Time and time again he practices his moves until

He kneels down, trying to lay low to avoid detection.   He has stalked his prey all day.   He has studied â€Å"the kill† from every conceivable angle.   He replayed every scenario in his mind.Time and time again he practices his moves until he is sure that there are no mistakes.   There can be no letting go of this one.   This is the big one that will make everything else seem so insignificant.This will be the last hunt.   It is as if his eyes are glued to this target.   Nothing will deny him this.   It is his birthright.   It is his destiny.   He approaches his prey confidently as his prey stares at him unaware of what will happen next.   As the first words are spoken, he knows that the game is afoot.   The mark has been engaged and the â€Å"con† shall now begin to unfold.It was a very simple transaction.   Legitimate on its face and humanitarian in character.   The young man’s life had taken on the most unfortunate of all turns.   In a span of one month, he had lost everything to the financial crisis.Formerly a successful trader on wall street, one error had cost him his entire life savings and even now threatened to ruin the futures of his daughters, whose pictures he was not slow to show.   â€Å"They are honor students in high school but I don’t know if I can afford to send them to college†, he claims.   The mark looks at him with compassion, reflecting a hint of suspicion.â€Å"Kind sir, I understand your wary nature and I would like to say that I do not appeal to your generosity but as an honest and working man who has fallen on hard times, I would just like to beseech you for an opportunity for me to redeem my pride and rebuild my spirit,† the con man begins his speech and he knows it is only a few more moments before the job is done.â€Å"If you would indulge me for a moment of your time to enlighten you about my situation for you see, I was not like this.   In fact, I liv ed among the haves and looked down on the have nots.   As luck would have it, however, I have fallen on hard times and seek only a way to redeem myself in my eyes so that I may have the courage to face my family when I return home to tell them of my tragic failure.†It is the perfect pitch.   Not an appeal to generosity but rather an appeal to the pride of all men; the need to be able to bravely face his troubles.   It strikes a chord in everyone’s heart, for who could ever deny a little help to a person who wants nothing more than a chance to regain his pride.   There has been no mention of money except that which has been lost by the con man.   Neither will there be a mention of money until the con man is convinced that he has secured his mark.â€Å"Dear sir,† he continues, â€Å"thank you indeed for this time and as you have given me the chance to walk with my head up high again, allow me to repay your act of kindness with a generous gesture.   I w as a trusted banker for a very wealthy family and as such, I am privy to many of their transactions.   If you are interested, I can invest your money in a few of their business that are already making so much money.The returns are not extraordinary but certainly better than normal bank rates.   I only offer this to you because you have been so kind.   Here is my card, please give me a call.   Have a nice day.†Game, set and match.   All he has to do is just sit and wait.   There is no cause for what he does.   It is simply just about the money.   For those who fall prey to the scam, the only cause is the money.   There is nothing more to it.   There are no deeper existential philosophies and moralities to wrestle with just the thought of having more cold hard cash or having none at all.Every con has an angle.   Every con plays on the emotions of people.   Logic never betrays its owner.   Every decision a person regrets in life can be traced back to a s ingle strand of emotion that clouded solid judgment.   This is something that every con man understands.   This is something that every con man counts on.   The cause is simply just money, for after all, a con is about the dollars and sense!

Arendt-Theory of Totalitarianism Essay

Hannah Arendt is widely regarded as one of the most important, unique and influential thinkers of political philosophy in the Twentieth century. Arendt was greatly influenced by her mentor and one time lover, Martin Heidegger, whose phenomenological method would help to greatly shape and frame Arendt’s own thinking. Like Heidegger, Arendt was sceptical of the metaphysical tradition which tended towards abstract conceptual reasoning; ultimately at odds with the reality of human lived experience. Consequently, Arendt was highly dubious of being referred to as a philosopher, as she felt philosophy was, by its own essence, confined to the proverbial ivory tower. She believed political life was at the apex of human experience and so she identified as a political thinker/actor. Her emphasis on the phenomenological nature of the lived political experience permeates her life’s works and perhaps can be said to constitute her own distinct brand of political philosophy. Arendt’s early publication, Ideology & Terror: A Novel Form of Government, is a profound elucidation of the nature of the theretofore unprecedented (she argues) phenomenon of Totalitarianism and its â€Å"origins†¦ elements†¦ and functioning†¦ † A Novel Form of Government: Arendt posited that the totalitarian forms of â€Å"government and domination† (Arendt. 03) which characterised the Nationalist Socialist party in Germany and Stalin’s oppressive regime in Soviet Russia, which saw systematic genocide and terror visited upon literally millions of innocent people, were unprecedented in the history of political systems, and were not mere modern manifestations of ancient forms of violent government such as despotism or tyranny. She went further even, to suggest that totalitarian systems had destroyed the very foundations upon which traditional ideas and presuppositions of government rested. Although totalitarianism seemed to contain elements of tyrannical or despotic forms of government i. e. terror, violence, absolute power etc Arendt contended that totalitarian regimes differed in important ways which rendered them qualitatively distinct. Tyranny and dictatorships, she argues are marked by â€Å"Arbitrary power, unrestricted by law, yielded in the interest of the ruler and hostile to the interests of the governed, on one hand, fear as the principle of action, namely fear of the people by the ruler and fear of the ruler by the eople†¦ †(Arendt. 306) Terror, according to Arendt, has traditionally been used as a means to an end, or tool for tyrannical regimes, namely the end of maintaining and sustaining a position of power over its subjects. Totalitarian systems however, do not function in this way, ideologically at least, According to Arendt. â€Å"total terror leaves no arbitrary lawlessness behind it and does not rage for the sake of some arbitrary will or for the sake of despotic power of one man against all. † (Arendt. 311) Context and Content: In order to understand the nature (if there is one) of Totalitarianism forms of government, it is important first to understand both their historical contexts and the Ideologies which underpin them, as Totalitarian regimes, are by their nature ideological, as Arendt shows. Take for example National Socialism, the political ideology which took root in Germany during the 1930’s, characterised by militant nationalism and overtly inherent racism. The context in which the Nazi party rose to prominence was the extreme devastation, debt and resulting poverty and hunger left in Germany in the wake of the First World War. It can indeed be argued that Adolph Hitler’s demagoguery and flair for rousing public sympathy with his intense speeches, was also crucial to the widespread proliferation, acceptance and support for Nazi ideology, at a time when people yearned for a clear solution to their plight and poverty. Hitler’s bellicose rhetoric displayed a typical trait of ideologies; a final solution, the idea that the answer to all of life’s problems can be understood and solved by following a particular stringent course of action determined by a single unambiguous worldview. Ideologies-isms, which to the satisfaction of their adherents can explain everything and every occurrence by deducing it from a single premise† (Arendt. 315) Nazi Ideology had at its core, a politically and indeed racially motivated perversion of the Darwinian concept of a natural hierarchy of species, in which the stronger/more successful species would inevitably replace the weaker ones. Darwin’s profound insight into the ways in which organisms evolve was warped and misrepresented by the Nazis, who filtered it through their racist and nationalist worldview, justifying the extermination of Jews and other supposed degenerate races by claiming they were following and indeed implementing a Law of Nature. In Darwin, Arendt explains, the Nazi party had found what they saw as an unbending Natural Law, the very source from which positive (manmade) laws had been traditionally derived. far from being â€Å"lawless,† it goes to the sources of authority from which positive laws received their ultimate legitimation† (Arendt. 307) Arendt argues that this Law of Nature was taken to be a suprahuman edict which was used justify their campaign of terror and genocide, and furthermore usurp any positive laws which were counter-productive to their cause. Nature itself mandated the extermination of lesser â€Å"degenerate† races according to Nazi ideology. And so the carrying out and indeed hastening of the process of this â€Å"Natural† decree was the end which the Totalitarian regimes sough to effect. In fact, Totalitarian ideology sought for the actual societal embodiment of these supposed Laws of history and nature, and asserted that by the strict implantation and of these laws, a utopia on Earth would be realised. â€Å"the Law of Nature or the law of History, if properly executed, is expected to produce mankind as its end product† (Arendt. 307) Arendt is highly critical of this thinking which she describes as particular to Totalitarian government. One of the most obvious critiques which she makes is the complete disregard in this line of thinking for basic anthropological concerns i. e. ow humans actually tend to behave and function. â€Å"It applies the law directly to mankind without bothering with the behaviour of men†¦ Totalitarian policy claims to transform the human species into an active unfailing carrier of a law to which human beings otherwise would only passively and reluctantly be subjected† (Arendt. 307) Terror as the essence of Totalitarian rule: Built into the notion of executing the Laws of nature and history is an inherent eschewing of the legitimacy, importance and even relevance of manmade or positive laws, which are intended to govern and ease the functioning of societies in which people participate. The denial of positive laws and their replacement with the bringing into effect, a Law of Nature or indeed a Law of History as per Totalitarian ideology, is, Arendt argues largely what separates Totalitarian regimes from despotism and tyranny. Because they drew their justification from the very source of all positive laws i. e. Natural law, Totalitarian regimes were able to substantiate this denial of the legitimacy of positive laws by claiming that in aiming to produce the perfect rule of Natural Law on earth, that mankind itself would become the very â€Å"embodiment of the law† (Arendt. 08) By claiming to actualise and bring into effect fundamental laws which determine the inevitable course of history by establishing the perfect rule of Natural law on earth through use of terror, Totalitarian regimes subvert at the same time traditional notions of government and also notions of the utility of terror. Terror was no longer merely an arbitrary tool of oppression, (although it was of course the methodology with which the terrible ideology of Totalitarianism was realised) Terror was itself the embodied form which submission to the supposed Law of Nature took, or as Arendt puts it â€Å"Terror as the execution of a law of movement†¦ Arendt. 311)† Terror was in fact now the end goal itself; as such Terror is indeed Totalitarianism’s essence. Arendt uses a good analogy to illustrate this point. â€Å"the absence of crimes in any society does not render laws superfluous but, on the contrary, signifies their most perfect rule-so terror in totalitarian government has ceased to be a mere means for the suppression of opposition, though it is also used for such purposes. Terror becomes total when it becomes independent of all opposition; it rules supreme when nobody any longer stands in its way. If lawfulness is the essence of non-tyrannical government and lawlessness is the essence of tyranny, then terror is the essence totalitarian domination† Dangerous Ideology: What made Nazism and Stalinism so dangerous, according to Arendt, were not merely the ideas which characterised their respective ideologies i. e. racism and dialectical materialism, but the logic which one could arguably follow from these types of thinking. If Ideologies are the logic of ideas, (which they are! ) then it is the seemingly logical implications of these ideas, which made them dangerous. To put it simply, if one concludes that there are suprahuman forces which determine the very course of history, as espoused by Nazism and Stalinism, then one must be bound to follow the logical steps which lead from this idea. â€Å"Whoever agreed that there are such things as â€Å"dying classes† and did not draw the consequence of killing their members, or that the right to live had something to do with race and did not draw the consequence of killing â€Å"unfit races,† was plainly either stupid or a coward†. (Arendt. 318) The dangers of commitment to the logic of ideas bviously are determined by the extremity of the ideas themselves, however as Arendt rightly points out, it is this ice cold reasoning which both Hitler and Stalin were very fond of which gave their ideologies a trajectory of power and an pseudo-scientific guise which legitimated them. Rather than a principle of action aimed at some common good or societal benefit such as the prevention of crime, this â€Å"logicality of ideological thinking† (Arendt. 321) is what makes Totalitarian government tick. Isolation, The Phenomenology of Terror: As we have seen, terror is the essence of Totalitarianism. But it is important to realise exactly what this means for the experiencing subject of Totalitarian rule. Terror, Arendt explains, destroys the ability to engage in any public life. Isolation is the most salient feature of terror. Terror wrought isolation has been used throughout the centuries by tyrannical rulers to inhibit political agency and thus destroy the possibility of revoltâ€Å"†¦ terror can rule absolutely only over men who are isolated against each other and that, therefore, one of the primary concerns of all tyrannical government is to bring isolation about†¦ Isolation and impotence, that is the fundamental inability to act at all, have always been characteristic of tyrannies. † (Arendt. 321-322) The final way in which Totalitarian governments differ from those regimes of tyranny, which have also employed terror as a tactic, is for Arendt, the destruction by terror of the private sphere of human life. Total terror, as it were, is not content with merely destroying the public life of people and their ability to interact. Total terror permeates the mind and destroys the faculties of creativity and mental autonomy. Totalitarianism seeks to destroy the entire ability for people to create something new and bring it into the world. While it obviously needs to destroy the ability of political life, it also enforces utter personal isolation (loneliness) on the mind of the individual, so that he or she has no outlet vent and indeed no ability to form ideas of their own. â€Å"In isolation, man remains in contact with the world as the human artifice; only when the most elementary forms of human creativity, which is the capacity to add something of one’s own to the common world, are destroyed, isolation becomes altogether unbearable†¦ Totalitarian government, like all tyrannies, certainly could not exist without destroying the public realm of life, that is, without destroying, by isolating men, their political capacities but totalitarian domination as a form of government is new in that it is not content with this isolation and destroys private life as well. It bases itself on loneliness, on the experience of not belonging to the world at all, which is among the most radical and desperate experiences of man. † (Arendt. 24) The phenomenological and anthropological implications of this total terror are for Arendt the complete breakdown of the human actor. She argues that humans are essentially social beings who need social interaction to function and live as we are hardwired to do so; our complete sense of who we are and what our world means ultimately derives from our experience of interacting with others. â€Å"For the confirmation of my identity I depend entirely upon other people† (Arendt. 324) In conclusion I think it may be prudent to summarise the central elucidations which Arendt makes in Ideology and Terror. . Totalitarian governments were unprecedented governmental forms before the early 20th century. 2. Totalitarian governments are ideological in nature and functioning, and derive their justifications from suprahuman â€Å"Laws of Nature and History† and implement the logic of these ideas through use of terror. 3. Terror is the primary tool and also the essence of Totalitarian governments, i. e. Total terror becomes the actual embodied form of the Laws of History and nature made manifest 4.  Totalitarian governments destroy the ability to act politically as all tyrannies do, but also they destroy the realm of private life as well, rendering human existence a miserable one in attempting to make each person the actual embodiment of Natural and Historical Laws Arendt’s masterful work has shed light on one of the darkest periods in human history and it al so lends insight into the nature of government, society and the human subject more broadly speaking. She remains a seminal figure in the discipline of political philosophy and continues to inspire thought and debate to this day.

Kingdom of Heaven

The Middle East has been a continuing source of rich history since the early times. Widely chronicled events in its history were the Crusades in which the â€Å"Kingdom of Heaven was based.† The story deals with the Crusades of the 12th century, and involves an artificer (a military mechanic; French: artificier) and Engineer (that is, someone who makes siege engines), serving as a village blacksmith who goes on to aid the city of Jerusalem in its defense against the great Islamic leader Saladin, who battles to reclaim the city from the Christians. The script is loosely based on the life of Balian of Ibelin (wikipedia.org, 2006) How the Crusades started were caused by religious, economical and political reasons. The order burning the Church of the Holy Sepulchre by a Fatimid caliph, and the molestation of pilgrims, cruelty of Muslims toward Christians, and following the papal â€Å"foreign policy† of expanding Christianity were religious sources of conflict why the Crusades were undertaken. One of the economical concerns was the overpopulation of Western Europe, consequently having the idea that Eastern Europe would be a new territory to conquer and would provide the necessary resources to provide for Western Europe’s burgeoning population, and politically, the Crusades would pave the way for wider trade. It would seem that the differences of faith is still one source of conflict today, considering the fact alone that Jerusalem is the central land of worship of different great religions, Christianity, Judaism and Islam, as of the present time. These different religions with different beliefs, different perspectives, try to assert the claim that Jerusalem, by right, is there own Holy land. They do not know how to share as neighbors. Conflict arises. The oil-rich Middle East today provides for a backdrop of political and economical maneuverings by different countries, with vested interests of their own, to gain control of this rich region. The phrase â€Å"History repeats itself† is justified. Reference: www.wikipedia.org, 2006 [webpage] http://en.wikipedia.org/wiki/Kingdom_of_Heaven_%282005_film%29 date accessed: 16 December 2006

Outsourcing Term Paper Example | Topics and Well Written Essays - 2000 words

Outsourcing - Term Paper Example For instance, a company may outsource non-strategic functions to companies that specialize in such fields of work. Additionally, outsourcing also includes the transferring of assets and employees to another firm. The term outsourcing extends over both domestic and foreign outsourcing, and it sometimes also involves the relocation of a firm elsewhere; this is known as off-shoring. The company that provides outsourcing services is commonly called as service provider Organizations enter into a business agreement with third-party service providers that involves an interchange of payments and services. Outsourcing helps firms perform efficiently in their core functions and minimize costs incurred and shortage of skill in disciplines where they deem outsourcing appropriate. Since the early 21st century, businesses have exceedingly outsourced to firms in foreign countries; this is commonly known as off-shore outsourcing. In consequence of the widespread practice of outsourcing, several appe llations have been designated to refer to various parts of the relationship between the discipline of outsourcing and firms, such as strategic outsourcing, multi-sourcing and near-shoring. Outsourcing offers more room or elasticity in controlling unnecessary expenses and spending where it is indispensable. Outsourcing gives organizations the advantage to spend on only the services that are absolutely needed and also the precise periods or times in which they need them. This reduces the expenses incurred on hiring and training of employees (Haugen, Musser and Lovelace, 2009). The biggest transition in outsourcing has come from the rapid increase in the number of firms or small groups of professionals using computer technologies to utilize outsourcing as a source or path for building pragmatic service providing businesses or systems that can be operated from any part of the globe where internet access is available. Such service providers are preferred by large firms for ephemeral empl oyment of experts in specialized disciplines so as to have their projects or services worked on and delivered completely virtually or online. This suggests that there is a rapidly growing increase in the number of such businesses that function completely online that outsource to offshore firms to work and complete the work contracted out to them before the final service or project is sent to the end user. This is commonly practiced in website designing. Albeit outsourcing has been practiced by corporations so long work specialization has remained an important part of industry, it is rather recently that there has been a surge in outsourcing by organizations for the execution of non-strategic or non-core processes such as data entry, or billing. This is owing to the fact that such processes could be more efficiently executed by companies that specialize in the aforementioned fields respectively; this makes it more time and cost effective for organizations. Some companies outsource se rvices for the execution of particular business functions, while others outsource services for the execution of entire processes. Outsourcing may take many forms but the two most common forms of outsourcing are: Business Process Outsourcing, BPO, and Information Technology Outsourcing, ITO. Furthermore, Business Process Outsourcing incorporates human resource outsourcing, HRO, call center outsourcing and accounting and finance outsourcing. Such processes for

Language Difficulties Of Foreign Students Essay Example | Topics and Well Written Essays - 750 words

Language Difficulties Of Foreign Students - Essay Example While other students would consider the learning difficulties presented by being a non-native English speaker quite insurmountable. I faced the obstacle more as a challenge that I was meant to overcome. By facing my demons and challenging myself to achieve more than others believed I could, I would be able to find a place during the semester where I would begin to enjoy the English classes. Over time, I was able to find my place, my voice, and a comfortable way to tackle my English assignments, coursework, and exams that allowed me to begin to feel comfortable with the use of the English language. As such I am now more comfortable with the English language classes I am taking this semester than the last term. I would have to say that peer reviews from my classmates served a definite purpose in helping me to improve my English writing technique. That is because I am given an opportunity to see the way other people view my writing. Which also helps me get a clearer idea as to the weak points that I have with my writing skills and how I can improve upon those errors. It is because of the peer reviews that I was also able to develop an idea as to what good writing is all about and how to recognize a well-written essay. For me, a well-written essay does not have much to do with the grammar or structure of the paper. Neither does it have to do with the way the writer approaches the subject. Although these things are of some importance to the written word, it is not the be all and end of a perfect essay.

Market Article Analysis Essay Example | Topics and Well Written Essays - 1000 words

Market Article Analysis - Essay Example The growth of mobile marketing upon which the Sorofman is stressing upon in his article can be substantiated by the following facts; There are 5x many cell phones in the world than PCs (Conner, 2013) 91% of adults keep their smart-phones within arm’s reach (Conner, 2013) By the end of 2013, there will be more mobile connected devices than there are people on earth (Brenner, 2013) The above mentioned facts authenticate the notion that mobile marketing has the tendency to emerge as the most powerful communication tool; with significant reach. It can be credited with innovative ways to connect with consumers and in giving a sales boost. A research conducted by Forrester Research in January 2013, depicts the increasing number of mobile commerce sales via smart-phones in American market (Siwicki,  2013). The author has further explained certain ‘ground rules’ to carry out an effective mobile marketing plan. He explains that bombarding smart-phone users with marketing content, by using location-based marketing, as soon as they enter a particular vicinity might be interpreted as ‘creepy’ and might be just simply ignored. ... Not to mention, that it might also dilute a brand’s image. This requires an integrated and holistic approach towards the marketing plan. Neil Richardson suggests that by adopting mobile marketing the marcomm activity would more effective, if the business’s website is accessible through a mobile phone. Because the consumers would not have to wait to log into their PCs or they would not have to take out specific time to go through a business website (Richardson, 2010) The businesses have to properly segment their potential market and identify the target audience, who should be specifically targeted. The nature of the content has to be carved out keeping in mind a particular set of target audience. Such a strategy has to be embedded in the overall communication plan of a brand. If the brands rely too heavily on discharging messages across fragmented media without adopting a properly devised strategy, then it might result have adverse affects such as; Wastage of time, costs , labor Misinterpretation of message Reaching wrong audience Reaching the right audience but failure to convey the message in the right way (Lieb, 2012) Sorofman has rightly said in his article that a combination of tools should be used rather than being â€Å"mono-focused†. This argument can be further supported by what Rachael Pashqua suggests in his book named ‘Mobile Marketing: An Hour a Day’ to integrate SMS in the overall marketing strategy of the firm (Pashqua & Elkin, 2013). This does not imply that the traditional mediums should be entirely ignored. The idea is to find a strategic fit between the traditional medium and the new mobile tools. The fundamentals of both the mediums should be well understood and its effects on customer response

Effectiveness of Medical Honey for Leg Ulceration and Wound Care Literature review

Effectiveness of Medical Honey for Leg Ulceration and Wound Care - Literature review Example These methods of wound care are meant to facilitate recovery and prevent the infection of the wound (Hess, 2004). In instances of prolonged healing, additional and alternative measures of wound care are often considered. One of these methods includes the use of medical honey (Boulton, Cavanaugh, and Rayman, 2006). Medical honey has been considered as an alternative form of therapy in wound management, especially for chronic and diabetic pressure ulcers (Boulton, et.al., 2006). Leg ulcers are common among diabetic patients and with diabetic patients often having prolonged wound healing times, the importance of implementing speedy and effective wound healing methods has become imperative (Shai and Maibach, 2004). The use of medical honey has been recommended by various studies and practitioners, with much support attributed to its use due to its healing and antibacterial properties (Shai and Maibach, 2004). The more traditional practitioners however have not supported the use of medica l honey over and above conventional methods of healing. Studies with contrasting results have been presented on this subject matter. For which reason, this study now seeks to carry out a literature review on studies discussing the use of medical honey for leg ulceration and wound care. ... A conclusion shall also provide a summary of the paper and a discussion on how the results of this study can contribute to the nursing practice. Literature Review Search strategy This literature review is being carried out in order to establish a critical analysis of the current research information on the efficacy of medical honey on leg ulcers and wound care. This literature review shall start through an internet database search of Google Scholar, Cochrane, PubMed, Medline Plus, and CINAHL using the following key words: medical honey leg ulcers; honey leg ulcers; and honey wound healing. The search shall also be narrowed down to a time limit from December 2006 to August 2012. Specific studies which discuss the efficacy of medical honey on leg ulcers and other wounds shall be prioritized and set aside for abstract review. Randomized controlled trials, cohort studies, systematic reviews, case studies, prospective, and English-language studies shall be used as inclusion criteria for t he literature search. Secondary research studies, retrospective, chart reviews, descriptive, non-English language literature shall be excluded from this review. Those meeting the inclusion criteria shall then be set aside for further review, mostly on authors, publication, reliability, and validity of results. Critical Analysis: Support for the use of honey in leg ulceration Various studies have been carried out on the use of medical honey on leg ulcers and other wounds (Cooper, et.al., 2010). In a study by Molan (2009), the antibacterial qualities of honey in wound care was reviewed. His systematic review discussed the inhibitory impact of honey seen in bacteria which often infect wounds. Based on Moran’s (2011) study, honey was seen to have

Mobile Van Restaurant Company Analysis Coursework

Mobile Van Restaurant Company Analysis - Coursework Example The name of the mobile van restaurant suggested is Fastbite Inc. and the target group of our business would be the executives who belong to the white and the blue collar working class. The van would operate from 6 am in the morning to 10 pm and we will sell breakfast such as raffles near Singapore MRT station car park or central of Singapore. However, in the afternoon during 11 to 2 pm, we will sell lunch in areas such as Tuas, Loyang Way or Woodand while after 2-5pm, we will deliver orders to our customers. Mobile van restaurants were more commonly found in Somerset MRT and East Coast Park but there are many other areas where can be covered by us. Besides serving the areas where factories are located, we will also sell food in deserted areas because this is the place where food is not available and it is also easy to locate vans in these areas since they are movable. Therefore, we will also sell food in boon lay area forest which is the place where the soldiers are trained. Since no thing is available for the soldiers to eat, they will buy the food we will offer them so the risk will be low. However, in the cities there are many other restaurants and options available to the customers which would make it difficult for us to attract the customers. The population of Singapore is 4,740,737 and 77% of the population falls in the age group of 15 to 64 years of age. Singapore has a 92.5% of literacy rate and unemployment rate of 2.1% which means that most of the population is employed which means that none of the individual living in Singapore lives below poverty line and even the rate of inflation is just 2.8%.1 Business Operation and management We will sell ready packed food which will be prepared from a home based kitchen and the mobile van will be used for selling purpose only. We will require both physical and human capital which will be our key resources to operate the business. For the van, we will hire two individuals while for the kitchen, we will hire three people to cook, pack and receive orders. For the need of physical capital we will buy a van. Convenience is the main benefit that we aim to give to our customers which will also be our competitive edge. We did a break even analysis which showed that our business idea would work well. The Industry Data that we collected gave us all the information about mobile van restaurants and some of the possible risks include the external factors such as changes in any government policies or weather changes and to meet these, we will have a backup plan. Business features, functionality and benefits Some of the business features includes convenience we provide to our customers along with nutritious and well packed warm food. Our business would operate mainly on a mobile van on which we will sell our food items. Although we have competition around, we will develop product differentiation on the basis of branding, service and location. Our business will operate in monopolistic competition which me ans an imperfect competition in which the products are substitutes but will be sold by the competitors will only be differentiated on the basis of branding and service. For this, we conducted market analysis to know more about the industry and competition. Branding Fastbite Inc. is our suggested name which would include pastries, sandwiches and minced noodles while we will sell barbecue including sea food and chicken wings, beef noddle and Kway Teow, chicken noddles and rice, curry

The Effects of Social Networks on Firm Performance Research Paper

The Effects of Social Networks on Firm Performance - Research Paper Example The paper tells that in the field of product development the inter organization networks can be very effective for the joint discussion about the product. Many new and small firms have lack of resources for the development, mainly due to inexperience and a lack of goodwill. Thus as a way of competing and grabbing a foothold in such a scenario involves bootstrapping, which involves activities for securing funds and resources. By using social networks such companies can gather finances, by building up strong ties in the initial stages and later on weak ties as they grow big. CEO’s of different firms have been known to have taken advice from outside through social networking. In this way they seek to get an outside opinion and an altogether different perspective regarding certain strategic issues. These enhance the performance of the firms. Another important aspect which is emerging slowly is the concept of a local social capital where an individual who values more of his local c ontacts, even though he has global contacts. This is relevant mainly in case of local entrepreneurs. Thus according to scientists, people with more and better social capital will be able to realize their goals. Ranging from contracts to building goodwill and securing finances, social capital is the priority in all types of endeavors around the globe. Social ties have been found to regulate exchanges through an informal and interpersonal way and they help to push back the limitations of a weak infrastructure, especially in the case of a financial crisis. (Sheng et al, 2011, p. 1). The study is to provide several facts and discussions in relation to social networks and social capital and their effect on firm performance based on the following

International Legal and Ethical Issues in Business Essay

International Legal and Ethical Issues in Business - Essay Example 113). For instance, if the employee chose to present the issue to the higher management, then it is expected that the company would incur losses for product test and recall. However, the action would benefit customers to stop from patronizing the defective products. In the code of ethics, it is an employee’s responsibility to act in professional manner and report promptly to the higher management about any information he or she knows about wherein the business is directly involve so that it could be given appropriate corrective actions. However, â€Å"it is not uncommon practice for lower-level employees to communicate upwards about only those matters which are likely to appeal to people at higher levels (Rashid, 1983, p. 133); therefore, the employee should present first the subject matter to his or her next in command particularly if the company’s structure is following an upward communication by subordinates. In addition, he or she is not at all responsible to tell directly to the company’s CEO and executives about the knowledge of potentially defective products that are being sold to the customers until such time that it is delegated to the immediate supervisor. In the first place, the employee is uncertain about the organization’s ethical guidelines which are supposed to be communicated to them to ensure that they understand the company’s values and policies. Lastly, he is just maintaining the welfare of the company and at the same time fulfilling his duties, respecting the higher authorities and maintaining social order. Values for professionals and employees in particular are not bound for the organization alone but it needs to serve for the good of the public. * How would you specifically notify customers of such an occurrence? Satisfied customer contributes higher revenue growth, therefore, it is their right to be notified and it is the company’s responsibility to provide them with real information. In case th e issue is effectively presented to the top management, then it is the company’s responsibility to test and recall the product to know the defects. This process is costly but it could prevent further losses. Also, it is one of their ethical and social responsibilities to secure the safety of their customers in return for their reputation (Jennings, 2009, p. 511; Shaw, 2010, p. 222). It should consider the seriousness and frequency of the injury that the product could create to the customers and remember that quality of products should be prioritized first. The customer will be notified through a press release, describing to them the real problem, guarantee their safety, and most importantly, ask for an apology. In this case wherein defective products are involved, it is a requirement that the company should respond promptly and efficiently. It should ensure that the remaining defective products will not reach the customers by tracking them through helpful signs, and setting u p tracking system for customers’ complaints. Through this way of keeping the customer informed, everything will be centralized and easier to control. * What kind of internal actions would you take to prevent future problems? The employee must define the problem clearly and be responsible on all his or her actions. For instance, if he or she discovers material information that involves the business, he or she should promptly report this to the

Creative Strategies for Community Health Assignment

Creative Strategies for Community Health - Assignment Example Currently 17 percent of children in the United States who are aged between the ages of 2 and 19 years old, and an average of 10.4 percent of preschoolers are overweight. The condition affects children of all ages, race, gender groups and countries (Davies, Fitzgerald & Mousouli, 2008). One of the most successful strategies used in Childhood obesity management is weight and nutritional counseling at the community level. This strategy is effectively being applied in a community based, Childhood obesity management program in Boston that has been dubbed â€Å"Fitness in the City† (FIC). 11 Boston community health centers are currently actively participating in the project with clinicians, nurses and other community based health practitioners being used to offer weight and nutritional counseling services to the community (Graham, 2008). The foremost benefit of this approach is that, clinicians are able to attend to both children and parents at the same time, and hence they find themselves better equipped to help work out adequate lifestyle changes suitable for the whole family. Another major advantage of this strategy is that the children attending the appointments and the rest of their families are not required to leave their neighborhoods so as to be able to access the services this has been of immense help in reducing the number of children who end up missing appointments (Graham, 2008). The Columbus city schools wellness initiative uses innovative strategies to help in reducing childhood obesity rates in the district. The programs uses strategies such as regular BMI screenings for children, water only options in vending machines, in the schools participating in the program, restricted servings for beverages other than water, development of enhanced health education curriculums in the schools. These strategies have considerably helped reduce the

Personal Attitude Speech FAA Medication Essay Example for Free

Personal Attitude Speech FAA Medication Essay Thesis Statement: I believe all pilots should avoid any type of medications that may slow the thinking process or reaction times before they fly. Introduction I. Many common medications are known to slow the thinking process and slow reaction times. II. I believe all pilots should avoid any type of medications that may slow the thinking process or reaction times before they fly. Body I. Slowness caused by medication can have a substantial negative impact on critical times of flight. a. When encountering bad weather, an unfamiliar area, or even just an unexpected flight event, the slowness caused by some medication could be the final determining factor that causes an accident. b. When encountering these types of conditions, a pilots mind must be clear to make split second decisions. II. Pilots have a great amount of responsibility placed on them with each and every flight. a. Some pilots may have the lives of several passengers behind their every move. b. Other pilots may be flying solo, but in a mishap can still cause danger to themselves or innocent bystanders on the ground. III. The FAA (Federal Aviation Administration) has compiled a list of prohibited medications, recognizing that some medications are valid for concern. a. In 12% of all fatal accidents in General Aviation prohibited medications were found to be a contributing factor (According to analysis of data by the FAA from the past decade). b. A valid point for concern that many pilots are still using impairing medications while operating aircraft, maybe unknowingly. i. Many OTC medications have a ubiquitous presence of sedating antihistamines. Conclusion I. A safe pilot should utilize the IMSAFE (which stands for Illness, Medications, Stress, Alcohol, Fatigue, and Emotions) to ensure they are safe prior to every flight, paying particular attention to the medications part of the checklist. II. I believe all pilots should avoid any type of medications that may slow the thinking process or reaction times before they fly.

Marxist Theory on Fake News and Media Propaganda

Marxist Theory on Fake News and Media Propaganda Fake News, Propaganda and Media Bias: An illusion of the truth? The internet has revolutionised the way information is presented and consumed. The traditional newspaper, for example, is no longer the main medium of news coverage. This therefore, has meant that mass media, in general, has had to find new ways of creating money. As a result, one could argue, that the ‘news’ is not objective but rather socially manufactured through a selective process. Events happen, but this doesn’t automatically mean that they will make the headlines or the news coverage at all. As a result, one could argue that the media is biased and is altered to represent certain views and ideologies. The concept of fake news and the deliberate misleading and deceptive information presented in the media could take the form of propaganda. As a society we have become more media saturated but are these agencies of communication, we refer to as mass media, transmitting an illusion of the truth? One could argue that the ‘news’ is socially constructed and as McQuail noted, it is not objective or impartial (McQuail, 1998). The reality is that the ‘news’ is socially manufactured as a result of a selective process carried out by gatekeepers : the editors, journalists and proprietors. This leaves room for media bias as the news is essentially influenced by a group or individuals own opinions and judgements. The news is not just simply a collection of facts but rather a collection of knowledge made up of information which is ‘loaded’ reflecting an interpretation. The process of selection, one could argue, is influenced by organizational constraints, values of media outlets and ideology. This links directly to the Marxist theory: that the news is fabricated and is an ideological apparatus which helps maintain power. Media outlets shape the ‘news’ and as a result we get injected, like the hypodermic syringe model suggests, with ideas that may be an illusion of the truth. As Miliband noted the media shapes how we think about the world we live in (Miliband, 1976) therefore if media bias is influencing the news, important issues like poverty, which show weakness in the capitalist system, are likely to be concealed. In contrast, media outlets are constantly providing us with information regarding political, financial and industrial states, for example recently: the benefits of Brexit, which reinforces corporate values. For example, during the EU referendum, media outlets helped broadcast the idea that the  £350 million sent to the EU weekly would be used to help the NHS instead, if voters opted to vote Brexit. However, after the referendum, the Brexit leaders decided to abandon the pledge (The Guardian, 2017). This case clearly demonstrates exploitation through misleading the public, as the NHS was a topic that they felt strongly about. This was a major political change, Marx would argue that the media transmitted the conservative ideology here in the interests of the elite. This could also be classified as a case of propaganda. As Herman and Chomsky noted the media participating in propaganda campaigns is nothing new (Herman and Chomsky, 1988). Taking this into account, one could argue that the media purposefully selected facts â€Å"designed to deceive us† (Brennen, 2017) and encourage Brexit. The media is dependent on the government and businesses as sources of information. These overlapping interests mean there is a certain degree of solidarity between them, as Highfield notes the personal and political are highly interlinked (Highfield, 2016), which means the effect was inevitable. Furthermore, analysing the headlines and news coverage, there seems to be a pattern where certain events are reported more than others, which reinforces the idea that media outlets choose what makes the ‘news’. For example, recently we got continuous reports and headlines which revolved around Hurricane Harvey which had a death toll of eighty-two (Moravec and Moravec, 2017). On the other hand, the floods near Sierra Leones capital, Freetown, Africa were hardly reported, even though the death toll was over three hundred (BBC News, 2017). The ethics can undoubtedly be questioned here, the two events occurred at similar times so why was one reported more than the other? This relates to Spencer-Thomas’s (Owen Spencer-Thomas, 2017) idea of â€Å"news values† where the guidelines for what is considered ‘newsworthy’ come into play. The Freetown floods it could be debated were not as significant as Hurricane Harvey, and consequently didn’t make the headlines. Alternatively, it could be argued that the media is not biased but rather like every other cooperation in society, works within the hierarchal structure conforming to the requirements which bring reward (Curran and Seaton, 2010). Media outlets are businesses essentially thus need people to invest to generate revenue. Therefore, rather than being biased and promoting fake news, it could be argued that media outlets actually focus and tailor the content based on their audiences. For example, Five News is characterized by short, snappy bulletins aimed at a young audience. In contrast, The Guardian has detailed articles which are aimed at more qualified professionals. Furthermore, to succeed, media outlets have now had to intensify media strategies to compete with cybermedia organisations (Williams and Tapscott, 2014). Considering this, it could be argued that media outlets choose the most important stories as a way of fulfilling users’ needs and their own profit interests(Fuchs, 2014), online. This links with the concept of ‘clickbaiting’ which is used by media outlets to attract audiences to ideas which appeal to them.   Postmodernists, would argue that media outlets are a channel to promote consumption rather than propaganda. They tailor and direct certain information towards certain people in the hopes of increasing revenue through advertisements. The increasing diversity of choice, globalisation and social media has resulted in a variety of influences shaping our identities. One could argue, that users are not exploited, as Fuchs notes, users voluntarily choose to use platforms (Fuchs, 2014). Marx’s theory can be criticised for presenting users as passive rather than active participants. The idea that there has been a â€Å"cultural shift away from the self-conscious user towards the subject as docile† (Lovink, 2016) can be debated. The revolution of the internet has meant that people can actively challenge the media, social media has become a â€Å"weapon of mass collaboration† (Williams and Tapscott, 2014). Therefore, it could be argued that fake news is a thing of the past, with social media flooding with different perspectives there has been, as Mason notes, an increase in individual freedom and human consciousness. The evidence lies in the streams of social media comments which critically challenge a piece of ‘news’.   From one perspective, it could be stated that social media has helped a digital revolution to occur where the masses have finally gained a voice and power. Moreover, it could be claimed that people choose which news stories to believe thus fake news can only exist if people allow it to be. Audiences receive and interpret the ‘news’ and as a result, not everyone will be affected in the same way. Consequently, if media outlets are promoting propaganda there is a very small chance that everyone will be misled. People tend to read and seek out information that interests them and confirms their existing views (Festinger, 1962). Taking this into account, one could argue that the media is just a scapegoat for media bias and fake news. The reality could be in fact that media bias and fake news is affected and created depending on a range of psychological and social factors, it may not be bias but rather unconscious nature. Without question, the media plays a major role in society today, whether it be influential or informative. Media technologies may not be the â€Å"contemporary opiates of the people† as Maxwell and Miller (Maxwell and Miller, 2012) suggest but the validity and objectivity of media outlets can undeniably be questioned. The ‘news’ is affected by a range of factors and it is impossible for it to be completely objective. This may not necessarily make it propaganda but rather a certain opinion. Media outlets need to generate revenue and therefore, media bias may be a method of tailoring articles towards audiences rather than intentionally ignoring incidents because of capitalist control and deliberate misinformation. On the other hand, the ‘news’ is essentially a root of information, consequently we should receive an equal coverage of incidents, like Hurricane Harvey and the Sierra Leone floods, so that one incident is not seen as more significant. It could also be argued that media outlets should stay neutral in political campaigns like the EU referendum, as it is very easy to misinform and mislead readers. However, the effect of misinformation can be oversimplified, as seen in the Marxist theory. People are not passive and critically challenge the ‘news’ and even play an active role in providing the ‘news’, as social media has given everyone the freedom to transmit information. The different perspectives, as a result, diminish the effect of fake news and allow us to assemble narratives and interpretations for ourselves. Consequently, there can only be an ‘illusion of truth’ if we allow there to be.    References BBC News. (2017).  Sierra Leone mudslides kill hundreds. [online] Available at: http://www.bbc.co.uk/news/world-africa-40926187 [Accessed 6 Nov. 2017]. Brennen, B. (2017). Making Sense of Lies, Deceptive Propaganda, and Fake News.  Journal of Media Ethics, 32(3), pp.179-181. Curran, J. and Seaton, J. (2010).  Power without responsibility. London: Routledge. Festinger, L. (1962).  A theory of cognitive dissonance. California: Stanford University Press. Fuchs, C. (2014).  Digital labour and Karl Marx. 1st ed. New York: Routledge, pp.254, 257, 280. Herman, E. and Chomsky, N. (1988).  Manufacturing Consent. New York: Pantheon Books. Highfield, T. (2016).  Social media and everyday politics. [S.l.]: Polity Press, p.3. Lovink, G. (2016).  Social media abyss. Cambridge, UK: Polity, p.5. Maxwell, R. and Miller, T. (2012).  Greening the media. New York: Oxford University Press. McQuail, D. (1998).  Mass communication theory. London: Sage. Miliband, R. (1976).  The state in capitalist society. London: Quartet Books. Moravec, E. and Moravec, E. (2017).  Texas officials: Hurricane Harvey death toll at 82, ‘mass casualties have absolutely not happened’. [online] Washington Post. Available at: https://www.washingtonpost.com/national/texas-officials-hurricane-harvey-death-toll-at-82-mass-casualties-have-absolutely-not-happened/2017/09/14/bff3ffea-9975-11e7-87fc-c3f7ee4035c9_story.html?utm_term=.5439927dfcdc [Accessed 6 Nov. 2017]. Owen Spencer-Thomas. (2017).  News values Owen Spencer-Thomas. [online] Available at: http://www.owenspencer-thomas.com/journalism/newsvalues/ [Accessed 6 Nov. 2017]. The Guardian. (2017).  Brexit camp abandons  £350m-a-week NHS funding pledge. [online] Available at: https://www.theguardian.com/politics/2016/sep/10/brexit-camp-abandons-350-million-pound-nhs-pledge [Accessed 10 Sep. 2016]. Williams, A. and Tapscott, D. (2014).  Wikinomics. New York: Portfolio, p.3.

Preventing Dengue Fever in the Mauritius

Preventing Dengue Fever in the Mauritius INTRODUCTION Mauritius is a small tropical island located at latitude 20à ¸ 18 0 S and longitude 57à ¸ 34 60 E. It has a tropical climatic condition. Mauritius has an area of about 2,040 sq km and is located to about 2000 kilometers from east west of Africa and some 800 kilometers from Madagascar. The positioning of Mauritius makes the latter a tropical country with moderately lofty temperature throughout the year. Winter and summer are the seasons that manifest onto the island. The island of Mauritius finds itself as one of the most accessible islands in the Indian Ocean. Situated amid R‚union island and Rodrigues island, the island of Mauritius has gained the reputation, through the course of time of that of the key and star of the Indian Ocean. The Mauritian population estimates for the year 2008 was about 1, 260, 781 with an annual growth rate of 0.7 %. Since the country is undergoing major developmental changes many industries have implanted here and thus the number of expatriates in the country is on the rise. These people may be a carrier of the disease and of course those Mauritians visiting the dengue endemic areas can also become infected and bring the disease in the country. It is an indisputable fact that during the lapsed decades, Mauritius has witnessed a multitude of diseases. The most prominent and recent one being Chikungunya which has infested merely about 12000 Mauritians. Furthermore, the history of diseases in Mauritius is marked with Malaria epidemics since colonial regimes and through the intensive effort of the Public Health sector, the latter has been proclaimed eradicated by the World Health Organization in 1973. Some years ago many of the realms citizens were not aware of what was dengue fever even though it had already occurred in the country but there was not mass infection by the virus. Providentially, the number of cases reported beforehand was only one or two and through the close collaboration between the Ministry Of Health and the infected person the situation was under control and hence no further positive case of dengue were recorded. The Mauritian government is putting forward all steps to prevent an epidemic rather than to rush for controlling it when it has already hit the population. The Ministry of Health is working on a list which highlights all water retaining sites and is identifying the hotspots of such sites that are liable to cause proliferation of mosquitoes; this process is carried out each year. Furthermore, an action plan is being prepared by the ministry which gives a layout of which and what job is to be done by which section of the ministry or other stakeholders (anonymous, 2009). Dengue viruses are transmitted by the Aedes species. Two known species the Aedes aegypti and Aedes albopictus are vectors of the disease. The Aedes albopictus can be found in large quantity all around the island whereas Aedes aegypti is said to be eradicated from the country. Surveillance on the abundance of mosquitoes is carried out by the entomological section throughout the year. All sites where mosquitoes that can be vectors of disease are seen, they are referred to the nearby health office for a larviciding to be carried out at that place and in the vicinity. Aedes albopictus (Skuse) is known as the Asian Tiger mosquito (Robertson and Hu, 1988). Aedes albopictus is native to Southeast Asia, but now occurs throughout the world. The worldwide spread of Aedes albopictus during the precedent 20 years has caused apprehension in the midst of public health officers and scientists over the possibility that the introduction of this species will amplify the risk of epidemic dengue fever and other arboviruses in countries where it has become established (Gubler, 2003). Aim The aim of this study is mainly to evaluate the effectiveness of the control measures taken to prevent dengue fever in Mauritius. Emphasis will be laid on the steps taken before, during and after the disease occurrence. This might highlight the shortcomings that Mauritius face in order to manage outbreaks of diseases. Objectives of study The objectives of this dissertation are to evaluate the management, procedures and legislation that are implemented in Mauritius during outbreaks of dengue fever. Furthermore, most interest is geared towards the application of chemicals, preventive measures, and health education of the public carried out by the Ministry of Health Quality of Life to prevent the occurrence of the disease and also to annihilate if ever found in the island. To elucidate the effectiveness of fogging, larviciding carried out in the country and health education of the public. CHAPTER TWO LITERATURE REVIEW 2.0 Dengue 2.0.1 General considerations Dengue fever and dengue hemorrhagic fever were first identified in the 1950s, during the dengue epidemics in Philippines and Thailand and by 1975 it had become a leading cause of hospitalization and death among children in many countries found in that region (Lloyd, 2003). In the year 1779 Egypt and Java had dengue-like epidemics, but it is thought that they were caused by the chikungunya virus (Carey, 1971). Dengue virus belongs to the genus Flavivirus, Family Flavivaridae and there are four serotypes of the virus (DEN-1, DEN-2, DEN-3 and DEN 4). All the four serotypes can cause dengue fever, dengue hemorrhagic fever and even dengue shock syndrome (Ramchurn et al, 2009). The four viruses are closely related but are distinct. Millions of people residing in tropical areas of the world are affected by epidemics of dengue fever. Dengue fever is associated with the severe form dengue hemorrhagic fever/ dengue shock syndrome (DHF/DSS) that is seen mostly in children and nevertheless adults also are attained by the disease. In the 19th and early 20th centuries dengue or dengue-like epidemics were reported in the Americas, Southern Europe, North Africa, the Middle East, Asia and Australia and on various islands in the Indian Ocean, South and Central Pacific and the Caribbean (Ehrenkranz et al, 1971). Generally these epidemics consisted of nonfatal feverish illnesses, often coupled with rash and either muscle or joint pains (Carey, 1971). Deaths occurred during dengue epidemics in Australia in 1897 and in Greece in 1928, when over 1000 deaths were reported (Halstead, 1980). Hemorrhagic demonstrations, including gastrointestinal bleeding, were described during dengue epidemics in Texas and Louisiana in 1922 (Scott, 1923). Nevertheless through the first half of the 20th century, dengue was generally described as a self-limited, nonfatal febrile illness, with occasional hemorrhagic manifestations such as red spots, acute hemorrhage from the nostril, nasal cavity, or nasopharynx, gingival bleeding and menorrh agia that only once in a blue moon resulted in more stern or fatal outcomes. During the last decade, dengue infection along with its complications has been on the rise all over the world. Their geographical spread is increasing: only 5 countries documented dengue in the 1950s but to date there are more than 100 countries reporting the incidence of dengue fever and dengue hemorrhagic fever (Guha -Sapi Schimmer, 2005). Dengue is found in tropical and sub-tropical climates worldwide, mostly in urban and semi-urban areas (WHO, 2009). Dengue fever is a very infectious mosquito borne viral disease characterized by either a mild febrile syndrome or the classic incapacitating disease with abrupt onset of high fever, severe headache, pain behind the eyes, muscle and bone or joint pains, nausea and vomiting and rash. Skin hemorrhages are not uncommon. Leukopenia is usually seen and thrombocytopenia may be observed (WHO 1997). Dengue is a flu-like mosquito-borne disease and has a soaring capacity for epidemic outbreaks, which according to the World Health Organization (2009) affects 50-100 million people each year in the tropical and sub-tropical areas of the world. Dengue is cited as being one of the most significant mosquito-borne disease affecting humans and as a major international public health concern (WHO 2009). Dengue fever is predominantly transmitted by Aedes species which have adapted themselves to living near human habitation (Hales et al., 2002). The dengue virus is a member of the family Flaviviridae virus, transmitted through the biting of infected Aedes aegypti and Aedes albopictus mosquito. The Aedes aegypti mosquito normally bites indoor and late in the afternoon whereas the proficient mosquito Aedes albopictus is an aggressive daytime biter, which is also known to bite early in the morning, late afternoon (Knight and Hull, 1952) and at night (Murray and Marks, 1984). This biter is usually an outdoor biting mosquito, but it also bites indoors (Hawley, 1988). Generally the mosquitoes bite at ground level (MacDonald and Traub, 1960, cited in Hawley, 1988). Females will bite any area of exposed skin, but prefer the ankles and knees (McClelland et al., 1973; Robertson and Hu, 1935). The time amid the bite of a mosquito carrying dengue virus and the apparition of symptoms ranges from 4 to 6 days, with a range of 3 to 14 days. 2.0.2 Pathogenicity of Dengue fever: 1. Asymptomatic and mild infection It is very common. 2. Dengue Fever (primary infection) Dengue fever is characterized by increase in body temperature; severe aching of the forehead; retro-ocular pain; muscle and joint pain; and widespread maculopapular inflammation. Conjunctiva may become red. Other common problems that may arise are diarrhea, vomiting, nausea and abdominal pain. Fear of light, sore throat, increase in the size of the lymph node and bleeding tendencies may also happen. The illness lasts 5 to 7 days. Immunity is lifelong. On the other side the incidence of Dengue Hemorrhagic Fever or Dengue Shock syndrome increases if the person has immunity or has already been infected before with a different serotype. Even after several months of recovery some patients may experience depression and fatigue. 3. Dengue Hemorrhagic fever The well-known feature is bleeding. It happens when a person is infected twice but with a different dengue virus serotypes or infrequently by primary infection is common in kids Under 15 years of Age (Rigall-Pewrez et al.1998). There is sudden rise in temperature and other manifestations of Dengue fever. Petechiae, effortless bruising, gingival bleeding and epistaxis are common. In severe cases bleeding of the gastrointestinal tract can be observed. In children, we can have an increase in the size of the spleen and the liver. 4. Dengue Shock Syndrome The prominent feature is hypotension. It normally occurs in people below 15 years of age. The clinical features include weak pulse with narrow blood pressure, cold and clammy skin (Rigall-Pewrez et al.1998). 2.0.3 Mode of transmission of dengue virus: Chikungunya and dengue viruses are transmitted to humans by the bites of infected mosquitoes. In contrast, Aedes albopictus is abundant and may be the only important vector of these viruses on the islands. Both species bite mainly during the daytime, particularly in the early hours after dawn and for 2-3 hours before darkness. Aedes albopictus is more active outdoors whereas Ae. aegypti typically feeds and rests more indoors (WHO 2008). In the cycle of dengue, the vertebrate host is man and the Aedes species the vectors. The disease is acquired only when bitten by female mosquitoes, as the female feed on blood in order for the development of their eggs whereas the male mosquitoes are not infectious due to the fact that they feed only on nectars rather than blood. In 8-10 days the infected mosquito is able to transmit the virus to other people. Thus the cycle of transmission takes only 14 days. One dengue-infected female mosquito is capable of biting and infecting several people during one feeding session. The dengue mosquito frequents backyards in search of containers holding water inside and outside the home, such as: cans, buckets, jars, and vases, pot plant dishes, birdbaths, boats, tyres discarded with no rims, roof gutters blocked by leaves striking containers, tarpaulins and black plastic. It can also breed in natural containers like: bromeliads fallen palm fronds. In drier conditions it also breeds in water inà ¿subterranean sites such as: wells, telecommunication pits, sump pits, gully traps. Transmission cycle of dengue results from a complex system based on several main constituents like: the density of susceptible hosts, environmental conditions and the presence of one or more serotypes of the dengue virus. The number of confirmed dengue cases has been increasing owing to the fact that the world is undergoing rapid urbanization and its population is also on the rise, disposal of non-biodegradable containers, rapid transportation and poor living conditions such as poor water supply and very rare scavenging services at squatter areas (Satwant, 2001). Various studies have shown that the Aedes albopictus is able to transmit all the 4 serotypes of dengue. Aedes albopictus mosquito can serve as an important maintenance vector of dengue viruses in endemic areas, and new endemic areas may be initiated by importation of vertically infected eggs (Gubler, 2002). That is the infected Aedes mosquito can pass the dengue virus to its progeny and when the eggs will develop into mature mosquitoes they will be already infected, hence capable of causing infection of human beings or even pass the virus to their progeny. Transmission cycle of dengue virus by the Aedes aegypti mosquito starts with a person infected with the dengue virus. The blood of the person will contain the virus thus circulating in his body and this is called a viremia which will last for about 5 days. During this period, an uninfected female Aedes aegypti mosquito bites the infected person and acquires the dengue virus. Within the mosquito, replication of the dengue virus occurs and this process usually takes between 8-12 days, after which the female mosquito can transmit the virus upon a blood meal. Once infected the virus takes 4-7 days to replicate within the new host (the person whom the infected mosquito bite) before inception of symptoms. Symptoms may last from three to 10 days, with an average of five days, after the onset of symptoms. Hence, the disease persists several days after apparition of symptoms (CDC Dengue Slideset). 2.0.4 Lifecycle of Aedes mosquito: The mosquito goes through four separate and distinct stages of its life cycle and they are as follows: Egg, Larva, pupa, and adult. Each of these stages can be easily recognized by their special appearance. Egg: Eggs are laid one at a time and they float on the surface of the water. Aedes species do not make egg rafts but lay their eggs separately. Aedes lay their eggs on damp soil that will be flooded by water. Most eggs hatch into larvae within 48 hours. Larva: The larva lives in the water where they eventually undergo a molting process to become a pupa. Pupa: The pupal stage is a resting, non-feeding stage and is the time the mosquito turns into an adult. It takes about two days before the adult is fully developed and upon complete development, the pupal skin splits and the mosquito emerges as an adult. Adult: The newly emerged adult rests on the surface of the water for a short time before flying away. In the Aedes mosquito family only the female bites because it requires protein to develop eggs, therefore if it bites a person infected with the dengue virus the mosquito becomes infectious after approximately 7 days. The mosquitoes are known to be biting at a highest frequency at dawn and dusk. Some more facts: The average lifespan of a mosquito of the genus Aedes in Nature is 2 weeks Mosquitoes may lay eggs about 3 times in his life, and about 100 eggs are produced each time. The eggs can live in dry conditions until approximately 9 months, after which they can hatch if it is subject to conditions, i.e food and water Source:http://dengue-feverdisease.blogspot.com/2008/02/lifecycle-of-aedes-mosquito.html [accessed on 05.12.09] 2.0.5 Investigation for dengue infections: Laboratory results Decrease in the number of white blood cell and peripheral neutrophils in the blood, abnormal increase in the number of lymphocytes in bloodstream and very low amount of platelets in the blood. Radiology X-ray of the chest normally shows pleural effusion and seldom pericardial effusion Ultrasound Used to detect pericardial effusion and 2) presence of excess fluids in the gap amid the tissues lining the abdomen and abdominal organ. Tests Laboratory diagnosis is done by detection of virus in specimen-serum at the virology laboratory. Culture is done in cell line derived from A. albopictus cell. Immunoflurescent techniques are used to detect viral replications. The virus can be isolated in patients with fever. Serology IgM is detectable in 90 % of patients by the 6th days of illness. Serum collected early may give false negative result. IgM can also be detected 2-3 months after. It is not possible to identify serotype with serological tests. In case where the IgM test is Positive it may imply recent infection with Dengue fever. However definitive diagnosis can only be made if the virus is isolated or the virus genome is detected by PCR. Seroconversion or boost in titer may indicate fresh infection. The appropriate samples for PCR test include plasma and serum. Molecular test is highly sensitive but it can be used in patients only with viraemia (Rigall-Pewrez et al.1998). 2.0.6 Treatment: The managing of dengue fever can be enhanced with bed rest, passable fluid intake, plus control of fever and pain with antipyretics in addition to analgesics (e.g. paracetamol). For the supplementary ruthless manifestations of dengue virus infection, correct management requires early identification and swift intravenous fluid substitution. Blood transfusion may be necessary in cases. There is currently no vaccine is available to shield against dengue infection. The current lack of a booming vaccine against the dengue virus causes prevention methods to be approached by plummeting disease vector population, with Integrated Pest Management programs for mosquito control. These employ a mishmash of control strategies, including mosquito surveillance, source diminution, eradicating larvae and eradicating adult mosquitoes (Ooi et al. 2007). Eradicating adult mosquitoes alone is fruitless in controlling mosquito populations because it is complex to treat the unattainable habitat of the adults. Mosquito larvae are left to carry on their development, and they quickly swap the adults. Nevertheless, mosquitoes can become resistant if pesticides are overused. 2.0.7 Dengue fever in Mauritius: Dengue virus infections are emerging as the major ones in Southeast Asia. Global warming may worsen the occurrence of dengue fever. Since very last few years mixed outbreak of chikungunya and periodic cases of dengue fever have been reported on R‚union Island and other South West Indian Ocean countries. From March 2005 till March 2006 it is estimated that about 204000 people in R‚union Island may have been infected by the chikungunya virus, which furthermore shows that there is presence of the transmitting vectors of the disease on the island which are also the vectors of dengue fever as well. Hereafter, the other South West Indian ocean countries were not spared from infection from the chikungunya virus. An outbreak of dengue fever was reported in Madagascar more specifically in the city of Toamasina that started mid-January 2006 and rare cases of chikungunya were also reported mid-February. Maldives also have suffered from a dengue outbreak in year 2006 where 602 people were suspected to be infected among which there were some severe form of dengue fever that is 64 dengue hemorrhagic fever cases and 9 cases of dengue shock syndrome (WHO 2006). In Mauritius the first case of dengue fever dates to the 1976s and it was contained thus limiting the disease from spreading. Then we had a case of imported dengue from a person who visited an endemic dengue area in January 2008 (CDCU). The main vectors of the disease remain the Aedes mosquitoes, among which the Aedes aegypti mosquito is the primary vector and Aedes albopictus the secondary one. The mosquito found to be spreading dengue fever and Chikungunya in Mauritius is the Aedes albopictus (CDCU 2009). It is to be noted that in Mauritius we had both the Aedes aegypti and Aedes albopictus mosquitoes, due to the intense anti-malaria campaign during the year 1952 the primary carrier of the dengue fever, the Aedes aegypti have been successfully eradicated. Still very minute amounts of this mosquito can be seen whereas the Aedes albopictus is abundant. Dengue is transmitted from person to person through the biting of infected mosquitoes. Most recently we had a short-lived epidemic of re-emerged dengue fever in Mauritius that started in the month of June 2009 which was imported. The mild fever was first localized in the city of Port Louis, where there were 192 cases and then we did have some sporadic cases in other regions of the island. Mosquito fogging and larviciding in whole Port Louis started on 3rd June 2009, and were repeated every seven days. Fogging was carried out outdoors early in the morning, early evenings and sometimes till late in the evenings (Dengue Unit 2009). The Ministry of Health and Quality of Life of Mauritius took the situation as being severe and all medium possible to contain the disease were put into action. Like the Special Mobile Force and manpower from other Ministries which joined the Ministry of Health to fight the dengue fever. Public alertness campaigns on the requisite to hunt and eliminate mosquito breeding sites at home and in the neighbourhood and to protect oneself against mosquito bites were carried out through radio, television and the press through a public private partnership. Detailed information leaflets were also distributed, door to door distribution of pamphlets showing pictures of possible breeding sites for mosquitoes and products to be used to prevent mosquito bite were carried out by the primary health care personnels. Target groups included the public, community groups and school children (Ramchurn et al, 2009). By the end of the month August no new or suspected cases of dengue were recorded in any of the countrys hospital. But still the control and prevention program were continued throughout the island as the summer season was coming near hence reappearance of the dengue fever was possible due to the ambient temperature, favorable for larvae development. The fear of having the virus again was due to the possibility of the infected mosquitoes to pass the virus to their progeny. Fortunately, till February 2010 no suspected case of dengue fever was reported from any in the country (Dengue Unit 2010). 2.1 Vector surveillance and control program Ever since mosquitoes are capable of transmitting diseases like dengue and chikungunya, till now it has not been possible to eradicate the mosquitoes completely from their originating site. The best way to monitor or control vector-borne diseases is to control or limit the population of the vector to such an extent that disease transmission is very low or even stopped. In order to achieve this goal, it is imperative to know all about the mosquito involved in the transmission of the disease. Detailed knowledge of all aspects such as the breeding sites, different features of the mosquito at different stages, feeding habits, mating, resting and structure and most importantly without forgetting the lifecycle of the mosquito, are the main required things in order to be able to break the chain of transmission. Furthermore, the only way to prevent infection of people who have not suffered from dengue is to control the population of dengue vector (Ooi et al.2001) and of course personal precaution has also proved to be effective in reducing the risk of being infected by a mosquito. Since no vaccine is yet available for dengue the only mode to control dengue fever is the control the amount of the disease vector that is of the Aedes mosquitoes. The control strategies of these mosquitoes are 1) carrying out larviciding -spraying a chemical called abate in any water retaining place which kill the larvae of the mosquitoes hence interrupting the cycle to be completed, 2) fogging operation- a thermal fogger is used to propel fumes of Aqua K-Othriner which when is in contact with a mosquito kills it, thus the amount of developed or simply mature mosquitoes are reduced and 3) health education- talks are organized for the members of the public, for children in schools, colleges, etc. Entomological survey is an important and integral part of dengue prevention and control. The effect of the intervention by the community can directly affect the ecology of the vectors that is the Aedes mosquitoes. The Communicable Disease Control Unit (CDCU) is the unit which is mostly concerned for the control of communicable diseases such as Malaria, Dengue fever, Chikungunya, and other infectious diseases. In Mauritius, surveillance, disease prevention and education of infectious diseases are mainly carried out by the Health Inspectorate Cadre. In Mauritius, we have the Public Health Act (Section 32A) which is used in case where there is presence of a mosquito borne disease in the island. The potential for predation to prevent pathogen invasion or reduce disease prevalence in a host population also has implications for the biological control of vector populations. Predators have been introduced, or proposed, as biological control agents of vectors for various diseases such as malaria, dengue fever and Lyme disease (Jenkins 1964; Legner 1995; Stauffer et al. 1997; Samish Rehacek 1999; Scholte et al. 2005; Kumar Hwang 2006; Ostfeld et al. 2006; Walker Lynch 2007). Several recent studies suggest that predator introductions led to a decline in local cases of dengue fever in Vietnam and Thailand (Kay Nam 2005; Kittayapong et al. 2008), and malaria in India (Ghosh et al. 2005; Ghosh Dash 2007). 2.2 Biology of Aedes albopictus (Skuse) Aedes albopictus are two winged insects from the family Culicidae of the order Diptera. They are among the best known groups due to their importance as pests and as vectors of diseases. They are easily identified due to a combination of the following characters: long trunk projecting head; charisma of scales on the wing veins, a tassel of scales along the posterior boundary of the wing, and the typical wing venation, the second, fourth and fifth longitudinal veins being branched (Miyagi and Toma 2000). Female mosquitoes feed on blood and they have highly specialized mothparts for piercing host skin and blood sucking (Wahid et al. 2002). Aedes species are normally day-time bitters and active during the day. During this time, they have peaks of landing and biting activity. The peak time for Aedes albopictus occurred about one hour after sunrise and then before sunset (Abu Hassan et al. 1996). Nevertheless, the rate of biting varies depending on the mosquito age and time of the day (Xue and Barnard 1996). CHAPTER 3 DATA COLLECTION 3.1 Introduction In this chapter, a summary of the various steps that was undertaken to finalize the research is attempted. The research work was started as from the month of September 2009 to the end of January 2010. 3.2 METHODOLOGY In order to assess the effectiveness of the control measures taken to prevent dengue fever, data were collected from the different partners who are involved in the control and prevention of dengue fever in Mauritius. Such data were collected from books, newspapers, published articles, magazines and official statistics from the Central Statistics Office, Dengue Unit, Communicable Disease Control Unit and the Ministry of Health Quality of Life. Moreover, constructive discussions were entertained with people who are in touch with the matters connecting to the piece of work. Search through the internet, review of available documents and properly classifying the information that would be used during the study. 3.3 METHODS OF ANALYSIS OF THE DATA OBTAINED Questions related with the way of application of the different control measures were selected for analysis from the filled questionnaires. Moreover, each particular question was analyzed by using SPSS software which provided the frequency and percentages and hence Microsoft Excel 2007 was used to express the data in forms of percentages, tables, figures, graphs, pie charts and charts. Chapter 4 Part I-Data Analysis 4.01 Introduction This chapter of the thesis will be dealing with the data collected from different stakeholders involved in the fight against dengue fever. Data collected mainly from the Communicable Disease Control Unit, Dengue Unit, and certain Health Offices of the country and the media will be expressed in figures. This section will be divided in to two parts: data analysis and press cot analysis. Much attention will be oriented towards the control measures in Port Louis, as the maximum number of cases occurred there and eventually the island in whole. 4.02 Progress of the disease through June 2009 in Port Louis Figure 4.1: Number of cases each day during the month of June 2009 From figure 4.1 it can be seen that the first case was detected on 2nd June 2009 and the maximum number of cases reported to the hospitals was around the 10th to 13th day of the same month. The number of confirmed cases by the end of June 2009 had decreased to less than five. 4.03 Age of people infected with dengue virus From the above chart (Fig 4.2) it can seen that about 34.55 % of the total number of cases (246 confirmed) of dengue were vulnerable ones that is the young and the elderly. 4.04 Aqua K Othriner used for fogging process Aqua K Othriner is a chemical used in mixture with another chemical substance called Nebolr, in thermal foggers to kill adult mosquitoes. Normally, the fogger produces fumes which in fact are fine droplets of the mixture which when in contact with a mosquito causes its death. The first day of fogging was started on 2nd June 2009 with a minimum cubic centimeter of Aqua K Othriner used, on the 7th day the maximum and throughout the rest of the days varying just a little in amount except for the 14th day. 4.05 Number of inspections carried out during the past 8 years throughout the Country Starting from the year 2001 till 2005 from the graph (fig 4.4) the number of inspections carried out by the health inspectorate cadre shows a slight decrease and suddenly in 2006 the number increases to approximately 3 fold than that in 2005. In year 2007, the amount of inspections carried again decreases to 112,087 and eventually for 2008 the number decreases a bit more. 4.06 Number of sanitary notices served during the past 8 years Public Health Act Sanitary notices are normally issued to the author of nuisance, as for in this case the notices served were to cause removal of water collected in used tyres, drums, roof tops, etc. From the year 2001 till 2005 the number of such type of notices served was ranging between 4933 and 8013. For 2006 the figure was the highest with 10657 of notices served and for the remaining 2 years a gradual decrease was noted. 4.07 Number of contraventions taken for none compliance with the Public Health Laws Notices Figur Preventing Dengue Fever in the Mauritius Preventing Dengue Fever in the Mauritius INTRODUCTION Mauritius is a small tropical island located at latitude 20à ¸ 18 0 S and longitude 57à ¸ 34 60 E. It has a tropical climatic condition. Mauritius has an area of about 2,040 sq km and is located to about 2000 kilometers from east west of Africa and some 800 kilometers from Madagascar. The positioning of Mauritius makes the latter a tropical country with moderately lofty temperature throughout the year. Winter and summer are the seasons that manifest onto the island. The island of Mauritius finds itself as one of the most accessible islands in the Indian Ocean. Situated amid R‚union island and Rodrigues island, the island of Mauritius has gained the reputation, through the course of time of that of the key and star of the Indian Ocean. The Mauritian population estimates for the year 2008 was about 1, 260, 781 with an annual growth rate of 0.7 %. Since the country is undergoing major developmental changes many industries have implanted here and thus the number of expatriates in the country is on the rise. These people may be a carrier of the disease and of course those Mauritians visiting the dengue endemic areas can also become infected and bring the disease in the country. It is an indisputable fact that during the lapsed decades, Mauritius has witnessed a multitude of diseases. The most prominent and recent one being Chikungunya which has infested merely about 12000 Mauritians. Furthermore, the history of diseases in Mauritius is marked with Malaria epidemics since colonial regimes and through the intensive effort of the Public Health sector, the latter has been proclaimed eradicated by the World Health Organization in 1973. Some years ago many of the realms citizens were not aware of what was dengue fever even though it had already occurred in the country but there was not mass infection by the virus. Providentially, the number of cases reported beforehand was only one or two and through the close collaboration between the Ministry Of Health and the infected person the situation was under control and hence no further positive case of dengue were recorded. The Mauritian government is putting forward all steps to prevent an epidemic rather than to rush for controlling it when it has already hit the population. The Ministry of Health is working on a list which highlights all water retaining sites and is identifying the hotspots of such sites that are liable to cause proliferation of mosquitoes; this process is carried out each year. Furthermore, an action plan is being prepared by the ministry which gives a layout of which and what job is to be done by which section of the ministry or other stakeholders (anonymous, 2009). Dengue viruses are transmitted by the Aedes species. Two known species the Aedes aegypti and Aedes albopictus are vectors of the disease. The Aedes albopictus can be found in large quantity all around the island whereas Aedes aegypti is said to be eradicated from the country. Surveillance on the abundance of mosquitoes is carried out by the entomological section throughout the year. All sites where mosquitoes that can be vectors of disease are seen, they are referred to the nearby health office for a larviciding to be carried out at that place and in the vicinity. Aedes albopictus (Skuse) is known as the Asian Tiger mosquito (Robertson and Hu, 1988). Aedes albopictus is native to Southeast Asia, but now occurs throughout the world. The worldwide spread of Aedes albopictus during the precedent 20 years has caused apprehension in the midst of public health officers and scientists over the possibility that the introduction of this species will amplify the risk of epidemic dengue fever and other arboviruses in countries where it has become established (Gubler, 2003). Aim The aim of this study is mainly to evaluate the effectiveness of the control measures taken to prevent dengue fever in Mauritius. Emphasis will be laid on the steps taken before, during and after the disease occurrence. This might highlight the shortcomings that Mauritius face in order to manage outbreaks of diseases. Objectives of study The objectives of this dissertation are to evaluate the management, procedures and legislation that are implemented in Mauritius during outbreaks of dengue fever. Furthermore, most interest is geared towards the application of chemicals, preventive measures, and health education of the public carried out by the Ministry of Health Quality of Life to prevent the occurrence of the disease and also to annihilate if ever found in the island. To elucidate the effectiveness of fogging, larviciding carried out in the country and health education of the public. CHAPTER TWO LITERATURE REVIEW 2.0 Dengue 2.0.1 General considerations Dengue fever and dengue hemorrhagic fever were first identified in the 1950s, during the dengue epidemics in Philippines and Thailand and by 1975 it had become a leading cause of hospitalization and death among children in many countries found in that region (Lloyd, 2003). In the year 1779 Egypt and Java had dengue-like epidemics, but it is thought that they were caused by the chikungunya virus (Carey, 1971). Dengue virus belongs to the genus Flavivirus, Family Flavivaridae and there are four serotypes of the virus (DEN-1, DEN-2, DEN-3 and DEN 4). All the four serotypes can cause dengue fever, dengue hemorrhagic fever and even dengue shock syndrome (Ramchurn et al, 2009). The four viruses are closely related but are distinct. Millions of people residing in tropical areas of the world are affected by epidemics of dengue fever. Dengue fever is associated with the severe form dengue hemorrhagic fever/ dengue shock syndrome (DHF/DSS) that is seen mostly in children and nevertheless adults also are attained by the disease. In the 19th and early 20th centuries dengue or dengue-like epidemics were reported in the Americas, Southern Europe, North Africa, the Middle East, Asia and Australia and on various islands in the Indian Ocean, South and Central Pacific and the Caribbean (Ehrenkranz et al, 1971). Generally these epidemics consisted of nonfatal feverish illnesses, often coupled with rash and either muscle or joint pains (Carey, 1971). Deaths occurred during dengue epidemics in Australia in 1897 and in Greece in 1928, when over 1000 deaths were reported (Halstead, 1980). Hemorrhagic demonstrations, including gastrointestinal bleeding, were described during dengue epidemics in Texas and Louisiana in 1922 (Scott, 1923). Nevertheless through the first half of the 20th century, dengue was generally described as a self-limited, nonfatal febrile illness, with occasional hemorrhagic manifestations such as red spots, acute hemorrhage from the nostril, nasal cavity, or nasopharynx, gingival bleeding and menorrh agia that only once in a blue moon resulted in more stern or fatal outcomes. During the last decade, dengue infection along with its complications has been on the rise all over the world. Their geographical spread is increasing: only 5 countries documented dengue in the 1950s but to date there are more than 100 countries reporting the incidence of dengue fever and dengue hemorrhagic fever (Guha -Sapi Schimmer, 2005). Dengue is found in tropical and sub-tropical climates worldwide, mostly in urban and semi-urban areas (WHO, 2009). Dengue fever is a very infectious mosquito borne viral disease characterized by either a mild febrile syndrome or the classic incapacitating disease with abrupt onset of high fever, severe headache, pain behind the eyes, muscle and bone or joint pains, nausea and vomiting and rash. Skin hemorrhages are not uncommon. Leukopenia is usually seen and thrombocytopenia may be observed (WHO 1997). Dengue is a flu-like mosquito-borne disease and has a soaring capacity for epidemic outbreaks, which according to the World Health Organization (2009) affects 50-100 million people each year in the tropical and sub-tropical areas of the world. Dengue is cited as being one of the most significant mosquito-borne disease affecting humans and as a major international public health concern (WHO 2009). Dengue fever is predominantly transmitted by Aedes species which have adapted themselves to living near human habitation (Hales et al., 2002). The dengue virus is a member of the family Flaviviridae virus, transmitted through the biting of infected Aedes aegypti and Aedes albopictus mosquito. The Aedes aegypti mosquito normally bites indoor and late in the afternoon whereas the proficient mosquito Aedes albopictus is an aggressive daytime biter, which is also known to bite early in the morning, late afternoon (Knight and Hull, 1952) and at night (Murray and Marks, 1984). This biter is usually an outdoor biting mosquito, but it also bites indoors (Hawley, 1988). Generally the mosquitoes bite at ground level (MacDonald and Traub, 1960, cited in Hawley, 1988). Females will bite any area of exposed skin, but prefer the ankles and knees (McClelland et al., 1973; Robertson and Hu, 1935). The time amid the bite of a mosquito carrying dengue virus and the apparition of symptoms ranges from 4 to 6 days, with a range of 3 to 14 days. 2.0.2 Pathogenicity of Dengue fever: 1. Asymptomatic and mild infection It is very common. 2. Dengue Fever (primary infection) Dengue fever is characterized by increase in body temperature; severe aching of the forehead; retro-ocular pain; muscle and joint pain; and widespread maculopapular inflammation. Conjunctiva may become red. Other common problems that may arise are diarrhea, vomiting, nausea and abdominal pain. Fear of light, sore throat, increase in the size of the lymph node and bleeding tendencies may also happen. The illness lasts 5 to 7 days. Immunity is lifelong. On the other side the incidence of Dengue Hemorrhagic Fever or Dengue Shock syndrome increases if the person has immunity or has already been infected before with a different serotype. Even after several months of recovery some patients may experience depression and fatigue. 3. Dengue Hemorrhagic fever The well-known feature is bleeding. It happens when a person is infected twice but with a different dengue virus serotypes or infrequently by primary infection is common in kids Under 15 years of Age (Rigall-Pewrez et al.1998). There is sudden rise in temperature and other manifestations of Dengue fever. Petechiae, effortless bruising, gingival bleeding and epistaxis are common. In severe cases bleeding of the gastrointestinal tract can be observed. In children, we can have an increase in the size of the spleen and the liver. 4. Dengue Shock Syndrome The prominent feature is hypotension. It normally occurs in people below 15 years of age. The clinical features include weak pulse with narrow blood pressure, cold and clammy skin (Rigall-Pewrez et al.1998). 2.0.3 Mode of transmission of dengue virus: Chikungunya and dengue viruses are transmitted to humans by the bites of infected mosquitoes. In contrast, Aedes albopictus is abundant and may be the only important vector of these viruses on the islands. Both species bite mainly during the daytime, particularly in the early hours after dawn and for 2-3 hours before darkness. Aedes albopictus is more active outdoors whereas Ae. aegypti typically feeds and rests more indoors (WHO 2008). In the cycle of dengue, the vertebrate host is man and the Aedes species the vectors. The disease is acquired only when bitten by female mosquitoes, as the female feed on blood in order for the development of their eggs whereas the male mosquitoes are not infectious due to the fact that they feed only on nectars rather than blood. In 8-10 days the infected mosquito is able to transmit the virus to other people. Thus the cycle of transmission takes only 14 days. One dengue-infected female mosquito is capable of biting and infecting several people during one feeding session. The dengue mosquito frequents backyards in search of containers holding water inside and outside the home, such as: cans, buckets, jars, and vases, pot plant dishes, birdbaths, boats, tyres discarded with no rims, roof gutters blocked by leaves striking containers, tarpaulins and black plastic. It can also breed in natural containers like: bromeliads fallen palm fronds. In drier conditions it also breeds in water inà ¿subterranean sites such as: wells, telecommunication pits, sump pits, gully traps. Transmission cycle of dengue results from a complex system based on several main constituents like: the density of susceptible hosts, environmental conditions and the presence of one or more serotypes of the dengue virus. The number of confirmed dengue cases has been increasing owing to the fact that the world is undergoing rapid urbanization and its population is also on the rise, disposal of non-biodegradable containers, rapid transportation and poor living conditions such as poor water supply and very rare scavenging services at squatter areas (Satwant, 2001). Various studies have shown that the Aedes albopictus is able to transmit all the 4 serotypes of dengue. Aedes albopictus mosquito can serve as an important maintenance vector of dengue viruses in endemic areas, and new endemic areas may be initiated by importation of vertically infected eggs (Gubler, 2002). That is the infected Aedes mosquito can pass the dengue virus to its progeny and when the eggs will develop into mature mosquitoes they will be already infected, hence capable of causing infection of human beings or even pass the virus to their progeny. Transmission cycle of dengue virus by the Aedes aegypti mosquito starts with a person infected with the dengue virus. The blood of the person will contain the virus thus circulating in his body and this is called a viremia which will last for about 5 days. During this period, an uninfected female Aedes aegypti mosquito bites the infected person and acquires the dengue virus. Within the mosquito, replication of the dengue virus occurs and this process usually takes between 8-12 days, after which the female mosquito can transmit the virus upon a blood meal. Once infected the virus takes 4-7 days to replicate within the new host (the person whom the infected mosquito bite) before inception of symptoms. Symptoms may last from three to 10 days, with an average of five days, after the onset of symptoms. Hence, the disease persists several days after apparition of symptoms (CDC Dengue Slideset). 2.0.4 Lifecycle of Aedes mosquito: The mosquito goes through four separate and distinct stages of its life cycle and they are as follows: Egg, Larva, pupa, and adult. Each of these stages can be easily recognized by their special appearance. Egg: Eggs are laid one at a time and they float on the surface of the water. Aedes species do not make egg rafts but lay their eggs separately. Aedes lay their eggs on damp soil that will be flooded by water. Most eggs hatch into larvae within 48 hours. Larva: The larva lives in the water where they eventually undergo a molting process to become a pupa. Pupa: The pupal stage is a resting, non-feeding stage and is the time the mosquito turns into an adult. It takes about two days before the adult is fully developed and upon complete development, the pupal skin splits and the mosquito emerges as an adult. Adult: The newly emerged adult rests on the surface of the water for a short time before flying away. In the Aedes mosquito family only the female bites because it requires protein to develop eggs, therefore if it bites a person infected with the dengue virus the mosquito becomes infectious after approximately 7 days. The mosquitoes are known to be biting at a highest frequency at dawn and dusk. Some more facts: The average lifespan of a mosquito of the genus Aedes in Nature is 2 weeks Mosquitoes may lay eggs about 3 times in his life, and about 100 eggs are produced each time. The eggs can live in dry conditions until approximately 9 months, after which they can hatch if it is subject to conditions, i.e food and water Source:http://dengue-feverdisease.blogspot.com/2008/02/lifecycle-of-aedes-mosquito.html [accessed on 05.12.09] 2.0.5 Investigation for dengue infections: Laboratory results Decrease in the number of white blood cell and peripheral neutrophils in the blood, abnormal increase in the number of lymphocytes in bloodstream and very low amount of platelets in the blood. Radiology X-ray of the chest normally shows pleural effusion and seldom pericardial effusion Ultrasound Used to detect pericardial effusion and 2) presence of excess fluids in the gap amid the tissues lining the abdomen and abdominal organ. Tests Laboratory diagnosis is done by detection of virus in specimen-serum at the virology laboratory. Culture is done in cell line derived from A. albopictus cell. Immunoflurescent techniques are used to detect viral replications. The virus can be isolated in patients with fever. Serology IgM is detectable in 90 % of patients by the 6th days of illness. Serum collected early may give false negative result. IgM can also be detected 2-3 months after. It is not possible to identify serotype with serological tests. In case where the IgM test is Positive it may imply recent infection with Dengue fever. However definitive diagnosis can only be made if the virus is isolated or the virus genome is detected by PCR. Seroconversion or boost in titer may indicate fresh infection. The appropriate samples for PCR test include plasma and serum. Molecular test is highly sensitive but it can be used in patients only with viraemia (Rigall-Pewrez et al.1998). 2.0.6 Treatment: The managing of dengue fever can be enhanced with bed rest, passable fluid intake, plus control of fever and pain with antipyretics in addition to analgesics (e.g. paracetamol). For the supplementary ruthless manifestations of dengue virus infection, correct management requires early identification and swift intravenous fluid substitution. Blood transfusion may be necessary in cases. There is currently no vaccine is available to shield against dengue infection. The current lack of a booming vaccine against the dengue virus causes prevention methods to be approached by plummeting disease vector population, with Integrated Pest Management programs for mosquito control. These employ a mishmash of control strategies, including mosquito surveillance, source diminution, eradicating larvae and eradicating adult mosquitoes (Ooi et al. 2007). Eradicating adult mosquitoes alone is fruitless in controlling mosquito populations because it is complex to treat the unattainable habitat of the adults. Mosquito larvae are left to carry on their development, and they quickly swap the adults. Nevertheless, mosquitoes can become resistant if pesticides are overused. 2.0.7 Dengue fever in Mauritius: Dengue virus infections are emerging as the major ones in Southeast Asia. Global warming may worsen the occurrence of dengue fever. Since very last few years mixed outbreak of chikungunya and periodic cases of dengue fever have been reported on R‚union Island and other South West Indian Ocean countries. From March 2005 till March 2006 it is estimated that about 204000 people in R‚union Island may have been infected by the chikungunya virus, which furthermore shows that there is presence of the transmitting vectors of the disease on the island which are also the vectors of dengue fever as well. Hereafter, the other South West Indian ocean countries were not spared from infection from the chikungunya virus. An outbreak of dengue fever was reported in Madagascar more specifically in the city of Toamasina that started mid-January 2006 and rare cases of chikungunya were also reported mid-February. Maldives also have suffered from a dengue outbreak in year 2006 where 602 people were suspected to be infected among which there were some severe form of dengue fever that is 64 dengue hemorrhagic fever cases and 9 cases of dengue shock syndrome (WHO 2006). In Mauritius the first case of dengue fever dates to the 1976s and it was contained thus limiting the disease from spreading. Then we had a case of imported dengue from a person who visited an endemic dengue area in January 2008 (CDCU). The main vectors of the disease remain the Aedes mosquitoes, among which the Aedes aegypti mosquito is the primary vector and Aedes albopictus the secondary one. The mosquito found to be spreading dengue fever and Chikungunya in Mauritius is the Aedes albopictus (CDCU 2009). It is to be noted that in Mauritius we had both the Aedes aegypti and Aedes albopictus mosquitoes, due to the intense anti-malaria campaign during the year 1952 the primary carrier of the dengue fever, the Aedes aegypti have been successfully eradicated. Still very minute amounts of this mosquito can be seen whereas the Aedes albopictus is abundant. Dengue is transmitted from person to person through the biting of infected mosquitoes. Most recently we had a short-lived epidemic of re-emerged dengue fever in Mauritius that started in the month of June 2009 which was imported. The mild fever was first localized in the city of Port Louis, where there were 192 cases and then we did have some sporadic cases in other regions of the island. Mosquito fogging and larviciding in whole Port Louis started on 3rd June 2009, and were repeated every seven days. Fogging was carried out outdoors early in the morning, early evenings and sometimes till late in the evenings (Dengue Unit 2009). The Ministry of Health and Quality of Life of Mauritius took the situation as being severe and all medium possible to contain the disease were put into action. Like the Special Mobile Force and manpower from other Ministries which joined the Ministry of Health to fight the dengue fever. Public alertness campaigns on the requisite to hunt and eliminate mosquito breeding sites at home and in the neighbourhood and to protect oneself against mosquito bites were carried out through radio, television and the press through a public private partnership. Detailed information leaflets were also distributed, door to door distribution of pamphlets showing pictures of possible breeding sites for mosquitoes and products to be used to prevent mosquito bite were carried out by the primary health care personnels. Target groups included the public, community groups and school children (Ramchurn et al, 2009). By the end of the month August no new or suspected cases of dengue were recorded in any of the countrys hospital. But still the control and prevention program were continued throughout the island as the summer season was coming near hence reappearance of the dengue fever was possible due to the ambient temperature, favorable for larvae development. The fear of having the virus again was due to the possibility of the infected mosquitoes to pass the virus to their progeny. Fortunately, till February 2010 no suspected case of dengue fever was reported from any in the country (Dengue Unit 2010). 2.1 Vector surveillance and control program Ever since mosquitoes are capable of transmitting diseases like dengue and chikungunya, till now it has not been possible to eradicate the mosquitoes completely from their originating site. The best way to monitor or control vector-borne diseases is to control or limit the population of the vector to such an extent that disease transmission is very low or even stopped. In order to achieve this goal, it is imperative to know all about the mosquito involved in the transmission of the disease. Detailed knowledge of all aspects such as the breeding sites, different features of the mosquito at different stages, feeding habits, mating, resting and structure and most importantly without forgetting the lifecycle of the mosquito, are the main required things in order to be able to break the chain of transmission. Furthermore, the only way to prevent infection of people who have not suffered from dengue is to control the population of dengue vector (Ooi et al.2001) and of course personal precaution has also proved to be effective in reducing the risk of being infected by a mosquito. Since no vaccine is yet available for dengue the only mode to control dengue fever is the control the amount of the disease vector that is of the Aedes mosquitoes. The control strategies of these mosquitoes are 1) carrying out larviciding -spraying a chemical called abate in any water retaining place which kill the larvae of the mosquitoes hence interrupting the cycle to be completed, 2) fogging operation- a thermal fogger is used to propel fumes of Aqua K-Othriner which when is in contact with a mosquito kills it, thus the amount of developed or simply mature mosquitoes are reduced and 3) health education- talks are organized for the members of the public, for children in schools, colleges, etc. Entomological survey is an important and integral part of dengue prevention and control. The effect of the intervention by the community can directly affect the ecology of the vectors that is the Aedes mosquitoes. The Communicable Disease Control Unit (CDCU) is the unit which is mostly concerned for the control of communicable diseases such as Malaria, Dengue fever, Chikungunya, and other infectious diseases. In Mauritius, surveillance, disease prevention and education of infectious diseases are mainly carried out by the Health Inspectorate Cadre. In Mauritius, we have the Public Health Act (Section 32A) which is used in case where there is presence of a mosquito borne disease in the island. The potential for predation to prevent pathogen invasion or reduce disease prevalence in a host population also has implications for the biological control of vector populations. Predators have been introduced, or proposed, as biological control agents of vectors for various diseases such as malaria, dengue fever and Lyme disease (Jenkins 1964; Legner 1995; Stauffer et al. 1997; Samish Rehacek 1999; Scholte et al. 2005; Kumar Hwang 2006; Ostfeld et al. 2006; Walker Lynch 2007). Several recent studies suggest that predator introductions led to a decline in local cases of dengue fever in Vietnam and Thailand (Kay Nam 2005; Kittayapong et al. 2008), and malaria in India (Ghosh et al. 2005; Ghosh Dash 2007). 2.2 Biology of Aedes albopictus (Skuse) Aedes albopictus are two winged insects from the family Culicidae of the order Diptera. They are among the best known groups due to their importance as pests and as vectors of diseases. They are easily identified due to a combination of the following characters: long trunk projecting head; charisma of scales on the wing veins, a tassel of scales along the posterior boundary of the wing, and the typical wing venation, the second, fourth and fifth longitudinal veins being branched (Miyagi and Toma 2000). Female mosquitoes feed on blood and they have highly specialized mothparts for piercing host skin and blood sucking (Wahid et al. 2002). Aedes species are normally day-time bitters and active during the day. During this time, they have peaks of landing and biting activity. The peak time for Aedes albopictus occurred about one hour after sunrise and then before sunset (Abu Hassan et al. 1996). Nevertheless, the rate of biting varies depending on the mosquito age and time of the day (Xue and Barnard 1996). CHAPTER 3 DATA COLLECTION 3.1 Introduction In this chapter, a summary of the various steps that was undertaken to finalize the research is attempted. The research work was started as from the month of September 2009 to the end of January 2010. 3.2 METHODOLOGY In order to assess the effectiveness of the control measures taken to prevent dengue fever, data were collected from the different partners who are involved in the control and prevention of dengue fever in Mauritius. Such data were collected from books, newspapers, published articles, magazines and official statistics from the Central Statistics Office, Dengue Unit, Communicable Disease Control Unit and the Ministry of Health Quality of Life. Moreover, constructive discussions were entertained with people who are in touch with the matters connecting to the piece of work. Search through the internet, review of available documents and properly classifying the information that would be used during the study. 3.3 METHODS OF ANALYSIS OF THE DATA OBTAINED Questions related with the way of application of the different control measures were selected for analysis from the filled questionnaires. Moreover, each particular question was analyzed by using SPSS software which provided the frequency and percentages and hence Microsoft Excel 2007 was used to express the data in forms of percentages, tables, figures, graphs, pie charts and charts. Chapter 4 Part I-Data Analysis 4.01 Introduction This chapter of the thesis will be dealing with the data collected from different stakeholders involved in the fight against dengue fever. Data collected mainly from the Communicable Disease Control Unit, Dengue Unit, and certain Health Offices of the country and the media will be expressed in figures. This section will be divided in to two parts: data analysis and press cot analysis. Much attention will be oriented towards the control measures in Port Louis, as the maximum number of cases occurred there and eventually the island in whole. 4.02 Progress of the disease through June 2009 in Port Louis Figure 4.1: Number of cases each day during the month of June 2009 From figure 4.1 it can be seen that the first case was detected on 2nd June 2009 and the maximum number of cases reported to the hospitals was around the 10th to 13th day of the same month. The number of confirmed cases by the end of June 2009 had decreased to less than five. 4.03 Age of people infected with dengue virus From the above chart (Fig 4.2) it can seen that about 34.55 % of the total number of cases (246 confirmed) of dengue were vulnerable ones that is the young and the elderly. 4.04 Aqua K Othriner used for fogging process Aqua K Othriner is a chemical used in mixture with another chemical substance called Nebolr, in thermal foggers to kill adult mosquitoes. Normally, the fogger produces fumes which in fact are fine droplets of the mixture which when in contact with a mosquito causes its death. The first day of fogging was started on 2nd June 2009 with a minimum cubic centimeter of Aqua K Othriner used, on the 7th day the maximum and throughout the rest of the days varying just a little in amount except for the 14th day. 4.05 Number of inspections carried out during the past 8 years throughout the Country Starting from the year 2001 till 2005 from the graph (fig 4.4) the number of inspections carried out by the health inspectorate cadre shows a slight decrease and suddenly in 2006 the number increases to approximately 3 fold than that in 2005. In year 2007, the amount of inspections carried again decreases to 112,087 and eventually for 2008 the number decreases a bit more. 4.06 Number of sanitary notices served during the past 8 years Public Health Act Sanitary notices are normally issued to the author of nuisance, as for in this case the notices served were to cause removal of water collected in used tyres, drums, roof tops, etc. From the year 2001 till 2005 the number of such type of notices served was ranging between 4933 and 8013. For 2006 the figure was the highest with 10657 of notices served and for the remaining 2 years a gradual decrease was noted. 4.07 Number of contraventions taken for none compliance with the Public Health Laws Notices Figur