips Essay Global Variations in the Potato Crisps and Potato Chips Market Its fair to assume that consumer snacking habits are likely to differ from country to country, particularly across different regions and cultures. A clear example is the consumption of potato crisps / potato chips which can be seen in the bar chart below. 86% of consumers throughout the USA and France consume potato crisps / potato chips closely followed by 84% of GB consumers. On the other end of the scale is the Chinese market with only 28% consumption. Potato Crisps/Potato Chips* Consumption per Country 84% 72% 43% 28% USA France source: Global TG 2012 Egypt Brazil South Africa China Base: Total population But do Chinese consumers simply snack less? Data from Chinas TGI (CNRS) show that (66%), candy (64%) and chocolate (44%) in the last year. As the best known potato crisps and potato chip brands are Western-owned such Kettle, Pringles and Lays and Walkers, this may explain their lack of popularity in China and their huge appeal to Western markets. Attitudes towards diet and health can also vary between different markets with the hart below offering a direct comparison between consumer attitudes in America and China. Only 25% of American consumers agree that it is worth paying more for organic foods, whereas 60% of consumers in China agree with this statement. A further difference can be highlighted as 46% of Chinese consumers agree that they always think of the calories in what I eat compared with a much lower level of agreement throughout the USA of 27%. Any Agree with the following statements: 25% 27% 39% Its worth paying more for organic food l always think of the calories in what I eat l consider my diet to be very healthy diet to be Very healthy. So, peoples perception of what they consider to be a healthy diet is likely to vary across different markets. In this case Chinese consumers are much more consistent in their perceptions of healthy eating and what this constitutes. *USA; Potato Chips France and 6B; Potato Crisp, Tortilla Corn Snacks Egypt; Potato Chips/Crisps Brazil; Potato Crisps South Africa; Potato Sticks and other Crisps China; Crisps

buy custom Increase of Alcohol-Related Traffic essay

buy custom Increase of Alcohol-Related Traffic essay Research indicates that there has been a rapid increase of alcohol-related traffic together with other unintended injury deaths, both within and out of college especially among individuals aged 18-24 years old. This with no doubt has emphasized the need for colleges and neighboring communities to increase and strengthen measures to curb excessive drinking not only among college students but also among those within the age bracket who are not in college. Many individually oriented counseling programs, comprehensive community interventions, and environmental interventions have been established by schools and other organizations to help ease drinking and associated problems (Morean et al, 235). College organization looks to reform and improve schools drinking behaviors Currently efforts to control drinking among students are ongoing in colleges. College organization, especially student bodies are in the frontline with a view of seeing that colleges serve the purposes they were meant other than being a drinking spree. Students not only in the US but around the world have come together to anti-alcohol and anti-drug abuse organizations to create awareness concerning the issue. For instance as reported by Rodriguez (1), National Organization for the Reform of Marijuana Laws (NORML) and Students for Sensible Drug Policys (SSDP) chapter of The Florida State University incorporated their event on 31st March, 2010 in support o the Alcohol Awareness Month. Their main objective as witnessed in their numerous rallies is educating the public on safety of using alcohol and marijuana. Stricter guidelines are being put into place to restrict the consumption of alcohol Colleges and states have come up with alcohol policy with strict rules and bearing severe consequences upon violation by any students. Parents have also been supplied with copies and research indicate that most of students whose parents have read the brochures were less likely to begin drinking if they did not drink before joining college. As part of environmental intervention, all states have laws prohibiting selling of alcohol to individuals younger than 21 years as opposed to 1984 where only 17 states had embraced the law (Ham Hope, 760). Researches indicate that sturdy college alcohol policies decrease binge and underage drinking on campus devoid of resulting to a compensatory increase in the use of marijuana. A study carried out by Centre for Adolescent Substance Abuse Research (CeASAR) among administrators and students o 11 universities and colleges in Massachusetts has clear indication of how a more restrictive enforcement policy for alcohol consumption could reduce the habit. Educational programs Many not-for-profit and student organizations incardination with colleges and universities are offering educational programs dedicated to tackle the issues of drug and alcohol abuse. For instance Alcohol and Drug Abuse Prevention Team (ADAPT) is composed of peer educators who offer educational outreach, promote awareness and act as accessible resources for students. It is found in universities such as the University of California and has helped to reduce the abuse of alcohol and other substances. According to CASE (2) other programs include Drug and Alcohol Prevention Education that has been initiated in most universities and colleges aimed at reducing the consuption of alcohol. The main aim of the program is to ensure drug alcohol-free schools. This is one component of health programs within schools and colleges. One way that has made the program successful is through community-college linkage that ensures parents and the community at large is actively involved in the efforts to reduce alcohol consumption. Support from Organizations A number of organizations have come up in support of a reduction of alcohol consumption within colleges and universities. Education awareness is a key area that all this organizations emphasize while trying to handle the situation (Gale Group, 1560). For example, Safer Alternative For Enjoyable Recreation is a national not-for-profit organization whose main goal is to educate the public of the safety of using alcohol versus alcohol. Many students have benefited from such programs through making an informed decision. What are the consequences of excessive drinking among college students? Excessive alcohol consumption has been known to have a very wide number of consequences. These consequences range from personal, medical and social. These effects or consequences largely depend on both the overall amount o alcohol consumption and largely on the kind of pattern being displayed (LaBrie et, 725). Medical problems Brain damage When alcohol is consumed in excess it causes toxicities in the brain therefore destroying various brain cells. Research indicates that continuous abuse of alcohol by college students has created an environment which is vulnerable to the brain of the student. it has been noted that when the brain of an adolescent who indulge in excessive drinking and that which does not, that which is indulge in excessive drinking had impaired memory especially in the reasoning skills. Blood pressure Excessive alcohol consumption has been predicted as the main cause of high blood pressure within an individual. Binge drinking causes a surge in the blood of an individual as compared to an individual who is consuming small quantities of alcohol over a long period. it has been noted that most young people especially those in colleges are suffering due to increased blood pressure. Strokes Medical practitioners have cautioned that binge drinking increases the risk of acute hemorrhagic up to the gauge of ten. The increased hemorrhagic leads to stoke which largely causes increase in blood pressure therefore creation of spasm within cerebral arteries. If college student are not careful there are likely to die because of constant strokes (CASE, 3). Heart disease It is known that binge drinking diminishes myocardial contraction, which has widely increases chances of heart failure among college student hence high cases of deaths. Studies have indicated that around 30% to 60% cases of atrial fibrillation with students are due to excessive indulgence in the consumption of alcohol most particular among college men. a quarter of sudden cardiac deaths that are been witnessed in various colleges are due to the fact that they have greatly engaged in binge drinking. Female college students be taken advantage of because of their decision to drink in access Female drinkers face a lot of prooblems when they are drunk. They are taken advantage of through violent victimization as indicated by a survey of female college students which established a considerable association between the level of alcohol the women take weekly and their encounters of sexual victimization. Additional studies indicate female college students using alcohol are more likely to be victimized on dating violence as compared to female nondrinking students (LaBrie et al, 721). Many rape cases have been reported among drunk females due to being taken advantage of. They also end up being forced into sexual intercourse without their knowledge. This is one reason of the rising cases of sexually transmitted diseases among the female college students. College students make the wrong decisions Being under the influence of alcohol is one of the major reasons why many college students make wrong decisions. Driving under the influence of alcohol has brought about another serious threat. About 32% of college drinkers have been established to drive under the influence of alcohol. This does not only put them at the risk of injury but also potentially death. A study done in 1999, established that other than 2 million colleges and university in the US driving under the influence of alcohol, more than 3 million individuals rode as passengers under a drinking driver (Gale Group, 1540). Conclusion Alcohol drinking among college students is not only a significant health but also a public concern. Many college students have found themselves being trapped into due this habit due to their inability to resist offer for free alcohol. There are a number of reasons why college students indulge in excessive drinking, first of all peer pressure plays a big role as most students will find it hard to resist practicing what their fellow peers do. Secondly parties held both at home and on campus, with alcohol as one of the drinks greatly encourage this habit. Due to the fact that college students often hold parties absence of their parents, they tend to consume what their parents take and they could not be allowed by their parents. Lastly expectancies is another factor leading to this excessive alcohol drinking in college. Colleges, communities and other organizations are however determined to curb through a number of strategies that go along way in ensuring that colleges are drug and alcohol free. Students also have their own organizations that fight excessive drinking in college. Such organizations include SSDP and NORML. On the other hand, strict guidelines within colleges aid in reducing its consumption. There are a number of educational programs that geared towards eradication of alcohol and drugs in colleges. A good example is ADAPT and Drug and Alcohol Prevention Education. The efforts ease this behavior can not be enough without the help of other numerous not-for-profit organizations that have strived to offer services such as counseling and awareness creation among college students. Finally, excessive drinking of alcohol has many negative consequences. They range from physical, psychological, and medical conditions that can come about as a result of alcoholism. The medical problems include: brain damage, high blood pressure, heart diseases, and strokes. Other than this, female drinkers suffer a lot as they are frequently taken advantage of while drunk. It is very apparent that while drank, students end up making wrong decisions like driving under the influence and having unsafe sex. Buy custom Increase of Alcohol-Related Traffic essay

Marie of France, Countess of Champagne

Marie of France, Countess of Champagne Known for: French princess whose birth was a disappointment to parents who wanted a son to inherit the French throne Occupation: Countess of Champagne, regent for her husband and then for her son Dates: 1145 - March 11, 1198 Confusion with Marie de France, Poet Sometimes confused with Marie de France, Mary of France, a medieval poet of England in the 12th century whose Lais of Marie de France survive along with a translation of Aesops Fables into the English of the time and perhaps others works. About Marie of France, Countess of Champagne Marie was born to Eleanor of Aquitaine and Louis VII of France. That marriage was already shaky when Eleanor gave birth to a second daughter, Alix, in 1151, and the pair realized that they were not likely to have a son. Salic Law was interpreted to mean that a daughter or daughters husband could not inherit the crown of France. Eleanor and Louis had their marriage annulled in 1152, Eleanor left first for Aquitaine and then married the heir to Englands crown, Henry Fitzempress. Alix and Marie were left in France with their father and, later, stepmothers. Marriage In 1160, when Louis married his third wife, Adà ¨le of Champagne, Louis betrothed his daughters Alix and Marie to brothers of his new wife. Marie and Henry, Count of Champagne, were married in 1164. Henry went to fight in the Holy Land, leaving Marie as his regent. While Henry was away, Maries half-brother, Philip, succeeded their father as king, and seized the dower lands of his mother, Adà ¨le of Champagne, who was also Maries sister-iin-law. Marie and others joined Adà ¨le in opposing Philips action; by the time Henry returned from the Holy Land, Marie and Philip had settled their conflict. Widowhood When Henry died in 1181, Marie served as regent for their son, Henry II, until 1187. When Henry II went to the Holy Land to fight in a crusade, Marie again served as regent. Henry died in 1197, and Maries younger son Theobold succeeded him. Marie entered a convent and died in 1198. Courts of Love Marie may have been a patron of Andrà © le Chapelain (Andreas Capellanus), author of one of the works on courtly love, as a chaplain who served Marie was named Andreas (and Chapelain or Capellanus means chaplain). In the book, he attributes judgments to Marie and to her mother, Eleanor of Aquitaine, among others. Some sources accept the claim that the book, De Amore and known in English as The Art of Courtly Love, was written at the request of Marie. There is no solid historical evidence that Marie of France with or without her mother presided at courts of love in France, though some writers have made that claim. Also known as:  Marie Capet; Marie de France; Marie, Countess of Champagne Background, Family: Mother:  Eleanor of AquitaineFather:  Louis VII of France  Stepmothers:  Constance of Castile, then Adà ¨le of ChampagneFull siblings: sister  Alix, Countess  of Blois; half siblings (father Louis VII): Marguerite of France, Alys of France, Philip II of France, Agnes of France. She also had half-siblings from her mothers second marriage, but theres not much evidence she interacted with them. Marriage, Children: husband: Henry I, Count of Champagne (married 1164)children:Scholastique of Champagne, married to William V of MaconHenry II of Champagne, 1166-1197Marie of Champagne, married to Baldwin I of ConstantinopleTheobald III of Champagne, 1179-1201

Country Report Essay Example | Topics and Well Written Essays - 3000 words

Country Report - Essay Example Nonetheless the country is on the verge of transformation into a potentially successful economy. This report has been prepared for the CEO of the ‘Read the World’, a British origin company, that has appointed the consultancy firm for the purpose of evaluating the market for books in Vietnam and present the threats and opportunities that exist in the country. The report focuses on the social initiative of Read the World that functions with the aim of designing and producing educational books and magazines for the needy people in developing markets. Economic Environment of Vietnam Back in the year 1986, Vietnam started off liberalizing its economy. Once it opened its doors to encourage foreign direct investment in various sectors, a considerable jump has been noticed in the number of foreign organizations and western companies entering into the country. In the South East Asian region, Vietnam has emerged as a significant economic power. With the initiation of the renovatio n policy in the year 1986, the country has been able to fetch a sustainable high GDP growth rate during the past decade. With the GDP growth rate of 8.4 percent in the year 2005, the country has been able to the address the issue of poverty. ... Still, there are more possibilities to spread the advantages of the rapid growth in Vietnam’s economy across the globe. The activities in the private sector concentrated across 64 provinces of the nation. The leaders of these provinces have established a regulatory framework which would encourage calculated risk taking by the private entrepreneurs. In the response, with the country’s continual decentralization process, the economic programs of the Asia Foundation have focused on the improvement of the business environment to enhance the private sector competitiveness as well as economic growth (The Asia Foundation, n.d., p. 1-2). Since early 1990s, the Vietnam Chamber of Commerce and Industry (VCCI) and the Asia Foundation together are responsible to promote global business development and economic integration across Vietnam, more specifically the growth among the small and medium enterprises (SMEs). In the year 2002, the Vietnam Chamber of Commerce and Industry (VCCI) and the Asia Foundation shifted their focal point to enhance the provincial governance, further encouraging the sector growth in the private sector. Started off in the year 2002, they initiated a program to find out the reason why some handful provinces have the ability to attract the private sector investment and to address the issue f economic success. This also reflects the eagerness of the respective authorities to make all the provinces equally attractive for the foreign investors. The economic outlook of Vietnam remains greatly positive supported by the government’s determination to comply with WTO. The country has experienced great progress with trade as well as investment reforms. Furthermore, its negotiation over the WTO entry has

Discuss how public sector organisations may respond to change as a Essay

Discuss how public sector organisations may respond to change as a result of changes to legislation and regulation - Essay Example They provide essential social services that cannot be provided by the private sector on grounds such as high capital investment. They also provide services that have little or no profit at all and are thereby shunned by the private sector. Normally public corporations are established on statutory grounds by the parliament. It therefore means that these corporations will normally have a lot of influence from the workings of the government. Public sector corporations are normally instituted to provide services such as health, education, social insurance and transport. Most of their management is comprises of political appointees. Legislations are laws or rules that are enacted by the government through the legislature or parliament. Such enactments are usually made relating to various issues that affect the masses. Public sector organizations are normally expected to respond to any new legislation that affects them. Much legislation has been enacted that affect the management of the pu blic corporations. Legislations affecting the public sector are customarily enacted out of the need to protect the general public from exploitation from these corporations. Exploitations have always been realized from these public corporations inasmuch as they are directly controlled by the government. It arises from the fact that some figures in government are always interested in the affairs of these corporations. As a result they end up influencing their operations most often for their own gains. Response to changes Public corporations are always expected to respond to legislations that are enacted to improve their operations or to bring sanity in the manner in which their operations are run. Most of these corporations were instituted several years back but unfortunately, many years later it is realized that their service delivery is usually below expectations. A comparison of some of these corporations with privately managed enterprises will reveal a lot of striking differences. It therefore begs the analysis of the reasons as to what might be wrong in the affairs of these corporations. It has always been realized that the manner in which some corporations respond to very pertinent legislations is always very slow and wanting. For instance, legislations relating to global warming , dumping of toxins into water bodies and other emerging issues have always raised a lot of questions regarding the slow pace of compliance from these corporations. Just like public enterprises, most of these corporations fall under specific regulatory authorities that are expected to regulate their operations. It has also been realized that that regulating these corporations is not easy as it may seem. Given the nature of their management, their organizational structures and the fact that they are not profit motivated, it makes it very difficult for the regulatory authorities to make them comply with the regulations expected. Most public sector organizations have very complex org anization structures in operation. Decision making in such an organization is not easy. As such it has always been difficult to implement some proposed regulations that are created for a specific purpose. Moreover managing employees in many public corporations is a daunting task. Most of them are protected by their terms of engagement which

Texas Is the First State To Approve Modified Test Essay

Texas Is the First State To Approve Modified Test - Essay Example According to Zyskowski and O’Malley (2009), TAKS vertical scale allows scores to be compared across grade levels for a subject.   In this manner, it is very much useful for tracking a student's progress in performance across years, at the same time, its performance standards (i.e. Met Standard and Commended) can be numerically compared across grade levels (Zyskowski and O'Malley, 2009). Texas created the so-called vertical scale per Section 39.036 of Senate Bill 1031, which required TEA to develop a vertical scale for assessing student performance on the TAKS assessments (Zyskowski and O'Malley, 2009; TEA, 2009). On the other hand, the Texas projection measure (TPM) is a multi-level regression-based projection model that is applied to TAKS, TAKS (Accommodated), and linguistically accommodated versions of TAKS. Furthermore, it projects student performance separately for each subject in the next high-stakes grade (defined by the Texas legislation as grades 5, 8, and 11) (Zyskowski and O'Malley, 2009, p. 25). The figure below illustrates the TPM: (taken from Zyskowski and O'Malley, 2009, p. 26. According to the stipulations in the Texas Education Agency's Accountability System for 2009 and Beyond - Standard Procedures (Commissioner of Education Final Decisions April 2009), the following quotations revealed the determination of the accountability rating for 2009: Standards for 2009 were published in the 2008 Accountability Manual and adopted as commissioner rule to provide districts and campuses with advance notice before the 2008-09 school year began.The 2009 Academically Acceptable standards are 70% for reading/ ELA, writing, and social studies; 55% for mathematics; and 50% for science. These standards represent increases of five percentage points to the Academically Acceptable standards for four of the five subjects (writing, social studies, mathematics, and science.)The 2009 Recognized standard of 75%, which applies to all subjects, is unchanged from the prior year. (p. 2) Still according to the Texas Education Agency's Accountability System for 2009 and Beyond - Standard Procedures, the following are quoted statements regarding the changes in accountability rating for 2010: Standards for 2010 will be published in the 2009 Accountability Manual and adopted as commissioner rule before the 2009-10 school year begins.The 2010 Recognized standard will increase by five percentage points to 80% as previously planned.The 2010 Academically Acceptable standards will increase by five percentage points for both mathematics and science to 60% and 55%, respectively.The reading/ELA, writing, and social studies standards will remain

Evaluating artists significance Assignment Example | Topics and Well Written Essays - 1250 words

Evaluating artists significance - Assignment Example As a painter, da Vinci developed a number of iconic artifacts key among which is the Mona Lisa. In this portrait, da Vinci couples a number of possibilities within a single face to come up with the most beautiful painting of its time. The painting portrays a fairer face of a woman with a protruding breast as though of a woman. In all aspects, the painting is a woman. However, several art professionals disagree with the actual portrayal in the painting some asserting that it is a combination of both male and female thereby depicting the beauty of creation (O'Connor 44). Such ambiguities in his works portray da Vinci’s creativity. Art is relative and therefore earns relative interpretations from different people. Leonardo da Vinci’s works on the contrary were difficult to interpret since the artist used simple artistic features to portray complex information mostly targeting the elite in the early society. This ability thus quantifies him as the father of the mannerist pe riod, a period in arts in which artists used complex artifacts to communicate and to criticize the society and the elite ruling class. Besides the Mona Lisa, da Vinci produced several other controversial paintings including the last supper, which is one of the most reproduced religious paintings. In the painting, Leonardo portrays Jesus sitting at a table with his twelve disciples. In a very controversial twist, Leonardo inserts a male disciple in the painting with fairer features next to Jesus. While most people view the image as that of Mathews one of the closest disciples of Jesus, other have rightly argued that she could be Marry Magdalene thereby raising questions about Marry Magdalene’s relationship with Jesus. This portrays the level of controversies that da Vinci left in most of his works. His other iconic painting is the Virgin and child with St Anne, in this, Leonardo includes a controversy as he superimposes two figures in the picture thereby complicating the ident ity of either Marry or St Anne. Despite the controversies that made his works more exciting, Leonardo da Vinci captured nature’s beauty in his works. He used some of the best models of the time and depicted nature as the most beautiful of all that existed. II. Late Renaissance and Baroque: Gian Lorenzo Bernini Lorenzo Bernini was yet another iconic Italian artist, architect, and sculptor. Bernini was a renowned playwright with the ability to develop dramatic narratives and a great sculptor who depicted magnificence in most of his works. As an artist of his time, Bernini portrayed arts as a reflector of the society; most of his narratives were therefore satirical criticisms of the elite in the early Roman society and the ruling class. He therefore portrayed the issues affecting the society in a sardonic manner thereby attracting the attention of the masses to the actions of the ruling elite through entertainment. His sculptors on the other hand were both realist and humanist. In such, he developed big sculptors of the great figures of the time in the streets and churches in Rome and developed others as decorations to similar places. The streets of Rome and some great international museums still stash some of his surviving artifacts. Among his great works that portrayed both beauty and opulence included the Apollo and Daphne, in the sculpture, Bernini portrays both a complex understanding to nature and the

Benzene Essay Example | Topics and Well Written Essays - 500 words

Benzene - Essay Example At room temperature, it is liquid and is a bit viscous. Its density is 0.879 g/mL and turns to vapor at 80.1Â ºC. It is a flammable aromatic hydrocarbon and is not completely miscible with water, but can dissolve in other solvents like acetone, chlorofom or carbon tetrachloride (EPA, 1988). Because of its high flammability and volatility, the chemical must be kept away from sparks, open flame, heat or other hot surfaces that may cause fire or explosion (cpchem.com, 2014). Benzene is a common part of industrial manufacturing of plastics, man-made fibers, rubber lubricants, colorants and pesticides. It is also a component in gasoline and other petroleum products. In nature, volcanoes and forest fires emit benzene into the atmosphere. Residential uses of benzene are found in adhesives, paint removers and gasoline. Petroleum products are the major contributors of benzene in the environment (dhs.wisconsin.gov, 2013). Other aromatic chemicals such as phenol and toluene, are also synthesized from benzene either by replacing the hydrogen atoms in the molecule or by cleavage of the bonds in the benzene molecule. Most chemicals from benzene are products of substitution reactions (epa.gov, 1988). Humans are exposed to benzene in different ways, namely through inhalation, ingestion or by skin contact. The most common route of benzene exposure is by inhalation, especially when humans are exposed to petroleum products or benzene-containing paints and resins. When benzene is released in its vapor form from manufacturing industries, the people living near the area are exposed and inhale it. The symptoms that may be experienced when exposed to benzene for short periods are headaches or nausea. However, for longer periods high risk of having cancer and anemia are some of the health effects. Some studies in animals have shown that prolonged exposure to benzene vapors caused infertility and damaged reproductive organs.

Probability Essay Example | Topics and Well Written Essays - 2000 words

Probability - Essay Example However, based on this ranking Judge Hellen comes in last followed by Paul, who comes in second last and finally Dianne was third last based on the probability of appeal. However, based on probability of cases being reversed Judge John comes in as the best judge followed by Angela and then David Friedman. Based on this ranking Paul Feinman comes in last and the second last position is taken by Sallie Manzanet-Daniels. Based on the probability of reversal given an appeal, then Karia Moskowitz is the best performing judge followed by Judith J. Gische. However, judge Darcel D. Clark is the least performing judge based on this system. Finally, the overall ranking of these judges is as shown in figure 4 above, it is, therefore, evident that Judge Sallie Manza is the best performing judge followed by Judith and then Peter Tom who completes the three best performing judges. From the figure above it can be seen that Judge David has the least probability of appeal therefore making him the best performing judge followed by Darcell and the least performing judge under this category is Rosalyn and then John comes in second last Judge on this category. In conclusion, this investigation has revealed that in the Court of Common Appeal Judge Sallie is the best performing Judge followed Judge Judith. However, Judge Angela comes in last in the overall ranking. On the other hand on the municipal category Judge Leslie is the best performing judge while Judge Edward is the least performing Judge overall. Finally, in the Municipal Courts Judge Angela is seen to be the one carrying out her duties diligently making her the best performing judge overall while Leslie is the last judge under this

Benzene Essay Example | Topics and Well Written Essays - 500 words

Benzene - Essay Example At room temperature, it is liquid and is a bit viscous. Its density is 0.879 g/mL and turns to vapor at 80.1Â ºC. It is a flammable aromatic hydrocarbon and is not completely miscible with water, but can dissolve in other solvents like acetone, chlorofom or carbon tetrachloride (EPA, 1988). Because of its high flammability and volatility, the chemical must be kept away from sparks, open flame, heat or other hot surfaces that may cause fire or explosion (cpchem.com, 2014). Benzene is a common part of industrial manufacturing of plastics, man-made fibers, rubber lubricants, colorants and pesticides. It is also a component in gasoline and other petroleum products. In nature, volcanoes and forest fires emit benzene into the atmosphere. Residential uses of benzene are found in adhesives, paint removers and gasoline. Petroleum products are the major contributors of benzene in the environment (dhs.wisconsin.gov, 2013). Other aromatic chemicals such as phenol and toluene, are also synthesized from benzene either by replacing the hydrogen atoms in the molecule or by cleavage of the bonds in the benzene molecule. Most chemicals from benzene are products of substitution reactions (epa.gov, 1988). Humans are exposed to benzene in different ways, namely through inhalation, ingestion or by skin contact. The most common route of benzene exposure is by inhalation, especially when humans are exposed to petroleum products or benzene-containing paints and resins. When benzene is released in its vapor form from manufacturing industries, the people living near the area are exposed and inhale it. The symptoms that may be experienced when exposed to benzene for short periods are headaches or nausea. However, for longer periods high risk of having cancer and anemia are some of the health effects. Some studies in animals have shown that prolonged exposure to benzene vapors caused infertility and damaged reproductive organs.

Police Corruption Essay Essay Example for Free

Police Corruption Essay Essay Police Corruption can be defined as a form of police misconduct in which law enforcement officers break their social contract and abuse their power for personal or department gain. There are three forms of police corruption. These forms are Nonfeasance, which involves failure to perform legal duty, another form is Misfeasance, which is failure to perform legal duty in a proper manner, and the third form is Malfeasance, which is commission of an illegal act. The three explanations of corruption are the â€Å"rotten apples†, â€Å"departmental†, and the other focuses on factors external to the department. An example of these would be an officer might feel unappreciated for their good work and actions and it might make them corruptible. An example of departmental explanation would be if officers feel uncommitted and unsupported, their outlooks and values are reinforced by others in the group which may lead to lack of commitment in their job, thereby leading to corruption. Some police officers may abuse their power because they see themselves as not enforcers of the law, but them as the law itself. The â€Å"blue wall of silence† is a term used in the United States to denote the unwritten rule that exists among officers, where they should not report on a colleague’s misconduct, errors, or crimes. This may impact an officer’s loyalty to their profession because they are not doing their job if they are letting another officer get away with crimes, and if they did report it then they would be breaking their loyalty to fellow cops. It’s important for officers to have a good ethical foundation before they enter into this job because it would help prevent them from doing wrong and abusing their power. In the â€Å"Stopped for Being a Mutt† video, I realized how bad some officers can act sometimes. The teen was stopped and questioned multiple times for looking suspicious, when really they were just racist. They were trying to provoke the teenager to justify an arrest. I feel the form of police corruption they were doing was misfeasance. Stopping someone because of their race, when they weren’t committing any crimes is humiliating to that person and is wrong of any cop to abuse their power in this way. The â€Å"Blue wall of silence† comes up in this type of situation because some other cops  witness it and knows that this goes on when officers have low numbers of stops, and they don’t want to tell because they don’t want to seem disloyal to their fellow police officers. In the â€Å"Los Angeles Police Department† video, they talked about the Rampart and Crash scandal. When I watched this video I was in disbelief that, that many officers were implicated in some form of misconduct. I understand that they wanted to get gangs and crimes off the street but this was no way of going about it. They would shoot or beat people when they were unprovoked. They would steal narcotics and plant false evidence, and frame suspects and cover up all that these officers were doing because it was getting rid of the gangs and â€Å"hoodlums†. I can’t understand how these officers didn’t think what they were doing was wrong and immoral. This form of corruption in this particular situation was malfeasance. What they were doing was illegal, and they are here to protect and obey the law. In the â€Å"Behind the Blue Wall† video. I was extremely shocked to see the police brutality that occurred in these cases. I don’t understand how an officer could deliberately torment a victim because of their race and think they can get away with what they’re doing and that it isn’t wrong. Malfeasance is the form of corruption that comes up in these cases because what they are doing is illegal. The unlawful beatings and shootings of these victims, when they are not provoking the officers; is completely wrong and these cases need to stop. The Blue wall of silence also comes up in these cases because there were officers who knew about what happened and what the other officers were doing and instead of reporting it, they attempted to cover it up. Co-workers should treat those who inform authorities of illegal activity in the police agency the same as how they treated them before they reported corruption. In the virtue ethics perspective, the habit of right desire, he was making the right choice by reporting corruption because he knew that what was going on in the agency wasn’t right and needed to be stopped. Frank Serpico’s response to this case was â€Å"It’s always worth it to be at peace with yourself.† I think this does imply reasoning of ethical thought. I  think Serpico meant that, as long as you feel good with what you are doing, and you are doing what you think is right, then that is all the matters. I agree with this because no matter what happens in the end, it is all worth it if you are at peace and happy with what you did. There are conflicts presented in terms of loyalty and duty. Loyalty is a good to have, but it is not a virtue. If loyalty is treated as a virtue, it can be misguided. It will lead to protection of illegal conduct and can turn into corruption. Officers may want to be loyal to fellow officers and not report what is really going on, however they also want to do their duty, and want to report because it is their duty to not participate in the corruption. The blue wall of silence impacts conflicting loyalty because it is an unwritten rule amongst officers to not report a fellow officer’s mistakes, misconducts, or crimes. This affects them if they want to be loyal to those officers and be loyal to their civic duty as well. If I was an officer in this situation, I would definitely report these crimes. I don’t believe in the blue wall of silence. I think that if an officer is doing something illegal then it needs to be reported and dealt with. Just because they are officers doesn’t mean they should be able to get away with things that they are arresting other citizens for doing.

The Boollywood Actor Shah Rukh Khan Film Studies Essay

The Boollywood Actor Shah Rukh Khan Film Studies Essay Success of My Name Is Khan: My Name Is Khan was not only big hit in India but also proved to be biggest bollywood opening in many foreign countries. Movie showed biggest Shah Rukh opening in India as well as in biggest weekend opening in United Kingdom and United States of America. Movie was directed by director and friend of Shah Rukh Khan, Karan Johar and actress in lead role was Kajol. Shah Rukh Khan and Kajol have given many big hits movies to bollywood which earned in country as well as in foreign countries. Such heroics were not on Shah Rukhs mind when he started preparing for the role of Rizvan, a character who turns into a Forrest Gumpian folk hero while journeying across the States and attempts to make America see the errors of stereotyping Islam. Rizvans journey takes him from the 30,000-strong town of Banville in California to the 204-strong village of Wilhelmina in Georgia. For the character of Rizwan Khan, Shah Rukh Khan prepared himself by reading the various books, wat ching documentaries and he also met two youngsters who were suffering from Aspergers Syndrome and recorded himself in the character and watching himself on screen in his bathroom-cum-video projection room, and even followed a man with the disorder around San Francisco for two days. He learned well and there was no stardom in role and it was a role of simple guy who have even trouble in looking people in the eye. His character was much alike a penguin and it was completely different from his previous movie he has ever done in his career. The character he played, Rizvan Khan was a cosmetics-salesman-cum-repairman who suffers from Aspergers Syndrome and his life changes dramatically after 9/11 attack. He proved himself once again with playing such a character that he is really King Khan of Bollywood. His movie My Name Is Khan was a big success worldwide because of the role he played so well. on nationalism: Shah Rukh Khan has always got the pride in the secular nation as well as a good Muslim. Shah Rukh Khan follows his religion with cosmopolitan ease but it is certainly one of the reasons that he is embraced so warmly in the Middle East, Indonesia and Malaysia. Comment which Shah Rukh Khan had made taking side of Pakistani player that should have been selected for the Indian Premier League made big issue and it was not easy for him to tackle with it. He was out of the city with his wife Gauri Khan during the first protest in the Mumbai while his mother in law was at home with his children and also his sister was at home so he was very worried about them and got too emotional. Saamna editorial asked him to go to Karachi and Islamabad to play cricket with the Pakistanis to Uddhav Thackeray comparing him to Ajmal Kasab when he said, Kasab and Shah Rukh are the most secure people in Mumbai. Shah Rukh Khan did not bend his knees in front of Shiv Sena and country accepted him by making his movie a big hit of the year. Karan Johar was happy with the fact Shah Rukh Khan tackled the conditions which was a heroic act taken by him in real life standing against people who were trying to prove him wrong while he had not done anything wrong. About Shah Rukh Khan: Shah Rukh Khan is star icon of bollywood and the richest as well. He is the star in todays date who can make a movie success only because with his name. He is having maximum millions of the fans across the world. He had started his film debut with movie Deewana in year 1992 and after that he never looked behind and emerged a big star with his movies earning good profits. He had started his career on television with serials in late 1980s. He is not only popular among Indian audience but his movies also earn a good amount in foreign countries as well. Shah Rukh Khan is at age of 44 now and working in bollywood from about last two decades. He has won thirteen film fare awards for his quality work in Indian movies out of which seven are in the best actor category which shows his quality of acting. Some of his movies are biggest hits of bollywood like Dilwale Dulhaniya Le Jayenge, Kuch Kuch Hota Hai, Chak De India, Om Shanti Om and Rab Ne Bana Di Jodi while some of t he movies like Kabhi Khushi Kabhie Gham, Kal Ho Naa Ho, Veer-Zaara and Kabhi Alvida Naa Kehna have been top-grossing Indian productions abroad which made him most successful actor of India. He started film production and television presentation in year 2000. He is founder and owner of two production companies Dreamz Unlimited and Red Chillies Entertainment which are continuously active in various entertainment activities. Other than acting he has produced many movies as well like Phir Bhi Dil Hai Hindustani, Asoka, Chalte Chalte, Main Hoon Na, Kaal, Paheli, Om Shanti Om, Billu and currently producing Ra. 1. He is also a playback singer as he has sung song in various movies. His journey is still continues as bollywoods most successful star and he is still aiming to go much far in his career. He is real star icon and his name is Khan.

Rereading Atwoods Surfacing :: Atwood Surfacing Essays

Rereading Atwood's Surfacing The class touched on a multitude of different subjects during the class time for the second discussion of the novel, Surfacing. These discussions were much deeper than the previous one, asking questions on motivation and symbolism rather than plot and language. Two of the most popular subjects were characterization and the validity of the narrator and the information she gives the reader. Other topics were discussed including religion, the bird motif that has appeared throughout our readings this semester, and the narrator's artistic frustration among many others. To begin with one of the most prominent subjects, the class discussed character-ization at length. Many students wondered what the narrator's friends added to the story, whether they were symbolic of something, reflections of the narrator's characteristics, or representatives of other individuals. Daniel suggested that the narrator was projecting the identities of her parents onto her friends. For instance, David was representative of the narrator's brother ("fascist pig yanks") with his militancy and Joe was the narrator's father, capable of love and close to her heart. Erin echoed this idea, saying that Anna was representative of the narrator's mother who concealed all of her pain and unhappiness throughout the story. Other students, though, had different ideas. Stephanie thought that the narrator's friends were symbolic, Joe as nature, David as the city, and Anna as the "icky" things about being a girl. As these were discussed, other ideas "surfaced" and the narrator's brother was thought to represent absolutism while her mother, like Joe, represented nature. Judy expanded on this, saying that David was perhaps representative of the narrator's previous lover. All of these ideas were well backed and well stated, leaving each individual student to decide which characters represented who or what. Another topic that was discussed at length was the narrator herself. In Forum II, Mandy began by questioning the narrator's humanness and what, exactly, constitutes being human. The discussion picked up these thoughts and began to question whether the narrator was actually domesticated or wild. She cooks and cleans for the others, taking care of them basically the whole time, but it was argued that she seemed to be hardly one predisposed to subservience.

Dietary Supplements Essay -- Work Out Supplements

  Ã‚  Ã‚  Ã‚  Ã‚  There are many different work out supplements. Some of those work out supplements are Proteins/Amino Acids, Performance Supplements, Energy Boosting Products, and Vitamins.   Ã‚  Ã‚  Ã‚  Ã‚  The first work out supplement we are going to tell you about is Proteins/Amino Acids. One supplement that is made of Protein is called, "The Ultimate Whey Designer Protein." This designer protein is 68% better than egg white and or regular whey. It mixes easy and gives you up to 18 grams of protein per scoop. This supplement will run you the consumer about $26.99 each 2 lbs bottle. This should last you a good 4 weeks. Another protein supplement is Promax Protein. This contains 50 grams of predigested, bioactive protein per serving it also contains less than 1 gram of fat and is sugar free. "Promax contains pure pharmaceutical quality branched chain amino acids," according to the manufacturer. Promax is for maximum growth, plus vitamins and minerals. This would run you about $32.07. That is just a little more than the Ultimate Whey Designer Protein, but this one gives you more than just protein and 68% better than egg white and or regular whey. So you would be smar t in the purchase of the Promax Protein instead of the Ultimate Whey Designer Protein.   Ã‚  Ã‚  Ã‚  Ã‚  Now, we are going to talk about the amino acids that you can buy from a gym or a local supplement store. The "Anabolic Amino Balance" is a foundation of 23 pure crystalline 100% pharmaceutical grade free form amino acids. This is all uniquely balanced and scientifically formulated high in the amino acids found in muscle tissue. This is very high in nitrogen and branched chain amino acids. This is most utilized during intense training and those your muscles need for tissue maintenance and repair. 1 bottle of 250 capsules would run you about $19.85. The other amino acid supplement that we will tell you about is the "Amino Plus". This supplement contains predigested crystalline amino acids which were scientifically profiled for use during periods of intense physical energy demand. "Free and peptide bonded (di & tri Peptides) amino acids from pancreatic digest of pharmaceutical grade casein, silica, hydrogenated vegetable oil and lecithin." A bottle of 250 capsules wo uld cost about $12.93. We would recommend that you use the Anabolic Amino Balance if you are going to use or are using a amino acid capsule to help you with the tis... ... multi-nutrient, vitamin, mineral, amino acid formula, formula includes nature's most powerful energy building and life protecting nutrients." A bottle of 240 capsules would run around about $36.50. Now if you have that kind of money to spend on this kind of product, don't spend the money give it to us! The last vitamin is "Vita Tech Mega Dose Vitamin Pak." This is designed for the competitive bodybuilder and serious athlete seeking to maximize physical performance. Containing a broad spectrum of performance nutrients. Vita Tech provides vitamins, minerals, stress B complex, amino acids, antioxidants, fat burners, and digestive aids, Each packet contains a total of 13 tablets, soft gelatin caps, and capsules.   Ã‚  Ã‚  Ã‚  Ã‚  Overall, dietary supplements really work. You see there is one catch though. If you want to take them you can, but once you do you are hooked and if you don't work out it all turns into fat! Yet, when you do take dietary supplements you put your life into the manufacturers hands! Here is some advice from us, "Work out, but don't take anything to help you build muscle or anything else cause your life's at risk when you do." Bibliography www.dietarysupplements.com

Family Welfare Statistics 2011

FAMILY  WELFARE  STATISTICS  Ã‚   IN  Ã‚   INDIA 2011 Statistics  Division   Ministry  of  Health  and  Family  Welfare   Government  of  IndiaAbbreviations AIDS AHS ANC ANM ANC APL ARI ASHA AWW AYUSH BCG BE BMS BPL CBR CDR CES CHC CNAA CPR CPR DLHS DPT DT EAG ECR EmOC FP FRUs HIV HMIS ICDS IDSP IDDCP IIPS IPHS IEC IFA Acquired Immunodeficiency Syndrome Annual Health Survey Antenatal Care Auxiliary Nurse Mid-wife Ante Natal Care Above Poverty Line Acute Respiratory Infection Accredited Social Health Activist Anganwadi Worker Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy Bacillus Calmette Guerin Budget Estimates Basic Minimum Services Programme Below Poverty Line Crude Birth Rate Crude Death Rate Coverage Evaluation Survey Community Health Centre Community Needs Assessment Approach Contraceptive Prevalence Rate Couples Protection Rate District Level Household Survey Diphtheria, Pertussis and Tetanus Diphtheria and Tetanus Empower ed Action Group Eligible Couple Register Emergency Obstetric Care Family Planning First Referral Units Human Immunodeficiency Virus Health Management Information Systems Integrated Child Development Services Integrated Disease Surveillance Programme Iodine Deficience Disorder Control Programme International Institute for Population Sciences Indian Public Health Standards Information, Education and Communication Iron and Folic Acid IMR IPHS IUCD IUD JSK JSY LHV MCTS M&E MIES MIS MMR MNP MoH&FW MPW-F/M MTP NACP NACO NCP NFHS NGO NLEP NIHFW NNMR NPCB NPP NPSF NRHM NSV NVBDCP NUHM Obs/gyn OP OPV ORS PC&PNDT PHC PHN PIP PMG PMUInfant Mortality Rate Indian Public Health Standards Intra Uterine Contraceptive Device Intra Uterine Device Jansankhya Sthirtha Kosh Janani Suraksha Yojana Lady Health Visitor Mother and Child Tracking System Monitoring and Evaluation Monitoring, Information & Evaluation System Management Information System Maternal Mortality Ratio Minimum Needs Programme Ministry of Health and Family Welfare Multi Purpose Worker – Female / Male Medical Termination of Pregnancy National AIDS Control Program National AIDS Control Organisation National Commission on Population National Family Health Survey Non-Governmental Organization National Leprosy Eradication Programme National Institute of Health and Family Welfare Neonatal Mortality Rate National Programme for Control of Blindness National Population Policy National Population Stabilisation Fund National Rural Health Mission No Scalpel Vasectomy National Vector Borne Disease Control Programme National Urban Health Mission Obstetrics and Gynecology Oral Pills Oral Polio Vaccine Oral Rehydration Solution Pre-conception & Pre-natal Diagnostic Techniques Primary Health Centre Public Health Nurse Programme Implementation Plan Programme Management Group Programme Management Unit PNC PPP PRCs RCH RHS RKS RGI RNTCP RTI SBA SC SC/ST SRS STDs STI TBAs TFR TT UIPPost Natal Care Public Private Partnership Po pulation Research Centres Reproductive and Child Health Rapid Household Survey Rogi Kalyan Samiti, Registrar General of India Revised National Tuberculosis Control Programme Reproductive Tract Infection Skilled Birth Attendants Sub Centre Scheduled- Caste / Scheduled- Tribe Sample Registration System Sexually Transmitted Diseases Sexually Transmitted Infections Traditional Birth Attendants Total Fertility Rate Tetanus Toxoid Universal Immunization Program CONTENTS Page No. Preface †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ Abbreviations Executive Summary and overview of Family Welfare Programme in India (Hindi & English version)†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. LIST OF TABLES SECTION – A Population & Vital Statistics TABLE NO. A. 1 TITLEPopulation Growth, Crude Birth Rate, Death Rate & Sex Ratio India 1901-2001 Distribution of Population, Sex Ratio, Density and Growth Rate of Population Census 2001 Rural and Urban Composition of Population, Census 1991 Total Population, Population of Scheduled Castes and Scheduled Tribes and their proportions to the total population Total Urban Population, Population of Cities/Towns Reporting Slums and Slum Population in Slum Areas – India, States, Union Territories Child Population in the age-group 0-6 by sex – Census 2001 & 2011 Population Aged 7 years and above 2011 (Provisional) Literates and Literacy Rates by sex, 2001 and 2011(Provisional) census Sex-ratio of total population and child population in the age-group 0-6 and 7+ years 2001 & 2011 Distribution of Population by Age Groups 2001(Census) Percentage Distribution of Population by Age and Sex, India, 1951-2001 census Projected Population Characteristics 2001-2012 Proportion of Population in Age Groups 0-4 and 5-9 a A. 2 A. 3 A. 3. 1 A. 3. 2 A. 3. 3 A. 3. 4 A. 3. 5 A. 3. 6 A. 4 A. 5 A. 6 A. 7 Child-Woman Ratio, and Dependency Ratio, 2001 A 8. Number of Married Couples (With Wife Aged Between 15-44 Years), All India 2001 Percentage Distribution of Married Couples (With Wife Aged Between 15-44 years) by Age Group, Censuses 1961, 1971 , 1981, 1991 & 2001 Number of Married Females in Rural Areas by Age,2001 Number of Married Females in Urban Areas by Age,2001. A. 9 A. 10 A. 11 A11. 1 Estimated eligible couples per 1000 population – 1991 & 2001 Census A. 12 A. 3 Expectation of Life at Birth 1901-2016 Projected Levels of the Expectation of Life at Birth By Sex ,1996-2016 A13. 1 Expectancy of life at birth by sex and residence, India and bigger States, 2002-06 A. 14 A. 15 A. 16 A. 17 A. 18 Fertility Indicators 1996-2009 – All India Time Series Data on CBR, CDR, IMR and TFR – India Crude Birth and Death Rates in Rural and Urban Areas 1981-2009 Estimated Birth and Death Rates in Different States/UTs – à ¢â‚¬ ¦1981,1991,2001-2009 Estimated Age-specific Death Rates by Sex, 2005-2009- India A. 18. 1 Estimated Age-specific Death Rates by Sex, 2005-2009- Rural A. 18. 2 Estimated Age-specific Death Rates by Sex, 2005-2009- Urban A. 19 A. 20 A. 21 A22 A. 2 A23 A24 Infant Mortality Rates by Sex, 1980 to 2009 – All India Infant Mortality Rates by Sex, 2001 to 2009 – India and Major States Mortality Indicators by Residence: All India 1980-2009 Infant Mortality Rate by Residence – All states/UTs Child Mortality Rate by Residence Mortality Indicators, India and Major States 2005 to 2009 Age Specific Fertility Rates (ASFR*) and Age Specific Marital Fertility Rates (ASMFR*): India, 2005-2009 Fertility Indicators for Major States -2005-2009 Estimated Age Specific Fertility Rates by Major States, 2005-2009 b A. 25 A. 26 A. 27 Age Specific Fertility Rates by Educational Level of the Woman, 2005 to 2009(All India) Mean Age at Effective Marriage (Female), India and Major States, 2005 to 2009 Mean age at effective marriage of females , by residence India and Major States ,2005 to 2009 Percentage of Females by Age at Effective Marriage by Residence, India and Major States, 2005 to 2009 Percent Distribution of Live Births by Order of Birth , India and Major States, 2005-2009 Percentage Distribution of Births By Order of Births By Residence, 2005 to 2009 Average Number of Children Born per Woman by Age – 2001 A. 28 A. 29 A. 30 A. 31 A. 32 A. 33 A. 34Proportion of Ever-married Womwn of parity (i+1) and above to 1000 Ever-married women of parity (i) and above 2001 Percentage of Ever-Married Women (Aged 50 and Above) With No Live Birth 2001 Percent distribution of live Births by Type of Medical Attention Received by the Mother at Delivery by Residence –All India Percentage of Deaths by Causes Related to Child Birth & Pregnancy (Maternal) – All India (Rural) – 1985, 1990 , 1995,1997 & 1998 Percentage Distribution of Deaths due to Specifi c Causes under the Major Group â€Å"Causes Peculiar to Infancy† for selected States 1996-98 Maternal Mortality Ratio, 1997-98 to 2007-09 Under-five Mortality Rates(U5MR) by sex and residence, 2008 & 2009 Sex-ratio of child (age group 0-4) 2004-06 to 2007-09 – SRS A. 35 A. 36 A. 37 A. 38 A. 39 A. 40 A. 41 SECTION – B Family Welfare Programme Statistics i) Immunisation Coverage & MTP Services B. 1 Year-Wise Achievement of Targets of MCH Activities – All India c B. 2 B. 3 B. 4State-wise Targets and Achievements of M. C. H. Activities, 2004-05 to 2007-08 Year-Wise Medical Termination of Pregnancy Performed – All India State-Wise Medical Termination of Pregnancy Performed (ii) Family Planning Acceptance & Impact of the programme B. 5 B. 6 B. 7 B. 8 B. 9 B. 10 B. 11 B. 12 Family Planning Acceptors by Methods – All India Sex-wise Break up of Sterilisation Performed Year-Wise Achievement of Family Planning Methods-All India State-Wise Achievements in respect of Sterilisations State-Wise Achievements in respect of IUD Insertions State-Wise Achievements in respect of Condom Users State-Wise Achievements in respect of O. P.Users State-Wise Vasectomies, Tubectomies and % share of Tubectomy to total Sterilisations State-Wise Number of Laparoscopic Tubectomies Along with Total Number Tubectomy Operations Performed State-wise Number of NSV & Total Number of Vasectomy Operations Performed State-Wise Distribution of Condom Pieces State-Wise Number of Oral Pill Centres Functioning and Distribution of Oral Pill Cycles of B. 13 B. 14 B. 15 B. 16 B. 17 B. 18 B. 19 Number of Condom pieces and Oral Pill Cycles Distributed – All India Information Relating to Maternal Health, 2007 to 2011 Couples Currently and Effectively Protected in India By Various Methods of Family Planning Percentage effective CPR due to all Methods Couples Currently and Effectively Protected Number of Births Averted dB. 20 B. 21 B. 22 SECTION – C HMIS- New Key Indicators C. 1 C. 2 C. 3 C. 4 C. 5 C. 6 C. 7 C. 8 C. 9 C. 10 Number of pregnant women received 3 ANC Checkups Number of women given TT2/Booster Number of women having Hb level < 11 (tested cases) Number of newborn visited within 24 hrs of home delivery Number of women discharged under 48 hrs of delivery from public facility Number of Still Births Number of newborns weighed at Birth Number of newborns having weight less than 2. 5 Kgs Number of Newborns breastfed within 1 hour Number of women receiving post partum check-up within 48 hours after delivery SECTION – D Survey Findings D. 1 D. 2 D. 3 D. Key Indicators NHFS-III Comparative Key Indicators – NFHS-III, NFHS-II and NFHS-I Comparative Key Indicators- DLHS-1, DLHS-2 and DLHS-3 Comparison of Key Indicators – NFHS(2005-06), DLHS (2007-08) and Converage Evaluation Survey(CES) 2009 conducted by UNICEF Concurrent Evaluation NRHM – India Facts (2009) Results of Annual Health Survey, 2010-11 D. 5 D. 6 S ECTION –E Infrastructure facilities E. 1 E. 2 Number of Sub-Centres, PHCs & CHCs functioning as on March, 2010 Facility Survey, DLHS ,2007-2008 e E. 3 E. 4 E. 5 E. 6 E. 7 Health Worker (Female)/ANM at Sub-Centre Health Worker (Female) Sub-Centre and PHCs Number of sub-centres without ANMs or and Health Workers(M) Doctors+ at Primary Health Centres Number of PHCs with Doctors and without Doctors/Lab Technician/Pharmacist SECTION –F Outlay and Expenditure on Family Welfare F. Year Wise BE, RE and Actual Expenditure relating to Department of Family Welfare Plan Outlay on Health Family Welfare in Different Plan Periods Centre, States and Union Territories Scheme-wise breakup of actual expenditure during 2007-08 and outlay for 2008-09 Details of External Assistance fro RCH Programme and Immunization Strengthening Project External Funding Assistance for Polio Programme F. 2 F. 3 F. 4 F. 5 Annexures Annex1 Annex 2 Annex 3 Demographic Indicators Demographic Estimates for Selec ted Countries, 2008 Definitions f SUMMARY  OF  FAMILY  WELFARE   PROGRAMME  IN  INDIA Executive Summary The Ministry of Health and Family Welfare brings out a statistical publication titled â€Å"Family Welfare Statistics in India†. The publication presets the most up-to-date data on the performance of various family welfare programmes and various demographic indicators. The 2011 edition contains six sections. Section â€Å"A† (Tables: A. 1 to A. 1) of the report covers Vital Statistics and captures data on population, sex ratio, rural & urban composition, child population, percentage distribution of population by age and sex, number of married couples, life expectancy at birth, fertility indicators, age specific fertility rates by educational levels, age specific death rates by sex, infant mortality rate by sex, child mortality rate, Maternal Mortality Ratio, etc. Analysis of some of the important indicators, is given in the â€Å"Over View† (Para 1 . 0 to 5. 0). Performance of immunization activities, family planning programmes, MTP services, etc. are covered in Section-B (Tables-B. 1 to B. 22). Para 6. 0 to 6. 9 discusses some of these important parameters in the â€Å"Overview†. The â€Å"Section-C† (Tables C. 1 to C. 0) of the Report covers State-wise data on some of the indicators like; Number of pregnant women received 3 ANC checkups, Number of women given TT2/Booster, Number of women having Hb level < 11 (tested cases), Number of newborn visited within 24 hrs of home delivery, Number of women discharged within 48 hrs of delivery from public facility, Number of Still Births, Number of newborns weighed at Birth, Number of newborns having weight less than 2. 5 Kgs. , Number of Newborns breastfed within 1 hour, Number of women receiving post partum check-up within 48 hours after delivery, etc. This data is an aggregation of district level data which is uploaded on Health Management Information System (HMIS) por tal of the Ministry by States/UTs.A number of large scale surveys are being carried out by the Ministry from time to time to assess the performance of various health and family welfare programmes. These surveys inter-alia include, National Family Health Survey (NFHS), District Level Household and Facility Survey (DLHS), Annual Health Survey (AHS), Facility Survey, Concurrent Evaluation Survey (CES) of NRHM, etc. Section-D focuses on the indicators covered in these large surveys. Data on key indicators (State-wise) covered in NFHS-III (2005-06) as compared with NFHS-II (1998-99) and NFHS-I (1992-93) are given in Tables D. 1 and D. 2. Tables D-3 captures data on key indicators covered in DLHS-III (2007-08) as compared with DLHS-II(2002-04) and DLHS-I (1998-99). Concurrent Evaluation of NRHM was carried out in 2009.The indicators covered include (a) health infrastructure facilities (b) Communitisation of services (c) Functioning of ANM (d) Availability of Human Resources (e) Service Ou tcomes. The results of the evaluation survey i are presented in Table D-5. A comparative data on common indicators covered in NFHS-III, DLHS-III and CES-2009 are brought out in Table D-4. The Ministry of Health & Family Welfare, in collaboration with the Registrar General of India (RGI), had launched an Annual Health Survey (AHS) in the erstwhile Empowered Action Group States (Bihar, Jharkhand, Madhya Pradesh, Chhattishgarh, Uttarakhand, Uttar Pradesh, Orissa and Rajasthan) and Assam.The aim of the survey was to provide feedback on the impact of the schemes under NRHM in reduction of Total Fertility Rate (TFR), Infant Mortality Rate (IMR) at the district level and the Maternal Mortality Ratio (MMR) at the regional level by estimating these rates on an annual basis for around 284 districts in these States. The results of the first round of AHS for some of the indicators viz. Crude Birth Rate (CBR), Crude Death Rate (CDR), Infant Mortality Rate (IMR), Neo-natal Mortality Rate, Under F ive Mortality Rate, Maternal Mortality Ratio (MMR), Sex Ratio, etc. have since become available and are given in Section-D (Tables D. 6. 1 to D. 6. 5).Data on key indicators covered in â€Å"Facility Survey-2007-08† conducted as part of DLHS-III are given in â€Å"Section E†. Latest data received from States /UTs regarding availability of Human resource & infrastructure facilities at Sub Centre, Primary Health Centre (PHC) and Community Health Centre (CHC) are also given in â€Å"Section-E† (Tables E. 1 to E. 7). Section-F covers â€Å"Outlay and Expenditure on Family Welfare† 2010-11 programmes for the year ii Overview Family Welfare Programme in India, 2011 DEMOGRAPHIC PROFILE OF INDIA 1. 0 Vital Statistics 1. 1 As on 1st March, 2011 India's population stood at 1. 21 billion comprising of 623. 72 million (51. 54%) males and 586. 47 million (48. 46%) females. India, which accounts for world's 17. percent population, is the second most populous country in the world next only to China (19. 4%). One of the important features of the present decade is that, 2001-2011 is the first decade (with the exception of 1911-21) which has actually added lesser population compared to the previous decade. In absolute terms, the population of India has increased by about 181. 46 million during the decade 2001-2011. Of the 121 crore Indians, 83. 3 crore (68. 84%) live in rural areas while 37. 7 crore (31. 16%) live in urban areas, as per the Census of India's 2011. Highlights of Census 2011 The average annual exponential growth declined to 1. 64% per annum during 2001-2011 from 1. 97% per annum during 1991-2001.Decadal growth during 2001-2011 declined to 17. 64% from 21. 54% during 1991-2001. The decade is the first, with the exception of 1911-21, which has actually added fewer people compared to the previous decade. The rural population (83. 31 crore) and urban Population (37. 71 crore) constitutes 68. 84% and 31. 16% respectively to the total popula tion of the country. During 2001-2011, for the first time, the growth momentum of population for the EAG States declined by about four percentage points. This, together with a similar reduction in the non-EAG States and Union Territories, has brought down the rate of growth of population for the country by 3. 9 percent as compared to 1991-2001. iiiThough the child-sex ratio [0 to 6 years] has declined from 927 female per 1000 males in 1991-2001 to 914 females per 1000 males, increasing trend in the child sex ratio was seen in Punjab, Haryana, Himachal Pradesh, Gujarat, Tamil Nadu, Mizoram and Andaman and Nicobar Island. Literacy rate increased from 64. 83% in 2001 to 74. 04% in 2011; 82. 14% male literacy, 65. 46% female literacy. Among the States and Union Territories, Uttar Pradesh is the most populous State with 199. 6 million people and Lakshadweep the least populated with 64,429 people. The contribution of Uttar Pradesh (UP) to the total population of the country is 16. 5% foll owed by Maharashtra (9. 3%), Bihar (8. 6%), West Bengal (7. 6%), Andhra Pradesh (7. 0%) and Madhya Pradesh (6. ). The combined contribution of these six most populous States in the country accounts for 55% to the country’s population 1. 2 The country's headcount is almost equal to the combined population of the United States of America (USA), Indonesia, Brazil, Pakistan, Bangladesh and Japan — all put together. The combined population of UP and Maharashtra is bigger than that of the USA. Population of many Indian States is comparable with countries like United Kingdom (UK), Germany, Italy, Japan, Mexico, etc. States in India vs Countries in the World (In Millions) State in India Population- Country @ [email  protected] 2011 Uttar Pradesh 199. 6 Brazil 195. Maharashtra 112. 4 Japan 127. 0 Bihar 103. 8 Mexico 110. 5 iv West Bengal Andhra Pradesh Madhya Pradesh Tamil Nadu Rajasthan Karnataka 91. 3 84. 7 72. 6 72. 1 68. 6 61. 1 Philippines Germany Turkey 93. 6 82. 1 72. 7 Thailand 68. 1 France 62. 8 United 61. 9 Kingdom Gujarat 60. 4 Italy 60. 1 Orissa 41. 9 Argentina 40. 7 Kerala 33. 4 Canada 33. 9 Jharkhand 33. 0 Morocco 32. 4 Assam 31. 2 Iraq 31. 5 Punjab 27. 7 Malaysia 27. 9 Chhattisgarh 25. 5 Saudi 26. 2 Arabia Haryana 25. 4 Australia 21. 5 @Source: State of World Population 2010 1. 3 The Average Annual Exponential Growth Rate (AAEGR) for 2001-2011 dipped sharply to 1. 64 percent per annum from 2. 6 percent during 1981-1991 and 1. 97 percent per annum during 1991-2001. Among the major States, Bihar, J&K, Chattisgarh, Jharkhand, Rajasthan, NCT of Delhi, Madhya Pradesh, Uttar Pradesh, Haryana, Uttarakhand and Gujarat recorded higher annual exponential growth rate as compared to the national average during 2001-2011. The State of Bihar registered the highest (2. 26%) AAEGR and Kerala (0. 48) registered the lowest. v 1. 4 The decadal rate of growth of population has slowed down to 17. 64% in 2001-2011 as compared to 21. 54% in 1991-2001. At the St ate level, growth rates varied widely. Nagaland with (-) 0. 47% had the lowest decadal growth rate.The phenomenon of low growth has started to spread beyond the boundaries of the Southern States during 2001-11, where in addition to Andhra Pradesh, Tamil Nadu and Karnataka in the South, Himachal Pradesh and Punjab in the North, West Bengal and Orissa in the East, and Maharashtra in the West have registered a growth rate between eleven to sixteen percent in 2001-2011 over the previous decade. Among the larger States, Bihar registered the highest decadal growth rate of 25% and Kerala the lowest (4. 86%). It is significant that the percentage decadal growth during 2001-2011 has registered the sharpest decline since independence. It declined from 23. 87 percent for 1981-1991 to 21. 54 percent for the period 1991-2001, a decrease of 2. 33 percentage point. During 20012011, this decadal growth has become 17. 64 percent, a further decrease of 3. 90 percentage points (Table A-1). 1. Traditio nally, for historical reasons, some States depicted a tendency of higher growth in population. Recognizing this phenomenon, and in order to facilitate the creation of area-specific programmes, with special emphasis on eight States that have been lagging behind in containing population growth to manageable limits, the Government of India constituted an Empowered Action Group (EAG) in the Ministry of Health and Family Welfare in March 2001. These eight States were Rajasthan, Uttar Pradesh, Uttarakhand, Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh and Orissa, which came to be known as ‘the EAG States'. During 2001-11, the rate of growth of population in the EAG States except Chhattisgarh has slowed down (Table-A-2).For the first time, the growth momentum of population in the EAG States has given the signal of slowing down, falling by about four percentage points. This, together with a similar reduction in the non-EAG States and Union Territories, has brought down the rate of gr owth for the country by 3. 9 percentage points during 2001-11 as compared to 1991-2001. vi 1. 6 Natural Growth Rate: The natural growth rate, which is the difference between the birth rate and death rate, was estimated as 1. 52% in 2009 against 1. 97 % in 1991. 1. 7 Sex Ratio: According to Census of India 2011, the sex ratio has shown some improvement in the last 10 years. It has gone up from 933 in 2001 census to 940 in 2011 census. Kerala with 1084 has the highest sex ratio followed by Pondicherry with 1038.Daman and Diu has the lowest sex ratio of 618. The Sex Ratio in Arunachal Pradesh (920), Bihar (916), Gujarat (918), Haryana (877), J(883), Madhya Pradesh(930), Maharashtra (925), Nagaland(931), Punjab(893), Rajasthan(926),Sikkim (889) and Uttar Pradesh (908) is lower than the national average. All UTs except Puducherry and Lakshadweep also have lower Sex Ratio as compared to national average (Table A-2). 1. 8 Child Sex Ratio: The child sex ratio (0-6 years), has declined to 91 4 in 2011 Census as compared to 927 in 2001. It showed a continuing preference for male children over females in the last decade. Increasing trend in the child sex ratio was seen in States/UTs viz.Punjab, Haryana, Himachal Pradesh, Gujarat, Tamil Nadu, Mizoram, Chandigarh and Andaman & Nicobar Islands but in all the remaining States / Union Territories, the child sex ratio showed decline over Census 2001 (Table-A-3. 6). Literacy level: According to the provisional data of the 2011 census, the literacy rate 1. 9 went up from 64. 83 per cent in 2001 to 74. 04 per cent in 2011 — showing an increase of 9. 21 percentage points. Significantly, the female literacy level saw a significant jump as compared to males. The female literacy in 2001 was 53 per cent and it has gone up to 65. 46 per cent in 2011. The male literacy, in comparison, rose from 75. 3 to 82. 14 per cent (Table A-3. 5). Kerala, with 93. 1 per cent, continues to occupy the top position among States as far as literacy is concerned while Bihar remained at the bottom of the ladder at 63. 82 per cent. vii Ten States and Union Territories, including Kerala, Lakshadweep, Mizoram, Tripura, Goa, Daman and Diu, Puducherry, Chandigarh, NCT of Delhi and Andaman and Nicobar Islands have achieved a literacy rate of above 85 per cent. 2. 0 POPULATION PROJECTIONS 2. 1 Population Projections: The projections for the country, individual States and Union Territories up to the year 2026 made by the Technical Group constituted by the National Commission on Population (NCP) under the Chairmanship of Registrar General, India, reveals that the country’s population would reach 1. 4 billion by 2026. Projected Population of India (In Millions)The projected population and proportion (percent) of population by broad age-group as on 1st March, 2001-2026 as per â€Å"Report of the Technical Group on Population Projections – Ministry of Health & Family Welfare (May 2006)† are given in the Table below: Ye ar Population (in millions) Proportion (percent) 15-59 15-49 (years) (years) (Female Population) 35. 4 57. 7 51. 1 32. 1 60. 4 53. 1 29. 1 62. 6 54. 5 0-14 (years) 60+ (years) 6. 9 7. 5 8. 3 2001 2006 2011 1029 1112 1193 (1210 )* 1269 1340 1400 2016 2021 2026 26. 8 25. 1 23. 4 63. 9 64. 2 64. 3 54. 8 54. 1 53. 3 9. 3 10. 7 12. 4 *As per provisional figures of Census 2011. viii 2. 2 National Population Policy (NPP), 2000: Government has adopted a National Population Policy in February, 2000. The main objective is to provide or undertake activities aimed to achieve population stabilisation, at a level consistent with the needs of sustainable economic growth, social development and environment protection, by 2045.The other objectives are: †¢ †¢ †¢ To promote and support schemes, programmes, projects and initiatives for meeting the unmet needs for contraception and reproductive and child health care. To promote and support innovative ideas in the Government, private and v oluntary sector with a view to achieve the objectives of the National Population Policy 2000. To facilitate the development of a vigorous people’s movement in favour of the national effort for population stabilisation. 2. 3 National Commission on Population (NCP): With a view to monitor and direct the implementation of the National Population Policy, the NCP was constituted in 2000 and it was re-constituted in 2005.The Chairman of the re-constituted Commission continued to be Hon’ble Prime Minister of India, whereas Deputy Chairman of the Planning Commission and the Minister of Health & FW are the two Vice-Chairmen and Secretary, H, is the Member-Secretary of the Commission. State Population Commissions: State Population Commissions have been 2. 4 constituted in 20 States/UTs. viz. Andhra Pradesh, Arunachal Pradesh, Assam, Haryana, Himachal Pradesh, J, Kerala, Madhya Pradesh, Gujarat, Uttar Pradesh, Maharashtra, West Bengal, Meghalaya, Mizoram, Punjab, Rajasthan, Sikki m, Tamil Nadu, Andaman & Nicobar Island and Lakshadweep. Janasankhya Sthirata Kosh (JSK): The Jansankhya Sthirata Kosh (JSK) has been set 2. 5 up as an autonomous body in the Ministry of Health and Family Welfare, duly registered as a Society under the Societies Registration Act, 1860.The objective of JSK is to facilitate the attainment of the goals of National Population Policy 2000 and support projects, schemes, initiatives and innovative ideas designed to help population stabilization both in the Government and Voluntary sectors and provide a window for canalizing resources through voluntary contributions from individuals, industry, trade organizations and other legal entities in furtherance of the national cause of population stabilization. 3. 0 DEMOGRAPHIC and HEALTH STATUS INDICATORS 3. 1 The demographic and health status indicators have shown significant improvements. The Table below captures data on Crude Birth Rate, Crude Death Rate, and Life Expectancy etc. ix Sl. No. 1 2 3 4Parameters Crude Birth Rate (per 1000 population Crude Death Rate (per 1000 population) Total Fertility Rate Maternal Mortality Ratio (per 100,000 live births) Infant Mortality Rate (per 1000 live births) Child Mortality Rate (0-4 yrs. ) per 1000 children Couple Protection Rate (%) Expectation of life at birth (in years) -Male -Female 1951 40. 8 25. 1 6. 0 NA 1981 33. 9 12. 5 4. 5 NA 1991 29. 5 9. 8 3. 6 398 SRS (199798) 80 26. 5 2001 25. 4 8. 4 3. 1 301 (2001-03) Current Levels 22. 5 (2009) 7. 3 (2009) 2. 6(2009) 212 SRS (2007-09) 50(2009) 14. 1(2009) 5 6 146 (1951-61) 57. 3 (1972) 10. 4 (1971) 110 41. 2 66 19. 3 7 8 22. 8 44. 1 45. 6 40. 4(2011) 37. 1 36. 1 (1951) 54. 1 54. 7 60. 6 61. 7 (199196) 61. 8 63. 5 (1999-03) 62. 6 64. 2 (2002-06)Source: Office of Registrar General of India, except 7 above which is based on estimation done by statistics Division of Ministry of Health and Family Welfare. NA – Not available 3. 2 Crude Birth Rate (CBR): The Crude Birth Rate decline d from 29. 5 in the 1991 to 22. 5 in 2009. The CBR is higher (24. 1) in rural areas as compared to urban areas (18. 3). Uttar Pradesh recorded the highest CBR (28. 7) and Goa the lowest (13. 5). Assam (23. 6), Bihar (28. 5), Chhattisgarh (25. 7), Jharkhand (25. 6), Madhya Pradesh (27. 7), Rajasthan (27. 2), Uttar Pradesh (28. 7) recorded higher CBR as compared to the national average. Among the Smaller States / UTs, D Haveli (27. 0) and Meghalaya (24. ) recorded higher CBR as compared to the national average while Tripura (14. 8) recorded the lowest CBR during 2009-Table A-15, A16 & A17. x 3. 3 Life Expectancy: The life expectancy at birth for male was 62. 6 years as compared to females, 64. 2 years according to 2002-06 estimates. Urban Male (67. 1 years) and Urban Female (70 years) have longer life span as compared to their rural counter parts. The life expectancy in Kerala is the highest (74 years) and the lowest in Madhya Pradesh (58 years) Table A-13. 1. xi 4. 0 MORTALITY INDICA TORS 4. 1 Crude Death Rate (CDR): The CDR, which was stagnant during 2007 and 2008 at 7. 4, came down to 7. 3 in 2009. The CDR is higher in rural areas (7. ) as compared to urban areas (5. 8). The death rate is highest (8. 8) in Orissa and lowest in Nagaland (3. 6) – (Table A-17). Age-specific Death Rates: The ASDR for the year 2009 was 14. 1 per 1000 in the age-group 0-4; it drastically declined in the next age-group (5-9) to 1 per 1000. The ASDR gradually increased in each age-group to reach to the level 20. 4 per 1000 in the age-group 60-64 and continued to increase to reach finally to the level 173. 9 per 1000 in the last age-group, 85+. ) The Age-specific Mortality rates are declining over the years; the rural-urban and Male – Female differentials are still high (Table A-18 to A-18. 3) xii 4. Infant Mortality Rate (IMR): According to SRS 2009, the IMR at national level was 50 per 1000 live births in 2009 as compared to 53 in 2008. The IMR is higher in respect of F emale (52) as compared to Male (49). The highest infant mortality rate has been reported from Madhya Pradesh (67) and lowest from Kerala (12). Assam (61), Bihar (52), Chhattisgarh (54), Haryana (51), Madhya Pradesh (67), Orissa (65), Rajasthan (59) and Uttar Pradesh (63) recorded higher IMR as compared to the national average (Table-A-20) Infant Mortality Rates – Rural/Urban (All India) xiii The IMR is very high in rural areas (55 per 1000 live births) as compared to urban areas (34). Rural areas of Madhya Pradesh registered the highest IMR (72) followed by Orissa (68), Uttar Pradesh (66).Rural areas of Kerala State recorded the Lowest IMR (12) in the country. Uttar Pradesh and Chhattisgarh recorded highest IMR in urban areas. Kerala had the lowest IMR (11) in urban areas. Amongst the smaller states, Rural and Urban areas of Goa recorded lowest IMR during 2009 (Table-A-22). The increase in medical attention to the pregnant women at the time of live births may have resulted in decline in IMR over the period. But in the rural areas, the medical attention is still on the lower side (Table-A36) Distribution of Live Births by Type of Medical Attention Received by the Mother-2009 (%) Neo-natal Mortality Rate: Neo-natal mortality refers to number of infants dying within one month.Neo-natal health care is concerned with the condition of the newborn from birth to 4 weeks (28 days) of age. Neo-natal survival is a very sensitive indicator of population growth and socio-economic development. The survival rate of female infants correlates to subsequent population replacement. The neo-natal mortality rate which was stagnant at 37 per 1000 live births during 2003 to 2006 marginally came down to 36 in 2007, 35 in 2008 and stood at 34 during 2009. The neo-natal mortality rate is very high in rural areas (38 per 1000 live births) as compared to 21 in urban areas in 2009. The neonatal mortality rate also xiv varies considerably among Indian States.Madhya Pradesh (47), Utt ar Pradesh (45), Orissa (43), Rajasthan (41), J (37), Himachal Pradesh (36), Haryana(35), Gujarat(34), Chhattisgarh(38) recorded higher neo-natal mortality rate as compared to national average. The Neo-natal mortality rate is lowest in the Kerala State (7). The significant feature is that, the Neo-natal Mortality Rate came down or remained stagnant in 2009 as compared to 2008 except in the case of Haryana, Himachal Pradesh, Jharkhand and Karnataka (Table A23) Post-Neo-Natal Mortality Rate: Refers to number of infant deaths at 28 days to one year of age per 1000 live births. The Post Neo natal Mortality Rate came down to 16 in 2009 from 24 in 2002.The Post Neo Natal Mortality Rate is high in rural areas (17) as compared to urban areas (13) (Table A-21) Peri–natal Mortality Rate: Refers to number of still birth and deaths within 1st week of delivery per 1000 live births. The Peri-natal Mortality Rate varies in the range of 37 to 35 since 2001 and stood at 35 in 2009. It is high in rural areas (39) as compared to urban areas (23) during 2009. The Peri-natal Mortality Rate significantly varied across the States. Kerala with 13 is the best performing State, Madhya Pradesh and Chhattisgarh (45) are least performing States during 2009. Still Birth Rate (SBR): The SBR came down to 8 in 2008 from 9 in 2007. However, it remained stagnant at 8 in 2009 also.The number of Still Births varied across the States between 1 (Bihar) and 17 (Karnataka) in 2009 (TableA-23). 4. 3 Child Mortality Rate (0-4): Child Mortality Rate is measured in terms of death of number of children (0-4 years) taking place per 1000 children (0-4 year’s age). As per SRS estimates, the Child Mortality Rate (CMR) has come down from 57. 3 in 1972 to 26. 5 in 1991 and 14. 1 in 2009. The CMR is very high in rural areas (15. 7) as compared to urban areas (8. 7) in 2009 and this observation is relevant for almost all States uniformly. The highest Child Mortality Rate was recorded in Madhya Prade sh (21. 4) closely followed by Uttar Pradesh (20. 1) and Assam (19. 0). Kerala with 2. 6 CMR is the best Performing State (Table A22. 1) 5. 0FERTILITY INDICATORS The three common measures of fertility are; (a) Crude Birth Rate (CBR), (b) Age-Specific Fertility Rates (ASFR), and (c) Total Fertility Rate (TFR). CBR has already been discussed in para 3 . 2 above. 5. 1 Age Specific Fertility Rates (ASFR) & Age Specific Marital Fertility Rates (ASMFR): ASFR is defined as the number of children born to women in the said age group per 1000 women in the same age group and ASMFR as the number of children born to married women in the said age group per 1000 women in the same age group. Table A-24 presents ASFR and ASMFR data separately for rural and urban areas, for the years 2004 to 2009. It is xv bserved that ASMFRs are higher than ASFRs in respect of all age groups as ASMFR covers only married women. Throughout the period 2004-2009, the age group 20-24 continued to have peak fertility rate s in rural and urban areas, but both these indicators are lower in urban areas as compared to rural areas. The ASMFR increased to 326 in 2009 from 303 in 2008 and the ASFR increased to 227. 8 in 2009 from 218. 6 in 2008 for the age group 20-24. Data on Age Specific Fertility Rate (ASFR) reveals that the fertility rate in 15 to 19 years age group has moderately declined in 2009 (38. 5) as compared to 2008 (41. 6). Lower fertility rates are observed in U. P. Bihar only after attaining the age 40 years while in Kerala, Tamil Nadu, Andhra Pradesh, Maharashtra, Karnataka, Himachal Pradesh and Punjab, this stage is reached in the earlier age groups namely 30-34 and 35-39 (Table A-26). ASFR is showing a decreasing trend as the literacy level increases in the age group of 20-24 (the peak fertility age group)-Tables A-27. 5. 2 Age at Effective Marriage (AEM): The Mean age at effective marriage is the age at consummation of marriage, is almost stagnant and hovering around 20 years between 200 5 and 2009. The State level data show variations in the AEM. It is the highest in J (23. 6) followed by Kerala (22. 7), Delhi & Tamil Nadu (22. 4), Himachal Pradesh (22. 2), and Punjab (22. 1) in 2009. Rajasthan (19. ) has the lowest AEM. The AEM in urban areas is higher than the rural one but the difference is just two years. The rural- urban difference is highest (3. 1 years) in Assam and least in Kerala (0. 1 years). The AEM in respect of more than 50% female in rural areas is 18-20 years whereas in urban areas, the AEM in respect of more than 60% female is 21+ (Tables A-28 to A-30) xvi 5. 3 Total Fertility Rate (TFR): The TFR for the country remained constant at 2. 6 during 2008 and 2009 with Bihar reporting the highest TFR at 3. 9 while Kerala and Tamil Nadu continued its outstanding performance with the lowest TFR of 1. 7. Among the major States, the TFR level of 2. has been attained by Andhra Pradesh (1. 9), Karnataka (2. 0), Kerala (1. 7), Maharashtra (1. 9), Punjab (1. 9), Tamil Nadu (1. 7) and West Bengal (1. 9). The rural woman is having higher TFR (2. 9) as compared to urban (2. 0) women (TableA-25). 6. 0 FAMILY PLANNING PROGRAMME: In 1952, the Indian Government was one of the first in the world to launch a national family planning programme, which was later expanded to encompass maternal and child health, family welfare and nutrition. The figures given in the publication are based on the data reported by the State/UTs at district level and then consolidated at State and National level on HMIS portal.Percentage of districts reported in 2009-10 and 2010-11 was 98%. 6. 1 Maternal Health: Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. Antenatal care (ANC) is the systemic medical supervision of women during pregnancy. Its aim is to preserve the physiological aspect of pregnancy and labour and to prevent or detect, as early as possible, all pathological disorders. Early diagnosis during pregnancy ca n prevent maternal ill-health, injury, maternal mortality, foetal death, infant mortality and morbidity. During 2010-11, 28. 30 million women got registered for ANC checkup and more than 20 million underwent 3 check-ups during the pregnancy period. vii The institutional deliveries to total deliveries (Institutional +home) increased from 56. 7% in 2006-07 to 78. 5% in 2010-11. Kerala and Tamil Nadu (99. 8%) are the best performing States in the country during 2010-11 (Table B-18). 6. 2 Medical Termination of Pregnancy: To avoid the misuse of induced abortions, most countries have enacted laws whereby only qualified Gynecologists under conditions laid down and done in clinics/hospitals that have been approved, can do abortions. The Medical Termination of Pregnancy Act was enacted by the Indian Parliament in 1971 and came into force from 01 April, 1972. The MTP Act was again revised in 1975.The MTP Act lays down the condition under which a pregnancy can be terminated, especially the pe rsons and the place to perform it. During 2010-11, 620472 MTPs were performed by 12510 approved institutions in the country. Uttar Pradesh with 576 approved institutions performed maximum number (81420) MTPs in the country followed by Maharashtra (78047) during 2010-11. xviii About 60% MTPs in the country were performed in 6 States viz. Assam, Maharashtra, West Bengal, Tamil Nadu, Uttar Pradesh and Haryana in 2010-11(Table B4). 6. 3 Child Health Immunization programmes aim to reduce mortality and morbidity due to Vaccine Preventable Diseases (VPDs), particularly for children.India's immunization programme is one of the largest in the world in terms of quantities of vaccines used, numbers of beneficiaries, number of immunization sessions organized and the geographical area covered. Under the immunization program, vaccines are used to protect children and pregnant mothers against six diseases. They are: †¢ †¢ †¢ †¢ †¢ †¢ Tuberculosis Diphtheria Pertussis Polio Measles Tetanus In India, under Universal Immunization Programme (UIP) vaccines for six vaccinepreventable diseases (tuberculosis, diphtheria, pertussis (whooping cough), tetanus, poliomyelitis, and measles) are provided free of cost to all. Tetanus Immunization for expectant Mother: During 2010-11, 78. 14% of the estimated need for vaccinating 29. 68 million expectant mothers was achieved. As compared to 200910 the achievement is on lower side (83. 82%).The achievement varied widely across the States, the highest percentage of achievement is observed in Lakshadweep (112. 1%) followed by the Mizoram (106. 8%). Among major States, Tamil Nadu immunized 98. 5% of the targeted numbers and Bihar recorded the lowest immunization (58%). The achievement xix of Bihar is the lowest among the major States consecutively for the third year (TableB1&B2). DPT Immunization for Children: The DPT is an immunization or vaccine to protect against the diseases of Diphtheria (D), Pertussis (P), and Tetanus (T). The III dose of DPT vaccination was to be administered to 25. 54 Million children (Target) and achieved 89. 20% during 201011 as against the achievement of 99. 0% in 2009-10. Andhra Pradesh (100. 3%), Tamil Nadu (102. %), Himachal Pradesh (105. 7%), J&K (105. 3%), Manipur (118. 8%), Meghalaya (108. 5%) and Mizoram (134. 2%) achieved more than 100% targeted numbers (Table- B1&B2). Polio: More than 89 percent children received the third dose of Polio vaccine in 2010-11 but the percentage dropped from 98. 6% in 2009-10. The percentage of children who received third dose of polio ranges from 31. 4% in A&N Islands to 133. 8% in Mizoram. Eight States viz. Andhra Pradesh, Orissa, Tamil Nadu, Himachal Pradesh, J&K, Manipur, Meghalaya and Mizoram achieved more than 100% targeted numbers during 2010-11. Achievement of Bihar State is the lowest (69. 1%) among the major States (Table- B1&B2).BCG: BCG vaccine is given for protection against tuberculosis, mainly severe forms of chil dhood tuberculosis. 23. 88 million Children of below one year were targeted for administering BCG vaccine during 2010-11 as against 25. 19 million in 2009-10. The achievement in 2010-11 was 93. 5% as against 101. 7 % in 2009-10. 14 States / UTs achieved more than 100% immunization during 2010-11 as against 20 States/UTs in 2009-10. Pondicherry achieved the highest percentage immunization (179. 8%) in 2010-11. Measles: 22. 10 million Children of below one year age received measles vaccine during 2010-11 as against 25. 54 million children accounting for an achievement of 86. 6% as against 95. 0% in 2009-10.Himachal Pradesh, J&K, Manipur, Meghalaya and Mizoram achieved more than 100% vaccination in 2010-11 (Table- B1&B2). Tetanus: Vaccination against Tetanus was administered to 9. 7 million (Target: 25. 1 Million) children of 5 years age (DT), 14. 30 million children of 10 years age (Target: 25. 66 million) and 13. 0 million children of 16 years age (Target: 26. 01 Million) during 2010 -11. The achievement as against the set target works out to 38. 6%, 54. 8% and 50. 0% respectively in respect of the above age group of children. Bihar State is lagging behind in achievement as compared to all other major States. The achievement is only 5. 6% (of the target) in the case of children 5 years of age, 14. 8% for children of 10 Years and 20. % for children of 16 years during 2010-11. Except Sikkim (for the age group children 10 years), no other State vaccinated the children to the extent of 100% of the target during 2010-11(Table- B1&B2). 6. 4 Family Planning: Birth control pills, condoms, sterilization, IUD (Intrauterine device) etc. are most commonly practiced Family Planning methods in the country. The efforts of the Government in implementing the Family Planning Programme in the country have significant impact. However, Social factors like reluctance, traditions and socio-cultural beliefs towards large family emerge as the major constraints towards adopting Family Pl anning methods. Female xx iteracy, age at marriage of girls, status of women, strong son preference, and lack of male involvement in family planning, are also significant factors associated with adoption of small family norm. IMPACT OF FAMILY WELFARE ACTIVITIES †¢ †¢ Knowledge of contraception is nearly universal: 98 percent of women and 99 percent of men age 15-49 know one or more methods of contraception. Among the permanent modern Family Planning methods, female sterilization was the most popular Over 97 percent of women and 95 percent men know about female sterilization. Male sterilization, by contrast, is known only by 79 percent of women and 87 percent of men. Ninety-three percent of men know about condoms, compared with 74 percent of women. More than 80 percent women and men know about contraceptive pills.Knowledge of contraception is widespread even among adolescents: 94 percent of young women and 96 percent of young men have heard of a modern method of contracepti on Source: NFHS-3 †¢ †¢ †¢ 6. 5 Family Planning Performance The year 2010-11 ended with 34. 9 million total family planning acceptors at national level comprising of 5. 0 million Sterilizations, 5. 6 million IUD insertions, 16. 0 million condom users and 8. 3 million O. P. users as against 35. 6 million total family planning acceptors in 2009-10 (Table B. 5) xxi Total FP Acceptors 60000 50000 40000 30000 20000 10000 0 6. 6 A total of 50. 09 Lakh sterilizations were performed in the country during 2010-11 as against 49. 98 Lakh in 2009-10. States/UTs viz.Assam, Bihar, Gujarat, Jharkhand, Madhya Pradesh, Orissa, Punjab. Arunachal, Manipur, Meghalaya, Nagaland, Tripura, Uttarakhand, Daman & Diu, Lakshadweep and Puducherry have shown improved performance in 2010-11 as compared to 2009-10. (Nos. 000†²) Sterilisations 6,000 5,000 (Nos. 000†²) 4,000 3,000 2,000 1,000 0 The proportion of tubectomy operations to total sterilizations was 95. 6 percent in 2010-11 as ag ainst 94. 6 percent in 2009-10 (Table B-6). xxii Though the share of vasectomy operations to total sterilizations is increasing, it is quite insignificant. 6. 7 IUD Insertions: During the year 2010-11, 5. 6 million IUD insertions were reported as against 5. 7 million in 2009-10.Assam, Bihar, Gujarat, Jharkhand, Uttar Pradesh, Arunachal Pr, Delhi, Goa, Meghalaya, Mizoram, Sikkim, D&N Haveli reported better performance in 2010-11 than in 2009-10 (Table B-9). 6. 8 Condom Users and O. P. Users: Based on the distribution figures reported, there were 16. 0 million equivalent users of Condoms and 83. 07 million equivalent users of Oral Pills during 2010-11 (Table B-10, B-11). 6. 9 Number of Births Averted: Implementation of various Family Planning measures averted 16. 335 million births in the country during 2010-11 as compared to 16. 605 million in 2009-10. The cumulative total of births avoided in the country up to 2010-11 was 442. 75 million (Table B-22). 7. 0 PROGRAMMES and SCHEMES 7. The National Rural Health Mission (NRHM): NRHM launched by the Hon’ble Prime Minister on 12th April 2005 throughout the country with special focus on 18 States, including eight Empowered Action Group (EAG) States, the North-Eastern States, Jammu & Kashmir and Himachal Pradesh, seeks to provide accessible, affordable and quality health care xxiii services to rural population, especially the vulnerable sections. The NRHM operates as an omnibus broadband programme by integrating all vertical health programmes of the Departments of Health and Family Welfare including Reproductive & Child Health Programme and various diseases control Programmes.The NRHM has emerged as a major financing and health sector reform strategy to strengthen States Health systems. The NRHM has been successful in putting in place large number of voluntary community health workers in the programme, which has contributed in a major way to improved utilisation of health facilities and increased health awarenes s. NRHM has also contributed by increasing the human resources in the public health sector, by up-gradation of health facilities and their flexible financing, and by professionalization of health management. The current policy shift is towards addressing inequities, through a special focus on inaccessible and difficult areas and poor performing districts.This requires also improving the Health Management Information System, an expansion of NGO participation, a greater engagement with the private sector to harness their resources for public health goals, and a greater emphasis on the role of the public sector in the social protection for the poor. †¢ †¢ †¢ †¢ †¢ †¢ †¢ 7. 2 NRHM GOALS Reduction in Infant Mortality Rate (IMR) and Maternal Mortality Ratio (MMR) Universal access to public health services such as Women’s health, child health, water, sanitation & hygiene, immunization, and Nutrition. Prevention and control of communicable and nonco mmunicable diseases, including locally endemic diseases Access to integrated comprehensive primary healthcare Population stabilization, gender and demographic balance. Revitalize local health traditions and mainstream AYUSH. Promotion of healthy life styles.Primary Health Care services Health Services are provided to the community through a network of Sub-centres, Primary Health Centres (PHCs) and Community Health Centres (CHCs) in the rural areas and Hospitals and Dispensaries etc. in the urban areas. The Primary Health Care infrastructure in rural areas has been developed as a three-tier system. The norms for establishing Sub centres, PHCs and CHCs are as under: xxiv Centre Plain Area Sub Centre PHC CHC 5000 30000 120000 Population Norms Hilly/Tribal Area 3000 20000 80000 7. 3 Sub-Centres (SCs): The Sub-Centre is the most peripheral and first contact point between the primary health care system and the community.Each Sub-Centre is manned by one Auxiliary Nurse Midwife (ANM) and on e Male Health Worker MPW (M). One Lady Health Worker (LHV) is entrusted with the task of supervision of six Sub-Centres. SubCentres are assigned tasks relating to interpersonal communication in order to bring about behavioural change and provide services in relation to maternal and child health, family welfare, nutrition, immunization, diarrhoea control and control of communicable diseases programmes. The Sub-Centres are provided with basic drugs for minor ailments needed for taking care of essential health needs of men, women and children. There were 147069 Sub Centres functioning in the country as on March 2010. An Auxiliary Nurse Midwife (ANM), a female aramedical worker posted at the Sub-Centre and supported by a Male Multipurpose Worker MPW (M) is the front line worker in providing the Family Welfare services to the community. ANM is supervised by the Lady Health Visitor (LHV) posted at PHC. 7. 4 Primary Health Centres (PHCs): PHC is the first contact point between village comm unity and the Medical Officer. The PHCs were envisaged to provide an integrated curative and preventive health care to the rural population with emphasis on preventive and promotive aspects of health care. The PHCs are established and maintained by the State Governments under the Minimum Needs Programme (MNP)/Basic Minimum Services Programme (BMS).There were 23673 PHCs functioning as on March 2010 in the country. A PHC is manned by a Medical Officer supported by 14 paramedical and other staff. It acts as a referral unit for 6 Sub Centres. It has 4-6 beds for patients. The activities of PHC involve curative, preventive, primitive and Family Welfare Services. 7. 5 Community Health Centres (CHCs): CHCs are being established and maintained by the State Government under MNP/BMS programme . It is manned by four medical specialists i. e. Surgeon, Physician, Gynaecologist and Paediatrician supported by 21 paramedical and other staff. It has 30 in-door beds with one OT, X-ray, Labour Room an d Laboratory facilities.It serves as a referral centre for 4 PHCs and also provides facilities for obstetric care and specialist consultations. As on March, 2010, there were 4535 CHCs functioning in the country. 7. 6 Reproductive Child Health (RCH) Programme: Reproductive and Child Health Programme is a major component of NRHM and aims at reduction of Infant Mortality Rate, Maternal Mortality Ratio and Total Fertility Rate xxv 7. 7 Janani Suraksha Yojana: The Jannani Suraksha Yojana (JSY) is a 100% centrally sponsored scheme and it integrates cash assistance with delivery and post delivery care. The scheme was launched with focus on demand promotion for institutional deliveries in States and regions where these are low.It targeted lowering of MMR by ensuring that deliveries were conducted by Skilled Birth Attendants at every birth. The Yojana has identified the Accredited Social Health Activist (ASHA), as an effective link between the Government and the poor pregnant women in 18 low performing States, namely the 8 EAG States and Assam and J&K and the remaining NE States. In other States and UTs, wherever, AWW and TBAs or ASHA like activist has been engaged for this purpose, they can be associated with this Yojana for providing the services. The JSY scheme has shown phenomenal growth in the last three years. Starting with a modest number of 7. 39 Lakhs beneficiaries in 2006-07, the total number reached 113. 89 lakh during 2010-11. 7. Family Welfare Linked Health Insurance Scheme: Family Planning Linked Insurance Scheme was introduced w. e. f. 29th November, 2005 to take care of the cases of failure of Sterilisation, medical complications for death resulting from Sterilisation, and also provide indemnity cover to the doctor / health facility performing Sterilisation procedure. The scheme is in operation for the last 5 years and is renewed with ICICI Lombard Insurance Company for the sixth year w. e. f. 01-01-2011 based on 50 lakh sterilization acceptors. The tot al liability of the company is limited to Rs. 25 crore under Section-I and Rs. 1 crore under Section-II. Benefits of the Scheme w. e. f. 1. 1. 011( 6th Year) Section Coverage Financial compensation I following IA Death sterilization (inclusive of Rs. 2 Lakhs death during process of sterilization operation) within 7 days from the date of discharge from the hospital. IB Death following Rs. 50,000 sterilization within 8 – 30 days from the date of discharge from the hospital IC Failure of Sterilization Rs. 30,000 ID Cost of treatment upto Actual not exceeding 60 days arising out of Rs. 25,000 complication following the sterilization operation (inclusive of xxvi II complication during process of sterilization operation) from the date of discharge. Indemnity Insurance per Upto Rs. 2 Lakh per Doctor/facility but not claim more than 4 cases in a year. 7. Compensation for Acceptors of Sterilisation: As a measure to encourage people to adopt permanent method of Family Planning, this Mi nistry has been implementing a Centrally Sponsored Scheme since 1981 to compensate the acceptors of sterilization for the loss of wages for the day on which he/she attended the medical facility for undergoing sterilization. Compensation for Acceptors of Sterilisation Public facilities Vasectomy Tubectomy Focus 1500 1000 1500 (Rs. ) Accredited Private/NGO facilities Vasectomy Tubectomy 1500 1500 1500 (BPL/SC/ST) High States Non-high Focus States 1000 (BPL/SC/ST) 1500 650 (APL) 8. 0 MONITORING AND EVALUATION SYSTEMThe Information System to measure the process and impact of the NRHM including Family Welfare Programme is as below: a) Service Statistics through HMIS and Routine Monitoring b) Sample Registration System & Population Census, Office of Registrar General India c) Large scale surveys- National Family Health Surveys, District Level Household and Facility Surveys. Annual Health Survey d) Area specific surveys by Population Research Centres e) Other specific surveys by National & International agencies f) Field Evaluation through Regional Evaluation Teams xxvii 8. 1 Service Statistics/Routine Monitoring The Statistics Division in the Ministry of Health & Family Welfare is responsible for Monitoring & Evaluation activities. 8. 2 Health Management Information System (HMIS) Health services are provided through the network of health centers spread throughout rural and urban areas of the country. Each centre maintains record of its activities in one or more of the primary registers.The performance data collected and compiled primarily at peripheral levels (Rural/Urban) such as Sub-centre, Primary Health Centres, Urban Family Welfare Centres / Post Partum Centres / Hospitals / Dispensaries are presented in Tables C-1 to C-10. For capturing information on the service statistics from the peripheral institutions, an exercise was undertaken to rationalize the facility level data capturing format by removing redundant information, reducing the number of forms and focu sed on facility based reporting. The revised forms were finalized in September 2008 and disseminated to the States. A web based Health MIS (HMIS) portal was also launched in October, 2008 http://nrhm-mis. nic. n to facilitate data capturing at District level. The HMIS portal has led to faster flow of information from the district level and about 98% of the districts are reporting monthly data since 2009-10. The HMIS portal is now being rolled out to capture information at the facility level. Some of indicators for which data has been captured through HMIS portal (district level) are included for the first time in the publication (Detailed tables are given in Section–C (Tables C1 to C-10). Data for these indicators are provisional and may only be compared with DLHS-III indicators keeping in view the methodological differences. 8. 3 Tracking of Mothers and ChildrenIt has been decided to have a name-based tracking whereby pregnant women and children can be tracked for their ANCs and immunisation along with a feedback system for the ANM, ASHA etc to ensure that all pregnant women receive their Ante-Natal Care (ANCs) and postnatal care (PNCs) Checkups; and the children receive their full immunisation. All new pregnancies detected/being registered from 1st April, 2010 at the first point of contact of the pregnant mother are being captured as also all births occurring from 1st December, 2009. A number of States have established the system and other are putting in place systems to capture such information on a regular basis. Mother and Child Tracking System require intense capacity building at various levels primarily at the Block and Sub-Centre levels. The National Informatics Centre (NIC) has developed software application. The rollout is being monitored centrally. xxviii 8. 4 Large Scale/Demographic SurveysA number of large scale surveys are being conducted by the Ministry of Health & Family Welfare as enumerated below: National Family Health Survey (NFHS): The 2005-06, National Family Health Survey (NFHS-3) was the third in a series of national surveys preceded by earlier NFHS surveys carried out in 1992-93 (NFHS-1) and 1998-99 (NFHS-2) with the objective to provide essential data on health and family welfare needed by the Ministry of Health and Family Welfare and other agencies for policy and programme purposes, and to provide information on important emerging health and family welfare issues. Annual Health Survey (AHS): The Ministry of Health & Family Welfare, in collaboration with the Registrar General of India (RGI), had launched an Annual Health Survey (AHS) in the erstwhile Empowered Action Group States (Bihar, Jharkhand, Madhya Pradesh, Chhattishgarh, Uttarakhand, Uttar Pradesh, Orissa and Rajasthan) and Assam. AHS will provide District-wise data on Total Fertility Rate (TFR), Infant Mortality Rate (IMR) and the Maternal Mortality Ratio (MMR) at the regional level. Other RCH indicators like Ante-natal care, Institutional delive ry, immunisation, use of contraceptives will also be available.The aim of the survey was to provide feedback on the impact of the schemes under NRHM in reduction of Total Fertility Rate (TFR), Infant Mortality Rate (IMR) at the district level and the Maternal Mortality Ratio (MMR) at the regional level by estimating these rates on an annual basis for around 284 districts in these States. The results of the first round of AHS for some of the indicators viz. Crude Birth Rate (CBR), Crude Death Rate (CDR), Infant Mortality Rate (IMR), Neo-natal Mortality Rate, Under Five Mortality Rate, Maternal Mortality Ratio (MMR), Sex Ratio at Birth (SRB), Sex Ratio (0-4 years) and Total Sex Ratio have been released by the Registrar General of India (RGI).The District-wise data in respect of the above indicators for the nine States viz. Bihar, Jharkhand, Madhya Pradesh, Chhattishgarh, Uttarakhand, Uttar Pradesh, Orissa, Rajasthan and Assam are given in Table D. 6. 0 (Section D). Comparison of State -wise AHS results and SRS: 2009, in respect of five indicators namely Crude Birth Rate (CBR), Crude Death Rate (CDR), Infant Mortality Rate (IMR), Neo-natal Mortality Rate and Maternal Mortality Ratio (MMR), Sex Ratio at Birth (SRB) reveals that they are broadly comparable (Table D. 6. 1). All 284 districts covered in the AHS (first round) have been ranked by arranging them in ascending order based on the rank of the individual indicators viz.Infant Mortality Rate (IMR), Neo-natal Mortality Rate, Under 5 Mortality Rate and Maternal Mortality Ratio (MMR) and presented in Table D. 6. 2. Tables D. 6. 3 and D. 6. 4 give details of bottom 100 districts as per the rankings and also covered under High Focus Districts identified under National Rural Health Mission, xxix The second Round of AHS (2011-12) would also cover additional parameters viz. height & weight measurement, blood test for anemia and sugar, blood pressure measurement and testing of iodine in the salt used by households thro ugh a separate questionnaire on Clinical, Anthropometric and Biochemical (CAB) test and measurements in addition to the indictors covered in AHS first round.District Level Household and Facility Survey (DLHS): The District Level Household and Facility S