Women Suceptability To Hiv Health And Social Care Essay Free Essays

string(41) even their children when their life partners die. Heavenly Cross Hospital is a 240 bed degree one clinic situated in the provincial Pondoland of Eastern Cape in the old Transkei, South Africa. It serves a populace of around 50,000 around Flagstaff, Lusikisiki, Mkambathi and Bizana. There are 153 individuals from the clinic staffs. We will compose a custom article test on Ladies Suceptability To Hiv Health And Social Care Essay or then again any comparative theme just for you Request Now The greater part of the provincial individuals are hapless and all things considered, infections related with destitution are winning among the individuals: TB, unhealthiness and HIV/AIDS. The hospital is isolated into various units among them is the HIV Clinic where heft of patient on the life rescuing ART move up their meds. Fig 6: Number of workers at Holy Cross Hospital, Eastern Cape. The executives 10, Professionals 56, Clerical 22, Unskilled 65 In the country network where grown-up females are the objects of cultural power like colza, local attack and most exceedingly terrible influenced by destitution, they can simply be enslaved by the harrying impacts of HIV. There are different parts that could be ascribed to the predominance of the infection among the grown-up females provincial occupants. Female venereal mutilation in spite of the fact that non a rampart in South African social orders, this could non be entirely precluded in the rustic networks where a bunch of exercises on making a trip are underreported because of hapless media inclusion. In another situation, the demonstration of masochism is other than a fuelling factor-a male predominant society. Writing REVIEW In the planetary, national and nearby reappraisals of HIV/AIDS occurrence and commonness, it has ever been that grown-up females are at higher extent. Indeed, even in the occasions of related perish, grown-up females are at the more prominent misfortune. There must be factors answerable for such properties. In a related contrasting, pre-birth specialists in South Africa have more prominent Numberss of the infection than the mean populace. Here, the ground is evident ; to be pregnant implied unprotected sex. Various reappraisals of one-year pre-birth concentrates in South Africa as directed by UNAIDS, AIDS plague update, 2009 ( hypertext move convention:/www.unicef.org/factoftheweek/index_53596.html ) the Human Sciences Research Council ( HSCR ) has ever shows a more noteworthy per centums than the national HIV/AIDS pervasiveness. This is other than the equivalent in numerous different conditions of the universe. Despite the fact that, the infection was principal found in 1981 among gay work powers in the United States of America, the dislodging in the worldview is a reason for concern. â€Å" This pandemic unfortunately stays a scourge of grown-up females. † †Michel Sidibe , Executive Director of UNAIDS. â€Å" At the terminal of 2009 it was assessed that out of the 33.3 million adults overall populating with HIV and AIDS, the greater part are grown-up females. It is proposed that 98 for every centum of these grown-up females live in creating states. The AIDS plague has alony affected grown-up females, which has been exacerbated by their capacity inside society and their natural presentation to HIV infection.A Generally grown-up females are at a more prominent danger of hetero transmittal of HIV. Organically grown-up females are twice bound to go septic with HIV through unprotected hetero intercourse than work powers. In numerous states grown-up females are less inclined to have the option to negociate elastic utilization and are bound to be exposed to non-consensual sex. Also, 1000000s of grown-up females have been in a roundabout way influenced by the HIV and AIDS pestilence. Ladies ‘s childbearing capacity implies that they need to hypothesize with issues, for example, mother-to-youngster transmittal of HIV. The obligation of thinking about AIDS patients and vagrants is other than an issue that has a more prominent outcome on grown-up females † ( Avert, 2010 ) 1. State 2001 predominance % 2002 predominance % 2003 predominance % 2004 predominance % 2005 predominance % 2006 predominance % 2007 predominance % KwaZulu-Natal 33.5 36.5 37.5 40.7 39.1 39.1 37.4 Mpumalanga 29.2 28.6 32.6 30.8 34.8 32.1 32.0 Free State 30.1 28.8 30.1 29.5 30.3 31.1 33.5 Gauteng 29.8 31.6 29.6 33.1 32.4 30.8 30.3 North West 25.2 26.2 29.9 26.7 31.8 29.0 29.0 Eastern Cape 21.7 23.6 27.1 28.0 29.5 28.6 26.0 Crocodile stream 14.5 15.6 17.5 19.3 21.5 20.6 18.5 Northern Cape 15.9 15.1 16.7 17.6 18.5 15.6 16.1 Western Cape 8.6 12.4 13.1 15.4 15.7 15.1 12.6 National 24.8 26.5 27.9 29.5 30.2 29.1 28.0 Assessed HIV commonness among pre-birth facility specialists, by state ( hypertext move convention:/www.avert.org/safricastats.htm Age Male commonness % Female commonness % 2-14 3.0 2.0 15-19 2.5 6.7 20-24 5.1 21.1 25-29 15.7 32.7 30-34 25.8 29.1 35-39 18.5 24.8 40-44 19.2 16.3 45-49 6.4 14.1 50-54 10.4 10.2 55-59 6.2 7.7 60+ 3.5 1.8 Whole 7.9 13.6 Assessed HIV commonness among South Africans, by age and sex, 2008 ( hypertext move convention:/www.avert.org/safricastats.htm ) There are diverse unmistakable highlights to the pestilence of HIV/AIDS in various social orders, yet the normal highlights comprehensively are the bigger grown-up females introduction. Anyway with regards to Africa, the common destitution, female sex offense and the disturbing in rates of colza occurrences in the country South Africa, male commanded society, joblessness, and lack of education are a portion of the overarching fortunes expanding the presentation to the infection. In the logical position, grown-up females despite everything take more prominent extent of PLWHA. The open nations of female venereal real estate parcel are more prominent than male and vaginal mucosal are all the more brittle which become simple wounded with cruel sex. For each brush of hetero intercourse, grown-up females are at more noteworthy peril of arriving at HIV ( WHO, 2010 ) . A similar standard other than applies to the spread of explicitly transmitted contaminations. Womans have been known to manage the more prominent burden. Access to data is other than another significant factor that is absent among grown-up females. Huge numbers of which are uneducated and all things considered, the Numberss of grown-up females in the spots of intensity and approval are slim. To do educated pick and cognizance regarding bar of HIV/AIDS is somewhat inadequate. â€Å" Lack of guidance and financial security influences 1000000s of grown-up females and misss, whose education degrees are all things considered lower than work powers and male childs ‘ . Numerous grown-up females, especially those populating with HIV, lose their places, legacy, possessions, bolsters and even their children when their life partners kick the bucket. You read Ladies Suceptability To Hiv Health And Social Care Essay in class Exposition models This powers numerous grown-up females to follow endurance conspires that expansion their chances of getting and disseminating HIV. Instructing misss makes them progressively equipt to do more secure se xual conclusions † ( WHO, 2010 ) . Crime percentage is another spotlight to the spread of HIV/AIDS. This demonstration of power makes grown-up females to be the objects of surges. In the neighborhood networks across South Africa, sex power is winning disposition. It was late revealed that British couple tourers were stole in the country network of Khayelitstha in Cape Town. The grown-up female was said to hold been assaulted lastly murdered by the provincial goons. The demonstration of this cultural power is only non against the neighborhood grown-up females again, it has risen above past the nearby networks. The story turned into a planetary exciting account. â€Å" A 26-year-old grown-up male has been accused of laying hold of the auto of a British pair who were honeymooning in Cape Town at the end of the week and killing the lady of the hour, constabulary said Wednesday.The grown-up male from Khayelitsha, the rambling township on the edges of Cape Town where Anni Dewani ‘s natural structure was found, was ch arged inside long stretches of being taken into constabulary detainment on Tuesday † ( Afro News 24, 2010 ) . The normal nearby put stock in South Africa is that HIV/AIDS is treatable by holding sex with virgin or individual old who has go without sex for long clasp. This is a striking variable declaring the up-flood in the colza occurrences in the state. Of class the conventional doctors ( Sangoma ) habitually times instill juvenile work powers populating with the infection to hold sex with virgin so as to be cure. Factually, South Africa has the biggest figure of PLWHA worldwide than some other state. What's more, with the nearby accept, the current situation would hold been normal. Another misnomer is the convention of grown-up females accommodation. A decent grown-up female is fairly much of the time saw by the nearby networks as accommodating to her hubby, non oppugning her hubby about his sexual life, prepared to give sex whenever without exchange and should bear numerous children. This disposition every now and again jeopardizes grown-up females life and perhaps the unborn children in situation where the grown-up male of the house participates in correspondent different sexual associations. An ongoing report in a nearby network in a South Africa neighboring state, Botswana found that 62 % of work powers have occupied with numerous sexual associations in the old three months ( New York State, 2010 ) . This is just what occurs in a state non sick celebrated for high occurrence of power against grown-up females. At that point, the situation could be far making in the country South African people group. OPERATIONAL DEFINATIONS AND HYPOTHESIS HIV/AIDS commonness is more prominent among Womans? HIV as ordinarily known is Human Immunodeficiency infection while AIDS is the terminal period of HIV contamination. Helps is Acquired Immune need Syndrome. In many occurrences, HIV disease relying upon the safe situation of the septic people can immediately make advances on AIDS in a year's clasp without clinical intervention. In any case, there were records of individuals that have lived more than 20

Understanding The Great Gatsby First Line and Epigraph

Understanding The Great Gatsby First Line and Epigraph SAT/ACT Prep Online Guides and Tips There’s a motivation behind why magazines normally set up arrangements of the best first lines in the entirety of writing: book openings establish a gigantic connection with readers.How a book begins encourages us situate on the planet that the book is making. In the first place, it gives us our first thought of the storyteller, and the kind of portrayal we’re going to experience. Will it be a raspy first-individual admission? Or on the other hand a cool and disconnected third-individual perception? Second, it presents the setting, telling us where and when the story happens - which is significant for regulating peruser desires. Our opinion of two individuals kissing in tidy and legitimate Victorian England will be totally different than our opinion of a similar couple in advanced Canada. So what does the start of The Great Gatsby uncover? Peruse on for the importance of this work’s epigraph, its initial line, and its starting sections. Article Roadmap Dissecting the epigraph ofThe Great Gatsby Investigating the importance behind The Great Gatsby's first lines Understanding Nick as a storyteller from The Great Gatsby's first passages Snappy Note on Our Citations Our reference design in this guide is (chapter.paragraph). We're utilizing this framework since there are numerous releases of Gatsby, so utilizing page numbers would just work for understudies with our duplicate of the book. To discover a citation we refer to by means of part and section in your book, you can either eyeball it (Paragraph 1-50: start of part; 50-100: center of part; 100-on: end of part), or utilize the hunt work in case you're utilizing an on the web or eReader form of the content. The Epigraph Poem of The Great Gatsby The tale is introduced by this four-line sonnet: At that point wear the gold cap, if that will move her; If you can skip high, ricochet for her as well, Till she cry Darling, gold-hatted, high-bobbing sweetheart, I should have you! - Thomas Parke D'Invilliers To start with, let’s dissect the sonnet, and afterward we can discuss who this D’Invilliers individual is. â€Å"Then Wear the Gold Hat† In the most essential sense, the sonnet is a recommendation. We know this in light of the fact that the principal words, â€Å"then wear,† make it sound like we are hearing the center of a discussion. Somebody has been whining about his sentimental issues with a particular â€Å"she,† and the poem’s speaker is replying with certain tips on what to do. The counsel the sonnet is: make a special effort to intrigue her with your riches/status (â€Å"gold hat†), and with your derring-do (â€Å"bounce high†). Whatever you can do to stand out for her is justified, despite all the trouble in the event that she winds up prevailed upon, in light of the fact that then she will be voracious (â€Å"I must have you†). Obviously, this picture of a ‘gold-hatted, high-ricocheting lover’ is clownish, best case scenario and totally ludicrous best case scenario. The poemechoesthe novel's plot and portrayals: Gatsby’s way to deal with prevailing upon Daisy is actually that of the gold-hatted, high-bobbing sweetheart, edgy totry anything - including purchasing a mammoth house nearby and tossing week after week parties in the unclear expectation that she would appear. Putting on a cap as a method of polishing your picture is actually what Gatsby has done in embracing his â€Å"Oxford man† persona, and identifies with the manner in which he is now and then portrayed as an on-screen character or con artist. (Scratch calls Gatsby a turbaned character spilling sawdust at each pore (4.31), while owl-eye glasses party visitor thinks about Gatsby to David Belasco, a renowned theater maker in Chapter 3). Simultaneously, the away from of the picture of this darling focuses to the madness of Gatsby’s fixation and the craziness of his monomaniacal mission for Daisy’s heart. There is no respect in the methodology the sonnet suggests, as there is none in Gatsby’s also. This thought is additionally strengthened when we consider that Fitzgerald initially needed the novel to have a progressively satiric flavor (look at our article on The Great Gatsby'stitle for additional subtleties). The sonnet additionally associates with novel through the character of â€Å"she,† who subs for Daisy. It's imperative to take note of that the she in the sonnet is somebody to dazzle and prevail upon, and not somebody to get the hang of anything about. Much the same as Daisy in the novel, the sonnet's she is a prize or a goal instead of an individual. Thomas Parke D’Invilliers Learn to expect the unexpected. There is no such artist as D’Invilliers! Fitzgerald caused him to up, and made up this sonnet also. Truth be told, D’Invilliers is a minor character in This Side of Paradise, Fitzgerald’s prior novel about Princeton. In that book, the principle character becomes a close acquaintence with D’Invilliers, who is a capable artist - yet whose sonnets will in general overlook the hazardous or terrible parts of the real world. Here, the accepted name and imagined persona of this writer likewise tie into the Gatsby venture, playing into the novel's key topic of the changeability of character. James Gatz changes himself into the spectacular Jay Gatsby, andthis writer is a spread character for Fitzgerald. So,D’Invilliers depended on the Fitzgerald's mate, artist John Peale Bishop. Couldn’t the genuine guyhave composed something to be Fitzgerald’s epigraph? The Great GatsbyFirst Lines This is the means by which Chapter 1 of this novel starts: In my more youthful and progressively powerless years my dad offered me some guidance that I’ve been turning over in my psyche from that point onward. â€Å"Whenever you want to reprimand any one,† he let me know, â€Å"just recall that all the individuals in this world haven’t had the points of interest that you’ve had.† (1.1-2) Let’s take the Great Gatsby first lines separated in an assortment of ways. What We Learn About the Narrator The principal thing we make sense of is that the story will be told in the main individual (which means it’s described by a â€Å"I† voice who is a character in the story and who is available at the occasions he portrays). The second thing we see is that there is at any rate onetime move in the portrayal. Scratch is more established presently, however is thinking back on youth and a more â€Å"vulnerable† time. There are a few distinct approaches to decipher this defenselessness, particularly before we have perused further: this storyteller might be helpless against being harmed by others, to being impacted by awful environmental factors/individuals, or perhaps to taking his dad’s exhortation at face esteem. We likewise get our first piece of information into Nick’s foundation: he originates from cash, instruction, and rearing (â€Å"advantages†), which will permit him to fit in sensibly well in the old-cash East Coast world that he will experience in the novel. The Advice Given to Nick by His Father We find that Nick experiences serious difficulties associating with his dad’s guidance. It’s intriguing that he enlightens us concerning this trouble before he really discloses to us the counsel itself - as though he might want us to peruse this bit of parental knowledge with a similar inner conflict and grain of salt that he himself has. Precisely why he has been â€Å"turning it over in his mind† isn't illuminated, and again could be for an assortment of reasons: Nick may ponder when and where it’s appropriate, valuable, valid, or even whether he can really adhere to it. The â€Å"advice† from his dad appears to be extremely progressively like a burrow at Nick. The expression â€Å"whenever you want to condemn anyone† makes it sound Nick regularly makes a decision about different people’s conduct and activities without thinking about setting or conditions. This discloses to us one of his principle shortcomings - and it’s an entirely noteworthy one considering Nick will be the eyes through which we see the various characters! How Nick’s Father’s Advice Shapes How Nick Tells The Story Not at all like the novel’s epigraph, which truly is guidance on what to do, Nick’s father’s words appear to be progressively similar to either an analysis of Nick’s unfortunate propensities or even an admonition or some likeness thereof. At the end of the day, the dad's-counsel encircling account makes the novelinto a reverseAesop’s tale, where the ethical starts things out and is trailed by the story that demonstrates the standard. Fundamentally, this â€Å"advice† puts a major boundary among Nick and â€Å"all the individuals in this world† on the grounds that he has had â€Å"advantages† that they haven’t. So what are these favorable circumstances? the sort of riches that orders Nickas â€Å"old money† (we discover that the Carraways have been a noticeable family for a few ages) a feeling of profound quality and enthusiastic groundedness that Nick calls the principal tolerabilities is distributed at birth† (1.3), bombastically suggesting that he is morally above most others This implies during the remainder of the novel, this grandiosity and this propensity to excuse every other person as being second rate is something to look for in Nick’s depiction of others and occasions. Gotta love that Nick’s father is essentially similar to, â€Å"Maybe check your benefit from time to time, son.† The Novel’sFirst SixParagraphs Scratch spends the primary passages of the novel urging us to confide in him and to have confidence in his unprejudiced nature and decision making ability. Rather than propelling into the plot of the story he's going to tell, Nick rather invests a critical piece of energy clarifying his family foundation, giving us a fast bio of himself up to the point of the mid year of 1922. As it were, the initial six sections of The Great Gatsby are committed to building up Nick as both an intriguing character and a generally target storyteller. Would it be advisable for us to acknowledge all that he says at face esteem? Scratch as a Narrator The primary inquiry we need to pose to ourselves is: is Nick's first-individual storyteller dependable or inconsistent? On the one ha

How to Choose a Descriptive Essay Topic

How to Choose a Descriptive Essay TopicThe more descriptive the topic of your essay, the better it will be. It also does not matter what kind of subject matter you choose to write about; even a long and boring tale is better than none at all. If you do have a vast amount of free time on your hands, think about writing a paper about something that is very appealing to you.The simplest way to write an impressive descriptive essay is to use a powerful story. Not only can this help to make a strong first impression, but it will also compel the reader to keep reading. If you feel as though you would enjoy such a journey yourself, you will definitely find it interesting. This is particularly true if the main character in the story is someone who represents you.Since so many students use the same writing style when writing a descriptive essay, it may be a good idea to try to come up with something that is original. Having several original descriptive essay topics can help you realize that n o two are alike. In fact, this is the key to success in your writing endeavors.Always ensure that the descriptive essay topics that you choose to use are simple to understand. There is nothing worse than getting a hold of a lengthy essay because the topics were simply too difficult to follow. The people who work on these types of essays are certainly not looking for easy pages. Instead, they want straightforward topics.When looking for different descriptive essay topics, one can start off by searching for those with which you are most familiar. You may also try searching for 'descriptive essay topics'descriptive essay topics'. For example, you may use 'smart guys'intelligent girls' to better define the types of topics that you may wish to focus on in your papers.Since there are many different opportunities available for descriptive essay topics, there is never a shortage of ones to choose from. One thing to keep in mind, however, is to always be careful about the type of description s that you use. It is a good idea to avoid using slang terms or using creative wordings. By using these types of styles, you run the risk of creating an unprofessional paper.Keep in mind that many descriptive essay topics can be copied, as long as the original writer is credited. However, when you are first beginning to work on a paper, you should try to stick to topics that are already familiar to you. This is simply because, if the ideas are not new to you, it is less likely that you will forget them.When choosing the right descriptive essay topics, keep in mind that the term 'different' is not always the best way to go. While it may seem like a good idea to have a variety of topics, it may actually cause you to come across as unprofessional. Instead, it is important to keep your research topics as 'simple' as possible. There is nothing wrong with this, as long as you still create something unique and compelling.

Stillbirth Fetus Death - Free Essay Example

Sample details Pages: 19 Words: 5654 Downloads: 7 Date added: 2017/06/26 Category Statistics Essay Did you like this example? Abstract: Feto-infant mortality is increasing worldwide. Stillbirth is defined as uterofetal death at 20 weeks of gestation or greater. Stillbirths contribute as a primary factor to the growing magnitude of feto-infant mortality. The reasons for stillbirth are usually not reported. In many cases, the specific cause of fetal death remains unknown. The key risk factors include smoking, increased maternal age, being overweight, fetal-maternal hemorrhage. Even though there has been remarkable development in prenatal and intranatal care, stillbirths have been consistently increasing and remain an important problem in obstetrics and gynecology. Current research studies focus mainly on the epidemiology of stillbirths. I review the known and suspected causes of stillbirth. It also describes the recommended diagnostic tests to evaluate definite cause of stillbirth. In this paper, I also review analysis of stillbirths in the United States (US). The National Center of Health Statistics recorded 26,359 stillbirths in 2001. The number of stillbirths can be greatly reduced if the specific reasons for stillbirth are understood. Don’t waste time! Our writers will create an original "Stillbirth Fetus Death" essay for you Create order Introduction: A pregnancy ending in stillbirth can be mentally devastating to a patient and her family. The most widely accepted definition of stillbirth is death of the fetus inside the uterus at 20 weeks of gestation or greater (Cartlidge et al., 1995). Much information is available on protocols for evaluating other types of postmortem examination but little work has been done on the evaluation of the causes of stillbirths (Mirlene et al., 2004). No universally followed protocol is available to guide the evaluation of stillbirths. In part because a wide variety of causes can be involved in stillbirths and it can be difficult to designate a specific cause of death. A stillbirth might result from various diseases, infections, trauma or genetic defects in the mother or fetus (Gardosi et al., 2005). In many cases, a specific reason is not known. Even though stillbirths are a serious problem, few resources have been focused on them and most obstetricians lack a sound method of evaluating of stillbirths (Petersson, 2002). In this document, I will review the accepted causes of still birth and the suggested diagnostic tests for evaluating the reason behind stillborn infants. In the year 2001 in the US, the National Center of Health Statistics recorded 26,359 stillbirths (Ananth et al., 2005). When compared to 27,568 infant deaths were reported in the same year. More than half of the stillbirths are before 28 weeks of gestation and almost 20% are close to the term. If a history of stillbirth exists then there is a 5-fold increase for subsequent stillbirth to occur. Prominent racial discrimination occurs in the rates of stillbirths. Stillbirths are almost three times more prevalent in African Americans when compared to whites (Puza et al., 2006). In 2001, the rate of stillbirths among white mothers was 5.5 per 1000 live births and 12.1 per 1000 among the black mothers. According to an analysis of U.S. vital statistics between 1995 and 1998, the increased risk of black, compared with white, stillbirths is greatest among singleton stillbirths (Puza et al., 2006). Reduction of proportion of fetal deaths at gestation of 20weeks or longer to 4.1 per 1000 live births and also reduction of fetal deaths for all racial and ethnic groups are the objectives of U.S. National Health for 2010. Categorization of Stillbirths: Different attempts were made in order to classify causes of stillbirth. Baird and his colleagues were among the first to classify the causes of perinatal death from the available clinical information. Depending on the British perinatal mortality survey, in 1958 Butler and Bonham designed a classification scheme that included the results of postmortem examinations. The most widely used is the 9 category classification system formulated by Wigglesworth and his coworkers (Wigglesworth, 1980). A new classification scheme which does not include neonatal deaths was proposed by Gardosi and his colleagues known as the ReCoDe Classification which focuses on the relevant conditions at the time of death in the uterus. It includes factors which affect the fetus followed by the factors which affect the mother (Gardosi et al., 2005). When compared with the Wigglesworth classification, a remarkable decrease in the number of unclassified stillbirth was achieved using this classification. One of the most vital aspects is to develop a proper definition of the factors that lead to death of the fetus. The basic definition for the cause of death is injury or disease responsible for a death. Froendefined cause of death in stillbirth as an event or condition of sufficient severity, magnitude, and duration for death to be expected in a majority of such cases in a continued pregnancy in the clinical setting where it was observed (Froen, 2002). When the definition of cause of death is reviewed, it is observed that only a few disorders are directly responsible for fetal death while many others are not. Causes of Stillbirth: Infection: Infections such as viral, protozoal and bacterial are linked with stillbirth. Almost 10-25% of stillbirths result from feto-maternal infections in the developed countries where as bacterial infections are common in developing countries (Goldenberg et al., 2003). Stillbirths that result from infection might be due to various factors which include direct infection, placental damage, and severe maternal illness. Usually the stillbirths in the initial weeks of gestation are linked with infection. Bacterial infections caused by Escherichia coli, group B streptococci, and Ureaplasma urealyticum are a cause of stillbirth in developed countries (Goldenberg et al., 2003). If syphilis epidemic occurs in an area then it might be the cause of a considerable proportion of stillbirths. If women come in contact with a parasite like malaria for the first time then stillbirth might be attributed to it. Toxoplasma gondii, leptospirosis, Listeria monocytogenes, Q fever, and Lyme disease are associated with the occurrence of stillbirth (Goldenberg et al., 2003). The magnitude of stillbirths due to viral infections is not known mainly due to the absence of a well defined systematic evaluation of infections in stillborn infants. The problem lies behind the fact that these viruses are difficult to culture and moreover, a positive viral serological diagnostic test identifying the DNA or RNA of the virus in the fetal tissue or placental tissue does not definitely determine that infection was the reason behind death. In most of the cases, infection is linked with stillbirth in early gestational weeks around twenty weeks. If molecular diagnostic technology (DNA and RNA polymerase chain reaction [PCR]) is utilized, it will help in diagnosis of viral infections without any error. Parvovirus B-19 appears to have the strongest association with stillbirth. According to a Swedish survey, in 8%of stillbirths B-19 PCR positive tissues were observed (Enders et al., 2004). In the United States, less than 1% of all stillbirths are reported to be due to parvovirus infection Parvovirus B19 moves across the placenta spreading the infection to fetal erythropoetic tissue resulting in fetal anemia leading to fetal death (Wapner et al., 2002). Myocardial damage may also occur due to Parvovirus B19. Here the virus directly attacks the fetal cardiac tissue. Parvovirus infection that leads to stillbirth usually occurs before 20 weeks of gestation (Wapner et al., 2002). Enteroviruses which include Coxsackie A and B, echoviruses and other enteroviruses are associated with stillbirth. Coxsackie viruses can cross the placenta and lead to villous necrosis, inflammatory cell infiltration, calcific pancarditis, and hydrops. Echovirus infection begins with severe maternal illness and finally ends with stillbirth. Cytomegalovirus (CMV) belongs to herpesvirus family and it is a congenital viral infection. Initially, the mother is infected and then it is transmitted to the fetus. CMV causes placental damage leading to intrauterine fetal growth restriction, but an association with stillbirth remains controversial (Goldenberg et al., 2003). Viral infections in the mother like rubella, mumps and measles are linked with stillbirth. If the vaccinations are administered on time then the proportion of stillbirths occurring due to infections can be reduced greatly. Genetics: Genetic causes are responsible for a considerable magnitude of stillbirths. 6- 12% of stillbirths attributed to genetic etiologies are due to karyotyping abnormalities. Due to the fact that in some of the cases cells cannot be cultured, karyotyping is not possible. Such factors alter the exact estimate of stillbirths resulting from chromosomal abnormalities. In stillborn fetuses which show apparent structural defects the probability of chromosomal abnormality is much higher when compared to normal stillborn fetuses. The usually focused abnormalities include monosomy X (23%), trisomy 21 (23%), trisomy 18 (21%), and trisomy 13 (8%). There are many instances where the karyotype of the stillborn is normal yet the cause of death is a genetic abnormality. Indeed, 25-35% of stillborn infants undergoing autopsy have intrinsic abnormalities (Wapner et al., 2002) .These include single malformations (40%), multiple malformations (40%), and deformations or dysplasia (20%) (Wapner et al., 2002). Almost 25% ofstillborns due to intrinsic defects show an abnormal karyotype whereas the rest of the 75% may have genetic defects which are not identifiable by the regular cytogenetic tests. This holds good for fetuses with multiple abnormalities. Single gene mutations may be responsible for death of the fetus in early weeks of development. Stillbirths in the midgestational weeks might be due to abnormal placental growth, development, or angiogenesis. Some autosomal recessive disorders including glycogen storage diseases and hemoglobinopathies have been reported as the cause of stillbirth (Wapner et al., 2002). In male fetuses, X-linked disorders may prove to be fatal. Many other genetic defects that are not recognized by the conventional cytogenetic diagnostics may lead to stillbirth. For example, conventional karyotype cannot identify chromosomal microdeletions that are linked with unexplained mental retardation. Confined placental mosaicism has also been associated with fetal growth impairment and stillbirth (Kalousek et al., 1994). Heritable Thrombophilia is another probable etiology of stillbirth.It is thought that placental infarction occurs due to thrombosis in the uteroplacental circulation leading to death. This poses concern over other thrombophilic defects and their effects on stillbirth. It is noteworthy that many heritable thrombophilias are common in normal individuals without a history of thrombosis or pregnancy loss (Rey et al., 2003). Even though many studies relate thrombophilias to fetal loss, most of the women with thrombophilias have healthy pregnancies with no lethal complications. It can be said that in the absence of any previous obstetric problems, thrombophilia will not result in stillbirth. Feto-maternal Hemorrhage: Feto-maternal hemorrhage has been linked to almost 3- 14% of all stillbirths which implies that it is responsible for a considerable number of stillbirths. Obstetric procedures such as external cephalic version and cesarean section lead to fetal maternal hemorrhage. Hemorrhage can also result due to placental abruption and/or abdominal trauma during pregnancy. Fetal maternal hemorrhage must be identified and quantitated using a proper dependable diagnostic test to attribute this reason behind the death of fetus. Hypoxia and anemia are indicators of death due to fetal hemorrhage. So, they should be confirmed by autopsy as in some normal cases too, few fetal cells can be seen in maternal blood. Maternal Features: Delayed child bearing or increased maternal age, prepregnancy obesity and stress are found to have their effects on the occurrence of stillbirth. The underlying mechanisms of action are unknown; however, with both obesity and delayed child-bearing on the rise, their importance as potential causes of stillbirth deserves greater attention (Cnattingius et al., 2002). Women whose only risk factor is being overweight have about a 2-fold increased risk of stillbirth (Nohr et al., 2005). Likewise, compared with women younger than 35 years of age, the stillbirth rate is increased 2- fold for women 35-39 years of age, and 3- to 4-fold for women aged 40 years old or olderwhereas some age-associated risk is due to higher rates of maternal complications, in uncomplicated pregnancies there may be a 50% increased risk associated only with maternal age 35 years or older (Nohr et al., 2005). Stress is a suspected cause of stillbirth which might occur as a result of a major life event (such as loss or poverty) (Huang et al., 2000) or through unexplained health changes related to adverse childhood experiences (Hillis et al., 2004). Different exposures are attributed to stillbirth. One of the most prevalent and preventable cause of stillbirth is cigarette smoking (Hillis et al., 2004). Smoking negatively affects fetal growth and oxygen supply to the tissues as it produces high levels of carboxyhemoglobin and decreases blood supply to the placenta. Smoking is also associated with increased risks of placenta previa and placental abruption and women who stop smoking in the first trimester have stillbirth rates equivalent to women who never smoked which indicates that quitting smoking in early pregnancy may significantly reduce the chances of occurrence of stillbirth (Hillis et al., 2004). A variety of complications result due to continuous exposure of different recreational drugs. Consumption of cocaine during pregnancy is also linked with stillbirth because it causes fetal growth restriction and/or abruption. The use of meth amphetamines leads to premature deliveries and stunted growth but its association with stillbirth remains unknown. In some cases, alcohol consumption during pregnancy has been associated with an increased risk of stillbirth (Mary et al., 2006). According to a study in Scandinavia, for women who consume less than 1 drink per week, the rate of stillbirth is 1.37 per 1000 births while the rate increases to 8.83 per 1000 births in women who consume 5 drinks or more per week. If smoking habits, caffeine intake, prepregnancy body mass index, marital status, occupational status, education, parity, and fetal gender are considered, the risk of stillbirth for women consuming 5 drinks or more per week was 2.96 (95% confidence interval 1.37 to 6.41) (Mary et al., 2006). Some studies show a protective effect on both stillbirth and fetal growth restriction rates if small amounts of alcohol are consumed during pregnancy (Mary et al., 2006). A link between pesticide exposure and stillbirth was observed by Pastore and his colleagues in 1997. Occupational exposures prove to be deleterious compared to residential exposure because the occupational exposures cause congenital abnormalities in addition to risk of stillbirth. A noteworthy fact is that the use of fertility drugs is also associated with stillbirths. This finding is problematic due to the fact that many women make use of fertility treatments to conceive. However, data on stillbirths due to exposures is obtained from retrospective studies which are prone to bias. The link between exposures and stillbirth should therefore be dealt with great attention and care. Maternal Diseases: Diabetes: There is always an increased danger of stillbirths in second and third trimester for mothers who are affected with type I or type II diabetes mellitus (DM) pregestationally. Even with modern obstetric care and diabetes management, stillbirth rates in women with type 2 DM have been reported to be 2.5-fold higher than nondiabetic women (Mary et al., 2006). The rate of stillbirth is the same between women with gestational diabetes (GDM) as well as normal women when the whole population is taken into account. The magnitude of danger involved with fetal death in women with type II DM is identical to women with GDM who in fact entered the pregnancy with undiagnosed type II DM. Therefore, women with GDM who have an undiagnosed type II DM are usually at a greater danger of encountering stillbirth. Examples of women with undiagnosed type II DM include history of GDM in previous pregnancies, high fasting glucose values;random glucose values greater than 200mg/dL or diagnosis of GDM early in pregnancy. The reason behind fetal death in late gestation in diabetic women is not known precisely. In addition to an increased risk of fetal death in diabetic women, there also exists a higher magnitude of danger associated with fetal abnormalities in these women compared to healthy women. Stress, hypertension and obesity complement each other in DM patients. In women with DM, there is a higher risk of stillbirth as it may lead to fetal abnormalities which may be either abnormally increased growth rate or retarded growth. To maintain the physiological range of the plasma glucose level, tremendous amounts of insulin is produced by the fetus resulting in fetal hyperglycemia. This fetal hyperglycemia is acquired from maternal hyperglycemia which finally results in fetal death due to excessive growth. The precise limit of plasma glucose level which poses a threat to the fetal life is not well defined. The most that could be done is to detect and deal with it using needed medications to lower the incidents of stillbirths.Many other maternal diseases have been linked to stillbirth, including thyroid disease, cardiovascular disease, asthma, kidney disease, and systemic lupus erythematosus (Simpson, 2002). These are subclinical diseases which in many cases has not been proven to be direct causes of stillbirth and women had normal pregnancies giving birth to healthy babies. Multiple Gestation and Stillbirth: Nearly 3% of all births and 10% of all stillbirths result from multiple pregnancies. According to national vital statistics, 1.8% of twin, 2.4% of triplet, 3.7% of quadruplet, and 5.6% of quintuplet fetuses suffered intrauterine fetal deaths (Salihu et al., 2003). The stillbirth rate among singleton pregnancies is approximately 0.5%. The reason behind fetal death in multiple pregnancies is difficult to be resolved when compared to singleton pregnancies. The broad causes of fetal death in multiple pregnancies include fetal growth retardation, preclamsia, abruption and cord accidents. It is vital to determine the chorionicity of multiple gestations as the rate of stillbirth is higher in monochorionic multiple gestations (Salihu et al., 2003) (Lynch et al., 2007). Assisted Reproductive Technology (ART) is an essential aspect in the occurrence of multiple pregnancies and stillbirth (Helmerhorst et al., 2004). Complications in Fetus: Fetal Growth Restriction: Some stillbirths result from fetuses which are smaller for a particular gestational age (SGA) compared to normal fetuses. Birth weight and risk of stillbirth are inversely proportional. If one increases, the other decreases. The main fact behind stillbirths in this condition is retardation of fetal growth and not the small size of fetus. An obstacle that occurs in determining the precise time of death of fetus due to SGA is the fact that the death might have occurred a long time before but the gestational age at the time of delivery is considered to be the time of death. This gives a false implication of the magnitude of stillbirths resulting from SGA. This problem can be solved by analysis of early and mid pregnancy placental hormones which are very specific for gestational periods (Smith et al., 2004). An evaluation of the amounts of these hormones relates directly to the time of death. Umbilical Cord Accidents: An increased number of stillbirths are due to accidents of umbilical cord like cord occlusion or blockage due to true knots, nuchal cords and compression of the cord. In almost 30% of normal healthy infant deliveries, nuchal cord and true knots in umbilical cords are observed. According to a study in Sweden, 9% of stillbirths were due to cord accidents (Petersson, 2002). Determination of cord accidents leading to fetal death by autopsy is smaller in proportion (up to 2.5%) (Horn et al., 2004). This difference indicates that in the absence of a proper cause, many times fetal death is attributed to cord entanglement. Due to the increased load of complications with live infants, little concern is expressed towards dead fetuses. In order to precisely relate a fetal death to cord accident, a clear indication of either hypoxic tissue injury or cord occlusion must be observed in autopsy. As nuchal cords are observed in normal deliveries also, the exact proportion of stillbirths due to cord accidents is biased. Obstetric Complications: Some of the obstetric complications are preclampsia, preterm premature rupture of membranes, preterm labor, cervical insufficiency, abruption, placenta previa, and vasa previa. These may either be direct or primary causes or may be indirect or secondary causes of stillbirth. Almost 10-19% of stillbirths occur due to abruption. Since cervical insufficiency or preterm labor lead to neonatal death, their role in causing stillbirth is not well defined. Evaluation of Stillbirth Stillbirth in itself may be emotionally devastating to many patients and their families. There the likelihood of carrying out genetic testing or autopsy on the fetus may not be readily agreeable from the family and culture. Lastly the procedures for evaluation must be cost effective and within reach. The two important facts that should be kept in mind while deciding which tests would prove as the most useful ones are primarily the consideration of cost of that test. It should not be beyond limits. Secondarily, if this test would be helpful in prevention of recurrent or sporadic stillbirths. In recurrent stillbirths, medical interference may prove helpful by preventing them in future. Analyzing the etiology of sporadic stillbirths might lead to reassurance and avoid irrelevant diagnostic tests in future pregnancies. The single most useful diagnostic test is a fetal autopsy (Peterson et al., 1999). Not only does the visible genetic and structural abnormalities but also an autopsy would be of great help in relating specific etiologies to stillbirth. The frequency of fetal autopsy is very less due to the fact that it is costly, not many trained pathologists are available and also it may be of great discomfort to the family and clinicians to deal with such a case. If autopsy is refused, partial autopsy or postmortem magnetic resonance imaging (MRI) scans may provide the necessary data. Embryonic membranes, placenta and umbilical cord must be physically and histologically examined while evaluating stillbirth etiology. This would give a precise cause of fetal death and might also provide clues for death due to secondary causes like infections, thrombophilia, and anemia. In most cases, families do not object on placental evaluation. In the cases where autopsy is not performed karyotyping the fetus would prove helpful. Cells and tissues from placenta (especially chorionic plate), fascia lata, skin from the nape of the neck, and tendons can be isolated and cultured and used for diagnostic tests like karyotyping. Comparative genomic hybridization shows tremendous promise for the identification of chromosomal abnormalities in stillbirths wherein fetal cells cannot be successfully cultured (Silver et al., 2006). An autopsy followed by a careful histological examination might help in relating stillbirths that result due to infections from the bacteria or virus. Parvovirus serology may be useful because this virus has been implicated in a meaningful proportion of cases (Erik et al., 2002). Diagnostic tests are performed for the detection of syphilis also since it contributes to the list of accepted causes of stillbirth. For various viral and protozoal agents like toxoplasmosis, rubella, cytomegalovirus (CMV) and herpes simplex virus (HSV) {TORCH}, serological screening is carried out. For bacterial and viral infections in the fetus, nucleic acid based tests are more helpful when compared to tissue cultures. Feto-maternal hemorrhage can be detected using Kleihauer Betke test (KBT). Most laboratories use manual KBT which is prone to error. It has been found that flow cytometry is a better tool in detecting fetal erythrocytes in maternal blood. In order to eliminate red cell alloimmunization as an etiology of stillbirth, an indirect Coombs test is performed. Autopsy and examination of placenta are helpful in this situation. During the initial prenatal visits, if the antibody screen comes out to be negative then there is a need for recurrent testing. Diagnostic tests for conditions like diabetes and heritable thrombophilias must be carried out on a regular basis to prevent any complications which may lead to stillbirth. The treatment of such conditions at the appropriate time may prevent similar complications in subsequent pregnancies. Heritable thrombophilia might be of concern in the cases where there is recurrent fetal loss or there is a history of thrombosis or with complications involving placental insufficiency like placental infarction and intrauterine growth restriction. Administration of illicit drugs through various modes may be a cause of stillbirth in many cases. Toxicological examination may reveal the results for women who are subjected to such exposures. A simple urinary examination may prove helpful. The advanced and cost effective technology like ELISA (Enzyme Linked Immuno Sorbent Assay) can be used to detect a variety of metabolites like steroids in various tissues like blood, hair, and homogenized umbilical cord. Conclusion: Many medical and nonmedical agents govern the best approach to evaluate a stillbirth. The obstacles faced by obstetricians in solving these issues include the fact that in most of the cases the reason behind fetal death is unknown. Also the magnitude of stillbirths resulting from a single cause is not known precisely. Here there arises a need for population based studies to attribute stillbirths to their specific etiologies. There is a clear cut need of experts in the field of perinatal pathology and the required funding should be provided at the national level to promote it. Moreover, the clinician should be aware of the history of pregnant women in better evaluation. In cases where the local clinicians cannot reach a conclusion, the tissue samples must be sent to senior pathologists who have a thorough command on the subject and can help in reaching decisive conclusions. A universally accepted protocol is required for a systematic evaluation of stillbirths. Due to its absence a difference of opinion occurs among the obstetricians and gynecologists. The institutions like Stillbirth Collaborative Research Network should formulate guidelines for the proper judgement of stillbirth etiologies. The responsibility lies in the hands of the clinicians to do the best they can to reach a definite conclusion from the available data. It is noteworthy that the proportion of stillbirths that are explained is much higher in centers using systematic evaluations for recognized causes and potential causes of stillbirth (Petersson, 2002) (Horn et al., 2004). In conclusion, autopsy, placental evaluation, karyotype, Kleihauer-Betke, antibody screen, and serologic test for syphilis are useful in evaluating the etiologies of stillbirth. Depending on the case, other relative tests should be performed. The approach towards the testing of potential causes of stillbirth is not clear if it should be very specific and sequential or should it be comprehensive which means that it is targeted towards a broad spectrum of causes. Each of these has its own advantage. Sequential testing avoids false positive results and is directed to a specific cause and more over, it is cost effective. Comprehensive testing may prove helpful in cases where more than one factor is responsible for stillbirth. The problem with autopsy, placental evaluation, karyotype, screen for fetal-maternal hemorrhage, and toxicology screen is that they are dependant on time, that is, these tests should be performed immediately after the delivery. Autopsy cannot be delayed because death of the fetus already occurred and this would lead to physiological changes in the whole body and decay begins. The necessary evidence for stillbirth is easily available from fresh samples of placenta and also for toxicology screen. As the time since death increases, the physiology of fetus also changes leading to false positive or false negative results. If the time of fetal examination is delayed, fetal hemorrhage may be mistaken for postmortem lividity. Therefore a serious call for action is expected from institutions like Stillbirth Collaborative Research Network (SCRN) which would help in creating the most applicable diagnostic setting for evaluation of stillbirth (Silver et al., 2006). SCRN was developed by the National Institute of Child Health and Human Development to target the range of etiologies of stillbirth in the U.S. The aim of SCRN is to focus on the following objectives. The use of standardized surveillance in a geographic catchment area will show that the stillbirth rates are greater than those reported in the vital statistics catchment. The use of a prospectively implemented, standardized, postmortem, and placental examination protocols will improve diagnosis of fetal or placental conditions that cause or contribute to stillbirth. Maternal biologic and environmental risk factors in combination with genetic predisposition increase the risk for stillbirth. This is a population based study which is carried out in different counties of different states in the U.S. This study would take into account all the stillbirths and live births occurring in rural as well as urban areas in different racial groups. Even though occurrence of stillbirths cannot be stopped completely, yet attempts of such sort can be made atleast to prevent them to a maximum extent. Glossary Abruptio placenta totalis A placental abruption is a serious condition in which the placenta partially or completely separates from the uterus before the baby is born. Achondrogenesis Dwarfism characterized by various bone aplasias and hypoplasias of the extremities and a short trunk with delayed ossification of the lower spine. Alloimmunization Development of antibodies in response to alloantigens; antigens derived from a genetically dissimilar animal of the same species. Angiogenesis The formation of new blood vessels. Anomaly abnormality Autosome a chromosome other than the X and Y sex-determining chromosomes. Camptomelia bending of the limbs that produce a permanent curving or bowing. Cholestasis a condition caused by rapidly developing or long-term interruption in the excretion of bile (a digestive fluid that helps the body process fat). Chondrodysplasia Congenital dwarfism similar to but milder than achondroplasia, not familial and not evident until mid-childhood, in which the skull and facial features remain normal. Chorioamnionitis Inflammation of the fetal membranes. Dystocia Difficult delivery or parturition. Erythema infectiosum mild infectious disease occurring mainly in early childhood, marked by a rosy-red maculopapular rash on the cheeks, often spreading to the trunk and limbs. Fever and arthritis may also be present. Erythropoetic production of red blood cells. Fascia lata the deep fascia of the thigh. Hydrops excessive accumulation of serous fluid in tissues or cavities of the body. Isoimmunization The development of specific antibodies as a result of antigenic stimulation using material derived from the red blood cells of another individual of the same species. Iatrogenic Induced in a patient by a physicians activity, manner, or therapy. Leptospirosis a febrile disease (fever) caused by infection with the bacteria Leptospira interrogans. Lividity discoloration of dependent parts by gravitation of blood. Monochorionic a single chorion. Neoplasia formation of new tissue. Oligohydramnios Deficiency in the amount of amniotic fluid. Placental mosaicism abnormal chromosomes in some or all placental tissue but not the fetus. Placental infarction blockage of blood circulation to the placenta resulting in tissue death. Polyhydramnios excess of amniotic fluid. Polysplenia multiple small accessory spleens. Preclamsia narrowing of blood vessels. Systemic lupus erythematosus a disease where a persons immune system attacks and injures the bodys own organs and tissues. Thrombophilia disorder of the hemopoietic system in which there is an increased tendency for thrombosis (blood clots). Vasa Previa condition in which fetal intramembranous blood vessels traverse the fetal membranes across the lower segment of the uterus between the fetus and the cervical opening. Velamentous Resembling a veil in shape and composition. References Cited: Ananth CV, Liu S, Kinzler WL, Kramer MS. Stillbirths in the United States, 1981-2000: An age, period, and cohort analysis. Am J Public Health 2005;95:2213-7. Cartlidge PH, Stewart JH., Effects of Changing the Stillbirth Definition on Evaluation of Perinatal Mortality Rates, ncbi, 346(8973): 486-8, 1995. Cnattingius S, Stephansson O. The epidemiology of stillbirth. Semin Perinatol 2002; 26:25-30. Enders M, Weidner A, Zoellner I, Searle K, Enders G. Fetal morbidity and mortality after acute human parvovirus B19 infection in pregnancy: prospective evaluation of 1018 cases. Prenat Diagn 2004;24:513-8. Erik D.H.and Kevin E. B. Human Parvovirus B19. Clinical Microbiology Reviews, July 2002, p. 485505 Faye-Petersen OM, Guinn DA, Wenstrom KD. Value of perinatal autopsy. Obstet Gynecol 1999;94:915-20. Frans M H, Denise A M P, Diane D and Marc J N C K, Perinatal outcome of singletons and twins after assisted conception: a systematic review of controlled studies, BMJ 2004;328;261-; Fren J F, Sudden intrauterine unexplained death, Series of dissertations submitted to the Faculty of Medicine, University of Oslo No. 67, ISBN 82-8072-041-3, 2002. Gardosi J, Kady SM, McGeown P, Francis A, Tonks A. Classification of stillbirth by relevant condition at death (ReCoDe): population based cohort study. BMJ 2005;331:1113-7. Goldenberg RL, Thompson C. The infectious origins of stillbirth. Am J Obstet Gynecol 2003;189:861-73. Hillis SD, Anda RF, Dube SR, et al. The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial consequences, and fetal death. Pediatrics 2004;113:320-7. Horn LC, Langner A, Stiehl P, Wittekind C, Faber R. Identification of the causes of intrauterine death during 310 consecutive autopsies. Eur J Obstet Gynecol Reprod Biol 2004; 113:134-8. Huang DY, Usher RH, Kramer MS, et al. Determinants of unexplained antepartum fetal deaths. Obstet Gynecol 2000;95:215-21. Kalousek DK, Barrett I. Confined placental mosaicism and stillbirth. Pediatr Pathol 1994; 14:151-9. Lynch A, McDuffie R Jr, Lyons E, Chase M, Orleans M, Perinatal Loss Among Twins The Permanente Journal/ Winter 2007/ Volume 11 No. 1 Mary C M M, Kate M F, Jaron A B, Pat D, Jo M, Dominique A, Shona G and Alison M, Perinatal mortality and congenital anomalies in babies of women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland: population based study. BMJ 2006;333;177-; Mirlene C.S.P., Francy R.S., Marcial F. G., Antonio F. M., Evaluation of a Protocol for Postmortem Examination of Stillbirths and Neonatal Deaths with Congenital Anomalies, Journal of Pediatric and Developmental Pathology, Vol 7, Number 4/ April,2004. Nohr E A, Bech B H, Davies M J, Frydenberg M, Henriksen T B and Olsen J. Prepregnancy Obesity and Fetal Death. (Obstet Gynecol 2005;106:2509) Pastore LM, Hertz-Picciotto I, Beaumont JJ. Risk of stillbirth from occupational and residential exposures. Occup Environ Med 1997;54:511-8. Petersson K. Diagnostic evaluation of fetal death with special reference to intrauterine infections. [Dissertation]. Stockholm Sweden: Karolinska Institutet, Department of Clinical Science, Division of Obstetrics and Gynecology; 2002. Puza P. Sharma, Hamisu M. Salihu, Yinka Oyelese, Cande V. Ananth, and Russell S. Kirby. Is Race a Determinant of StillbirthRecurrence? (Obstet Gynecol 2006;107:3917) Rey E, Kahn SR, David M, Shrier I. Thrombophilic disorders and fetal loss: a meta-analysis. Lancet 2003;361:901-8. Salihu HM, Aliyu MH, Rouse DJ, Kirby RS, Alexander GR. Potentially preventable excess mortality among higher-order multiples. Obstet Gynecol 2003;102:679-84. Silver RM, Varner MW, Reddy U, Goldenberg R, Pinar H, Conway D, Bukowski R, Carpenter M, Hogue C, Willinger M, Dudley D, Saade G, Stoll B, Work up of stillbirth: A review of evidence, Am J Obstet Gynecol 2007 May;196(5):433-44. Simpson LL. Maternal medical disease: Risk of antepartum fetal death. Semin Perinatol 2002;26:42-50 Smith GC, Crossley JA, Aitken DA, et al. First-trimester placentation and the risk of antepartum stillbirth. JAMA 2004;292:2249-54. Wapner RJ, Lewis D. Genetics and metabolic causes of stillbirth. Semin Perinatol 2002;26:70-4. Wigglesworth JS. Monitoring perinatal mortality. A pathophysiological approach. Lancet, 1980;2:684-6.

Magical Realism in Gabriel Garcias A Very Old Man with...

Magical Realism in Gabriel Garcias A Very Old Man with Enormous Wings A Very old Man with Enormous Wings (1955) is a short story by Garbriel Garcia Marquez, a Latin American author. This story contains many elements of Magical Realism, such as having one fantastic element while being reality based, having a deeper meaning, and having no need to justify or explain events or human actions. The magical elements in this story are the old man (that is assumed to be an angel) and the girl who was turned into a spider because she disobeyed her parents. The angel is the element in Magical Realism that discovers the mysterious parts in life. Most people believe in supernatural beings like angels. Angels are usually thought of as†¦show more content†¦It shows how one would normally react to something different and strange. The characters reactions differ. The parents, Peylo and Elisenda were afraid and upset when they saw the old angel. They assumed he was coming to take their baby since it had been sick. The crowds reaction was complete curiosity. They never doubted that the man was not an angel, but they did want to see him for themselves. No one questioned the way that the angel was being treated by the crowd or Peylo and Elisenda, either. As a matter of fact, the wise neighbor wanted Peylo and Elisenda to club him to death. The author, Gabriel Garcia Marquez, write with the attitude that it would be perfectly normal to be walking back towards ones house after getting rid of some crabs and seeing an angel. He did offer some explanation to the sudden appearance of the angel. The explanation was that the angel was coming to get the baby but the hard rains knocked him down into the mud. The problem that was caused by the angels appearance was that the crowds overwhelmed the area where he was staying. Because they were nosy and pushy, there was more mistreatment in store for him. At one point in the story, the crowd threw stones at him, threw food at him, plucked out his feathers, and burned his side with an iron for branding steers (527). At the end of the story, Elisenda kept on watching [him fly away] until it was no longer possible to see him, because then he was noShow MoreRelatedA Very Old Man With Enormous Wings Essay1193 Words   |  5 PagesGabriel Marquez Garcia’s short story, â€Å"A Very Old Man with Enormous Wings,† is a children’s story about a fallen angel and the tribulations and humiliations he endures to finally be able to repair his wings and fly back to the divine. It was published in 1955, and it is categorized in the â€Å"magical realism† for it takes place in a real world where magic is possible. For me the author made the angel to represent Jesus Christ, because it shows a humble man, devoid of power, naked luxuries that came

Understanding A Data Breach - 1111 Words

Understanding a Data Breach Ten years ago business professionals were grappling with the decision of whether to implement cloud computing into their organizations. Today, we no longer have the luxury of â€Å"If† we will embrace the new technology but rather â€Å"How† we will make it as safe as possible. The Article In his November 2013 article published in Business Finance Magazine, â€Å"The Real Security Risks of Running Finance Apps in the Cloud†, Ramesh Rajagopal suggests that the real threats with cloud computing fall into two main categories, data compromise through exploit and data compromise through user misstep. Data Compromise through Exploit Rajagopal maintains that the very nature of browsers themselves lends itself to exploitation.†¦show more content†¦These computers would only be used for one purpose for example accessing a company’s banking portal. I find this theory to be impractical at best. Most companies that are leveraging cloud services are doing so for the benefit of ease of use. Larger companies often have employees or consultants working off-site or in multiple locations. Accountants and executives are increasingly pushing to be able to access their data at any time, from anywhere, using any device. Data Compromise through User Misstep Rajagopal does not cover the topic of BYOD extensively in his article. â€Å"In the consumerization of IT, BYOD, or bring your own device, is a phrase that has become widely adopted to refer to employees who bring their own computing devices – such as smartphones, laptops, and PDAs – to the workplace for use and connectivity on the secure corporate network.† (Beal, 2014) This can cause increased security risks as there is no way for corporate IT to insure that the traditional protections methods are up to date and functioning properly or even installed at all. While it may be cost effective to allow employees to furnish their own

New York Yankees free essay sample

Ever since they became an official organization in 1903, the New York Yankees have established themselves as one of the world’s top sport organizations. As a Major League Baseball team, they have historically achieved the ultimate goal of winning the World Series and have gained fans and profit in the process. With thirty-one different managers, the Yankees have won a total of twenty-six World Series and have built a fan base across the globe (â€Å"New†, 2008). Nowadays, the organization even makes yearly revenue close to 300 million dollars (Cohen, 2007). I chose this organization because I believe that their structure and management style is the definition of success. I will apply most of the methods and concepts from the book and from class to the Yankees, and I will discuss why I consider them to be one of the world’s greatest sport organizations today. First, when analyzing the New York Yankees from a managerial perspective, it is important to consider the structure and management style of the organization. We will write a custom essay sample on New York Yankees or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page For example, the New York Yankees have three levels of managers: the owner or executive manager who monitors the business environment (George Steinbrenner), the general manager or middle manager who negotiates and controls player transactions (Brian Cashman), and the field manager or first-line supervisor who supervises individuals within the organization (Joe Girardi). For them to be successful, all of these parts need to work together and form a systems-based organization. In this open system, where everything is â€Å"relatively open to the influences of the environment in which it lives† (Chelladurai, 2005), Steinbrenner is able to react to the goals, structures, and processes of the organization, as well as employers, customers, and so forth. Even though the Yankees did not make the playoffs this year, it is easy to see how the system is successful. All of the managers perform certain tasks, some of which include planning, organizing, leading, and evaluating. Each of these levels do these things for different time frames. When discussing the roles of the Yankee managers, it is important to note that all of them have been successful. Brian Cashman has a large decisional role because he has to make the correct decisions for the fans to be content and the team to win. Back when the Yankees won several consecutive championships in the ‘90s, Joe Torre (field manager) was a leader of the team with excellent human skills. He was able to interact with his players in a way that allowed them to perform at or above their potential, and he also had an incredible amount of knowledge for the types of players he needed to succeed. The owner and general manager had good technical and conceptual skills because it was important that they plan, evaluate, and organize the formation of a successful organization. They had to evaluate the existing organization, plan what players to trade for, and organize the business matters. I know that the organization’s main goal is to win national championships, but they also want to be effective and efficient in doing so. When the owner George Steinbrenner goes out and gets all-star caliber players to win the American League East division and the World Series, he has to pay a lot of money in order to attract them to his team. In terms of being a successful leader, it is obvious that George Steinbrenner â€Å"exerts influence in a way that achieves the organization’s goals by enhancing the productivity and satisfaction of the work force† (Chelladurai, 2005) because he is trying to achieve his goals by getting the best players in the league and making his team more productive. It has been known that George Steinbrenner spends the most money on his players in the league, so the efficiency of the team is minimized even though they have the largest fan base out of any organization. The effectiveness, however, in drawing the support of fans, emotionally and economically, is maximized, since the people want to see the best teams with the best athletes play. In 2004, â€Å"by the completion of the season, which saw Joe Torre at its helm for his ninth season, the New York Yankees had set a new team record for largest team attendance thanks to 3,775,292 loyal fans who attended home games at Yankee Stadium† (â€Å"New†, 2008). You can see here how popular the organization has become, and I can only imagine how much more money it can make in the future. In conclusion, I have analyzed an organization that I felt would help me understand the concepts and methods that are associated with sport management. Based on the structure and personnel of the New York Yankees baseball club now and in the past, I classify it as being one of the world’s most successful organizations. This statement can only be judged by the results that have accompanied the Yankees ever since its inception, twenty-six championships and a world-wide fan base.