The Effect Of Task Switching And Their Effects On...

This paper explores a published article that reports on results of Task Switching and Their Effects on Cognitive Processes with in an individual’s mind when asked to do something. This article addresses the shifts in between cognitive tasks, the reaction time and error time based on the task switch. This article also addresses how to decrease the chance of error by giving a chance of having an individual prepare beforehand. This paper will examine Monsell’s (2003) research in relation to how Task Switching is fully understood and what effects on the brain for the individual switching task and its cognitive process. As well as the analysis of participants which conducted this experiment and the materials that were used for this experiment.†¦show more content†¦Before reading this article I didn’t realize how much thought and change it took for a person to task switch. Based on reviewing the article by Monsell (2003), the problem he is looking to address h ow to reduce reaction time based on the control processes that reconfigure mental resources for a change of a task by requiring subjects to switch frequently among a small set of simple tasks. The cost of task switching for an individual normally leads to a higher error rate, one factor that has a big impact on error rate is the environment and how adjustable people are. Monsell (2003) states â€Å"responses take longer to initiate on a â€Å"switch trail†, than on a â€Å"non-switch† or tasks repetition trail, often by a substantial amount. The concept of the task-setting requires each individual to pay attention to, and classification of, a different element or attribute of the stimulus, or retrieval from memory or computation of a different property of the stimulus Monsell (2003). The point of task-setting examines how each individuals mind set should change based on the new task given. Task set gives an individual’s mind state to change to perform the speci fic operation based on the new task given at the change. When a task switch or task set is implemented, the individual doing the switch, mind frame goes through a state of task set reconfiguration. Monsell (2003) starts that the task-set reconfiguration (TSR) - a sort of mental â€Å"gear changing† must happen before

Connor Jackson. Integrative Medicine. 8 May 2017. Final

Connor Jackson Integrative Medicine 8 May 2017 Final Paper This class has been vital in providing me with a new perspective on different types of alternative medicine and practices. Although there were some lectures which came across to me as a bit hard to believe, such as Scott Roos’s Ayurveda lecture, in the end all of these different methods of healing and self-betterment gave me a new understanding of the importance of alternative types of medicine. And even with the rather far-fetch topics, if they ultimately have worked for people, even without scientific backing, then who are we to judge what is the right or wrong way. For the most part, my knowledge of medicine was backed mainly by the western medicine I was exposed to growing up,†¦show more content†¦From the lecture, I learned that pregnancy can be a very unique experience for different types of people and can surely be a psychological challenge. With this this new understanding, it became easy to recognize why midwives could end up being very beneficial for expecting mothers, all the way throughout the process of pregnancy. This is where I became particularly interested because besides the midwives job having the women understand the process of pregnancy, it was their job to help the women attain a certain level of peace and calm, all the way throughout the process, as they have someone that they come to trust right up until the end. Having the women in the mindset that it will be a good experience is vital in making it be so in actuality. This indirect lesson about mentality carried over nicely into one of the workshops that I chose to do, which was yoga. The practice of yoga and its results yield such a counterintuitive experience. In fact, for a long time, I have had family members, my girlfriend, and countless others rave about the benefits of the practice, but for some reason I never bought in and decided to go to a class. It felt to me like something that wouldn’t really make much difference overnight and even if it did over time, it wouldn’t be too substantial. I could not be more wrong. My girlfriend convinced me to go to a Corepower session with her, and for some reason the intense heat combined with the goal of achieving

Case Control Study Analysis Venous Thromboembolism

Questions: 1.Provide one paragraph of summary of the study youve chosen and I approved (200 words Max) in your OWN WORDS to show the reader (me) that you have understood the study and you everything about it because you read it few times.2. What is the research question? Provide the full version3. Was the study design appropriate and how else can it be done (give details of another alternative design in relation to the same objectives and study settings)?4. What are the comparison groups in this study? Were theysimilar to the cases? explain5. Are the study population representative of the general population? Explain your answer6. How were the control group selected? What do you think of that?7. What analytical strategy was used to assess results?8. What measures were used to assess the relationship between risk factor and outcome? Where these objective or subjective?9. What are the types of bias that may affect this study? Explain these specifically and in relation to the following:Study popula tion (think of the groups)Recruitment process (observation, objective or subjective, responder etc.)Measurements used andIssues related to the use of cases and control groups10. How do you think issues (Bias) in the previous question can influence the results (discuss this in details and in relation to the above)?11. Comment on external validity of the results12. How precise was the estimate of the effect or the assosciation?13. What confounders did the authors adjust for? In your opinion, couldhave there beenany other confounders in his study that could have influenced the results (i.e. the association between exposure and outcome)? Answers: 1. Venous Thromboembolism (VTE) is one of the major health issues prevalent in United States. Scientists attribute the reason behind not being able to reduce the incidence rate of the disease, to lack of known risk factors and consequently inability to identify the risk groups in the population. Heit et al. (2000), in their study aim to identify the independent risk factors related to deep vein thrombosis and pulmonary embolism (PE) and evaluate the magnitude of the individual risks as well. The authors seek to conduct this study as pervious researches on this issue did not have efficient study designs to encompass the whole spectrum of the disease. A case control study was conducted by utilising the data of Olmsted County residents from the Rochester Epidemiology Project, by applying certain selection and exclusion criteria. 625 patients of Olmsted County with first time VTE were selected as the study group and 625 patients without the condition as the control group. The authors fou nd surgegy, trauma, hospital or nursing home confinement, malignant neoplasm with or without chemotherapy, central venous catheter or pacemaker, superficial vein thrombosis and neurological disease with extreme paresis as independent risk factors. 2. The research question of the study: What are the independent risk factors associated with VTE and PE and the magnitude of the risk factors? 3. The study design followed is a case control study where the authors sample the population into diseased and non-diseased individuals from previous records and evaluate the association of VTE and PE with past exposures. Another study design that could have been utilized for the purpose of this study is a Cohort Study. In such a study disease free are sampled based on certain exposures and observed over time to identify who are affected by the disease of concern. It can measure new incidence of the disease and thus identify the risk factors based on which the samples were classified. 4. The comparison group in the study comprised of 625 Olmsted County patients who were not affected by VTE. The patients were similar in that they were sampled based on similar age, sex, calendar year and medical record number compared to that of the study group. 5. Yes the study population can be considered as representative of the general population as it was sampled using data recorded over a period of 15 years and patients were selected based on specific selection criteria of first lifetime VTE. 6. The control group was selected from the same data set, collected over the same time period, after matching for age (1 year), calendar year (1 year), sex and those with the closest medical record numbers. Hence, it can be considered that the control group efficient and eliminates the effects of time which are of pivotal importance especially for case control studies. 7. Initially several baseline characteristics were tested as risk factors. Data was collected from medical records of each patient. The baseline characteristics were analyzed based on both univariate and multivariate assumptions. More than 25 baseline characteristics were classified of being potential risk factors. 8. The assessment of baseline characteristics as being potential risk factors was done by conditional logistic regression method. The measures were objective as the data collected was recorded in the past over a period of 15 years. 9. The study may have several biases regarding different aspects. The Study and control groups selected were strictly from the Olmsted County and hence the results cannot be considered appropriate for a larger population as location related confounding factors may affect the same. No bias was found in the recruitment process as the authors avoided referral bias by selecting subjects on specific set of selection criteria which were efficient. However, attributes such as race and ethnicity were not considered that may have an influence on the incidence of the disease. The measurement used was objective as data was not collected directly from the patients and hence certain bias may prevail while recoding the data in the first place. The control groups were selected based on similar age, sex, calendar year and nearest medical record number and hence apart from the fact that other confounding factors may be present in both the groups there were no direct bias issues in the study group and the control group. 10. The results can be severely misleading if other confounding factors are present in the population that is related to the location of the study. In such cases the risk factors identified needs to be studied for prevalence discrepancies over different locations in order to extrapolate the findings beyond Olmsted County. 11. As already mentioned, as the study population was confined to a specific location, the external validity of the results cannot be evaluated efficiently. Further insight on the topic is required to estimate the application of the results over generalized population and location. 12.The estimates of the association can be considered precise as they were consistent with previous study findings and some risk factors even showed a greater association compared to previous study results. Association of the disease with hospital, nursing home or other care facility confinement was first identified in this study. 22-fold increased risk was found in patients hospitalized with a prior history of surgery, 13-fold increase for patients with trauma, 4-fold increase for patients with malignant neoplasm alone, and a 3-fold increase for patients with neurologic disorders and extremity paresis or plegia. 13. In case of confinement to hospital, nursing home or healthcare facility the authors considered the confounding factors of acuity and severity of the illness. The study was the first to identify current or recent central venous catheterization as an independent variable, which the authors considered as having the possibility of being a confounding factor for the disease. Additional confounding factors that should have been considered are environmental factors, race and ethnicity of the subjects of both the groups. References Heit, J.A., Silverstein, M.D., Mohr, D.N., Petterson, T.M., O'Fallon, W.M. and Melton, L.J., 2000. Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study.Archives of internal medicine,160(6), pp.809-815.

Intoxicated Drivers Essays - Driving Under The Influence

Intoxicated Drivers On 31 August 1997, Princess Diana died tragically in a car crash driven by a drunken chauffer. Her death was shocking on several levels. It was violent. "It sent those she had touched through her charity work into heartbroken mourning, and saddened millions more who had never met her but who had followed her troubled and sometimes troublesome life with the intimacy that modern celebrity affords". This accident would not have happened if the driver was not intoxicated by alcohol. The recent figures from Statistics Canada show that there has been a 50% reduction from 1981 to 1996 in the number of Canadians being charged with drunk driving. There is a lifelong sorrow for the relatives of the fatal victims; moreover, there are astronomical costs, and problems for repeat offenders. Drunk drivers cause more deaths, injuries, and destruction than all murderers, muggers, rapists, and robbers combined. Every six hours, someone is killed by an impaired driver. Every twenty minutes, someone somewhere in Canada becomes a victim to an impaired driver. Every year, more than 45% of all traffic fatalities involve alcohol. More than 1.700 Canadians die each year as the consequence of intoxicated drivers. Tens of millions of dollars are spent annually in court costs, rehabilitation, lost earnings, health care, and social programs all because of drinking driving accidents. This money comes directly out of the citizens' pockets in taxes and lost revenue. Transport Canada reports the minimum loss to society as a result of road accidents involving alcohol as: $390,000 per fatal accidents $310,000 per fatality $12,000 per injury accidents $3,600 per injured victim Almost 30,000 Criminal Code license suspensions were issued in 1992 for drinking driving related charges. Over one-half (59%) were repeat drinking driving offenses. Of all suspensions issued for impaired driving, 65% were issued for a second or subsequent offense. Crashes happen more often in summer than winter. Over two-thirds of the crashes occur on weekends; one quarter of all crashes happens on Saturday. More than 66% of drinking driving crashes happen between 1800hrs and 0300hrs. Every forty-five minutes in Ontario, a driver is involved in an alcohol related crash. The profiles of these perpetrators of this crime are 90% male in the 25-34 age category. People drink for many reasons. It is a way to escape from pressure and stress. Also, it is a relief from emotional and financial problems. Some people are pressured into drinking by their peers. Drinking is a social aspect. It is an accepted practice in the business world. Some solutions to reduce drinking driving problems are to lower the blood alcohol content (BAC) for the Breathalyzer test. The government can increase the suspension of licenses from a three-month period to a longer period such as one year. Repeat offenders should receive a jail sentence. Lastly, our government should strongly increase the education about alcohol abuse and the consequences of drinking and driving

La vida de la estudiante †Spanish Essay (200 Level Course)

La vida de la estudiante – Spanish Essay (200 Level Course) Free Online Research Papers La vida de la estudiante Spanish Essay (200 Level Course) Cuando me desperto en la manana yo no sà © que es el dà ­a? Es un dà ­a cuando yo voy a la trabajar o la escuela. Yo tengo seis classes porque yo no planeo mis clases bien. Yo tranajo con los abogados. Me posicià ³n es litigacion soporte. Yo escribo mucho en un dà ­a en mi trabajo. Un problemo con mi trabajo es en el fin de el dà ­a yo estoy muy cansada. Despues me trabajo yo tengo muchas horas de escuela. Me gustan buenas notas en mi clases. Yo quiero acabo la escuela en cuatro o cinco anos. Es posible solo yo tengo cinco o seis classes. No me gusta atttendar mis clases muy cansada, pero yo tengo cansada todos los dà ­as. Mis padres no contribuen a mi educacion. Es muy dificil attendo escuela y mi trabajo. Me gusta salgo con mis amigos pero ahora, yo trabajo y duermo much y no salà ­ much. Para la fin de semana yo duermo much. Me gusta duermo mucho. Es muy dificil para me a hace los amigos porque yo trabajo mucho y duermo mucho, pero cuando yo salgo yo tengo mucho divertido. Mis bien amigos son mis primos Michael y Junior. Ellos son muy susoporte de mi y mis clases. Ellos son muy importa en mi vida. Pero yo recuerdo much que estes son los dà ­as bien para me vida, y si yo no vivo con mi tà ­a yo no attendo escuela. Son las dà ­as de mi vida. Research Papers on La vida de la estudiante - Spanish Essay (200 Level Course)Comparison: Letter from Birmingham and CritoAssess the importance of Nationalism 1815-1850 EuropeStandardized TestingBionic Assembly System: A New Concept of SelfNever Been Kicked Out of a Place This NiceHarry Potter and the Deathly Hallows EssayCanaanite Influence on the Early Israelite ReligionTwilight of the UAWEffects of Television Violence on ChildrenPETSTEL analysis of India

Slave Revolts in Ancient Italy

Slave Revolts in Ancient Italy According to Barry Strauss in * prisoners of war enslaved at the end of the Second Punic War rebelled in 198 B.C. This slave uprising in central Italy is the first reliable report of one, although it was surely not the first actual slave uprising. There were other slave uprisings in the 180s. These were small; however, there were 3 major slave revolts in Italy between 140 and 70 B.C. These 3 uprisings are called the Servile Wars since the Latin for slave is servus. First Sicilian Slave Revolt One leader of the slave revolt in 135 B.C., was a freeborn slave named Eunus, who adopted a name familiar from the region of his birth- Syria. Styling himself King Antiochus, Eunus was reputed to be a magician and led the slaves of the eastern section of Sicily. His followers wielded farm implements until they could capture decent Roman weapons. At the same time, in the western part of Sicily, a slave manager or vilicus named Kleon, also credited with religious and mystical powers, gathered slave troops under him. It was only when a slow-moving Roman senate dispatched the Roman army, that it was able to end the long slave war. The Roman consul who succeeded against the slaves was Publius Rupilius. By the 1st century B.C., roughly 20% of the people in Italy were slaves- mostly agricultural and rural, according to Barry Strauss. The sources for such a large number of slaves were military conquest, slave traders, and pirates who were particularly active in the Greek-speaking Mediterranean from c. 100 B.C. Second Sicilian Slave Revolt A slave named Salvius led slaves in the east of Sicily; while Athenion led the western slaves. Strauss says a source on this revolt claims the slaves were joined in their lawlessness by impoverished freeman. Slow action on the part of Rome again permitted the movement to last four years. The Revolt of Spartacus 73-71 B.C. While Spartacus was a slave, as were the other leaders of the earlier slave revolts, he was also a gladiator, and while the revolt centered in Campania, in southern Italy, rather than Sicily, many of the slaves who joined the movement were much like the slaves of the Sicilian revolts. Most of the southern Italian and Sicilian slaves worked in the latifundia plantations as agricultural and pastoral slaves. Again, local government was inadequate to handle the revolt. Strauss says Spartacus defeated nine Roman armies before Crassus defeated him.

Etiology and Treatment of Schizophrenia Essay Example | Topics and Well Written Essays - 2750 words

Etiology and Treatment of Schizophrenia - Essay Example This essay demonstrates a discussion, that represents the symptoms of the disorder, and of its etiology and treatment. Schizophrenia is a disorder that is distinguished by a major disruption in cognition and emotion, influencing the primary areas of language, thought, perception, affect, and self-concept. The range of symptoms, while various and extensive, usually includes psychotic manifestations, such as hearing internal voices or experiencing other sensations of unconventional importance to normal events or upholding fixed false personal beliefs. There is no one single symptom that makes diagnosis conclusive; instead, such diagnosis covers a pattern or an aggregate of signs and symptoms, that concurrently occur with occupational or social malfunction. Treatment options are frequently related to the clinical phases of schizophrenia, namely the acute phase, stabilizing phase, stable phase, and recovery phase. When possible, this essay links available information to these treatment p hases. Although the Schizophrenia PORT study recommendations are based in research, it may be worth noting that treatment practices fail to comply with these recommendations. The troubling gap between knowledge and practice are attributed to the many barriers that exist in the transfer of information about treatment practice to clinicians, family members, and service users. And yet, the most effective interventions remain to be those that prove to be potent combinations of biological and behavioral treatment approaches.

The objective of this qualitative study will be to explore the Thesis

The objective of this qualitative study will be to explore the influence of socialization and ambition may have on the under-representation of women in the U.S. Congress - Thesis Example Children will also identify with the political ideologies that are supported by their parents.1 It has been proven that the children of educated parents tend to support ambitious characters. Since children at this stage tend to identify with their families, it is this support that can inspire a female child to harbor dreams of being an achiever in later life. In addition, parents from higher socioeconomic settings are usually more concerned with political developments. They also expose their children to political systems and encourage them to develop opinions about various political aspects. The daughters of parents who dynamically speak about politics with their offspring tend to be more assertive in stating their views about various political functions. Family discussion patterns that include parents cheering their children when they express their personal political opinions are frequently better oriented toward participation in public affairs. Conversely, there are parents that do not encourage their children to develop political and other views that are in any way different from their own. These parents emphasize on the significance of being respectful and promoting social harmony by maintaining that their children have to avoid any deep arguments or give in immediately they sense that the person they are arguing with is unfriendly. Daughters from such families are usually more likely to embrace traditional roles that call for them to be accepting of other’s opinion. Daughters from socio-oriented family units are usually less critical of facts, and experience few arguments in the home. Such realities encourage them, from a young age, to value social harmony over exploring new fields which may bring considerable challenges and conflicts.2 Moreover, the daughters from families that support open communication and the development of distinctive ideas are encouraged to be more daring and to engage in critical thinking and

Cloud Computing Essay Example for Free

Cloud Computing Essay * Integrated development environment as a service (IDEaaS) In the business model using software as a service, users are provided access to application software and databases. The cloud providers manage the infrastructure and platforms on which the applications run. SaaS is sometimes referred to as â€Å"on-demand software† and is usually priced on a pay-per-use basis. SaaS providers generally price applications using a subscription fee. Proponents claim that the SaaS allows a business the potential to reduce IT operational costs by outsourcing hardware and software maintenance and support to the cloud provider. This enables the business to reallocate IT operations costs away from hardware/software spending and personnel expenses, towards meeting other IT goals. In addition, with applications hosted centrally, updates can be released without the need for users to install new software. One drawback of SaaS is that the users data are stored on the cloud provider’s server. As a result, there could be unauthorized access to the data. End users access cloud-based applications through a web browser or a light-weight desktop or mobile app while the business software and users data are stored on servers at a remote location. Proponents claim that cloud computing allows enterprises to get their applications up and running faster, with improved manageability and less maintenance, and enables IT to more rapidly adjust resources to meet fluctuating and unpredictable business demand.[2][3] Cloud computing relies on sharing of resources to achieve coherence and economies of scale similar to a utility (like the electricity grid) over a network.[4] | This article may contain original research. Please improve it by verifying the claims made and adding references. Statements consisting only of original research may be removed. (January 2013)| The origin of the term cloud computing is obscure, but it appears to derive from the practice of using drawings of stylized clouds to denote networks in diagrams of computing and communications systems. The word cloud is used as a metaphor for the Internet, based on the standardized use of a cloud-like shape to denote a network on telephony schematics and later to depict the Internet in computer network diagrams as an abstraction of the underlying infrastructure it represents. The cloud symbol was used to represent the Internet as early as 1994.[5][6] The underlying concept of cloud computing dates back to the 1950s, when large-scale mainframe became available in academia and corporations, accessible via thin clients / terminalcomputers. Because it was costly to buy a mainframe, it became im portant to find ways to get the greatest return on the investment in them, allowing multiple users to share both the physical access to the computer from multiple terminals as well as to share the CPU time, eliminating periods of inactivity, which became known in the industry as time-sharing.[7] In the 1990s, telecommunications companies, who previously offered primarily dedicated point-to-point data circuits, began offering virtual private network (VPN) services with comparable quality of service but at a much lower cost. By switching traffic to balance utilization as they saw fit, they were able to utilize their overall network bandwidth more effectively. The cloud symbol was used to denote the demarcation point between that which was the responsibility of the provider and that which was the responsibility of the users. Cloud computing extends this boundary to cover servers as well as the network infrastructure.[8] As computers became more prevalent, scientists and technologists explored ways to make large-scale computing power available to more users through time sharing, experimenting with algorithms to provide the optimal use of the infrastructure, platform and applications with prioritized access to the CPU and efficiency for the end users.[9] John McCarthy opined in t he 1960s that computation may someday be organized as a public utility. Almost all the modern-day characteristics of cloud computing (elastic provision, provided as a utility, online, illusion of infinite supply), the comparison to the electricity industry and the use of public, private, government, and community forms, were thoroughly explored in Douglas Parkhills 1966 book, The Challenge of the Computer Utility. Other scholars have shown that cloud computings roots go all the way back to the 1950s when scientist Herb Grosch (the author of Groschs law) postulated that the entire world would operate on dumb terminals powered by about 15 large data centers.[10] Due to the expense of these powerful computers, many corporations and other entities could avail themselves of computing capability through time sharing and several organizations, such as GEs GEISCO, IBM subsidiary The Service Bureau Corporation (SBC, founded in 1957), Tymshare (founded in 1966), National CSS (founded in 1967 and bought by Dun Bradstreet in 1979), Dial Data (bought by Tymshare in 1968), and Bolt, Beranek and Newman (BBN) marketed time sharing as a commercial venture. The development of the Internet from being document centric via semantic data towards more and more services was described as Dynamic Web.[11] This contribution focused in particular in the need for better meta-data able to describe not only implementation details but also conceptual details of model-based applications. The ubiquitous availability of high-capacity networks, low-cost computers and storage devices as well as the widespread adoption of hardware virtualization, service-oriented architecture,autonomic, and utility computing have led to a tremendous growth in cloud computing.[12][13][14] After the dot-com bubble, Amazon played a key role in the development of cloud computing by modernizing their data centers, which, like most computer networks, were using as little as 10% of their capacity at any one time, just to leave room for occasional spikes. Having found that the new cloud architecture resulted in significant internal efficiency improvements whereby small, fast-moving two-pizza teams (teams small enough to be fed with two pizzas) could add new features faster and more easily, Amazon initiated a new product development effort to provide cloud computing to external customers, and launched Amazon Web Service (AWS) on a utility computing basis in 2006.[15][16] In early 2008, Eucalyptus became the first open-source, AWS API-compatible platform for deploying private clouds. In early 2008, OpenNebula, enhanced in the RESERVOIR European Commission-funded project, became the first open-source software for deploying private and hybrid clouds, and for the federation of clouds.[17] In the same year, efforts were focused on providing quality of service guarantees (as required by real-time interactive applications) to cloud-based infrastructures, in the framework of the IRMOS European Commission-funded project, resulting to a real-time cloud environment.[18] By mid-2008, Gartner saw an opportunity for cloud computing to shape the relationship among consumers of IT services, those who use IT services and those who sell them[19] and observed that organizations are switching from company-owned hardware and software assets to per-use service-based models so that the projected shift to computing will result in dramatic growth in IT products in some areas and significant reductions in other areas.[20] On March 1, 2011, IBM announced the Smarter Computing framework to support Smarter Planet.[21] Among the various components of the Smarter Computing foundation, cloud computing is a critical piece. [edit] Similar systems and concepts Cloud computing shares characteristics with: * Autonomic computing — Computer systems capable of self-management.[22] * Client–server model — Client–server computing refers broadly to any distributed application that distinguishes between service providers (servers) and service requesters (clients).[23] * Grid computing — A form of distributed and parallel computing, whereby a super and virtual computer is composed of a cluster of networked, loosely coupled computers acting in concert to perform very large tasks. * Mainframe computer — Powerful computers used mainly by large organizations for critical applications, typically bulk data processing such as census, industry and consumer statistics, police and secret intelligence services, enterprise resource planning, and financial transaction processing.[24] * Utility computing — The packaging of computing resources, such as computation and storage, as a metered service similar to a traditional public utility, such as electricity.[25][26] * Peer-to-peer — Distributed architecture without the need for central coordination, with participants being at the same time both suppliers and consumers of resources (in contrast to the traditional client–server model). * Cloud gaming Also known as on-demand gaming, this is a way of delivering games to computers. The gaming data will be stored in the providers server, so that gaming will be independent of client computers used to play the game. [edit] Characteristics Cloud computing exhibits the following key characteristics: * Agility improves with users ability to re-provision technological infrastructure resources. * Application programming interface (API) accessibility to software that enables machines to interact with cloud software in the same way the user interface facilitates interaction between humans and computers. Cloud computing systems typically use REST-based APIs. * Cost is claimed to be reduced and in a public cloud delivery model capital expenditure is converted to operational expenditure.[27] This is purported to lower barriers to entry, as infrastructure is typically provided by a third-party and does not need to be purchased for one-time or infrequent intensive computing tasks. Pricing on a utility computing basis is fine-grained with usage-based options and fewer IT skills are required for implementation (in-house).[28] The e-FISCAL projects state of the art repository[29] contains several articles looking into cost aspects in more detail, most of them concluding that costs savings de pend on the type of activities supported and the type of infrastructure available in-house. * Device and location independence[30] enable users to access systems using a web browser regardless of their location or what device they are using (e.g., PC, mobile phone). As infrastructure is off-site (typically provided by a third-party) and accessed via the Internet, users can connect from anywhere.[28] * Virtualization technology allows servers and storage devices to be shared and utilization be increased. Applications can be easily migrated from one physical server to another. * Multitenancy enables sharing of resources and costs across a large pool of users thus allowing for: * Centralization of infrastructure in locations with lower costs (such as real estate, electricity, etc.) * Peak-load capacity increases (users need not engineer for highest possible load-levels) * Utilisation and efficiency improvements for systems that are often only 10–20% utilised.[15] * Reliability is improved if multiple redundant sites are used, which makes well-designed cloud computing su itable for business continuity and disaster recovery.[31] * Scalability and elasticity via dynamic (on-demand) provisioning of resources on a fine-grained, self-service basis near real-time,[32] without users having to engineer for peak loads.[33][34] * Performance is monitored, and consistent and loosely coupled architectures are constructed using web services as the system interface.[28] * Security could improve due to centralization of data, increased security-focused resources, etc., but concerns can persist about loss of control over certain sensitive data, and the lack of security for stored kernels.[35] Security is often as good as or better than other traditional systems, in part because providers are able to devote resources to solving security issues that many customers cannot afford.[36] However, the complexity of security is greatly increased when data is distributed over a wider area or greater number of devices and in multi-tenant systems that are being shared by unrelated users. In addition, user access to security audit logs may be difficult or impossible. Private cloud installations are in part motivated by users desire to retain control over the infrastructure and avoid losing control of information security. * Maintenance of cloud computing applications is easier, because they do not need to be installed on each users computer and can be accessed from different places. The National Institute of Standards and Technologys definition of cloud computing identifies five essential characteristics: On-demand self-service. A consumer can unilaterally provision computing capabilities, such as server time and network storage, as needed automatically without requiring human interaction with each service provider. Broad network access. Capabilities are available over the network and accessed through standard mechanisms that promote use by heterogeneous thin or thick client platforms (e.g., mobile phones, tablets, laptops, and workstations). Resource pooling. The provider’s computing resources are pooled to serve multiple consumers using a multi-tenant model, with different physical and virtual resources dynamically assigned and reassigned according to consumer demand. Rapid elasticity. Capabilities can be elastically provisioned and released, in some cases automatically, to scale rapidly outward and inward commensurate with demand. To the consumer, the capabilities available for provisioning often appear to be unlimited and can be appropriated in any quantity at any time. Measured service. Cloud systems automatically control and optimize resource use by leveraging a metering capability at some level of abstraction appropriate to the type of service (e.g., storage, processing, bandwidth, and active user accounts). Resource usage can be monitored, controlled, and reported, providing transparency for both the provider and consumer of the utilized service. —National Institute of Standards and Technology[4] On-demand self-service See also: Self-service provisioning for cloud computing services and Service catalogs for cloud computing services On-demand self-service allows users to obtain, configure and deploy cloud services themselves using cloud service catalogues, without requiring the assistance of IT.[37][38] This feature is listed by the National Institute of Standards and Technology (NIST) as a characteristic of cloud computing.[4] The self-service requirement of cloud computing prompts infrastructure vendors to create cloud computing templates, which are obtained from cloud service catalogues. Manufacturers of such templates or blueprints include Hewlett-Packard (HP), which names its templates as HP Cloud Maps[39] RightScale[40] and Red Hat, which names its templates CloudForms.[41] The templates contain predefined configurations used by consumers to set up cloud services. The templates or blueprints provide the technical information necessary to build ready-to-use clouds.[40] Each template includes specific configuration details for different cloud infrastructures, with information about servers for specific tasks such as hosting applications, databases, websites and so on.[40] The templates also include predefined Web service, the operating system, the database, security configurations and load balancing.[41] Cloud consumers use cloud templates to move applications between clouds through a self-service portal. The predefined blueprints define all that an application requires to run in different environments. For example, a template could define how the same application could be deployed in cloud platforms based on Amazon Web Service, VMware or Red Hat.[42] The user organization benefits from cloud templates because the technical aspects of cloud configurations reside in the templates, letting users to deploy cloud services with a push of a button.[43][44] Cloud templates can also be used by developers to create a catalog of cloud services.[45] [edit] Ser vice models Cloud computing providers offer their services according to three fundamental models:[4][46] infrastructure as a service (IaaS), platform as a service (PaaS), and software as a service (SaaS) where IaaS is the most basic and each higher model abstracts from the details of the lower models. In 2012 network as a service (NaaS) and communication as a service (CaaS) were officially included by ITU (International Telecommunication Union) as part of the basic cloud computing models, recognized service categories of a telecommunication-centric cloud ecosystem.[47] Infrastructure as a service (IaaS) See also: Category:Cloud infrastructure In the most basic cloud-service model, providers of IaaS offer computers physical or (more often) virtual machines and other resources. (A hypervisor, such as Xen or KVM, runs the virtual machines as guests.) Pools of hypervisors within the cloud operational support-system can support large numbers of virtual machines and the ability to scale services up and down according to customers varying requirements. IaaS clouds often offer additional resources such as images in a virtual-machine image-library, raw (block) and file-based storage, firewalls, load balancers, IP addresses, virtual local area networks (VLANs), and software bundles.[48] IaaS-cloud providers supply these resources on-demand from their large pools installed indata centers. For wide-area connectivity, customers can use either the Internet or carrier clouds (dedicated virtual private networks). To deploy their applications, cloud users install operating-system images and their application software on the cloud infrastructure. In this model, the cloud user patches and maintains the operating systems and the application software. Cloud providers typically bill IaaS services on a utility computing basis: cost reflects the amount of resources allocated and consumed. Examples of IaaS providers include Amazon CloudFormation, Amazon EC2, Windows Azure Virtual Machines, DynDNS, Google Compute Engine, HP Cloud, iland, Joyent,Rackspace Cloud, ReadySpace Cloud Services, and Terremark. [edit] Platform as a service (PaaS)

The Cantebury Tales was Geoffrey Chaucers Satire Towards the Catholic

Geoffrey Chaucer expresses his disillusionment with the Catholic Church, during the Medieval Era, through satire when he wrote, The Canterbury Tales. The Medieval Era was a time when the Catholic Church governed England and was extremely wealthy. Expensive Cathedrals and shrines to saints' relics were built at a time when the country was suffering from famine, scarce labor, disease and the Bubonic Plague, which was the cause of death to a third of Europe's population and contributed to the rise of the middle class. It seemed hypocritical to the people when the church preached against the sin of greed when the church was built and dressed so lavishly. There were rumors of corrupt Popes, church clerical and priest ignoring their vows of poverty and celibacy. They ignored the Canon law, which is an ecclesiastical law that governs the Roman Catholic Church. This triggered Chaucer to satirize the corruption through his use of comedic, pleasant ridicule of human vices with his characters, the Pardoner, the Monk, the Prioress, the Summoner and the Friar. He incorporates the seven deadly sins in his stories, which are pride, envy, sloth, gluttony, avarice, lechery and wrath to explain the fall of man with his religion. The Canterbury Tales is recognized as the first book written in English and this paved the way for other writers such as Shakespeare. With his collection of stories written in English it gave the non wealthy an opportunity to enjoy his literature, because before Chaucer only the wealthy had the education to read stories that were written in other languages, such as French. The Canterbury Tales is written about a group of pilgrims wh... ... preached what God would desire of man and that there are many ways to heaven as part of his tale to the other pilgrims. The second part of the tale is about asking for forgiveness for one?s sins. He went on explaining the seven deadly sins to the other pilgrims. Chaucer sent an intelligent, virtuous churchman on the journey to Canterbury as an example to the other pilgrims and an opportunity for them to seek redemption. Geoffrey Chaucer created ironies between the church clergy's characterizations and their duties to express the corruption and the decline of the Catholic Church in England. Most of the English clergy did not live up to the expectations of the congregation. The Church was so full of hypocrisy that this left the congregation feeling disillusioned with their church leaders and paved the rise of Protestantism.

Abstract of Investment Analysis

Investment Analysis is a classical application in Long-Range Planning. It deals with the investigation of uncertainties, the evaluation of alternatives, the answer to â€Å"What-if† questions. The study of how an investment is likely to perform and how suitable it is for a given investor. Investment analysis is key to any sound portfolio-management strategy. Investors not comfortable doing their own investment analysis can seek professional advice from a financial advisor. An analysis of past investment decisions. An investment analysis is a look back at previous investment decisions and the thought process of making the investment decision. Key factors should include entry price, expected time horizon, and reasons for making the decision at the time. For example, in conducting an investment analysis of a mutual fund, the investor would look at factors such as how the fund has performed compared to its benchmark. The investor could also compare performed to similar funds, its expense ratio, management stability, sector weighting, style and asset allocation. Investment goals should always be considered when analyzing an investment; one size does not always fit all, and highest returns regardless of risk are not always the goal. For any beginner investor, investment analysis is essential. Looking back at past decisions and analyzing the mistakes and successes will help fine-tune strategies. Many investors don't even document why they made an investment let alone analyze why they were wrong or right. You could make a proper decision, extraordinary events could lose you money, and if you didn't analyze it, you would shy away from making the same decision. Finally to conclude I made measurement for interpretation and better solution, which may helps the company performance.

An Inspector Calls

Though the girl subject to this as they find out ay not have actually died, this changes some Of the group's views which results in a family backlash. However, if Eva Smith, Daisy Rent and the girl who came to the Brimley women's council were all the same girl, and she subsequently died because of their actions, which character was the least responsible for her death? The first person to experience the effortless wrath of the inspector is Mr. Bribing, who is easily recognizable as the most stubborn of the lot.Instantly he tries to intimidate the inspector by rather cockily stating his past and present positions such as his time as Lord Mayor as well as his continued place on the Bench. Unlike many people Mr. Geol. stays calm and even emerges as the most dominate figure in the room almost immediately with ease. After Bribing notices this he begins to show a bit more intolerance or ‘impatience' as it says in the stage directions. Mr. Burbling part in the death is effectively star ting off a chain reaction.Eva was a worker in his factory at a time when the lower class were beginning to speak out about the cruelties of their lives and their work. The suffragettes were a growing voice since 1903 when they were formed. Trade unions were growing increasingly large with strikes happening thick and fast, with two years before being ebbed as ‘the great unrest'. Thus when the girl came asking for a couple shillings more a week she was instantly rejected along. After ‘a week or two' on strike all the workers on strike were allowed to return apart from a few ringleaders, of course one of these was Miss Smith.I believe this makes him one of the least responsible as he followed the general course of action that almost every other factory owner would have at that time. Although many people would still highlight and abhor his complete lack of remorse he consistently shows throughout the play, showing no consideration to anyone rower down the ladder of class. Th is is proven almost every time he opens his mouth; statements such as ‘a man has to look after himself' and ‘I still can't accept any responsibility, with the latter coming just after he found out his part in it all. Even though it used to be him near the bottom.The next victim of the inspector is the sweet Sheila Bribing. As she only entered the room as Geol. was moving away from Brisling's time in the spotlight she only learned little of the detail that had actually been disclosed. But still she showed great sorrow towards the tragedy. This builds up an image of Sheila that allows the audience to be much more forgiving when her role comes to light. When Mr. Geol. carries on his story telling we find out that Eva very fortunately takes advantage of the spreading influenza to grab a job at a high up the market clothes shop, Milliards.With secrecy he shows Sheila the photo of her and instantly its effect is evident, causing her to give ‘a half stifled sob' and scatt er out of the room. Her father while he may feel her actions are immature, takes this opportunity to have a much wanted dig at the informant. Once again attempting to make him feel uncomfortable and under pressure, this like before is unsuccessful. When Sheila re-enters the room it is explained that how she caused the girl to lose her job in a very UN-necessary manner. Wink very few people would see this as terrible and unforgiving, whereas most, like myself, would view this as provoked bad luck. Meaning we understand her errors but also believe the timing overlooks that. This is because as she puts it she was already in a ‘furious temper beforehand and adding to this it's never pleasing to be proven wrong (especially by your mother). So Eva unluckily faced the brunt of Sheila's own immaturity and momentary selfishness by eyeing fired, leading her to go in search of a new life.Thirdly is Gerald. Though his part is much different to the rest as he didn't affect her life for the worst. The inspector tells us how becoming Daisy Rent is Eve's fresh start, but when hearing this name Gerald is clearly shocked. So much so that his fiancee begins quizzing him on her before he's even admitted to anything. With only a visual answer she finds out how last summer when Mr. Croft was apparently too busy (with work) to spend much time with her, was actually a cover-up.Consequently turning Gerald from charming fiance to the audience's villain. That nickname, however, does not last long. His actions towards her prove he has a lot more respect for the opposite sex then many people of his grade. More evidence is he tells us how it wasn't intentional for her to end up his mistress nonetheless he did gracefully accept that it was inevitable. Most likely because she was young, ‘pretty' and ‘warm-hearted'. Soon his friend was returning home and it had to end, but this time she left in a better place.Even though he was having an affair which enforces that he can't r espect women to a huge extent, it is still clear he did only have good intentions in his heart. Taking this into consideration I still think this makes him the least responsible as he did actually re-instate happiness into her increasingly torrid life. Next in the play but last in the real time events IS Mrs. Bribing. Ever since her introduction to the conversation (and often argument) she has been closed-mined like her husband but this completely opposite to their children.This is much in line with the common perception of the older ages and the younger ages. The older one being how they are Often stubborn, especially if they have been caught out or proven wrong, causing them to effuse themselves the ability to learn from they're mistakes. Whereas Sheila and Eric accept and even exaggerate their responsibility which makes them the subject of patronizing from their parents, such as being told numerous times to ‘keep quiet' and referring Sheila's behavior as ‘like an hyst erical child'.Mrs. Burbling faults were perhaps the most influential as she turned the UN-named girl away at by far the most important time. Eva pretending her name was Mrs. Bribing almost confirmed her fate. As older women of the time's tendency to hold grudges was Omni-present here. The real Mrs. Bribing scribed this as ‘a piece of gross impertinence', impertinence being possibly Sibyl's favorite word to describe people she believes to be beneath her (which is almost everyone).This altogether gives no opportunity for anyone to speak positively about her in any manner. Sybil constantly adds to her already very pessimistic persona by egocentric comments throughout the play. After being proven guilty she comes out with ‘l accept no blame at all', deliberately evading the truth like she continues to do for the rest of the play. She tries to make herself seem more innocent than everyone else – but in fact everything he says is based on her desire to avoid anything wh ich is ‘offensive' to her social sensibility.Her twisted morals and her missing compunction which led to an innocent girl's death makes me believe she is more responsible for Eve's death. Lastly Eric who is not all the man his parents believe him to be. As for 2 years he has been ‘steadily drinking' unbeknown to his parents. Throughout the play he is shown as a weak, foolish, and thoughtless youth with his part in the loss of life coming down to character-flaws. Though at least it is clear he genuinely grief-stricken with the death as when he finds out his mother laded a huge role in the death he almost breaks down.Partly because it was the death of her own grandchild and partly because he is mortified by the fact she could have made a difference but chose not to. With Eric you can so nearly synthesis but his lack of responsibility ruins that. For example when he admits to stealing money to support Eva you can acknowledge the attempted act of kindness but then you have t o condemn the cowardly way in which it was carried out. Regardless of this Rise penitence is to be respected, also his errors were not out of wickedness, but from his own attributes. An Inspector Calls Though the girl subject to this as they find out ay not have actually died, this changes some Of the group's views which results in a family backlash. However, if Eva Smith, Daisy Rent and the girl who came to the Brimley women's council were all the same girl, and she subsequently died because of their actions, which character was the least responsible for her death? The first person to experience the effortless wrath of the inspector is Mr. Bribing, who is easily recognizable as the most stubborn of the lot.Instantly he tries to intimidate the inspector by rather cockily stating his past and present positions such as his time as Lord Mayor as well as his continued place on the Bench. Unlike many people Mr. Geol. stays calm and even emerges as the most dominate figure in the room almost immediately with ease. After Bribing notices this he begins to show a bit more intolerance or ‘impatience' as it says in the stage directions. Mr. Burbling part in the death is effectively star ting off a chain reaction.Eva was a worker in his factory at a time when the lower class were beginning to speak out about the cruelties of their lives and their work. The suffragettes were a growing voice since 1903 when they were formed. Trade unions were growing increasingly large with strikes happening thick and fast, with two years before being ebbed as ‘the great unrest'. Thus when the girl came asking for a couple shillings more a week she was instantly rejected along. After ‘a week or two' on strike all the workers on strike were allowed to return apart from a few ringleaders, of course one of these was Miss Smith.I believe this makes him one of the least responsible as he followed the general course of action that almost every other factory owner would have at that time. Although many people would still highlight and abhor his complete lack of remorse he consistently shows throughout the play, showing no consideration to anyone rower down the ladder of class. Th is is proven almost every time he opens his mouth; statements such as ‘a man has to look after himself' and ‘I still can't accept any responsibility, with the latter coming just after he found out his part in it all. Even though it used to be him near the bottom.The next victim of the inspector is the sweet Sheila Bribing. As she only entered the room as Geol. was moving away from Brisling's time in the spotlight she only learned little of the detail that had actually been disclosed. But still she showed great sorrow towards the tragedy. This builds up an image of Sheila that allows the audience to be much more forgiving when her role comes to light. When Mr. Geol. carries on his story telling we find out that Eva very fortunately takes advantage of the spreading influenza to grab a job at a high up the market clothes shop, Milliards.With secrecy he shows Sheila the photo of her and instantly its effect is evident, causing her to give ‘a half stifled sob' and scatt er out of the room. Her father while he may feel her actions are immature, takes this opportunity to have a much wanted dig at the informant. Once again attempting to make him feel uncomfortable and under pressure, this like before is unsuccessful. When Sheila re-enters the room it is explained that how she caused the girl to lose her job in a very UN-necessary manner. Wink very few people would see this as terrible and unforgiving, whereas most, like myself, would view this as provoked bad luck. Meaning we understand her errors but also believe the timing overlooks that. This is because as she puts it she was already in a ‘furious temper beforehand and adding to this it's never pleasing to be proven wrong (especially by your mother). So Eva unluckily faced the brunt of Sheila's own immaturity and momentary selfishness by eyeing fired, leading her to go in search of a new life.Thirdly is Gerald. Though his part is much different to the rest as he didn't affect her life for the worst. The inspector tells us how becoming Daisy Rent is Eve's fresh start, but when hearing this name Gerald is clearly shocked. So much so that his fiancee begins quizzing him on her before he's even admitted to anything. With only a visual answer she finds out how last summer when Mr. Croft was apparently too busy (with work) to spend much time with her, was actually a cover-up.Consequently turning Gerald from charming fiance to the audience's villain. That nickname, however, does not last long. His actions towards her prove he has a lot more respect for the opposite sex then many people of his grade. More evidence is he tells us how it wasn't intentional for her to end up his mistress nonetheless he did gracefully accept that it was inevitable. Most likely because she was young, ‘pretty' and ‘warm-hearted'. Soon his friend was returning home and it had to end, but this time she left in a better place.Even though he was having an affair which enforces that he can't r espect women to a huge extent, it is still clear he did only have good intentions in his heart. Taking this into consideration I still think this makes him the least responsible as he did actually re-instate happiness into her increasingly torrid life. Next in the play but last in the real time events IS Mrs. Bribing. Ever since her introduction to the conversation (and often argument) she has been closed-mined like her husband but this completely opposite to their children.This is much in line with the common perception of the older ages and the younger ages. The older one being how they are Often stubborn, especially if they have been caught out or proven wrong, causing them to effuse themselves the ability to learn from they're mistakes. Whereas Sheila and Eric accept and even exaggerate their responsibility which makes them the subject of patronizing from their parents, such as being told numerous times to ‘keep quiet' and referring Sheila's behavior as ‘like an hyst erical child'.Mrs. Burbling faults were perhaps the most influential as she turned the UN-named girl away at by far the most important time. Eva pretending her name was Mrs. Bribing almost confirmed her fate. As older women of the time's tendency to hold grudges was Omni-present here. The real Mrs. Bribing scribed this as ‘a piece of gross impertinence', impertinence being possibly Sibyl's favorite word to describe people she believes to be beneath her (which is almost everyone).This altogether gives no opportunity for anyone to speak positively about her in any manner. Sybil constantly adds to her already very pessimistic persona by egocentric comments throughout the play. After being proven guilty she comes out with ‘l accept no blame at all', deliberately evading the truth like she continues to do for the rest of the play. She tries to make herself seem more innocent than everyone else – but in fact everything he says is based on her desire to avoid anything wh ich is ‘offensive' to her social sensibility.Her twisted morals and her missing compunction which led to an innocent girl's death makes me believe she is more responsible for Eve's death. Lastly Eric who is not all the man his parents believe him to be. As for 2 years he has been ‘steadily drinking' unbeknown to his parents. Throughout the play he is shown as a weak, foolish, and thoughtless youth with his part in the loss of life coming down to character-flaws. Though at least it is clear he genuinely grief-stricken with the death as when he finds out his mother laded a huge role in the death he almost breaks down.Partly because it was the death of her own grandchild and partly because he is mortified by the fact she could have made a difference but chose not to. With Eric you can so nearly synthesis but his lack of responsibility ruins that. For example when he admits to stealing money to support Eva you can acknowledge the attempted act of kindness but then you have t o condemn the cowardly way in which it was carried out. Regardless of this Rise penitence is to be respected, also his errors were not out of wickedness, but from his own attributes.

Free Essays on Altruism And Nursing

Altruism and Nursing In the earlier days, nursing was not a profession, but rather an altruistic behavior of any man or woman caring for, or nurturing, another individual (Carruthers, 1997, 1). How can a nurse show more altruism in his or her daily life? Deborah Adelman, from Illinois, shows altruism by taking time from her job as a nursing professor to use her disaster nursing skills to help the victims of the September eleventh attacks (Trossman, S., 2002, 3). Another example that shows heart of an altruistic nurse is Melissa Sapp. She was interviewed at the LSU hospital in Shreveport and explained how many patients come to her because she goes the extra mile to help the needs that may not be required in a hospital. She will take her lunch break to sit and listen to their problems or take her break time to walk with them (Sapp, M. 2002). According to the Random House Webster’s College Dictionary, altruism is defined as the principle or practice of unselfish concern for the welfare of others at s ome cost for that first individual (Costello, 1991). An altruistic nurse may take no further education as an egoistic, or selfish nurse would. As stated in the Nursing Microsoft Encarta Online Encyclopedia, as of 1965 the American Nurses’ Association (ANA) proposed nursing as a higher learning level. Two levels of the practice of nurses should either be professional or technical (Carruthers, 1993, 2). Also, the Online Encyclopedia shows decreased altruism in the hospitals as these degrees were required. Modern day nursing requires for the technical practice of nurses to be a Licensed Practical Nurse (LPN). This requires an Associate Degree in Nursing (ADN) and passing the NCLEX-PN. The Registered Nurse (RN) requires having a Bachelor of Science in Nursing (BSN) and passing the NCLEX-RN (Carruthers, 1993, 2). Marilyn McMahon from Mississippi believes that altruism in nursing comes with age. She says in nurseweek.com that â€Å"older... Free Essays on Altruism And Nursing Free Essays on Altruism And Nursing Altruism and Nursing In the earlier days, nursing was not a profession, but rather an altruistic behavior of any man or woman caring for, or nurturing, another individual (Carruthers, 1997, 1). How can a nurse show more altruism in his or her daily life? Deborah Adelman, from Illinois, shows altruism by taking time from her job as a nursing professor to use her disaster nursing skills to help the victims of the September eleventh attacks (Trossman, S., 2002, 3). Another example that shows heart of an altruistic nurse is Melissa Sapp. She was interviewed at the LSU hospital in Shreveport and explained how many patients come to her because she goes the extra mile to help the needs that may not be required in a hospital. She will take her lunch break to sit and listen to their problems or take her break time to walk with them (Sapp, M. 2002). According to the Random House Webster’s College Dictionary, altruism is defined as the principle or practice of unselfish concern for the welfare of others at s ome cost for that first individual (Costello, 1991). An altruistic nurse may take no further education as an egoistic, or selfish nurse would. As stated in the Nursing Microsoft Encarta Online Encyclopedia, as of 1965 the American Nurses’ Association (ANA) proposed nursing as a higher learning level. Two levels of the practice of nurses should either be professional or technical (Carruthers, 1993, 2). Also, the Online Encyclopedia shows decreased altruism in the hospitals as these degrees were required. Modern day nursing requires for the technical practice of nurses to be a Licensed Practical Nurse (LPN). This requires an Associate Degree in Nursing (ADN) and passing the NCLEX-PN. The Registered Nurse (RN) requires having a Bachelor of Science in Nursing (BSN) and passing the NCLEX-RN (Carruthers, 1993, 2). Marilyn McMahon from Mississippi believes that altruism in nursing comes with age. She says in nurseweek.com that â€Å"older...

Hillary Clinton Quotes on Politics, Women, Life

Hillary Clinton Quotes on Politics, Women, Life Attorney Hillary Rodham Clinton was born in Chicago and educated at Vassar College and Yale Law School. She served in 1974 as counsel on the staff of the House Judiciary Committee which was considering impeachment of then-President Richard Nixon for his behavior during the Watergate scandal. She married William Jefferson Clinton. She used her name Hillary Rodham through Clintons first term as governor of Arkansas, then changed it to Hillary Rodham Clinton when he ran for reelection. She was First Lady during Bill Clintons presidency (1993-2001). Hillary Clinton managed the failed effort to seriously reform health care, she was the target of investigators and rumors for her involvement in the Whitewater scandal, and she defended and stood by her husband when he was accused and impeached during the Monica Lewinsky scandal. Near the end of her husbands term as President, Hillary Clinton was elected to the Senate from New York, taking office in 2001 and winning reelection in 2006. She unsuccessfully ran for the Democratic presidential nomination in 2008, and when her strongest primary opponent, Barack Obama, won the general election, Hillary Clinton was appointed Secretary of State in 2009, serving until 2013. In 2015, she announced her candidacy once again for the Democratic presidential nomination, which she won in 2016. She lost in the November election, winning the popular vote by 3 million but losing the Electoral College vote. Select Hillary Rodham Clinton Quotations There cannot be true democracy unless womens voices are heard. There cannot be true democracy unless women are given the opportunity to take responsibility for their own lives. There cannot be true democracy unless all citizens are able to participate fully in the lives of their country. We all owe so much to those who came before and tonight belongs to all of you.  [July 11, 1997]  Tonights victory is not about one person. It belongs to generations of women and men who struggled and sacrificed and made this moment possible.  [June 7, 2016]People can judge me for what Ive done. And I think when somebodys out in the public eye, thats what they do. So Im fully comfortable with who I am, what I stand for, and what Ive always stood for.I suppose I could have stayed home and baked cookies and had teas, but what I decided to do was to fulfill my profession which I entered before my husband was in public life.If I want to knock a story off the front page, I just change my hairstyle. The challenges of change are always hard. It is important that we begin to unpack those challenges that confront this nation and realize that we each have a role that requires us to change and become more responsible for shaping our own future.The challenge now is to practice politics as the art of making what appears to be impossible, possible.If I want to knock a story off the front page, I just change my hairstyle.The failure was principally political and policy driven, there were many interests that werent at all happy about losing their financial stake in a way that the system currently operates, but I think I became a lightning rod for some of that criticism. [about her role, as First Lady, in attempting to win reforms in health care coverage]In the Bible, it says they asked Jesus how many times you should forgive, and he said 70 times 7. Well, I want you all to know that Im keeping a chart.I have gone from a Barry Goldwater Republican to a New Democrat, but I think my underlyi ng values have remained pretty constant; individual responsibility and community. I do not see those as being mutually inconsistent. Im not some Tammy Wynette standing by my man.I have met thousands and thousands of pro-choice men and women. I have never met anyone who is pro-abortion. Being pro-choice is not being pro-abortion. Being pro-choice is trusting the individual to make the right decision for herself and her family, and not entrusting that decision to anyone wearing the authority of government in any regard.You cannot have maternal health without reproductive health. And reproductive health includes contraception and family planning and access to legal, safe abortion.When does life start? When does it end? Who makes these decisions?... Every day, in hospitals and homes and hospices... people are struggling with those profound issues.Eleanor Roosevelt understood that every one of us every day has choices to make about the kind of person we are and what we wish to become. You can decide to be someone who brings people together, or you can fall prey to those who wish to divide us. You can be someone who edu cates yourself, or you can believe that being negative is clever and being cynical is fashionable. You have a choice. When I am talking about It Takes a Village, Im obviously not talking just about or even primarily about geographical villages any longer, but about the network of relationships and values that do connect us and binds us together.No government can love a child, and no policy can substitute for a familys care. But at the same time, government can either support or undermine families as they cope with moral, social and economic stresses of caring for children.If a country doesnt recognize minority rights and human rights, including womens rights, you will not have the kind of stability and prosperity that is possible.Im sick and tired of people who say that if you debate and disagree with this administration, somehow youre not patriotic. We need to stand up and say were Americans, and we have the right to debate and disagree with any administration.We are Americans, We have the right to participate and debate any administration.Our lives are a mixture of different roles. Most of us are doing the best we can to find whatever the right balance is . . . For me, that balance is family, work, and service. I wasnt born a first lady or a senator. I wasnt born a Democrat. I wasnt born a lawyer or an advocate for womens rights and human rights. I wasnt born a wife or a mother.I will fight against the division politics of revenge and retribution. If you put me to work for you, I will work to lift people up, not put them down.I am particularly horrified by the use of propaganda and the manipulation of the truth and the revision of history.Would you tell your parents something for me? Ask them, if they have a gun in their house, please lock it or take it out of their house. Will you do that as good citizens? [to a group of schoolchildren]I think it does once again urge us to think hard about what we can do to make sure that we keep guns out of the hands of children and criminals and mentally unbalanced people. I hope we will come together as a nation and do whatever it takes to keep guns away from people who have no business with them.We need to be as well prepared to defend ourselves agains t public health dangers as we should be to defend ourselves against any foreign danger. Dignity does not come from avenging insults, especially from violence that can never be justified. It comes from taking responsibility and advancing our common humanity.God bless the America we are trying to create.I have to confess that its crossed my mind that you could not be a Republican and a Christian.Women are the largest untapped reservoir of talent in the world.In too many instances, the march to globalization has also meant the marginalization of women and girls. And that must change.Voting is the most precious right of every citizen, and we have a moral obligation to ensure the integrity of our voting process. From Hillary Clintons Nomination Acceptance Speech at the 2016 Democratic National Convention If fighting for affordable child care and paid family leave is playing the woman card, then deal me in!Our country’s motto is e Pluribus Unum: out of many, we are one.  Will we stay true to that motto?So don’t let anyone tell you that our country is weak.  We’re not.  Don’t let anyone tell you we don’t have what it takes.  We do.  And most of all, don’t believe anyone who says: â€Å"I alone can fix it.†None of us can raise a family, build a business, heal a community or lift a country totally alone.  America needs every one of us to lend our energy, our talents, our ambition to making our nation better and stronger.Standing here as my mother’s daughter, and my daughter’s mother, I’m so happy this day has come.  Happy for grandmothers and little girls and everyone in between.  Happy for boys and men, too – because when any barrier falls in America, for anyone, it clears the way for everyone. When there are no ceilings, the sky’s the limit.  So let’s keep going until every one of the 161 million women and girls across America has the opportunity she deserves.  Because even more important than the history we make tonight is the history we will write together in the years ahead. But none of us can be satisfied with the status quo. Not by a long shot.My primary mission as President will be to create more opportunity and more good jobs with rising wages right here in the United States, from my first day in office to my last!I believe America thrives when the middle class thrives.I believe that our economy isn’t working the way it should because our democracy isn’t working the way it should.It’s wrong to take tax breaks with one hand and give out pink slips with the other.I believe in science. I believe that climate change is real and that we can save our planet while creating millions of good-paying clean energy jobs.He spoke for 70-odd minutes – and I do mean odd.In America, if you can dream it, you should be able to build it.Ask yourself: Does Donald Trump have the temperament to be Commander-in-Chief?  Donald Trump can’t even handle the rough-and-tumble of a presidential campaign.  He loses his cool at the slightest pr ovocation. When he’s gotten a tough question from a reporter. When he’s challenged in a debate. When he sees a protestor at a rally.  Imagine him in the Oval Office facing a real crisis. A man you can bait with a tweet is not a man we can trust with nuclear weapons. I can’t put it any better than Jackie Kennedy did after the Cuban Missile Crisis. She said that what worried President Kennedy during that very dangerous time was that a war might be started – not by big men with self-control and restraint, but by little men – the ones moved by fear and pride.Strength relies on smarts, judgment, cool resolve, and the precise and strategic application of power.I’m not here to repeal the 2nd Amendment.  I’m not here to take away your guns.  I just don’t want you to be shot by someone who shouldn’t have a gun in the first place.So let’s put ourselves in the shoes of young black and Latino men and women who face the effects of systemic racism, and are made to feel like their lives are disposable.  Let’s put ourselves in the shoes of police officers, kissing their kids and spouses goodbye every day and heading off to do a dangerous and necessary job.  We will reform our criminal justic e system from end-to-end, and rebuild trust between law enforcement and the communities they serve. Every generation of Americans has come together to make our country freer, fairer, and stronger.  None of us can do it alone.  I know that at a time when so much seems to be pulling us apart, it can be hard to imagine how we’ll ever pull together again.  But I’m here to tell you tonight – progress is possible.

Motivational case assignment Example | Topics and Well Written Essays - 500 words

Motivational case - Assignment Example Another assumption is that people should be treated fairly and this identifies with Joe’s case to suggest that unfair treatment, based on his lack of college degree, explains his loss of motivation. Elements of the model also identify with the case and management’s failure to mitigate Joe’s challenges, such as academic based discrimination, explains his lack of motivation. In addition, the level of discrimination that Joe perceives suggests to him that his promotion opportunities in the organization are limited, and this establishes a barrier between outcomes and satisfaction elements for Joe (Whetten & Cameron 332, 333). Limited availability of rewards to Joe, despite his high performance, is the cause of the problem, and Joe’s expression that identifies focus on his poor academic qualifications explains this. He explains that he is not regarded because of his low qualifications and that he is the lowest paid worker because of the low qualification. This however occurs while he performs as his graduate workmates do and he contributes valuable ideas to the organization even with existence of the graduates. He therefore lacks motivation because of biased reward and recognition system (Whetten & Cameron 362). Elements of reprimand, redirection, and reinforcement can be used to reshape Joe’s behavior. The management should identify the discrimination that Joe suffers, inform other employees of this, and warn against further discrimination. Pointing out effects of the discrimination, such as Joe’s refrain from offering valuable ideas and his declining performance, on organizational objectives will also shape Joe’s behavior by eliminating the cause of low motivation. Similarly, establishing guidelines for non-discriminative actions towards Joe, ensuring that employees are willing to comply, and praising Joe for all his success

An arguementative paper on home schooling vs. public school Essay

An arguementative paper on home schooling vs. public school - Essay Example Various forms of bullying that include but are not limited to physical abuse, verbal abuse, sexual abuse, hitting, punching, kicking, threatening, and seducing have become frequent in schools these days. This leads us to the question: Is home schooling better than public schooling? Owing to the widespread violence in schools, home schooling should be preferred over public school. Home schooling is much better option than public schooling because of a number of reasons. In the home, children are not exposed to racism of any sort. In the educational environment of public schools, children have to be in the company of racist fellows on daily basis. In the environment of a home, a child studies in the atmosphere created by his parents. He/she feels protected and is better able to concentrate upon the studies. Quite often, one or both parents are educated enough to teach the children themselves. In cases where the parents are not educated enough, tutors can be arranged very easily. A lot of educated people look forward to such opportunities because of unemployment. In addition to that, such platforms as internet have become a potential means of education in the present age. A lot of informative videos are available online and the child is just a click away from education.

Journal Assignment Example | Topics and Well Written Essays - 250 words - 15

Journal - Assignment Example In the same article, the Los Angeles Times describes the action as seemingly a part of a series of disturbing behavior from the military stationed at Afghanistan, continuing to enumerate alarming acts of violence committed by military personnel against people in the middle-eastern country. Before he became US president in 2009, one of the promises Obama made was to pull out the troops in Afghanistan. I strongly believe this promise was one of the reasons Americans voted for him. America had already lost so many men and women to the fighting in Afghanistan and Iraq before Obama entered the presidential race. The people wanted their fathers, mothers, brothers, sisters, husbands, wives, sons and daughters safe back home. It was therefore disappointing that after 3 years, that particular promise has yet to be fulfilled. There is no excuse for the misbehavior American troops are showing in Afghanistan. Nevertheless, for someone who is in a situation where getting to wake up each day is a gift, it is only a matter of time before the stress gets the best of an individual. If President Obama does not want a repeat or similar incidents like these to happen, he should start making good on his promise to bring the troops in Afghanistan back

The Keynesian Neoclassical Synthesis Economics Essay

The Keynesian Neoclassical Synthesis Economics Essay Introduction Economics A study which involve the understanding on how well a countrys economy on a Macro scale whereby it look at the GDP, national output, inflation rate and unemployment. The other side will be the Micro scale of the economy, which is the study of the composition of output such as the supply and demand for individual goods and services, how they are traded in markets and patterns of their relative prices. The beginning of economics started in year 1776 from Adam Smith, the first economist, which he came out with a theory Classical Economics follow by Keynesian Economics created by John Maynard Keynes as he put forward a book The general Theory of Employment, interest and Money, Published in 1936 in response to the Great Depression of the 1930s. (Skousen 2007, 3-9) Neoclassical synthesis was then created by John Hicks 1937 (on his IS/LM Curve) However, it was only popularize by Paul Samuelson (1948) with his textbook Economics which Paul Samuelson (Economist 2011). Which make him awarded the second Nobel Prize for Economics in 1970. However, this model falls out of favor in the 1960s. This paper will be explaining in depth on the KNS model on it strength and weakness, follow by a critical analysis on this model. What make this model failed in the 1960s and what aspects have remained in the current model of the Keynesian Neoclassical Synthesis. Keynesian Neoclassical Synthesis As we know this theory basically come from John hicks on his IS/LM curve on his article in the 1937 and popularize by Paul Samuelson with his famous textbook Economics in 1948. The Keynesian Neoclassical Synthesis is created after the World War II as the war had is the roots cause of the financial and economics to collapse. The Great Depression in the post 1930 was the result after the World War II. The Keynesian approach to the macroeconomics in the neoclassical theory and the importance of a mixed economy was stressed in John Maynard Keynes Book: The General Theory of Employment, Interest and Money. He believes that having a balance between both micro and macro can provide a balance to the system. Beside that the Keynesian approach to the macroeconomics into the neoclassical theory had also help most part in the western world to regain supreme. Keynesian neoclassical Synthesis major idea was to have government management to be involved in order to control recessions or economics depressions. The model believes that government intervention could be the most effective at time of economic depression under the private sector of the economy. For example at time of low demand or high unemployment, they believe that government management could help the economy to stimulate in boosting employment and control inflation. Hence, to reduce unemployment and control inflation is the key objective under the KNS model. The model believe the by government increase their spending can be seen as a reduction in the interest rates and an investment infrastructure to be the most effect role of the government in order to boost the economy when it is on the down side. The theory also believes that by government involvement could create an economics positive feedback cycle. For example government investment would create employment as more workers are required, more workers mean more income and more income increases the spending, which also increase production and with more production needed, unemployment will decrease and more jobs available so on and so forth. However, Keynesian agreed that government involvement is required to achieve in reducing unemployment and also control inflation. There are numbers of economists who are concerned with the KNS model, namely the effectives of the market mechanism in generating stable full employment equilibrium without the involvement of the government. This is still in the debate between economists. Main feature of the KNS Model Upon the born of KNS model, the model itself have a couple of important features and point which this model explained. The points will be explained in the below paragraph. Money one of the most important factors among the economy. Keynesian believe that money is not neutral as compared to the thinking under the classical theory where it believe the money does not impact consumer behavior, employment and output. Money is treated as endogenous. (Gail M. Hoyt 2012, 642) However, under the classical model it argue that money is neutral where people only hold money for transactions motive and if they are not doing any transactions the money will then be use for investment with the assumption that a rational person would not hold money if they are not using them for transactions or investment purposes. (Net 2009 2011) The question is how true this is? Under the KNS model is disagree with the classical model where people do keep their money and not spending them all way under several reasons: Uncertainly for the future, interest rates, liquidity and animal spirits. These factor will then be explained in the below paragraph. Why the model falls out of favor in 1960s? 500 800 What aspects have survived in contemporary model? 300 Summary 300 words

Poverty in Australia Essay examples -- Poverty Essays

Poverty in Australia Before discussing the extent of poverty in Australia, it is first crucial to mention the difference between absolute poverty and relative poverty. Absolute Poverty is a situation where deprivation is extreme because people do not have access to the basic necessities such as food, clothing, and shelter. In contrast Relative Poverty is a situation in which the incidence of poverty is measured relative to things such as average weekly earnings or income per head. Therefore poverty, as talked about in Australia is the state where income is insufficient to meet the minimum needs of the household or individual. The Poverty Line is the level of income below which the income of the household or individual is inadequate to meet the essential needs of the household or individual as determined by society. The Poverty line is determined by a percentage of average weekly earnings. In 1966, the original poverty line for Australia, was set by Professor Henderson as basic wage plus the child endowment payable for two children. There is a definite lack of recent data on poverty in Australia, therefore we have to look back as far as reports from the 1970’s, in order to find any relevant information on poverty in Australia. In 1975 there was a report made on the extent of poverty in Australia by Professor Henderson. It has since been known as the Henderson Report. The Henderson Report found that 8.5 per cent of Australians were living under the poverty line. It also found that: â€Å"Most of the poor suffer from one or more of the following disabilities: old age, lack of a male bread-winner, a large number of dependant children, recent migration to Australia, or prolonged illness. The incidence of poverty was much higher in these categories than among those without any of these disabilities.†(Henderson 1975) At the time of this report average weekly earnings in Australia were $165 per week, the poverty line for a single person was set at $49.60 for a single person, and $93.20 for a couple w ith 2 children. (Jackson, McIver 1998) A report similar to the Henderson report was carried out in 1987, where the poverty line, still using the original method used in 1966, had been raised to $146 per week for a single, and $274 per week for a couple with two children. (Jackson, McIver 1998) Although the poverty line had risen due to economic grow... ... every fortnight without fail, and without the hassles of having to go to work every morning. Whilst the Australian Welfare System is not perfect it does without question assist in its main objective which is reducing inequality of incomes, and therefore the level of poverty. Although there is no current data on the amount of Australians living under the poverty line, and it is very difficult to estimate, it appears likely that using Professor Henderson’s original method, the increasing inequality in the distribution of household incomes has caused the percentage of Australians living below the poverty line to increased substantially. Bibliography: Collier, B. 1992. Introducing Economics. Sydney, New South Wales. Anzarut, D. 1985. Senior Economics. Melbourne, Victoria. Lipsey, R. Langley, P. Mahoney, D. Positive Economics for Australian Students, Sydney, New South Wales. National Coalition against Poverty. 10 September 2001. URL http://www.bsl.org.au/ncapwebsite Trends in Income Inequality in the 1990’s. 15 September 2001. URL http://www.natsem.canberra.edu.au/pubs/cpol.html. Pearce, Y. August 20 2001. â€Å"Poverty level ‘Just hot air’† The West Australian.

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