Challenges to Sexual Health Care in Todays Society

Challenges to Sexual Health Care in Todays Society Meeting the sexual health demands facing young people in todays society The issue of sexual health in adolescent people is a vast topic with an associated vast literature on the subject. In this essay we aim to consider some of the major themes and critically analyse some of the peer reviewed literature to act as an evidence base for further consideration. (Berwick D 2005) In broad terms, sexual health can be divided into areas of physical health and emotional (or psychological) health. The adolescent age is classically one of turmoil, of establishing identity, values and ideals. This is arguably the time when the emotional turmoil relating to sexual identity comes to the fore. We should remind ourselves, before perhaps dismissing the notion of psychological health as being on a different level of seriousness as an overtly physical problem such as a sexually transmitted disease, (Coyle KK et al 2001), that one of the commonly accepted definitions of health is a state of complete physical, mental, and social well being, and not just merely the absence of disease or infirmity. (UN 1995). One can argue that it is an essential component part of the developing person’s ability to become well adjusted, responsible and productive (in every sense of the word) members of society (UN 2002) Issues of sexuality have, ideally, to be resolved. The apparently eternal adolescent dilemmas of â€Å"am I sexually attractive?† â€Å"am I gay or straight?† or â€Å"am I ready to have sex?† clearly have a direct relevance to the psychological health of a person but the behaviour patterns that these questions can engender in an attempt to resolve them, can pose clear risk patterns to the physical sexual health of the adolescent. (Larson, R., et al. 2002.) To a large extent the issues that concern the adolescent have their origins in earlier life. As they progress through childhood, adults treat boys and girls differently, and thereby establish different expectations for their behaviour. These expectations are clearly influenced by their culture and a myriad of more subtle influences. They largely determine life outcomes. They also shape the adolescent’s introduction to sexual practices, sexuality and relationships generally. (Aarons SJ et al 2000) The reason for dwelling on these factors is that they have a fundamental bearing on the possibility of adverse reproductive and sexual health outcomes in later life, including events such as unwanted pregnancy, unsafe abortion and sexually transmitted diseases, all of which have major socio-economic components. (Churchill D et al 2000), Differential gender expectations and social treatment in childhood and the early adolescent period are thought to be frequent causal factors in adolescent problems. The bulk of this essay will be on the issues surrounding the major issues of STDs in the adolescent community. One of the most pressing issues in this regard (at least in terms of sheer numbers) is the issue of chlamydia. (Fenton KA et al 2001). In the specific terms of meeting the demands of the adolescent population we will begin this examination with a consideration of the National Chlamydia Screening programme. The programme was originally set up after the realisation that chlamydia was responsible for a large amount of morbidity in the community which had, hitherto been unrecognised (Cates W, et al. 1991). It is now seen as the single most commonly transmitted STD in the UK today. A huge proportion of what used to be called NSU is now recognised as being due to the chlamydia pathogen (Duncan 1998). If we consider the issues behind the screening programme, on one level the issues appear fairly straightforward and simple. Because we know that many cases of chlamydia are asymptomatic and that it can cause considerable damage and that it is also easily treatable, why not screen for it and minimise its impact? (Kufeji O et al 2003) On a more sophisticated level one must consider the cost-effectiveness considerations together with issues such as feasibility, efficiency and use of resources. If we examine the published rationale behind the National Chlamydia Screening programme as set out by The National Institute for Clinical Excellence (NICE) we can see that it states that: Genital Chlamydia trachomatis is the commonest Sexually Transmitted Infection (STI) in England Genital chlamydial infection is an important reproductive health problem ~ 10-30% of infected women develop pelvic inflammatory disease (PID). A significant proportion of cases, particularly amongst women, are asymptomatic and so, are liable to remain undetected, putting women at risk of developing PID. Screening for genital chlamydia infection may reduce PID and ectopic pregnancy. They also concluded that there was not a great deal of data on the cost effectiveness of the possible procedure (Harry et al 1994) The paper itself is extremely detailed and, in essence, it points to the fact that it is extremely cost effective to detect and treat asymptomatic patients before they develop complications that then need treatment. Complications are outlined in the paper by Berry (et al 1995) and include the sequelae of infertility, pelvic inflammatory disease and ectopic pregnancy in women together with the complications that can occur in the male partners (infertility and prostatitis). The authors point to the fact that their screening programme reduced both the incidence and prevalence of pelvic inflammatory disease by 60% when compared to the unscreened population. Of particular relevance to our theme, we note that the screening programme became cost effective when the incidence of infection in the population of asymptomatic women rose above 1.1%. Figures quoted by Pimenta J (et al 2001) suggest that in our target age range the prevalence is approaching 11%. If we examine the literature on the subject we can see that the adolescent age range has the fastest growing proportion of chlamydial infections (Gilson et al 2001). This finding is therefore at odds with the logic of the report commissioned by the Chief Medical Officer (CMO 1998) which suggests that the groups to be screened under the National Programme should be: Everyone with symptoms of chlamydia infection, All those attending genitourinary medicine clinics, Women seeking termination of pregnancy. Opportunistic screening of young sexually active women under 25 years Women over 25 with a new sexual partner or two or more sexual partners in the past year. It will therefore be immediately apparent that there is no provision for screening for asymptomatic men and also that the adolescent population are not to be specifically targeted unless they attend clinics. On the subject of screening young men, there are a number of well written papers on the subject. Notable amongst them is the Duncan paper (Duncan et al. 2001) which looks at the issues of male screening from both a Public Health viewpoint and it also considers it from a feminist sociological angle which makes it, (in our examination of the current literature), almost unique. It is a thoughtful and well written document and tackles the thorny issue of the fact that many young women are reluctant to attend screening clinics as being screened for STDs has overtones and perception of being dirty and unattractive. A positive screening result can be associated with considerations of promiscuity. Such feelings are clearly counterproductive, particularly in the light of our earlier comments relating to the developing psyche of the adolescent. Duncan puts forward the hypothesis that by not screening men, it not only fosters gender inequalities, but it sends of negative messages regarding the man’s responsibility for sexual health (Pierpoint et al 2000). Critical analysis of this point suggest that although it may be intuitively true, the authors don’t produce any counter evidence with regard to the cost effectiveness of screening adolescent males (or any other age group for that matter) in the population (Stephenson et al 2000) Other authors do also make the point that it appears to be a generally accepted fact that women are actually easier to target than men as they tend to be heavier health care users than men in this age range (Stokes T 2000). The main practical thrust of this paper however, is in its call for a greater understanding of the woman’s point of view when organising and running screening clinics in order to broaden their appeal to the intended target groups (Santer et al 2000). Clearly this point is central to our considerations here as clearly there is no point in providing services to meet a perceived need if there is no uptake from the targeted population. If we turn our attention to the second most common STD in this age range we need to consider genital herpes. (Schacker T et al 2000) There are many common arguments in the areas of screening for genital herpes and chlamydia. Qualitative studies have shown a greater level of concern relating to genital herpes amongst the adolescent population that there is for chlamydia, and it is second only to HIV/AIDS (Corey L et al 2001). The specific problem with the age range that we are specifically considering here is that there is a general perception that genital herpes is a nuisance and a comparatively trivial condition. Indeed the majority of infections are either mild or subclinical. Serious complications are actually comparatively common and there is an increasing body of evidence that suggests that genital herpes infection is a potent facilitator of sexual transmission of the HIV virus. (Tripp J et al 2005) The major epidemiological factor that is relevant with genital herpes is the fact that transmission can occur in a long-standing monogamous relationship. Its immediate problem is that the longer the period of infectivity, the greater the potential for transmission. In the adolescent years when there is a greater likelihood of a number of sexual partners, infections can be contracted only to be passed on at a considerably later time due to the fact that subclinical or unrecognised reactivation in the infected partner is intermittent. (Hopkins J 2005) There is another element of sexual health that is specific to the adolescent age range. As we have already observed, adolescence is a time of considerable turmoil not only in terms of psyche but also in terms of hormones. There is an eye-catching paper by Brabin (2001) which considers the impact of fluctuating hormone levels on the body’s susceptibility to STDs It is already established that sex hormones play a role in the host’s resistance to STDs (Hewitt RG et al 2001). We can show this by considering sex differences in susceptibility to infection, variations in the clinical manifestations of infection during the menstrual cycle (Greenblatt RM et al 2000) and also during pregnancy (Brown ZA et al 1997) and also by the fact that the OC Pill predisposes to some infections (Wang CC et al 1999) The paper considers the implications of these facts with particular reference to the adolescent age group. It points to the sex differences in the acquisition of STDs with the adolescent girl getting infections such as genital herpes and chlamydia with greater frequency than the adolescent boy. (Obasi A et al 1999) Sex differences also have an effect on the efficacy of a genital herpes vaccine trial which showed a limited protective efficacy against genital herpes in women but none in men. (Stephenson J 2000). The whole area of the ability of the NHS to meet the demands of the sexual health needs of the adolescent is vast. We have not presumed to cover all of the relevant areas in this particular essay. In the areas that we have selected for examination and consideration we have been at pains to critically assess the evidence base as this is fundamental to the acceptance of the comparative validity of the various papers used. The adolescent age group has certain unique characteristics which set its sexual health related problems apart from the rest of the population. In short, they can be encapsulated in the turmoil of the characteristic psychological and physical changes that are typical of the age. We have examined how the psychological issues impinge on both the sexual behaviour patterns and therefore the disease exposure risks and also the willingness to attend clinics if a sexually acquired disease process becomes apparent. We have contrasted this pattern with the pattern of screening that is currently advised and implemented under the auspices of the National Chlamydia Screening Programme. We have also examined the negative aspect of the disproportionate concentration of resources of the older female population and therefore, by inference, the impact that this will have on the adolescent population. Issues such as genital herpes also have unique implications for the adolescent, particularly with the long period of infectivity that is relevant to this disease process. We also have examined the implications of the hormonal differences that are amplified by the hormonal changes that are apparent in this age range. References Aarons SJ, Jenkins RR, Raine TR, El-Khorazaty MN, Woodward KM, Williams RL, et al. 2000 Postponing sexual intercourse among urban junior high school students. A randomised controlled evaluation. J Adolesc Health 2000; 27: 236-247 Berry J, Crowley T, Horner P, et al. 1995 Screening for asymptomatic Chlamydia trachomatis infection in male students by examination of first catch urine. Genitourin Med 1995;71:329–30. Berwick D 2005 Broadening the view of evidence-based medicine Qual. Saf. Health Care, Oct 2005; 14: 315 316. Brabin L 2001 Hormonal markers of susceptibility to sexually transmitted infections: are we taking them seriously? BMJ 2001;323:394-395 ( 18 August ) Brown ZA, Selke S, Zeh J, Kopelman J, Maslow A, Ashley RL, et al. 1997 The acquisition of herpes simplex virus during pregnancy. N Engl J Med 1997; 337: 509-515 Cates W, Wasserheit JN. 1991 Genital chlamydial infections: epidemiology and reproductive sequelae. Am J Obstet Gynecol 1991; 164: 1771-1781 Churchill D, Allen J, Pringle M, Hippisley-Cox J, Ebdon D, Macpherson M, et al. 2000 Consultation patterns and provision of contraception in general practice before teenage pregnancy: case-control study. BMJ 2000; 321: 486-489 CMO 1998 Chief Medical Officer. Main report of the Chief Medical Officers Expert Advisory Group on Chlamydia trachomatis. London: Department of Health , 1998. Corey L, Wald A. 2001 Genital herpes. In: Holmes KK, Mà ¥rdh PA, Sparling PF, eds. Sexually Transmitted Diseases. 4th ed. New York, NY: McGraw Hill; 2001:285-312. Coyle KK, Basen-Engquist KM, Kirby DB, Parcel GS, Banspach SW, Collins JL, et al. 2001 Safer choices: reducing teen pregnancy, HIV, and STDs. Public Health Rep 2001; 116(suppl 1): 82-93 Duncan B, Hart G. 1998 Screening for Chlamydia trachomatis: a qualitative study of womens views. Prevenir 1998; (suppl 24): 229. Duncan B, Graham Hart, Anne Scoular, and Alison Bigrigg 2001 Qualitative analysis of psychosocial impact of diagnosis of Chlamydia trachomatis: implications for screening BMJ, Jan 2001; 322: 195 – 199 Larson, R., et al. 2002. Changes in Adolescents’ Interpersonal Experiences: Are They being Prepared for Adult Relationships in the Twenty-first Century?† Journal of Research on Adolesence 12(1): 31-68; 2002 Fenton KA, Korovessis C, Johnson AM, et al. 2001 Sexual behaviour in Britain: reported sexually transmitted infections and prevalent genital Chlamydia trachomatis infection. Lancet 2001;358:1851–4. Gilson RJC and Mindel A 2001 Recent advances: Sexually transmitted infections BMJ, May 2001; 322: 1160 1164 Greenblatt RM, Ameli N, Grant RM, Bacchetti P, Taylor RN. 2000 Impact of the ovulatory cycle on virologic and immunologic markers in HIV-infected women. J Infect Dis 2000; 181: 82-90 Harry T, Saravanamuttu K, Rashid S, et al. 1994 Audit evaluating the value of routine screening of Chlamydia trachomatis urethral infections in men. Int J STD AIDS 1994;5:374–5 Hewitt RG, Parsa N, Gugino L. 2001 The role of gender in HIV progression. AIDS Reader 2001; 11: 29-33 Howell MR , TC Quinn, CA Gaydos. 1998 Screening for Chlamydia trachomatis in asymptomatic women attending family planning clinics. Annals of Internal Medicine 1998 128:277-84 Kufeji O, R Slack, J A Cassell, S Pugh, and A Hayward 2003 Who is being tested for genital chlamydia in primary care? Sex. Transm. Inf., June 1, 2003; 79(3): 234 236. Obasi A, Mosha F, Quigley M, Sekirassa Z, Gibbs T, Munguti K, et al. 1999 Antibody to herpes simplex virus type 2 as a marker of sexual risk behavior in rural Tanzania. J Infect Dis 1999; 179: 16-24 Pierpoint T, Thomas B, Judd A, et al. 2000 Prevalence of Chlamydia trachomatis in young men in north west London. Sex Transm Infect 2000;76:273–6. Pimenta J, Catchpole M, Gray M, Hopwood J, Randall S. 2001 Screening for genital chlamydial infection. BMJ 2001 321: 629-631 Santer M, Warner P, Wyke S, et al. 2000 Opportunistic screening for chlamydia infection in general practice: can we reach young women? J Med Screen 2000;7:175–6. Schacker T, Zeh J, Hu HL, et al. 2000 Frequency of symptomatic and asymptomatic herpes simplex virus type 2 reactivations among human immunodeficiency virus-infected men. J Infect Dis. 2000;178:1616-1622. Stephenson J. 2000 Genital herpes vaccine shows limited promise. JAMA 2000; 284: 1913-1914 Stephenson J, Carder C, Copas A, et al. 2000 Home screening for chlamydial genital infection: is it acceptable to young men and women? Sex Transm Infect 2000;76:25–7. Stokes T, Mears J. 2000 Sexual health and the practice nurse: a survey of reported practice and attitudes. Br J Fam Plann 2000;26:89–92 Tanne JH 2005 US teenagers think oral sex isnt real sex BMJ, Apr 2005; 330: 865 ; Tripp J and Viner R 2005 Sexual health, contraception, and teenage pregnancy BMJ, Mar 2005; 330: 590 593 ; UN 1995 United Nations. 1995. Population and Development, vol. 1: Programme of Action adopted at the International Conference on Population and Development: Cairo, 5-13 September 1994, paragraph 7.2. New York: Department of Economic and Social Information and Policy Analysis, United Nations. 1994 UN 2002 United Nations. 2002. World Youth Report 2003: Report of the Secretary- General (E/CN.5/2003/4), para. 16. New York: Commission for Social Development, United Nations. 2002 Wang CC, Kreiss JK, Reilly M. 1999 Risk of HIV infection in oral contraceptive pill users: a meta-analysis. J AIDS 1999; 21: 51-58 Wilson JS, Honey E, Templeton A, et al. 2002 A systematic review of the prevalence of Chlamydia trachomatis among European women. Human Reproduction Update 2002;8:385–94. ############################################################# 11.3.06 PDG Word count 3,100

The Rime Of The Ancient Mariner

The Rime Of The Ancient Mariner Samuel Taylor Coleridges The Rime of the Ancient Mariner is said to be his attempt to bring supernatural terrors to a naturalistic setting. Some critics have argued that the moral truths of the poem are not only unintelligible but also irrational. But for other critics, this irrationality is what gives the poem its greatest quality. In analyzing and critiquing Coleridges poem, an in depth analysis of the irrational is needed. This irrationality is not Coleridges failure to explain the supernatural but actually an evidence of its Christian moral code and that the poems irrationality emerges because of Coleridges inner conflict with his conversion from Unitarianism to the Anglicanism religion. This hermeneutic must be in mind when attempting to interpret Coleridges poem. Before we can look at modern critics such as Christopher Stokes, J Robert Barth, John T Netland, and even Jerome J. McGann, we must first look at how earlier critics have looked at Coleridges work through a Christian eyes. The article Coleridge And The Luminous Gloom: An Analysis Of The Symbolical Language In The Rime Of The Ancient Mariner' by Elliott B. Gose, Jr. examines the poem through a Christian perspective only because Gose believes the poem is filled with Christian trappings (239). Gose shows how symbols carry a Christian ideology and spends considerable time on examining how the sun (whether glorious or red) represents God while the other forces in the poem represent the forces of nature. In the end, Gose claims that nature is subordinate to God and that the Mariners voyage does not deal with a physical voyage but it represents a Romantic urge to explore the eternal soul and the temporal emotions (244). But throughout the article, Gose fails to fully explain the other stran ger elements in Coleridges poem. For instance, he brings up life-in-death, who wins the Mariner in a gamble, but then dismisses her by stating how she is obviously outside the Christian hierarchy and is connected with a whole strand of non-Christian figures, incidents, and images in the poem (242). He interprets this from the obscure explanation given from the gloss and continues with the rest of the poem still in Christian ideological framework. More modern critics will point out how though much of the poem seems to use Christian terms, the more stranger elements and the ambiguous details create distance between familiar and unfamiliar which gave trouble to many earlier Christian critical readings of Coleridges text. Goses confusion with the gloss and its obscure Christian emphasis can be explained in Reading And Resistance: The Hermeneutic Subtext Of The Rime Of The Ancient Mariner by John T Netland. He suggests that the poem displays an incongruous mixture of pagan and Christian symbols (38) and examines the use of the gloss as a hermeneutic. Although the gloss-writing editor is responding to the original poem and seeks to interpret it for a modern audience, the editor marginalizes the Mariners experiences and emphasizes the Christian overtones of the poem. Netland states the gloss and the poem itself create a unique tension between contrasting religious imaginations (41). One is a world of categorized and rational set of religious experiences (inferred from gloss) while the other a spiritual, mystical, irrational religious sublimity (from the poem). Netland states that Coleridge may have gotten his idea from Bibles at that time with their gloss notes that gave a clearer interpretation of the b iblical text. This is very similar to Jerome J. McGanns examinations in his brilliant article, The Meaning Of The Ancient Mariner, where McGann briefly details the poems history from its initial criticism to Coleridges embracing of Christian ideology to his Higher Critical analytics of the re-interpretative process of the Bible to Coleridges attempt in mimicking this layered hermeneutic upon his own work. McGann points to the fact that Coleridges poem was originally a literary ballad among all the other lyrical ballads found Wordsworths printed work, Lyrical Ballads. With the second edition, and with Wordworths concerns, Coleridge made alterations to make the poem less a literary ballad and more a lyrical ballad. Coleridge may have realized what he was doing was similar to what occurred in Biblical narratives. Coleridge had argued in length on issues of Higher Criticism that Scriptures were not an unmediated and fixed biblical text but an evolved and continuously evolving set of rec ords which include the Churchs later glosses on and interpretations of the earlier documents (47). McGann remarkably suggests that Coleridges revised version of his poem shows four clear layers of development: (a) an original mariners tale; (b) the ballad narrative of that story; (c) the editorial gloss added when the ballad was, we are to suppose, first printed; and (d) Coleridges own point of view on his invented materials (50). The last shows Coleridges own theory of religious and symbolic interpretation. McGann believes that The Rime of the Ancient Mariner is Coleridges imitation of a culturally redacted literary work (51). But coming back to Netlands article, the gloss, he believes, becomes an inadequate hermeneutic for analyzing the poem. Netland suggests that the gloss is inadequate as a hermeneutic since the editor reduces the Mariners spiritual journey, actions, and sufferings into a straight-forward neat plot to emphasize Christian redemption. Netland states that the Marinerà ¢Ã¢â€š ¬Ã‚ ¦has experienced something of the religious sublime (whether real or delusive), and his compulsive retellings of his story point to the inexplicable profundity of his experience (51). The writer of the gloss fails to understand this and the gloss represses the Mariners heightened religious experience. Netland suggests that we instead respond like the stunned Wedding Guest which is far more consistent to Coleridgean hermeneutics when analyzing the journey of the Mariner. But can the gloss be ignored? McGann disagrees and states that the changes (as well as the addition of the gloss) from 1798 to 1817 show an important story in Coleridges development of the purposes of his poem. Many believed that these changes were a reactionary movement in which a daring and radical poem is transformed into a relatively tame work of Christian symbolism (42) when Coleridge retreated from his radical views to his later Christian ideology. McGann, in his article, dives deeply into Coleridges understanding of the Higher Critical analysis of the Christian Bible to show Coleridges Hermeneutic Model of his poem originating from his ideas of the process of the Bibles creation. Coleridge saw how Gods Word was expressed and later reexpressed through commentary, gloss, and interpretation by particular people at different times according to their differing lights (43). Coleridges poem is presented as just this type of reinterpreted text retaining its own ideological coherence e ven through the fragmentation from reinterpretation. McGann states that the poem shows Coleridges process of textual evolution and the symbolic meaning of that process is a Christian redemptive one. We can see how the very nature of religion affected Coleridge in his earlier 1798 version and his later 1817 version (with gloss) and can conclude that the poet himself and his faith must be examined. J. Robert Barths book, Romanticism and Transcendence: Wordsworth, Coleridge, and the Religious Imagination, delves deeply into Coleridges theories, struggles, and faith. Although, he spends the first four chapter exploring Wordsworths works and how it practices Coleridges theories of imagination, he examines closely the nature of religion in The Rime of the Ancient Mariner in chapter 6. Although Coleridge had theological speculations, he was a practical Christian (89). Coleridge believed in living out the practical aspects of his faith. Barth does not give a complete examination of Coleridges poem, but hones in to what he believes gives strength and beauty to Coleridges poetry. The notion of polarity (a balance or reconciliation of opposites (6)) is central to Coleridges theories of ima gination. Opposite objects, qualities, or tensions exist within the same field of force' (6). Barth also looks at prayer as a means of bringing these two forces into harmony (natural and supernatural). Coleridge is concerned with prayer but at a deeper level as a means of uniting the creature with the Creator (90). Coleridges guilt and need for redemption is bound to his longing for forgiveness and friendship with God. Coleridge calls prayer the the effort to connect the misery of Self with the blessedness of God (90). It is a means of connecting the natural to the supernatural, the temporal to the eternal, and the immanent to the transcendent. Barth states that even though Coleridge does move from his Unitarian ideology to his Christian ideology, a shift that can be seen in the poem and its revision, this idea of prayer is still deep within Coleridges soul. Although, Barth explores prayer within the poem during Coleridges conversion, this shift of faith can be explored further as m eans for a proper hermeneutic in interpreting Coleridges poem. Christopher Stokes article My Soul In Agony: Irrationality And Christianity In The Rime Of The Ancient Mariner explores the struggle between the physical and the spiritual world in Coleridges poem. His poem contains strange elements that seem unintelligible and irrational. Stokes states that these elements stem from Coleridges Unitarian moral theory that he subscribed to at the time. Because these strange elements are unintelligible, there is an ambiguity between the supernatural events and orthodox religion. Though much of the poem seems to use Christian terms, there is still details that are ambiguous and this creates distance between familiar and unfamiliar. Stokes states that these ambiguous moments create a divided tone and he claims this is from Coleridges difficult transition from Unitarianism to Anglican Christianity. Coleridge struggled with Christianitys concept of original sin and a closer examination must be conducted to understand why he possibly struggled with it. The concept and doctrine of Original Sin was developed by the early Roman church and was based on Pauls teachings found in the Book of Romans. In the Old Testament (specifically from Genesis), Adam and Eve disobeyed God in the Garden and the result was that they were cursed and banished out of the Garden. Because of the actions of Adam and Eve, sin (a propensity to disobey God) originated in the Garden and continued to all future generations. Paul teaches a reinterpretation of this Genesis story. In Romans 5.12, Paul states that just as sin entered the world through one man, and death through sin, and in this way death came to all people, because all sinned. At the time of Pauls teaching, audiences of the early Gospels will be familiar with the story of Jesus (especially since Mark and Matthew may have been circulating prior to Romans being written). The audiences would understand that Jesus died as a sacrificial lamb for the sins (actual personal committed sins; a personal disobedie nce) of all man. But Paul goes to reinterpret Christs death to add that Jesus died to not only remove our personal sins but also to remove the hold of original sin on humanity which results in death. For just as through the disobedience of the one man the many were made sinners, so also through the obedience of the one man the many will be made righteous (Romans 5.19). This meant that all humanity was guilty for their personal sins and guilty for the sin of Adam and Eve that was passed to generations. Later under the Roman church, Saint Augustine of Hippo taught that all of humanity was in a state of sin that came from Adam. Man is born with sin and a weakened free-will that gravitates toward sin. Adam and Eves sin and guilt is carried onto each generation (Kelley, 34-38). This was the concept of Original Sin. This is a belief that is still held today by Catholics and Protestants (although, it may vary based on demonization). But Unitarians do not believe in the concept of Original Sin. They do not believe that the sin of Adam and Eve corrupted all of humanity and that we still carry their guilt. They state it would contradict the love and justice of God to attribute to us the sin of others, because sin is ones own personal action (JoÃÅ' zsef, 107). This was a key to why Coleridge struggled in his conversion to Christianity and is evident in his poem. Stokes, in his article, explains the struggle readers have with the strange and irrational elements in the poem are reflective and evidence of Coleridges struggle in his departure from Unitarian ideology to Anglican ideology. An example can be seen with the killing of the Albatross which many critics agree is a strange element to the poem. The Mariner simply kills the bird with no thought prior and the only shock is from the Wedding Guest. The crew at first thought it wrong, but then agreed that the bird was bad luck. Without the gloss notes (and in the original 1798 version), it seems that even nature is unmoved by something that seemed like a crime and the reader isnt given any reason that the killing set any clear event in motion (a determinative effects of motives based on Unitarian moral theory (5)). The albatross death is a powerful but initially unintelligible event but has no obvious moral or religious significance (6). Coleridge, after his conversion and firming in Christian ideology, comes to term with original sin and revises his work (through additions, subtractions, and including a gloss for the poem) giving it a more Anglican tone. The gloss becomes an Anglican hermeneutic bringing the poem under a Christian ideology and moral order. The poem under the gloss gives it a Christian salvational trajectory (20). It is only through the gloss (and Coleridges later revision in 1817) that we learn that the ancient Mariner inhospitably killeth the pious bird of good omen. Stokes understands the common critical belief that the Mariner conspicuously relies on Christian rituals and beliefs . . . the Christian doctrine fails to explain his world of excessive suffering and irrational events (11). But he states that before we dismiss these strange elements as irrational, we must explore Coleridges religious thinking at the time of writing the poem and both its revisions. It is only through the examination of his personal faith and conversion that we can develop a proper hermeneutic to interpret Coleridges poem. It would be erroneous to assume irrationality as a failure of the poems Christian moral code. One must look at Coleridges conversion as well as his struggle with the Christian doctrine of original sin that creates the irrational or at least creates ambiguous language. It is only through this hermeneutic that we can fully understand and appreciate Coleridges poem where he attempts to understand and present to us the concepts that are beyond understanding.

Russias Economic Transition :: Russian History Historical Communism Essays

Russia' Economic Transition In August of 1991, the collapse of the communist system in the USSR and it's neighboring republics occurred. Out of the smoke emerged fifteen new republics and a union known as the Commonwealth of Independent States. These new regimes faced formidable obstacles. The collapse brought massive inflation which in turn forced the economy into a spiraling decline and a state of almost worthless value. Many people were quick to point the finger at their communist past, and even more eager to lay blame. Traditional communist ideology was to "provide for every individual an equal amount of goods and services, thus creating a state of equality amongst the populous" (Leveler, 16). Many people felt as if their current hardships could be blamed on the communists and their economic policies, specifically their "Core-Periphery" plan. The communist sponsored "Core-Periphery" economic policy that was evident in Russia was quite simplistic in nature. The theory, traditionally used to describe inter-continental trading and production, was adapted for use in the Russian economic zones. The theory was as follows; Areas which surround the capital (core region), usually rich in one material or another, would be used for the extraction of raw materials. These materials would then be shipped back to the capital in order to be manufactured into goods. From there, the manufactured products would be shipped back to the surrounding regions (periphery region) for resale. The citizens of Russia were surviving on this system, but barely. The Core-Periphery policy was not efficient, nor effective, for usually a product needed on one side of the federation, was produced at the other end. Factors such as transportation costs and adequate use of human resources was very inefficient and cost-consuming. Strong influences from the world urged Russia to make the transition into the market-oriented economy. This seemed tempting, for the market-oriented economy preached individual wealth and prosperity. Seeing no better solution to their current economic woes, Russian policy-makers took the plunge.   Ã‚  Ã‚  Ã‚  Ã‚  By 1995, 4 years since the beginning of the transition into a market- oriented economy, no satisfactory economic improvment had taken form. Productivity in many states such as Turkmenistan and Belarus continued to fall (Table 2), and inflation was still at high levels. Many new Russian capitalists in the regions chose to exploit what had already been exploited in the past; raw materials. Looking to make a fast income, these new Russian capitalists sold whatever they could get their hands on, for practically no cost at all (Co- Existence, 146). Expropriation of state property, shady deals, and corruption were rampant. Productivity in industries such as agriculture declined as farmers did not want to take care of their land (Co-Existence, 146).

Carandiru - Movie Overview Essay examples -- essays research papers

Carandiru The adaptation of Carandiru Station, a best-seller by Drauzio Varella, Carandiru proposes diving into the heart of SÃ £o Paulo's prison, the largest in Latin America with approximately 7,000 prisoners with a capacity for 4,500. Guided by a humanist doctor (the author) who has an affection for the prisoners, the audience shares in the daily life of the condemned before the massacre perpetrated on October 2, 1992 by the police force following a riot. The film opens with a settling of scores by Ebony, a prisoner in charge of the kitchens. While the director quickly arrives on the spot, Ebony doesn't let go of the reins of the situation. He's understood: in Carandiru, the voices of management and prisoners rise in a choir and vibrate in diapason, in order to maintain a balance and precarious order, essential for the place to function well. The armed sentinels carrying out their rounds along the ramparts, always discrete, only represent only the last resort in case of outbursts. What's immediately striking about Babenco's film is the details used to account for the tacit rules laid down in this place of imprisonment. Killers, robbers and rapists seem to cohabit by enacting their own rules, often transpositions of the law of the street, with its codes, duties, rights and punishments. Between the walls of the various wards, one witnesses the everyday life of a city totally apart, with its neighborhoods, trades, residences. No cell is closed: the impression...

The Host Book Review

The Host Book Review Melanie Stryder is one of few â€Å"wild† human rebels who have evaded the alien souls currently taking over the Earth. With her younger brother, Jamie, and the man she loves, Jared Howe, Mel is on the run from souls who hunt down host bodies for use. Souls are creatures that rely on host bodies to survive. After insertion, they erase any mental presence of the being originally there and establish a claim over the body and mind. Earth is Wanderer's ninth planet, and Mel is her ninth host body.Upon waking inside her new body, she is shocked not only by the vividness of human emotions, memories, and senses, but quickly learns that Melanie Stryder is not willing to give up the entirety of her mind. Stephenie Meyer’s Twilight Saga has often been described as vampire fiction for people who don’t like vampires. It is fair to say that with The Host, her latest novel, she has once again managed to break the usual genre stereotypes. This time, writing a science fiction novel for people who don’t like science fiction.Unlike the most popular alien invasion movies and science fiction television shows, The Host doesn’t have Will Smith or Richard Dean Anderson to save the planet against a background of gun fire, secret weapons, and loud explosions. In The Host humanity is lost, vastly outnumbered and overwhelmed by superior technology. There are tiny pockets of resistance left; just a handful of humans who have yet been captured, but they don’t spend their days plotting to retake the planet from the aliens.Just trying to survive consumes all their time. The Host isn’t really about saving the planet from alien invaders; it’s a story about what it is to be human, about identity and about individuality. Most of all The Host is a story about the nature of love. Romantic  love, love of family, love of friends – all of these emotions are explored by Wanderer as she first surrenders to Melanieâ₠¬â„¢s emotional memories then surrenders to the emotions for herself.There is more than just memories left of Melanie though; she is trapped inside her own head unable to take control of her own body, forced to be an unwilling host to the alien Wanderer. Which makes things very interesting when Wanderer and Melanie eventually meet up with Melanie’s loved ones. Possibly the largest similarity between The Host and Stephenie Meyers Twilight Saga is the character of Wanderer. She has something of a Bella vibe going on. It is the way that they are both self sacrificing.Wanderer’s alien nature actually makes her even more self sacrificing than Bella which means that she needs others to look out for her and take care of her since she has little instinct for self preservation. Unlike the Twilight Saga, I would recommend The Host for both teens and adults. Stephenie Meyer wrote this book to attract a wide audience. All in all The Host makes a very compelling read. Avoiding the obvious science fiction cliches, it concentrates on humanity and the human emotions experienced by an alien invader who really wants to be a human.

Brand Community Analysis

Brand Community Analysis As the development of communication technology and global market, the concept of Brand Community was fist defined as ‘a specialized, non-geographically bound community, based on a structured set of social relationships among admirers of a brand’ by two social scientists, Albert M. Muniz, JR and Thomas C. O’Guinn (2001). This essay will firstly give a brief overview of brand community, and then point out three main characteristics and further discuss these features of brand community based on the article by Muniz and O’Guinn (2001) using the supporters of Manchester United Football Club as an example.Brand community is a customer-customer-brand triad. It reflects on a collection of brand-centric social group stressing the use of brand and the relationship formed by emotion between consumers (Muniz and O’Guinn, 2001). Furthermore, McAlexander, Schouten and Koenig (2002) have extended this model to the extent that brand communit y is actually a customer-centric network and aim to provide customer special brand-related consumption experience. They have also emphasized the concept of brand experience in a community.Any brand experience comes from the interaction among members, and at the same time customers also construct the meaning of the brand in the process of interaction and experience. Subsequently, by the research in the abandoned Apple Newton, Muniz and Schau (2005) found brand community can be regarded to a kind of religious affiliation. Manchester United Football Club (MUFC) is a famous professional football team founded in 1878 in England. It is the best supported in Europe (Rice, 2009) and probably the most popular football club in the world.According to the article by Cass (2007) from Daily Mail, the number of worldwide MUFC supporters was closed to 333 million in 2007. In this case, I assume the fans of MUFC all are the members of the club community and they principally consume match tickets and club-related products. Muniz and O’Guinn (2001) raised 3 basic characteristics for brand community, like other traditional communities, which respectively were a shared consciousness, rituals and traditions and a sense of moral responsibility. The most important shared consciousness is group awareness.It means there is an implicit relationship between community members and members can be distinct from others. Rituals and traditions is a vital social process. Brand and the meaning of brand community with their history, culture and consciousness can be duplicated and passed on through ritual and traditions. Moral responsibility indicates that community members are responsible for each other. These 3 characteristics show the nature of brand community. For the sense of consciousness, members feel a great relation toward one another is more important than the connection to the brand (Muniz and O’Guinn, 2001).That is why two main organisations for MUFC supporters in the UK, Independent Manchester United Supporters Association (IMUSA) and Manchester United Supporters Trust (MUST), were established to let like-minded people join together and formed local communities. IMUSA has even set up a committee to better represent the interest and voice of supports. Supporters from all around the world can also just easily use web-based communication tools such as Twitter, Facebook, and forums like MUFC fansforum (http://community. manutd. com/forums/) to share updated news and maintain connections.On the other hand, members, ‘also set them apart from others and makes them similar to one another’ Muniz and O’Guinn (2001) claimed, especially try to distinct them from the main competitive brand in the market. This regards to oppositional brand loyalty. In this MUFC case, the oppositional brand is its main rivalry in the Premier league located in the same city – Manchester City Football Club (MCFC). Fans from MUFC always differentiate them against MCFC supporters. Members usually said MCFC is built by money, just an upstart and a noisy neighbour.Most of the community members despise this kind of team because they think MUFC has the glories that MCFC lack of and embodies the passion and excitement of the world's most popular sport (Hill and Vincent, 2006). Muniz and O’Guinn (2001) indicated rituals and traditions focus on sharing consumption experience with the brand. Supporters sing several specific songs during the match regarding to different circumstances to encourage and cheer the team. Those songs have already become a kind of spiritual symbol of the MUFC brand, and therefore will be passed on each time they are sung in matches.Celebrating the history of the brand is crucial for maintaining community and reproducing culture (Muniz and O’Guinn, 2001). For the MUFC community, the most vital history is the trophies they gained. After MUFC won their 19th English top league title last season, the Barclay s Premiership Trophy Cup was being demonstrated around the world for the whole summer in 2011. This tour is not only presenting the precious trophy cup to supporters but also a promotion of the great history of MUFC to further raise reputation and attract new members.Sharing brand stories is another important means of maintaining and creating community (Muniz and O’Guinn, 2001). MUFC fans always mention either face to face or on internet about the classic victory of the champion league final in 1999 in Munich. This can be related to viral marketing by which positive image and consciousness of the brand and community can be delivered through word of mouth or improved by the internet network effects. ‘The sense of moral responsibility is what produces collective action and contributes to group cohesion’ Muniz and O’Guinn (2001) said.There are two traditional shared missions: intergrading and retaining members and assisting members in the proper use of the br and. Firstly, it is crucial to retain existing members and obtain new ones. The fundamental way for MUFC to save and fascinate supporters is to keep winning. Getting consistent good record and reputation will really help the brand to attract and retain members. MUFC also gives discount to the existing official members to renew their membership and buy season tickets in the following year. Thus members can gain benefit from their loyalty.Secondly, moral responsibility also provides assistant normally in problem solving and shares brand-related information. For instance, members share transport information in away games on fansforum. In conclusion, the notion of brand community has been extended in recent years and become a usual marketing phenomenon. The three key characteristics represent the essence of brand community and each of them has its own manifestation. Due to the improvement of communication way, members of brand community are more convenient to communicate and the brand i s also easier to build connection with customers and create brand communities.Looking to the future, I believe brand community will become a crucial and staple marketing strategy. Reference: Cass, Bob (2007). â€Å"United moving down south as fanbase reaches 333 million†. Daily Mail (London: Associated Newspapers); 15 December 2007. Manchester United official fansforum: http://community. manutd. com/forums/t/84281. aspx Manchester United Membership benefit: http://www. manutd. com/en/One-United/Member-Benefits. aspx McAlexander, J H, Schouten , J W, and Koenig , H F. Building brand community[J ] . Journal of Marketing; Jan 2002; 66, 1; ABI/INFORM Global p. 8 Muniz Albert M. Jr. and Thomas C. O’Guinn (2001), Brand Community, Journal of Consumer Research; March 2001; 27, 4; ABI/INFORM Global p. 412 Muniz Albert M. Jr. and Schau, H J. (2005), Religiosity in the Abandoned Apple Newton Brand Community, Journal of Consumer Research; Mar 2005; 31, 4; ABI/INFORM Global p. 737 Rice, Simon (6 November 2009). â€Å"Manchester United top of the 25 best supported clubs in Europe†. The Independent (London: Independent Print). Vincent, John, Hill, John S. (2006) Globalisation and sports branding: the case of Manchester United.

Malcom X “My First Conk” Essay

Through the years African Americans have been growing their roots in the United States. It wasn’t too long ago that they weren’t accepted as a part of society. Since then the gap between them and the Caucasian community has begun to close. As both populations blend together we start to think of them as one nation with more similarities than differences. What happens when one society bleeds out its culture more than the other? African Americans have increasingly opted to ditch their natural selves and instead take on the task of manipulating themselves in order to appeal to the white man’s idea of beauty. Rather than revolt against the insults thrown at blacks they seem to have adopted them as true. Why is it that instead of defending their natural kinks they cover them up with wigs or chemically alter them? Although some beauty practices are commonplace throughout most African American communities engaging in these activities is the equivalent of validating the notion that blacks aren’t good enough. Malcom X illustrates for us in his piece titled â€Å"My first Conk† how his first conking went. For those unfamiliar with the term conking is a procedure in which black males concoct a gel, using mainly household ingredients, then apply it to the hair in order to straighten it. The incorporation of lye in the gel is what causes the bearer to feel as though the scalp burns. Malcom was at first a devoted conker but through the years has come to regret his old habit. At first he explains how good the conk made him feel, later in his life he mentions that conking was his first step towards self-degradation. He calls out all those who have or still sport a conk and urges them to stop. He even goes as far as saying it makes blacks look foolish. He also concludes that hair unimportant and it’s a shame that so much time has already been wasted on this. A compelling story I stumbled upon tells the drastic measures some are willing to take in order to shed themselves of the image they have come to associate as inferior. A woman around 35 years old willingly admitted that she bleached not only herself but her children. She wet cloths with store-bought Clorox and placed the on her and the kids’ faces for about a couple of minutes. This woman openly acknowledged that she was ashamed of being black. Alongside with her there were other testimonies who felt the same. They all mentioned how they were looked down upon for being black. They told some of the insults they faced on a day to day for being who they were. They felt the measures they took to appeal to the white community was  necessary. It was necessary if they wanted to feel good, if they wanted to be seen as equals, and if they wanted to stop the mental abuse . When I first came upon these people I was shocked. How could someone be so insensible as to literally bleach their skin? What would compel people to undergo such painful procedures as the one mentioned by Malcom? I was shocked but little did I know I too was just as guilty of caving in to society’s ideals of what I should look like. Just last year, my senior year in high school, I would have a morning ritual. At 5:00 a.m. sharp I would stumble out of bed and turn on the coffee machine. The energy from the coffee was to help me stay awake so I could complete the lengthy task of straighten my hair. 2 long hours it took for me to do only my hair! As is probably imaginable I was often late to school. I was late so many times in fact that I nearly didn’t graduate on stage. How then did I dare judge poor lady who bleached herself when in reality I was no different? I too unnecessarily took it upon myself to change the way I was because the pressure I felt to be just a bit sim ilar to white people. Consciously I did not notice this was what I was getting across, as I presume many black people that do things such as perming or wearing wigs are also unaware, but ultimately we have been brainwashed so much that this behavior is reasonable. Many may argue that we have the right to express ourselves any which way we want. This is true but why then are blacks ridiculed when they defy the expectations and take pride in their true selves. Why must wearing their natural selves take courage? We as a blended society should know better than to judge. Oppressing people has to be a thing of the past. The oppressor is not the only one to blame here. The oppressed are guilty of not fighting back. No change will come until we try to change ourselves. Too many have suffered and continue to suffer. Both mentally and physically these people are abused but to no avail. Society will not let up. Instead of conforming to society, as we have done for so long, we must pave a different path. Comparing ag ainst another race is futile. Blacks will never be the same as whites, they shouldn’t try to be. Each a culture rich in its own way. Teach ourselves and our peers to take pride in our appearance once again. Dig back into a culture once covered up and exhume it. Let it breathe for when it does so will we.