Connections Essay Example for Free

Connections Essay The overall connection that I chose to analyze in this report was the importance of marriage, as it is an idea that is present in almost everybody’s life, and it is something that heavily impacts the nature of a society. Marriage is seen in society in both positive and negative ways, involving emotions from true love to bitterness. In the texts A Thousand Splendid Suns, by Khaled Hosseini, The Ballad of Calvary Street by James K Baxter, The Silk by Joy Cowley and Atonement directed by Joe Wright, this idea of the importance of marriage is clearly present in all of them, yet they are all shown so differently (negatively and positively) as to give examples of the ways that it is interpreted in different societies, and allow me to deduce the importance that this idea holds on a global scale. Romantic love is recognized in most societies by the practice of marriage. This is a prominent symbol in all the texts I have covered except for Atonement, where the absence of marriage is used to show the couple’s true love. In this film, we see that Cecelia and Robbie are in love, however a misunderstanding on the part of Cecelia’s sister, Briony, means that Cecelia and Robbie are prevented from marriage or even being together. This is shown as a particularly tragic incident, which shows the importance that society places on the process of marriage. This is also a very prominent idea in the novel, A Thousand Splendid Suns, which is set in Afghanistan. We see two women, Laila and Mariam, who are owned and controlled by their shared husband, and their lives literally rely on him, because as women, they are unable to attain independence due to their country’s beliefs. In Afghan society, marriage is a sacred business, and any sexual relations outside of marriage are greatly looked down upon, and the punishment for a female offender can be as severe as torture or death by the girl’s family or husband. This also shows the idea of the importance of marriage that is shown in Atonement, as marriage is seen as the pinnacle of happiness in both texts, However in A Thousand Splendid Suns it is shown in a more negative manner, with marriage being shown as an essential burden rather than a desire. Marriage is also shown as a necessity in the poem, The Ballad of Calvary Street, but for different reasons. In this poem, a poorly suited elderly couple stay together, to prevent the disruption of their family. This shows that even New Zealand society can view marriage as an important action, and a obligation in functional family life. This shows a similar idea to that in A Thousand Splendid Suns and Atonement, that marriage is a necessary action. In the short story The Silk, we see an elderly married couple, of which the husband is nearing death. The woman in the relationship is finding it hard to come to terms with her husbands impending demise, as she has a set routine which revolves around her and her husband’s relationship. This presents the idea that is shown in A Thousand Splendid Suns, Atonement and The Ballad of Calvary Street, that marriage is a prerequisite for a happy life, and it is a tragedy to be without it. In the Silk, we can tell that this married couple are truly in love from quotes such as, â€Å"she guarded him so possessively that she even resented the twice-weekly visits from the district nurse,† which shows the devoted way that they take care of each other, presenting the traditional idea of marriage. In Atonement, when childhood sweethearts Robbie and Cecelia are prevented from being together, we are struck by the tragedy of the fact that they will never be able to get married, and live out their lives together. This portrays the aspect of marriage that is shown in The Silk, that marriage is a symbol of the love between two people, and that it is a contract which binds the two people together for the rest of their lives, as we see Robbie and Cecelia denied of this entitlement. In today’s society, a happy couple who are in love are expected to get married. This relates to both The Silk and Atonement, as in both texts marriage is seen as a necessity for the happiness of the people involved, which further supports the idea that society regards marriage as particularly important. From these texts, society may be able to reassess its outlook on the controversial matter of gay marriage. The tragedy of Cecelia and Robbie’s separation that is shown in Atonement and the portrayal of the happiness involved in marriage that is shown in The Silk could be enough to convince the large portion of society that is against gay marriage that they are wrong, as in both texts marriage is shown as a component of happiness that should not be denied of anyone. The relationships and situations that are shown in the texts are not exclusive to heterosexual couples, and would translate just as well to homosexual relationships, meaning that the ideas attached to the texts can be applied to same-sex couples as well, and could have an influence on the opinion that people hold towards gay marriage. Unfortunately, marriage is not always a happy affair, as it is intended to be. This is plainly shown in the text The Ballad of Calvary Street, as we see an unfortunate couple who are forced to remain together due to the stigma attached to divorce. Quotes such as â€Å"Mum takes down the family files,† suggest that family is not an important thing to the couple, since they have fallen apart, but that they continue to treat it as such, as they consider it their duty as parents to remain married. This idea that marriage is a compulsory task is also shown in A Thousand Splendid Suns, as we see protagonist Laila is forced into marriage, for her own survival. Her husband knowingly takes advantage of her vulnerable situation, saying, â€Å"These days, times being what they are, a woman needs a husband,† showing that marriage can often take place for reasons other than love (as was shown in The Ballad of Calvary Street), and that this can easily be taken advantage of. This presents the idea that in many different societies, (New Zealand and Afghan), marriage is seen as an essential measure, even when one or both of the people involved in the relationship are unhappy. Although this is an unfortunate truth, it is one that must sometimes be accepted, as it is often present in today’s society. These texts could help people come to terms with the idea that marriage is not always a representation of love, as they show legitimate alternative reasons for marriage, (the stability of family life or the safety of a person in a certain community. ) This could benefit society as it would create an understanding and acceptance of the reality of marriage today. In conclusion, the idea of marriage is a common theme in many texts, including Atonement directed by Joe Wright, The Silk by Joy Cowley, A Thousand Splendid Suns by Khaled Hosseini and The Ballad of Calvary Street by James K Baxter. Although marriage is not always the quintessential act of love and can sometimes tell a tragic story, it is important that it is expressed in forms such as these texts so that society can reflect on its faults and hopefully improve its approach on the subject.

Automatic Quantification of the Myocardial Extracellular

Automatic Quantification of the Myocardial Extracellular Automatic Quantification of the Myocardial Extracellular Volume by  Cardiac Computed Tomography: Synthetic ECV by CCT Thomas A Treibel, MBBS1,2, Marianna Fontana, PhD,1,2, Jennifer A Steeden PhD2,3, Arthur Nasis, MD1, Jason Yeung, MBBS4, Steven K White, BSc, MBChB1,2, Sri Sivarajan4, Shonit Punwani, PhD4, Francesca Pugliese, PhD1, Stuart A Taylor, MD4, James C Moon, MD1,2, Steve Bandula, PhD4 1Barts Heart Centre, St Bartholomews Hospital, London, UK. 2Institute of Cardiovascular Science, University College London, London, UK. 3UCL Centre for Medical Image Computing, Department of Medical Physics, London, UK. 4Centre for Medical Imaging, University College London, London, UK. Manuscript Type: Original Manuscript Manuscript: 3924 words (all including) No conflict of interest declared. Funding: TAT and SB are supported by Doctoral Research Fellowships from the NIHR, UK (NIHR ­DRF ­ 2013-06-102 / NIHR ­DRF ­ 2011 ­04 ­008). MF and SKW are supported by Clinical Research Training Fellowships from the British Heart Foundation (grants FS/12/ 56/29723 and FS/10/72/28568). JCM is directly and indirectly supported by the University College London Hospitals NIHR Biomedical Research Centre and Biomedical Research Unit at Barts Hospital, respectively. FP: this work form part of the translational portfolio of the Cardiovascular Biomedical Research Unit at Barts, which is supported and funded by the NIHR. SAT is an NIHR senior investigator. This work was undertaken at University College London Hospital, which received a proportion of funding from the UK Department of Health National Institute for Health Research Biomedical Research Centres funding scheme. ABSTRACT [TT1] Background: The quantification of myocardial extracellular volume fraction (ECV) by Cardiac Computed Tomography (CCT) can identify changes in the extracellular space due to fibrosis or infiltration. Current methodologies require laboratory blood hematocrit (Hct) measurement which complicates the technique.   The attenuation of blood (HUblood) is known to change with anemia. We hypothesized that the relationship between Hct and HUblood could be calibrated to rapidly generate a synthetic ECV without the need to formally measure Hct. Methods: This retrospective study received institutional review board approval. The association between Hct and HUblood was derived from forty non-contrast thoracic CT scans using regression analysis. Synthetic Hct was then used to calculate synthetic ECV, and in turn compared with ECV using blood Hct in a validation cohort with mild interstitial expansion due to fibrosis (aortic stenosis, n=28, ECVCT = 28 ±4%) and severe interstitial expansion due to amyloidosis (n=27; ECVCT = 54 ±11%, psynthetic ECV was correlated with collagen volume fraction (CVF) in a separate cohort with aortic stenosis (n=18). All CT scans were performed at 120kV and 160 mAs. Results: HUblood was a good predictor of Hct (R2=0.47; p), with the regression model (Hct = [0.51 * HUblood] + 17.4) describing the association. Synthetic ECV correlated well with conventional ECV (R2=0.96; p with minimal bias and 2SD difference of 5.7%. Synthetic ECV correlated as well as conventional ECV with histological CVF (both R2=0.50, p). Finally, we implemented an automatic ECV plug-in for offline analysis. Conclusion: Synthetic ECV by CCT provides instantaneous quantification of the myocardial extracellular space without the need for blood sampling. KEYWORDS: Computed tomography; Myocardial tissue characterization; Extracellular matrix; Myocardial extracellular volume fraction; Myocardial fibrosis; cardiac amyloidosis. LIST OF ABBREVIATIONS AL amyloidosis = Immunoglobulin light-chain amyloidosis AS = Aortic stenosis CCT = Cardiac computed tomography CMR = Cardiovascular magnetic resonance CVF = Collagen volume fraction ECV = Extracellular volume fraction HU = Hounsfield units INTRODUCTION Extracellular volume fraction (ECV) quantification by cardiac computed tomography (CCT) 1-5 and cardiovascular magnetic resonance (CMR) 6, 7 is a promising new imaging biomarker for interstitial expansion due to myocardial fibrosis and cardiac amyloid deposition. Emerging data suggests ECV predicts outcome as well as left ventricular ejection fraction 8, 9 and there is increasing interest in targeting the interstitium during the development of heart failure therapy.10 Current methodologies for ECV quantification require blood hematocrit (Hct) measurement, which adds a layer of complexity and is potentially a barrier to easy clinical implementation. Alternatively, for CMR, Treibel et al. recently proposed a synthetic ECV technique, removing the need for Hct measurement by utilizing the relationship between relaxivity of blood and lab measured Hct.11 It is unknown if a similar approach can be used for CCT, although a relationship between anemia and unenhanced blood attenuation has been observed.12-17 For example the aortic ring sign and dense intra-ventricular septum on unenhanced thoracic CTs suggest underlying anemia.17-19 We hypothesized that the relationship between Hct and unenhanced blood attenuation (HUblood) could be used to estimate a synthetic Hct, permitting immediate synthetic ECV calculation without blood sampling. We used existing patient cohorts1, 4 to investigate how synthetic ECV (a) compares to conventional ECV, and (b) correlates with the reference standard collagen volume fraction. We also tested implementation of an automated synthetic ECV measurement plug-in within the open-source DICOM viewer OsiriX.20 MATERIAL AND METHODS This study is a retrospective analysis of prospectively acquired data, received local ethical approval and conformed to the principles of the Helsinki Declaration. The study received no industry support.   All participants provided informed and written consent. Exclusion criteria were uncontrolled arrhythmia or impaired renal function (estimated glomerular filtration rate ECV CCT Protocols. The CCT protocol consisted of three steps: first, a low dose non-contrast scan to obtain baseline attenuations; second, contrast administration with a contrast-enhanced 1-minute acquisition and a 5 minute delay to allow blood to myocardial contrast equilibration; third, a repeat scan to re-measure blood and myocardial attenuations. CCT examinations were performed on a 64-detector row CT scanner (Somatom Sensation 64; Siemens Medical Solutions, Germany).1, 4 A topogram was used to plan CT volumes from the level of the aortic valve to the inferior aspect of the heart, typically a 10 cm slab. Cardiac scans (tube voltage, 120 kV; tube current-time product, 160 mAs; section collimation, 64 detector rows, 1.2-mm section thickness; gantry rotation time, 330 msec) were acquired with prospective gating (65%-75% of R-R interval), and reconstructed into 3-mm-thick axial sections with a B20f kernel. All pre- and post contrast acquisitions were performed and reconstructed with the same parameters and matched the level of the pre-contrast scan. The iodinated contrast material used was iohexol (Omnipaque 300; Nycomed Amersham, Oslo, Norway; 300 mg of iodine per milliliter) at a standard dose of 1mL/kg and injection rate of 3ml/sec without a saline chaser. Image Analysis. CCT image analysis was performed using a free and open-source Digital Imaging and Communications in Medicine viewer (OsiriX v4.1.2; Pixmeo, Bernex, Switzerland) independently by two experienced readers blinded to all other study data. For Hct estimation, regions of interest (ROIs) were placed in in a single axial slice in the center of the right atrium. The mean area of these ROIs were 4.8 ±1.2cm2. ROIs were drawn in the myocardial left ventricular septum and blood pool in the contrast-enhanced 1-minute acquisition in axial sections and propagated to the pre-contrast and post contrast acquisitions. Myocardial and blood attenuation values (pre-and post contrast only) were used to calculate the ECV fraction from the ratio of the change in blood and myocardial attenuation (ΆHU) corrected by the blood volume of distribution (1 Hematocrit): ECV   =   (1 Hematocrit) x (ΆHUtissue / ΆHUblood) Synthetic Hematocrit and ECV Methodology 1. Derivation of synthetic Hematocrit To derive a regression model predicting hematocrit from pre-contrast HUblood, clinical unenhanced CT scans of the thorax were retrospectively analyzed (120 kV; reconstructed at 5mm slice thickness and B70F soft tissue kernel). These were consecutive clinical CT scans of the thorax for investigation of malignancy, fibrosis or infection. Datasets were included if the patients had a contemporaneous paired laboratory measured Hct (within 20 days, median 8 days). HUblood was analyzed in a single axial slice through the center of the right atrium. This was chosen to minimize beam-hardening artifact from the spine (compared to aortic blood pool) and partial voluming of papillary muscles in the left or right ventricular blood pool. Synthetic Hct was obtained from the equation describing the linear regression line between laboratory HUblood and Hct. 2. Creation of a synthetic ECV Equation Blood hematocrit was substituted by the derived synthetic Hct to derive a synthetic ECV: Synthetic ECV   =   (1 synthetic Hct) x (ΆHUtissue / ΆHUblood) 3. Validation of synthetic ECV For validation, we used existing patient cohorts to investigate how synthetic ECV (a) compares to conventional ECV with laboratory blood hematocrit,4 and (b) correlates with the reference standard collagen volume fraction.1 3a. Clinical Validation Cohort In order to test synthetic ECV across a range of ECV values, the cohort used by our group to validate ECV by CT in amyloidosis was chosen; this comprised of two sub-groups with differing degrees of extracellular volume expansion: I. patients with cardiac amyloidosis (typically high ECV), comprising of 26 patients with systemic amyloidosis (21 males, age 55 ±10 years; 18 with transthyretin amyloidosis; 8 with systemic AL amyloidosis) with varying degrees of cardiac involvement; II. A comparator group of 27 age- and sex-matched patients with severe aortic stenosis (19 male, age 68 ±8 years) who typically exhibit only mild ECV elevation. Scans were performed between January and December 2013. In the clinical cohort, contrast administration was performed using a bolus only approach with a 1 mL/kg bolus of iohexol and post-contrast imaging at 1 minute (for segmentation) and 5 minutes (for post contrast analysis), as validated by our group previously.4 3b. Histological Validation Cohort For histological validation, the performance of synthetic ECV against a histological measure of fibrosis, the collagen volume fraction (CVF), was tested in a second smaller cohort of patients with severe AS, who underwent intra-operative biopsy (no overlap with clinical cohort). This cohort had been used by our group to validate ECV by CT again histology:1 Consenting severe AS patients (n = 17, median age 71 ±10 years, 76% male) underwent CCT between July 2010 and February 2012. Biopsies were obtained and stained with picrosirius red for histological measurement of collagen volume fraction (CVF) as previously described.21 In the histology cohort, contrast administration followed primed iodinated contrast material infusion (bolus plus maintenance infusion) with a 1 mL/kg bolus of iohexol followed by a maintenance infusion of at a rate of 1.88 mL/kg per hour for 25 minutes, when the post contrast imaging was performed.1 4. OsiriX Plugin To facilitate offline analysis and to exemplify future inline automation by scanner manufacturers, an automatic synthetic ECV plug-in was developed for OsiriX. Statistical analysis Analyses were performed using SPSS (Chicago, IL, USA, version 22). All data are presented as mean  ± SD. Normal distribution was assessed by using the Kolmogorov-Smirnov test. Differences were assessed using unpaired, two-sided student t-tests (significance level p). Agreement between conventional and synthetic ECV was analyzed using the Bland-Altman method. The significance of the difference between two correlation coefficients was tested using the Fisher r-to-z transformation. RESULTS[TT2] Step 1. Derivation cohort 40 thoracic CT scans with contemporaneous Hct samples within 20 days (mean 8 ±7 days) of the scan were included (n=40, 53% male, age 60 ±20 years) with a broad range of Hct (mean 38.2 ±6.0%; range 24.7-50.7%) and HUblood (mean 40 ±8; range 20-55). The linear regression equation was:   (sHct = [0.51 * HUblood] + 17.4) with R2=0.47 p (Figure 1). Step 2. Creation of the synthetic ECV Equation Blood hematocrit was substituted by the derived synthetic Hct to derive a synthetic ECV: Synthetic ECV   =   (1 ([0.51 * HUblood] + 17.4)x (ΆHUtissue / ΆHUblood) Step 3. Validation Step 3a. Clinical cohort Baseline characteristics of twenty-six systemic amyloidosis and twenty-seven AS patients are shown in Table 1.In this cohort, Hct were mean 41.4 ±3.8% (range 29.3-47.4%) and HUblood mean 40.2 ±3.9 (range 29.3-50.1). Synthetic ECV, calculated using the regression model to derive HCT,and conventional ECV were highly correlated (R2=0.96; p) with a 5.7% SD of differences and minimal bias (2.4%) on Bland-Altman analysis (Figure 2). ECVCT was significantly higher in amyloid patients with definitive cardiac involvement than aortic stenosis (54 ±11% versus 28 ±4%, p Step 3b. Histology cohort Baseline characteristics of the histology cohort are described in Table 2.The mean histological CVF of the 17 biopsies was 18  ± 8% (range 5% to 40%), Hct were 40.2 ±4.6% (range 29.4-46.4%) and HUblood 37.7 ±4.2 (range 29.5-45.1). Synthetic and conventional ECV both correlated well with collagen volume fraction (R2 = 0.50, p vs. R2 = 0.50, p ; Figure 3) and did not differ statistically on Fisher r-to-z transformation (p = 0.8). Step 4. Automatic synthetic ECV plug-in in OsiriX Example output of the OsiriX plugin are shown in Figure 4, and the code is provided in the supplementary data. This plugin involves three simple steps: I. Manual segmentation of the blood pool in the pre- and post-contrast images; II. The plug-in automatically estimates blood hematocrit using the attenuation relationship defined above; III. The plug-in produces a three-dimensional myocardial ECV volume, where each image voxel represents an ECV value. Reproducibility Inter- and intra-observer agreement was excellent for myocardial (ICC = 0.92 and ICC = 0.94, respectively) and blood pool (ICC = 0.96 and ICC = 0.99, respectively) attenuation measurements. Similarly for ECV, excellent agreement was found (ICC = 0.95 and ICC = 0.98, respectively). Repeat sampling variability was tested in 44 patients who underwent two samples a median of 4 hours apart. Test:retest variability of laboratory hematocrit was higher than expected (n=44, variability 10% with hct:hct R2=0.86.11 DISCUSSION Identifying interstitial heart disease is important for diagnosis and prognosis,10 and myocardial extracellular volume fraction (ECV) can be measured non-invasively by CCT.1-4 However, its measurement is complicated by the necessity for venous blood sampling, image analysis and then offline ECV calculation. This process is cumbersome and a major obstacle for implementing this technique into routine clinical practice. In this manuscript, we simplify the technique by calculating ECV without blood hematocrit. This development arose out of a need to simplify ECV measurement to make it more clinically applicable. We utilize the relationship between hematocrit and blood attenuation (the attenuation of blood decreases with anemia)12-14, 17-19 to derive a synthetic hematocrit for immediate synthetic ECV calculation without blood sampling. We show that synthetic ECV was highly correlated to conventional ECV, and had a similar association to the histologic reference standard of CVF. The implementation of an offline automated processing tool provides a significant aid to workflow, allowing for ECV measurement in routine clinical practice.   Automated synthetic ECV can be implemented inline on CT scanners with test performances approaching that of conventional ECV measurement. ECV quantification by CT, despite it lower signal to noise ratio, has key advantage over CMR: The CT approach is cheaper and widely available, can be completed in 5 minutes, and the scanner design can accommodate patients with obesity and claustrophobia (CMR is not suitable in around 10% of patients due to claustrophobia or many cardiac pacemakers).22 Furthermore, ECV by CCT can provide high-resolution 3D ECV volumes with whole heart acquisition and limited cardiac motion. Finally, the concentration of iodine has a linear relationship with th e CT attenuation value, which is not affected by fast exchange mechanism like CMR T1 mapping (depending on cell size and contrast dose, fast transcytolemmal water-exchange may reach its limits), which do not apply to CT.23, 24 ECV (by CMR or CT) allows quantification of a key pathophysiological pathway in heart failure: interstitial expansion due to diffuse myocardial fibrosis (or in rare cases by deposition of amyloid fibrils).1-4 As the CMR field is showing, ECV is diagnostic in certain diseases, tracks myocardial remodelling and predicts outcome.25, 26 Interstitial expansion can be global (hypertension, aortic stenosis) or focal (hypertrophic or dilated cardiomyopathy), therefore high spatial resolution and whole heart coverage is important. Due to the aforementioned advantages of CT over CMR, ECV by CT will undoubtedly receive greater attention as part of comprehensive assessment of the heart by CT coronary angiography, perfusion and myocardial tissue characterization. Limitations[TT3] The study has limitations. In the derivation cohort, the mean interval between Hct samples and CT 8 days. Normal within-subject variation in Hct between 1 day and 1-2 months in a healthy adult is actually very low (3%), but together with an analytical variation (3%) this may explain a relative change of >10% between two successive Hct values.27 The control cohort used in this study comprised of patients with AS rather then healthy volunteers, but, given the exposure to ionizing radiation and contrast, patients with AS were deemed as adequate control cohort, avoiding exposure of healthy volunteers. For the same reasons, variability of repeat synthetic ECV was not tested. Development and validation were performed using a single scanner platform, therefore this regression model is only valid for 120 kV and an X-ray tube used in a specific CT vendor. Spectrum of the X-rays emitted by a CT X-ray tube substantially varies among CT vendors. In addition, low KV scans are increasingly used to reduce radiation exposure to the patients. Consequently, multiple regression models for different KV settings as well as for different CT vendors should be carefully prepared for synthetic ECV by CCT. Other factors that may affect the attenuation of blood such as temperature28 and other blood constituents such as macromolecules, fat and iron require further investigation. The 64-slice-CT-system employed here reflects commonly available systems, but did not offer iterative reconstruction algorithms, dual energy acquisition and larger detector arrays that allow acquisition of whole heart, isotropic volumes of in one heart beat and at low radiation dose. In single-source 64 detector rows CT, myocardial CT attenuation is not homogenous due to artifacts, especially in the inferior wall and lateral wall. In the current study, we only included data from ROIs in the left ventricular septum. The accuracy of synthetic ECV should be validated in other segments in LV myocardium, if synthetic ECV by CT is more widely available and used in patients. Furthermore, 3D image registration and processing, reduces the errors of whole heart ECV maps.29 CONCLUSION Synthetic hematocrit derived from the relationship between blood hematocrit and blood attenuation allows quantification of the myocardial extracellular volume fraction by cardiac computed tomography without the need for blood sampling. ECV shows great potential, allowing myocardial tissue characterization with negligible effect on workflow and radiation dose. However wider adoption requires simplification and automation of the established technique synthetic ECV offers this. REFERENCES 1.Bandula S, White SK, Flett AS, et al. Measurement of myocardial extracellular volume fraction by using equilibrium contrast-enhanced CT: validation against histologic findings. Radiology. 2013;269:396-403. 2.Nacif MS, Kawel N, Lee JJ, et al. Interstitial myocardial fibrosis assessed as extracellular volume fraction with low-radiation-dose cardiac CT. Radiology. 2012;264:876-883. 3.Nacif MS, Liu Y, Yao J, et al. 3D left ventricular extracellular volume fraction by low-radiation dose cardiac CT: assessment of interstitial myocardial fibrosis. J Cardiovasc Comput Tomogr. 2013;7:51-57. 4.Treibel TA, Bandula S, Fontana M, et al. Extracellular volume quantification by dynamic equilibrium cardiac computed tomography in cardiac amyloidosis. J Cardiovasc Comput Tomogr. 2015. 5.Kurita Y, Kitagawa K, Kurobe Y, et al. Estimation of myocardial extracellular volume fraction with cardiac CT in subjects without clinical coronary artery disease: A feasibility study. J Cardiovasc Comput Tomogr. 2016;10:237-241. 6.Ugander M, Oki AJ, Hsu LY, et al. Extracellular volume imaging by magnetic resonance imaging provides insights into overt and sub-clinical myocardial pathology. Eur Heart J. 2012;33:1268-1278. 7.Banypersad SM, Fontana M, Maestrini V, et al. T1 mapping and survival in systemic light-chain amyloidosis. Eur Heart J. 2015;36:244-251. 8.Wong TC, Piehler K, Meier CG, et al. Association Between Extracellular Matrix Expansion Quantified by Cardiovascular Magnetic Resonance and Short-Term Mortality. Circulation. 2012;126:1206-1216. 9.Wong TC, Piehler KM, Kang IA, et al. Myocardial extracellular volume fraction quantified by cardiovascular magnetic resonance is increased in diabetes and associated with mortality and incident heart failure admission. Eur Heart J. 2014;35:657-664. 10.Schelbert EB, Fonarow GC, Bonow RO, Butler J, Gheorghiade M. Therapeutic targets in heart failure: refocusing on the myocardial interstitium. J Am Coll Cardiol. 2014;63:2188-2198. 11.Moon JC, Treibel TA, Schelbert EB. T1 mapping for diffuse myocardial fibrosis: a key biomarker in cardiac disease? Journal of the American College of Cardiology. 2013;62:1288-1289. 12.New PF, Aronow S. Attenuation measurements of whole blood and blood fractions in computed tomography. Radiology. 1976;121:635-640. 13.Black DF, Rad AE, Gray LA, Campeau NG, Kallmes DF. Cerebral venous sinus density on noncontrast CT correlates with hematocrit. AJNR. American journal of neuroradiology. 2011;32:1354-1357. 14.Collins AJ, Gillespie S, Kelly BE. Can computed tomography identify patients with anaemia? The Ulster medical journal. 2001;70:116-118. 15.Lan H, Nishihara S, Nishitani H. Accuracy of computed tomography attenuation measurements for diagnosing anemia. Jpn J Radiol. 2010;28:53-57. 16.Jung C, Groth M, Bley TA, et al. Assessment of anemia during CT pulmonary angiography. Eur J Radiol. 2012;81:4196-4202. 17.Kamel EM, Rizzo E, Duchosal MA, et al. Radiological profile of anemia on unenhanced MDCT of the thorax. Eur Radiol. 2008;18:1863-1868. 18.Wojtowicz J, Rzymski K, Czarnecki R. Severe anaemia: its CT findings in the cardiovascular system. Eur J Radiol. 1983;3:108-111. 19.Doppman JL, Rienmuller R, Lissner J. The visualized interventricular septum on cardiac computed tomography: a clue to the presence of severe anemia. Journal of computer assisted tomography. 1981;5:157-160. 20.Jalbert F, Paoli JR. [Osirix: free and open-source software for medical imagery]. Revue de stomatologie et de chirurgie maxillo-faciale. 2008;109:53-55. 21.Flett AS, Flett AS, Hayward MP, et al. Equilibrium contrast cardiovascular magnetic resonance for the measurement of diffuse myocardial fibrosis: preliminary validation in humans. Circulation. 2010;122:138-144. 22.Rosmini S, Treibel TA, Bandula S, et al. Cardiac computed tomography for the detection of cardiac amyloidosis. J Cardiovasc Comput Tomogr. 2016. 23.Moon JC, Messroghli DR, Kellman P, et al. Myocardial T1 mapping and extracellular volume quantification: a Society for Cardiovascular Magnetic Resonance (SCMR) and CMR Working Group of the European Society of Cardiology consensus statement. J Cardiovasc Magn Reson. 2013;15:92. 24.Coelho-Filho OR, Holland DJ, Mongeon FP, et al. Role of Transcytolemmal Water-Exchange in Magnetic Resonance Measurements of Diffuse Myocardial Fibrosis in Hypertensive Heart Disease. Circulation. Cardiovascular imaging. 2013;6:134-141. 25.Banypersad SM, Banypersad SM, Sado DM, et al. Quantification of Myocardial Extracellular Volume Fraction in Systemic AL Amyloidosis: An Equilibrium Contrast Cardiovascular Magnetic Resonance Study. Circulation. Cardiovascular imaging. 2013;6:34-39. 26.Wong TC, Wong TC, Piehler KM, et al. Myocardial extracellular volume fraction quantified by cardiovascular magnetic resonance is increased in diabetes and associated with mortality and incident heart failure admission. European Heart Journal. 2013. 27.Thirup P. Haematocrit: within-subject and seasonal variation. Sports Med. 2003;33:231-243. 28.Bydder GM, Kreel L. The temperature dependence of computed tomography attenuation values. Journal of computer assisted tomography. 1979;3:506-510. 29.Nacif MS, Liu Y, Yao J, et al. 3D left ventricular extracellular volume fraction by low-radiation dose cardiac CT: assessment of interstitial myocardial fibrosis. J Cardiovasc Comput Tomogr. 2013;7:51-57. FIGURES Figure 1: Derivation of synthetic hematocrit from the attenuation of blood Thoracic CT scans (n=40, 53% male, age 60 ±20 years) with contemporaneous hematocrit samples (mean interval 8.8 ±7.3 days) of the scan were used to create a regression line between hematocrit (Hct; 38.2 ±6.0%; range 24.7-50.7%) and blood attenuation (HUblood; 40.7 ±8.0; range 19.5-55.2). The regression line between Hct and HUblood was linear (R2=0.47 p) with a regression equation for synthetic Hct = [0.51 * HUblood] + 17.4). Figure 2: Validation of synthetic ECV vs conventional ECV in AS and Amyloid Synthetic ECV, calculated using the regression model,and conventional ECV were highly correlated (R2=0.96; p) with a 5.7% SD of differences and minimal bias (2.4%) on Bland-Altman analysis (right image). Figure 3: Histological Validation of Synthetic ECV Synthetic and conventional ECV both correlated well with collagen volume fraction (R2 = 0.50, p vs. R2 = 0.50, p ) and did not differ statistically. Figure 4: OsiriX Plugin workflow To facilitate offline analysis and allow future inline automation, an automatic synthetic ECV plug-in was developed for Osirix. Following manual segmentation of the blood pool in the pre- and post-contrast images, the plug-in automatically estimates blood hematocrit using the attenuation relationship defined above, and produces a three-dimensional myocardial ECV volume from pre- and post-contrast CCT data.

Carlos Ghosn’s approach to turning Nissan around

Carlos Ghosn’s approach to turning Nissan around In order to give a thorough in-depth evaluation of Carlos Ghosns approach to turning Nissan around I have chosen to apply John Kotters 8-step model to strategic change implementation (Kotter J. P., 1996) displayed below. Kotter is regarded as an authority within the field of organization and change management and I find his model helps securing a comprehensive evaluation. The model is usually used as a forward-looking plan for how to handle a change process, but I will apply it as a retrospective analytical tool to review how the process was handled at Nissan. The first three steps are about creating the right climate for change and making sure the organization is ready to make a move ahead. The next three steps are about engaging and enabling the organization to pursue the strategy. Without support from a large part of the organization, change will not be successful, but equally important the organization needs to be equipped to handle such process change. The last two steps are all about implementing and sustaining change. Without focus on these aspects the organization is in risk of regress. The assignment puts emphasis on organizational and national culture. That is for good reason as I find them central aspects of the challenges Ghosn was facing, when he took over as the first non-Japanese COO of Nissan. Kotters 8-step model does not focus on culture, but it is implicitly handled in several of the steps most noticeable in step two and four. In the conclusion I will sum up the findings in the analysis and explicitly answer the four questions given in the text. 1 à ¢Ã¢â€š ¬Ã‚ ¢Establish a sense of urgency2 à ¢Ã¢â€š ¬Ã‚ ¢Form a powerful coalition3 à ¢Ã¢â€š ¬Ã‚ ¢Create a vision4 à ¢Ã¢â€š ¬Ã‚ ¢Communicate the vision5 à ¢Ã¢â€š ¬Ã‚ ¢Empower others6 à ¢Ã¢â€š ¬Ã‚ ¢Plan for and create short-term wins7 à ¢Ã¢â€š ¬Ã‚ ¢Consolidate improvements8 à ¢Ã¢â€š ¬Ã‚ ¢Institutionalize changes 3 | P a g e 2. EVALUATION ANALYSIS 2.1 ESTABLISH A SENSE OF URGENCY It is an ill wind that blows no good, this was also the case for the Yamaichi bankruptcy. The misfortune of the major financial house in Japan helped open the eyes of the employees in Nissan. Now the employees realized that lifetime employment was no longer a reality and that they had to do their own part to secure the companys future and thus their own jobs. Ghosn, to his credit, used the Yamaichi example whenever he could to continue to motivate his employees, repeating that their fate would be no different if they did not put all of their effort into figuring out, and then executing, the best way to turn Nissan around. (Millikin Dean, 2003) The bankruptcy was indeed a blessing in disguise for Ghosn as it created the burning platform that according to Kotter is crucial to do change. Change is always accompanied by anxiety for the unfamiliar, but this event made sure the whole organization was aware that status quo is more dangerous for Nissan and each employee than venturing into the unknown. Kotter believes that around half of the failed change efforts can be traced back to step one. If people do not see why change is necessary, then motivation for change will be nonexistent. Moving a huge organization simply by brute force is an impossible task, but Ghosns strike of luck created a powerful momentum that diminished potential resistance to change. 2.2 FORM A POWERFUL COALITION One man cannot change a huge company such as Nissan. Ghosn realized this as well. Even though he had been talking with plant employees and had gained a lot of knowledge about what should be done, he chose not to impose a revival plan on Nissan. He wanted the employees to come up with ideas themselves and to lay down a plan for what was to happen. His establishment of the nine Cross-Functional Teams (CFTs) and their sub-teams created powerful coalitions that were essential in turning the company around. These coalitions mainly consisted of middle managers, but they were empowered because they reported directly to two supervisors from the executive committee, had full access to all 4 | P a g e necessary information, and they had the full support from top management. The cross-functional aspect gave the freedom and insight to create radical changes without being weighted down by the need for conscientiousness and corporation, which is a general characteristic for most Japanese companies including Nissan. This powerful coalition is, according to Kotter, fundamental for a successful change as Ghosn needed protagonists to influence the whole organization and these protagonists needed to have enough impact to counteract the inherent resistance to change. A powerful coalition is especially important in Japanese culture as group harmony is a cornerstone in their work environment. A powerful coalition will have fewer problems, relative to a similar situation in a company in Western culture, converting the minds of opponents as many will act opportunistic and follow the majority or as Ghosn puts it: When you get a clear strategy and communicate your priorities, its a pleasure working in Japan. The Japanese are so organized and know how to make the best of things. They respect leadership. (Millikin Dean, 2003) 2.3 CREATE A VISION According to Ghosn, Nissan had been suffering from management lacking vision and he pointed this out as one of five main issues that he wanted to address. First creating the Nissan Revival Plan and then formulating Nissan 180 was an excellent two-step vision, which was guiding, laying a foundation for decision making, and created a bridge from the present to where he wanted to take the company in the future. The vision helped the employees understand why they had to undergo change by showing what was in store in the future. That they had to change their attention from regaining market shares to focus on customer demands. Not only was Ghosn aggressively launching the Nissan 180 program to transition out of the Nissan Revival Plan program, but he was also pushing a new, customer-focused initiative called Quality3-3-3. (Millikin Dean, 2003) 5 | P a g e Creating a vision that is tangible, concise, and easy to relate to for the employees is key when setting out to change an organization. Detailed plans for what needs to be done are at this point not advisable because they do not create the much needed excitement and enthusiasm, which is so vital. It is important to bear in mind that this step is part of the first three steps, which focus on creating the right climate for change. It is therefore all about talking to peoples feelings and not necessarily to their intellect. Furthermore Kotter stresses that leaders need to walk the walk. Actions often speak louder than words and if leaders want people to follow them, then they must take the lead. Ghosn was aware of this. One issue Ghosn noticed, shortly after arriving at Nissan, was the lack of communication between the layers of the organization, and as the quote below shows Ghosn was prepared to walks the walk himself. He was the first manager to actually walk around the entire company and meet every employee in person, shaking hands and introducing himself. (Millikin Dean, 2003) 2.4 COMMUNICATE THE VISION It is not enough to create a great vision. It also has to be communicated effectively to the organization. It says in the text that Ghosn communicated both NRP and Nissan 180 aggressively and that two of his three philosophies of management are: Transparency an organization can only be effective if followers believe that what the leaders think, say, and do are all the same thing. Communication of company direction and priorities this is the only way to get truly unified effort and buy-in. (Millikin Dean, 2003) Information concerning his methods of communication is unfortunately lacking, but there is no doubt, that he understood the importance of communicating the vision, and results show that he succeeded brilliantly. Ghosn and his coalition managed to reach out to all employees and motivate them to move towards the vision. If he had not been able to communicate 6 | P a g e effectively enough the NRP arguably would not have been the rapid success it turned out to be. The NRP was achieved in March 2002, one year ahead of schedule. (Millikin Dean, 2003) Kotter stresses the importance of having focus on communication of the vision because it will act as a guideline, and if people do not get that information they do not know which direction to go. Because mental images are easier to remember one of the effective ways to get the message across is using metaphors, analogies, and examples. His metaphor of 180 in the Nissan 180 vision is a paragon of virtue in that way. It clearly creates a picture of turning the company around, and incorporating the metrics in the 180 made it easier for employees to remember what they needed to do. 2.5 EMPOWER OTHERS The Japanese culture forced Ghosn to pay extra attention on the empowerment of employees. As mentioned, Japanese business culture is characterized by a search for conscientiousness, corporation, group harmony, and an avoidance of mistakes. This all leads to a delay of decision making and a lack of responsibility. The introduction of CFTs was an attempt to break with the inconveniences of Japanese culture without harassing the fundamentals. à ¢Ã¢â€š ¬Ã‚ ¦cultural conflict, if paced and channeled correctly, could provide opportunity for rapid innovation. (Millikin Dean, 2003) People in CFTs got a birds eye perspective of the company and it gave them a sense of ownership and responsibility, which was necessary to turn things around. Ghosn even went as far as to put his own fate in the hands of his employees as he had publicly stated his trust in the employees abilities. He encouraged employees to come forth with their ideas and take risks. This was contradictory to their instincts as it was embedded in the organizational culture not to seek risks and to reach consensus before making a decision. Furthermore, he made organizational changes such as permanent cross-functional departments and matrix organization for higher-level staff, which all emphasized the demand for 7 | P a g e responsibility and accountability. Finally he changed the traditional Japanese compensation system to a more Western approach with possibility for employee advancements based on performance instead of seniority. This greatly empowered the talented employees, which was much needed in this change. In many cases, these midlevel managers enjoyed learning about the business à ¢Ã¢â€š ¬Ã‚ ¦and felt fully engaged in the change process, giving them a sense of responsibility and ownership about turning Nissan around. (Millikin Dean, 2003) 2.6 PLAN FOR AND CREATE SHORT-TERM WINS Ghosn excels when it comes to creating short-term wins. His NRP created tremendous results that boosted motivation throughout the organization. One success was a 20% reduction in purchasing costsà ¢Ã¢â€š ¬Ã‚ ¦ à ¢Ã¢â€š ¬Ã‚ ¦the supplier base shrunk by 40% and the service suppliers decreased by 60%. (Millikin Dean, 2003) It is incredibly important that short-term wins are communicated broadly to the organization, so people can see their hard work come to fruition. Often leaders of change hope that short-term success will arise, but according to Kotter it is necessary to actually plan for them. A commitment to create short-term goals has a positive side effect as it increases the sense of urgency throughout the first period. Ghosn did it brilliantly by announcing to the public that the company would show a profit within two years. This is something all employees can understand and it creates a commitment that helps in the realization of his promises. 2.7 CONSOLIDATE IMPROVEMENTS One of Ghosns three management principles is to execute. He states that 95% of the job is about execution. It is not enough to have a strategy if it is not carried out. This is completely in line with Kotters thinking. The consolidation of improvements is all about securing the short-term wins by rooting them in the company and using that as a foundation for further work. At the same time as he declared that the NRP was achieved he announced the Nissan 180. Nissan 180 represented a plan for growth based on the improvements that NRP yielded. 8 | P a g e Now that they had made the necessary improvements, it was time to consolidate and improve further. I think many leaders mistakenly would have left out the second step of Ghosns two-step vision. But if he had done so, the company presumably would have had difficulties rooting the tremendous results and huge changes that were created in such a short time. His timing of the announcement of Nissan 180 was perfect as it kept the momentum going. The Nissan Revival Plan is over. Two years after the start of its implementation, all the official commitments we took have been overachieved one full year ahead of scheduleà ¢Ã¢â€š ¬Ã‚ ¦ Nissan is now ready to grow. 2.8 INSTITUTIONALIZE CHANGES Another of Kotter areas of focus is that changes are often considered finished too early. The organization needs time to really settle in the new ways and if victory is declared too early, then there is a risk of returning to the old ways. Ghosn was aware of that as he was concerned with what will happen when he returned to Renault. à ¢Ã¢â€š ¬Ã‚ ¦ Ghosn contemplates the future, he knows that the transformation has really just begun The momentum and positive energy that have been created from all the success needs to be followed-up by a new vision and new goals. This can potentially be a difficult task because the great success could diminish the employees sense of urgency. Whether or not his successor is able to do so remains unknown, but the fact that Ghosn was aware that there is still a long way to go shows his great insight to problems with turning a company around and institutionalizing changes. 9 | P a g e 3. EVALUATION CONCLUSION Omitting the fact that Kotter introduced his 8-step model in 1995 one could almost suspect that Ghosn had read about Kotters model to strategic change as it looks like he follows them closely. Ghosns ability to establish the right climate for change, engaging and enabling the whole organization, and implementing and sustaining the change in such a large organization is admirable. 1) I think the resistance to change that Ghosn faced was inevitable. Turning a company around as drastically as was needed for Nissan is bound to create resistance. Such a big change makes the future uncertain for many employees and the uncertainty is something many naturally try to avoid. Combining that with strong Japanese traditions, an organizational culture that is hindering innovation and adaptability, and a Japanese government that historically always have bailed out troubled employees, and thereby created a pretext for inaction, only made it worse. Trying to move people, who do not find movement necessary, will unavoidably create tension and resistance. That being said, I think Ghosn handed the resistance to change ideally. 2) I am sure that many parts of the Nissan organization did not feel very good about having Ghosn changing things as drastically as he did. The reduction of 21,000 jobs will inevitably create opponents among the lower level employees as well as higher in the hierarchy. Furthermore, the demotion of Vice President of Sales and Marketing in Japan would presumably create antagonists with more leverage. Throughout the text examples of his no-nonsense approach to leadership shows that he is a tough leader that does not accept failure and he demands that people take responsibility for their actions. I think this kind of approach combined with his philosophies of management and his capacity for global leadership was the key to his success in Nissan and the reason why his opponents were not able to challenge him seriously. Another reason is the respect for leadership that is inherent in most Japanese. This made his approach to leadership even more effective. Finally, his involvement of the CF Ts made sure that he would not be the only one in the line of fire. The delegation of responsibilities to the CFTs helped getting the support of middle and lower levels, so he could focus his attention on top management. 10 | P a g e 3) The national culture has without a doubt played a large part in the outcome of Ghosns attempt to turn Nissan around. On the one hand it hindered change because of the sense of security the government created and its rigid approach to decision making and career advancement. On the other hand the respect for leadership made it easier for him and his CFTs to have an impact on the organization. The cultural differences between Ghosn and the Nissan organization was profound because he had never been exposed to Japanese culture before, but his approach to the culture ensured that he was fully aware of the issues that could arise. He stated that he wanted to discover Japan by being in Japan with Japanese people. That shows his humble and respectful approach to their culture, which I think benefitted him. 4) There is no doubt that Ghosn was lucky. His timing was impeccable as the bankruptcy of Yamaichi happened when he took office as COO in Nissan. This fortunate misfortune paved the way for a major organizational and cultural change that otherwise would have been hard to push through. Without this, Ghosn and his CFTs would probably have faced a much more daunting task. Whether or not they would have been able to power through in spite remains unknown, but having learned about Ghosn leadership abilities I think he would have found a way. All in all I think Carlos Ghosn did an incredible job turning Nissan around in a very short period of time. As a non-Japanese COO he managed to overcome Japanese cultural obstacles, as well as effectively transforming a bureaucratic organizational culture and turning a large continuing deficit into a profit within 18 month. One could question whether his successor will be able to continue what Ghosn started or if he/she needs to find his/her own way. Either way, Ghosn has a justifiable concern for the future of Nissan. They might be on the right path, but they are still far from reaching their goals. 11 | P a g e

Brown vs. Board: The Brown Sisters Speak :: papers essays

Brown vs. Board: The Brown Sisters Speak I remember heading over to Foellinger Auditorium with Jessica saying to myself, I have no clue what this event was going to be all about. All Jessica had said to me was that the Brown sisters were going to be speaking. We entered the auditorium to find the first floor surprisingly alive with people talking among each other and seats quickly becoming full. We decided that it would be better to observe from above so we took the stairs up to the balcony and found seats right along the edge. From above, I could see the many people who came out for the event. The crowd contained many scholars and professors as well as a good group of students. I received a call from my friend, who spotted me from her seat in the first floor. She said that she was there to take notes for a class assignment as well. So, I think many students were also there because, just like, had an assignment to accomplish. It was at this point that I had finally put two and two together and realized that the Brown sisters were the daughters of the Reverend Oliver Leon Brown, who is the same person involved in the infamous Brown v. Board case. Jessica laughed at me for my slowness. I, however, began to get excited because this was truly rare and special occasion. I had wished that more people attended the event but looking at the crowd a second time, I was pleased to see the varying ages of the people in the crowd. There were people that looked older than the Brown sisters to young grade school students who came in as a class. Somehow, we were all connected because in one way or another, whether we are young or old, the decision that was passed down by the Supreme Court on Brown v. Board changed many lives. There were many things said by the Brown sisters that ranged from the historical context of the case to what it did for their lives. But one quote stood out in my head, and it was made by Dr.

Little Brother Music :: essays research papers

Little Brother: The Listening Describing this CD in three words would be personal, stylish, and free. Not â€Å"free† like it comes with your purchase of fifty dollars or more at Best Buy but â€Å"free† as in no boundaries or limitations. When I first put this album in my CD player and pressed play I was completely entranced by the sounds that followed. That was back in 2003 and still to this day you might catch me blasting songs in the morning or humming their tunes to sleep at night. If I try to put my finger on why this ONE album can last so long with a person as picky with music as me it would come down to how well the two rappers, Phonte and Big Pooh, convey every aspect of their lives into their lyrics. Not only can they describe fully the pressures of having a growing family and a low paying job, but also let loose stories about groupie love, haters getting put in their place, and partying until daybreak; all this with clever wordplay that puts them in a class of their own! I wouldn’t call them underground hip-hop because they don’t make a conscious effort to be different. They’re not considered mainstream because their focus isn’t just on making music to be rich. They’re just an alternative, and it is refreshing to hear someone strive to be the best at what they do artistically, not by how well they can market themselves. At a business level, we all know the importance the actual beat plays with finicky listeners. Even the songs with sub-par lyrics and rhyme schemes can still become a hit when a famous producer is behind the scenes. Luckily, production is another criteria Little Brother controls so well. Their producer, and third member of the group, is named 9th Wonder for more than just the cool moniker: he represents his own unique sound not yet overused and exploited by the masses. With a pension for taking old school samples and churning out beats unbelievably hypnotic and hard-hitting, 9th lays the backdrop perfectly for each a nd every bit of musical art on Little Brothers’ first major release. Taking a different direction than sampling producers like Kanye West and Just Blaze, he has been steadily gaining fame ever since he produced the song â€Å"Threats† on Jay-Z’s final record, â€Å"The Black Album†. Because

RE: Letter to the editor Essay

In reply to your letter, I would like to inform you, that the policy regarding the removal of Aboriginal children was not as you stated. As soon as a child was born, they were considered a ward of the state because of their Aboriginality. The policy of Assimilation was established in 1911 for the removal of children from their community to extinguish their culture. This is also known as Genocide, but was not seen that way until the policy was removed in the mid 1960s. Bessy Flower was born in 1943, and taken from her home at 19 months. She was a product of the Assimilation policy. Bessy was removed just the same as most of the other children, pulled obscenely from her mothers arms. She was placed to live in the Annesfield native institution for the next 14 years of her life. Just the same as most of the other Aboriginal children in the homes, she was no longer allowed to make any contact with her family and was subjected to ongoing physical, mental and sexual abuse, malnutrition and humiliation. In some of the institutions the standards of living were degrading just so that the children could have an education and become ‘absorbed’ into the white community, some say it was as if they had been tried to be turned a ‘different shade of white’. The half-caste children were taken under a legislation, which gave guardianship to the protectors in their state of origin. The people that looked after the children once they were removed, once called ‘protectors’, took up the role of paternalism. This gave the parents no right to appeal to the court of law, and the children had no choice in what they did or where they went. After 1940 the children were removed under the general child welfare legislation, but still the way the children were extracted was much the same  as before. Only very gradually did the ritual of separating half-caste children from their homes meet with the general non-Aboriginal practices concerning child abuse and neglect. This came as late as the 1970s, when already tens of thousands of children had been removed. The reason the children were removed was always thought to be for their own benefit, to protect them from themselves, as well as to ‘breed-out’ the Aboriginal race as it was thought that they were less-superior to white people. Some people remember; â€Å"†We were told that our mother was an alcoholic and that she was a prostitute and she didn’t care about us. They used to warn us that when we got older we’d have to watch it because we’d turn into sluts and alcoholics, so we had to be very careful. If you were white you didn’t have that dirtiness in you †¦ It was in our breed, in us to be like that.†Ã¢â‚¬  Although now, there is thought to be not one Aboriginal family that has not been scared by the removal of a child, sibling, niece or nephew. Somewhere between one in three and one in ten children were removed. One in ten is a big number of people to be subjected to the abuse endured, but one in three is preposterous. Some of these children were taken at birth, some at two years of age, some in their childhood years. When the children were removed, they were given a chance at an education that they would never have gotten otherwise. Not all of the children had a horrible up-bringing; some were placed into homes and treated with respect from their foster families. â€Å"†We were all happy together, us kids. We had two very wonderful old ladies that looked after us. It [Colebrook, South Australia] wasn’t like an institution really. It was just a big happy family. Y’know they gave us good teaching, they encouraged us to be no different to anybody else.†Ã¢â‚¬  These children have called themselves the ‘Stolen Generation’. Although all  the State governments in Australia have apologized for the injustice that went on, the Federal Governments still refuse the Aborigines right to an apology or compensation. Bibliography: http://72.14.203.104/search?q=cache:NldOa-78ca0J:www.ondix.com/pdf/docs/studies_research_college_1071167943.pdf+bessy+flower+1943+assimilation&hl=en&gl=au&ct=clnk&cd=2 Told a story that helped with the insight to the cruelty of what really went on in some people’s lives as an affect of assimilation. http://www.tim-richardson.net/misc/stolen_generation.html Explains clearly the Assimilation policy, and the legislations surrounding it. http://www.hreoc.gov.au/bth/additional_resources/bth_guide/children_experiences.htm Gave some quotes form people that were removed who grew up with good lives, and bad. Documentary watched with Mrs. Hooks class can’t remember what it was called, but it had people explaining just how much they suffered, even when they had a good life to find out what really happened and where their family might have been for the past 70 years. More informative than internet sites because they were proper interviews.

Women fashion 1930’s

Due to the crash of the Wall Street on October 24th 1929 many people thought that fashion was going to be crippled, but thankfully fashion continued and grew over the years. 2. After the crash women had to sew and mend their own cloths. Due to this women who had great sewing skills began copying magazines and the latest fashion. This action was the of starts of necklines lowering, and skirts were being designed with greater detail 3. The style of the sass's began with clothing that was elegant and botfly feminine. . The cloche hats of the ass's were replaced by hats with brims worn over the right eye at an angle, berets, and pillboxes. 5. Pillboxes are hats that women wore at an angle. Pillboxes where created in the thirties, and were designed in the shape of a square to fit right on top of the head 6. Women were designing skirts with a v-necked shape extending from one hip to the other on the upper part of the skirt; this design was called a yoke. 7. Skirts were beginning to have a ruffed look and were beginning to become layered.Women's skirts were beginning to be filled with many gatherings and pleats at the very bottom as well. 8. A material that was very popular was fur. If a woman wanted fur and she had the money for it than she got fur. Many different types of fur were worn both during the day and at night. 9. Some different fur products such as fur â€Å"scarves† (a whole pelt with feet, head, and tail all together, were worn over the shoulder or carried in arms), capes, trimmings adoring dresses, and coats uses furs or pelts.Those furs or pelts come from animals such as a mink, abbot, fox, lamb, wolf, stable, and chinchilla. Or any animal fur from trapping or hunting. 10. During the sass's the hand bags were very similar to the hand bags of the sass's. The bags were beaded and enameled meshed, but during the ass's leather hand bags had started to become popular. 11. A day dress had a bodice that could be draped with shaped shoulders or bloused. The dresses were slender with the waist lightly defined and an easy fitted vertical line. 12. During the sass's a lot of different shoe styles.Thick rounded toes; pumps; wide heels; flats; ankle straps with moderate heels; lace-up; slip-ones; buckles; and two-toned spectators. 13. Women adapted Hollywood fashion with what they saw in movies. The Hollywood fashion was especially adapted into evening wear. 14. The hemline of skirts and dresses were in a tug-of-war between how many inches from the ankles the hemline was allowed to be. At the end of the decade skirts were shortened and no longer in a tug-of-war. 15. The Art deco movement heavily influenced fashion in the early ass's.Some popular motifs were exotic, floral, geometric, abstract, and Middle Eastern. 16. Dresses were made of natural fibers (sometimes linen, mostly cotton, wool, and silk), acetate fabric, and rayon. 17. In 1933 American tennis player Alice marble, was the first to publicly wear shorts. By 1934 sports cloths were frequently being worn. Women's sportswear developed into wide legged mid-thigh shorts, beach pajamas, culottes, halters, tanks, plaudits, skirted bathing suits, middy blouses, wide legged sailor slacks, and sport suits. 18.A new type of dress that also appeared in 1934 was the â€Å"Hoovers†. These dresses were made of cotton, tied, and wrapped around the back. 19. In 1937 business women found favor with suits. Wearing a suit made people take women more seriously when their attire is a more masculine form off dress. 20. When women started wearing suits a new style of Jacket was created to go with their dresses. The Jacket was shorter and went to the waist, had high pockets or yoke trims. The Jacket also had with it a shawl or tuxedo collar, and elbow length sleeves to go over their dress.