Tuesday, April 28, 2020
Principles of Safeguarding and Protection in Health and Social Care Essay Essay Example
Principles of Safeguarding and Protection in Health and Social Care Essay Essay Principles of safeguarding and protection in wellness and societal. Ai ;Physical Abuse is when person causes feelings of physical hurting. hurt other agony or bodily injury. such as hitting. kicking. rubing. squeezing. agitating. Sexual Abuse is where you are forced to make. state and watch sexual things. Eg ; being undressed or holding sexual contact when you do non desire to or even touching another individual. being made to state sexual things and being made to watch erotica is besides sexual maltreatment. Emotional Abuse is a signifier of power that person has over you to do depression. anxiousness. emphasis. It is strong-arming person by naming them names that hurts their feeling or to frighten them and even endanger them. Fiscal Abuse is when another individual bargains or takes something that belongs to you. Eg ; stealing your money. doing you buy things you are non willing to. declining to let persons to pull off their fundss and flim-flaming persons to manus over their belongings. Institutional Abuse is non merely confined to big scale physi cal or sexual maltreatment. persons can besides be abused in many other ways in settngs where they could exoect to be cared for and protected. Eg ; Individuals non given pick over determinations ( repasts. excursions. clothing. ) Mistreated to their medicine. Privacy and self-respect besides non respected. Self-neglect is when an single disregards to go to to their basic demands. Eg ; personal hygiene. visual aspect. feeding non trouble oneselfing to obtain medical aid or an unwillingness to see people or travel out. Disregard by others is when the victim is being looked after by person else but fails to supply equal attention. For illustration failure to supply sufficient supervising. nutrient or medical attention. or the failure to carry through other demands that the victim is unable to supply for herself or himself. We will write a custom essay sample on Principles of Safeguarding and Protection in Health and Social Care Essay specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Principles of Safeguarding and Protection in Health and Social Care Essay specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Principles of Safeguarding and Protection in Health and Social Care Essay specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Signs and symptoms of maltreatment.Physical maltreatmentAii ;BruisingFracturesNathan birnbaumsFearDepressionWeight lossAssaultHuddlingFlinchingWelch MarkssMalnutritionUntreated medical jobsBed soresConfusionOver sedationEmotional maltreatment: .FearDepressionConfusionLoss of slumberChange in behaviorOnset of phobic disorderNo communicatingSexual Maltreatment:Loss of slumberDiseasesRepeated urinary infectionsBruisingTenderness around the genitaliasTorn. stained bloody underwear or bed sheetsPreoccupation with anything sexualExcessive lavationReluctance to be entirely with an unknown personFiscal Maltreatment:Unexplained loss of fundsor withdrawels from bank histories Inability to pay measuresChange in lifestyle/standard of lifeBasic needs non being metLoss of belongingsUnnecessary edifice work or fixs to belongingsNot swearing anyone around themSelf-neglect:Poor hygiene ( odor of urine fecal matters )DehydrationWeight lossAbnormal organic structure tempInappropriate vestureNot taking medicineInfectionsIllnesssInstitutional maltreatment:No flexibleness at bed clipWaking up to a modus operandiDirty beds and vestureMissing vesture. ownerships. paperss and lettersExcessive or deficiency of medicineLack of consideration of dietetic requirementââ¬â¢sAiii ;If you was to surmise an person was being abused you should describe your concerns to the director. Besides ask to compose a private history for your records. doing certain it doesnââ¬â¢t travel in the attention program in instance the maltreater comes across it. Aiv ;If a client was to state you they are being abused. you should halt what youââ¬â¢re making and listen carefully to them. All conversations should be treated with assurance and information merely passed on to those who need to cognize. Even if the individual speaks in the strictest of assurance. line directors must still be informed and the treatment must be written down. Never agree with the client that you wont state anyone else. Say that youââ¬â¢ll merely state person who can make something about it. Av ; Make a written record of messages ( e. g reply phones ) to guarantee they are non lost. Include the day of the month and clip and subscribe them. Ensure written records ( notes. letters. bank statements. medicine records etc ) are kept in a safe topographic point. Make non clean up up. wash apparels. bedding or any other points. Do non seek to unclutter or clean up things up Try non to touch anything un ; ess you have to for the immediate well-being of the victim- if you have to seek do a record of what you have done. If any sexual offense is suspected attempt to deter the vicim from rinsing. imbibing. cleaning their dentitions or traveling to the toulet until the constabularies are present. Continue anything used to warm or soothe the victim ( E. g: a cover ) . If you can seek to guarantee that the alleged culprit does non hold any contact with the victim. Record any physical marks or hurts utilizing a organic structure A ; map or manus pulling write a description of any physical marks or hurts including size. determine color etc. Always retrieve to subscribe and day of the month your notes and any other records you have made. Avi. Avii: No secrets- set out a codification of pattern of how commissioners and suppliers of attention services should protect vulnerable grownups. Condemnable records bureau- DBS will filtrate certain old and minor cautiousnesss and strong beliefs. rebukes and warnings from condemnable records certifications. DBS- Disclosure and blackball service. In safe custodies ( wales merely ) sets out functions and duties of CCIW in relation to other statutory organic structures including local governments who have the lead function in organizing the development of local policies and processs in grownup protection. Office of the public guardian -agency with duties so extend across England and Waless. If supports the public quardian in the enrollment of digesting powers of lawyer and permanent powers of lawyer and the supervising of debuties appointed by the tribunal of protection. The codification of practice- sets out the standards against which a registered suppliers conformity with the demands asso ciating to cleanliness and infection control will be assessed by the attention quality committee. It besides provides counsel on how the supplier can construe and run into the enrollment demand and comply with the jurisprudence. Local Partnership boards- committed to forestalling the maltreatment of grownups and reacting quickly when maltreatment is suspected. Safeguarding grownups means that local governments. constabulary and NHS bureaus involved with grownups who might be at hazard of maltreatment have a responsibility of attention to guarantee that processs are in topographic point. that encourage coverage of suspected maltreatment. and take action to halt the maltreatment. Care Quality Organisations ( CQC ) registered over 18. 000 attention places and print all review studies. which cheque on the indispensable criterions of quality and safety. Aviii: Social worker- Protect and support vulnerable people. and put them in a safe environment off from hazard of danger. A hazard appraisal is used to make up ones mind what aid is needed and the right actions to take. They besides investigate any studies. Police- Protect the community. investigate allegations of maltreatment. fix tribunal instances and do instance studies. Informal bureaus or 3rd sector agencies- Research and raise consciousness. campains. charities. Offer support ( reding services ) Health attention practitioners- Perform scrutinies and study happening relevant governments. Serious instance reappraisal chair person- Review serious probes and/or failures that have antecedently been investigated and look at what changed demand to be made. Aix: Many local Governments run free. multi-agency. safeguarding classs for anyone who works with vulnerable kids and grownups. and so should any nice employer in this field. Ask your workplace preparation section about this. You can besides happen more information through their local safeguarding squad in the Social Services Department or the Independent Safeguarding Authority. Direct. gov Cqc. org. United KingdomLancashire county council.
Friday, March 20, 2020
Free Essays on WWE Sexual Ethics
Over the past ten or so years, I have been following and watching World Wrestling Entertainment; formerly known as WWF. As I have grown it seems that the content on the television show has matured as well. The wrestling program was once centered on the good vs. bad storyline. I always found it amusing and entertaining and sort of grew up with it. As television itself has become mature and explicit, the WWE has followed. The program now airs from 9pm to 11pm so that they can broadcast more violence, sexuality, and more mature language. Since during these hours young children are not supposed to be watching television, the WWE has taken advantage of the matter and looks to entertain an older audience. Any decision made and any segment that airs on a WWE program is always approved by owner Vince McMahon. Therefore, aside from the writers, it can be said that McMahonââ¬â¢s form of entertainment reflects, in a way, his way of thought. When WWE programming is not entertaining its audience with violence and comedic segments, it probably is doing something that involves and reflects their sexual ethics. Whether it has to do with homosexuality, adultery, nudity, and even lately necrophilia, they do what it takes to boost ratings. The WWE has always had a womanââ¬â¢s wrestling division but it used to involve more wrestling. The woman of wrestling today that we see on television are not exactly the best performers in the ring and usually fail to put on a good show. But these days in the WWE, the truth about that fact is not as important as it once was. Woman nowadays that wrestle are often former models or dancers. They are trained minor ring skills to be able wrestle. Always when they appear on television they are wearing close to nothing and they all seem to have the figure of every manââ¬â¢s personal dream girl. These women come out for a few minutes each week and flirt with the audience, exposing all that they are allowed or told to. I usually w... Free Essays on WWE Sexual Ethics Free Essays on WWE Sexual Ethics Over the past ten or so years, I have been following and watching World Wrestling Entertainment; formerly known as WWF. As I have grown it seems that the content on the television show has matured as well. The wrestling program was once centered on the good vs. bad storyline. I always found it amusing and entertaining and sort of grew up with it. As television itself has become mature and explicit, the WWE has followed. The program now airs from 9pm to 11pm so that they can broadcast more violence, sexuality, and more mature language. Since during these hours young children are not supposed to be watching television, the WWE has taken advantage of the matter and looks to entertain an older audience. Any decision made and any segment that airs on a WWE program is always approved by owner Vince McMahon. Therefore, aside from the writers, it can be said that McMahonââ¬â¢s form of entertainment reflects, in a way, his way of thought. When WWE programming is not entertaining its audience with violence and comedic segments, it probably is doing something that involves and reflects their sexual ethics. Whether it has to do with homosexuality, adultery, nudity, and even lately necrophilia, they do what it takes to boost ratings. The WWE has always had a womanââ¬â¢s wrestling division but it used to involve more wrestling. The woman of wrestling today that we see on television are not exactly the best performers in the ring and usually fail to put on a good show. But these days in the WWE, the truth about that fact is not as important as it once was. Woman nowadays that wrestle are often former models or dancers. They are trained minor ring skills to be able wrestle. Always when they appear on television they are wearing close to nothing and they all seem to have the figure of every manââ¬â¢s personal dream girl. These women come out for a few minutes each week and flirt with the audience, exposing all that they are allowed or told to. I usually w...
Tuesday, March 3, 2020
Top 10 Resume Writing Tips for 2018
Top 10 Resume Writing Tips for 2018 Top 10 Resume Writing Tips for 2018 Top 10 Resume Writing Tips for 2018 By Ali Hale Writing a resume can be really tough. You know you need to convince an employer that youââ¬â¢re the best person for the job ââ¬â but how exactly do you do that? It can be especially hard if youââ¬â¢ve been out of the job market for a while, and you feel that youââ¬â¢re not sure whatââ¬â¢s required from your resume ââ¬â or if this is the first resume youââ¬â¢ve ever written. Donââ¬â¢t worry! Weââ¬â¢re going to quickly recap the basics, before digging into some crucial tips for writing a winning resume. What Is a Resume Anyway? A resume is a document that lets employers know about your work history, your educational achievements, and your key skills. If youââ¬â¢re in the UK, a resume is commonly called a ââ¬Å"CVâ⬠(curriculum vitae). (Note that in the US, you may hear CV used to refer to a long, academic resume.) What Should a Resume Look Like? While thereââ¬â¢s no absolute rule on how your resume should be formatted, a quick Google Images search for resume will give you an idea of how most resumes look. Itââ¬â¢s normally unwise to do anything clever or cute with the format of your resume: employers want to get information clearly and easily from it, and you donââ¬â¢t want to risk standing out in a bad way. Your resume should include the following information, in this order: Personal Details (name, address, phone number, email address) ââ¬â this goes right at the top of the first page. Normally, you should put your name in a large font as the title for your resume. Personal Profile (optional) ââ¬â a high-level summary of who you are and what youââ¬â¢re looking for from a job. This has become popular in recent years, though itââ¬â¢s not absolutely essential. Core Skills (optional) ââ¬â immediately beneath your personal profile, you can opt to include a bullet-pointed list of your core skills, so your prospective employer can quickly see what youââ¬â¢re good at. Career History ââ¬â list your past jobs, in reverse chronological order (the most recent job should come first on the page). Itll usually be appropriate for your most recent job to have the most details. Education and Qualifications ââ¬â this should come after your career history, unless youââ¬â¢re fresh out of school / college ââ¬â in which case it might make sense to give it greater prominence. You can also include information about volunteering on your resume, especially if you have few or no previous jobs to write about. Of course, you probably already know that you shouldnt use coloured backgrounds, lots of unusual fonts, or anything else that makes your CV look odd and hard to read. So how do you write a winning resume in 2018? Tip #1: Tailor Your Resume to Each Position Youââ¬â¢re Applying For If you only follow one tip from this list, make it this one: your resume should be carefully tailored to the position youââ¬â¢re applying for. Donââ¬â¢t view your resume as a document that you write once then forget about. Of course, you wonââ¬â¢t be restarting from scratch every time ââ¬â but you should make appropriate tweaks to highlight how exactly your past experience matches up the role you want to be considered for. Youll almost certainly find it helpful to Tip #2: Use the Job Advert to Guide You Whatever job youââ¬â¢re applying for, thereââ¬â¢ll be an advert detailing what the company is looking for. Use this to help you make it very clear that you have exactly what they need. For instance, if the advert says they need someone ââ¬Å"whoââ¬â¢s adept with Microsoft Wordâ⬠, you might include Microsoft Word in your core skills, or mention it in the description for one of the jobs youââ¬â¢ve had in the past. If they ask for someone with experience managing a team, youll want to make sure you emphasise this in your career history even if it was only a relatively small part of one of your roles. Tip #3: Present Information Chronologically Although some people think that a ââ¬Å"functionalâ⬠CV can help show you in your best light, if you have an unconventional work history, this will lead employers to wonder what youââ¬â¢re hiding! As Allison Green puts it in ââ¬Å"hereââ¬â¢s the right way to format your resumeâ⬠on Ask a Manager: Functional resumes ââ¬â which are focused on one long list of skills and accomplishments rather than connecting them to a chronological work listing ââ¬â are widely disliked by employers, since they make it difficult to understand what the candidateââ¬â¢s work progression has been. Stick with the standard reverse-chronological order instead. Tip #4: Give Appropriate Weight to the Various Sections Normally, it makes sense for your most recent roles and achievements to take up the most space on your resume. You donââ¬â¢t need to go into lots of detail about a job that you had for six months ten years ago itââ¬â¢s not likely to be very relevant to your employer. The same goes for your educational qualifications: if youââ¬â¢ve graduated college, your high school classes and GPA are no longer very significant. You can include them briefly, but donââ¬â¢t spend half a page of your resume on them. Tip #5: Include Examples to Back Up What Youââ¬â¢re Claiming Itââ¬â¢s not enough to say that you have ââ¬Å"excellent time management skillsâ⬠ââ¬â it doesnââ¬â¢t mean anything, and itââ¬â¢s the sort of phrase that almost any candidate can use. Back up your claims with concrete examples. For instance, you could write: Excellent time management skills: managed heavy workload in a busy department, prioritising and dealing with customer emails (frequently over 50/day). Where possible, give figures: for instance, if you took on the task of writing newsletters to your companyââ¬â¢s client base and this resulted in 10% more sales to customers on the newsletter list ââ¬â say so! Tip #6: Donââ¬â¢t Be Cutesy About Your Stay-at-Home Parenting One rather cringe-worthy trend with resumes is for stay-at-home parents (both moms and dads) to describe their time parenting in terms of a job. For instance,à James Wilkinson fromà Advice from Super Dad writes that: If I was to include my stay at home dad role on a resume it would probably look something like this: STAY AT HOME DAD July 2011 ââ¬â Present Responsibilities /Achievements Primary child care duties. Design and implementation of household operational procedures. Supervising, training and managing children and their needs. Complaint resolution, Household bookkeeping and finance management Additionally you may have had to learn to meal plan and cook, to do cleaning and washing duties or a myriad of other assorted essential household and child rearing skills. Now, Iââ¬â¢ll be the first to say that being a stay at home parent is hard work ââ¬â itââ¬â¢s a whole job and a half, at least. Iââ¬â¢ve every respect for parents. But this sort of entry does not belong in your work history. It looks silly, it makes you seem a little desperate for something to put on your resume and it could also come across as quite insulting to a potential boss who may well have children of their own (and all of these duties to handle in addition to their job). So what should you do? The safest professional approach is to simply leave those years out of your work history: you can write a sentence in your cover letter to explain ââ¬Å"from July 2011, Iââ¬â¢ve been a stay at home parentâ⬠. Tip #6: Keep it to Two Pages Maximum (Unless Youââ¬â¢re an Academic) In todayââ¬â¢s digital age, you might think that it really shouldnââ¬â¢t matter if your resume doesnââ¬â¢t fit onto two sides of a sheet of paper. But it does! If your resume goes on for three or four pages, no-oneââ¬â¢s going to want to read the whole thing plus it makes you look like someone whoââ¬â¢ll ignore professional norms. If you absolutely need to fit in an extra paragraph or two, itââ¬â¢s better to go onto a third side than to squeeze all your text so that itââ¬â¢s tiny. The main exception here is if youââ¬â¢re applying for an academic role, where you might well be listing your publication history, presentation experience, and so on in a longer CV. In this case, itââ¬â¢s often expected that your CV will run to three or four pages. Tip #7: Use Bullet Points Where Appropriate If youââ¬â¢re fresh out of school, you might think that bullet points look informal and odd. But in a business context, itââ¬â¢s completely normal to use bullet points to summarise information and to make it easy to take in. You can find plenty of examples of resumes here on Live Career ââ¬â this should give you an idea of how often bullet points are used! Some key areas to include bullet points on your resume are: Your core skills (probably in a list with two or three columns, rather than a single long list that leaves a lot of white space on the right hand side of the page). Your duties for each of the previous job roles youââ¬â¢ve held Your educational history and qualifications Tip #8: Donââ¬â¢t Include a Photo of Yourself This might seem like a strange tip, but itââ¬â¢s something that employers have increasingly mentioned as an issue ââ¬â perhaps with the ease of taking and inserting digital photos. You do not need to include your photo on your resume however fantastic you look! Employers donââ¬â¢t (or shouldnââ¬â¢t) care what you look like, and it looks weird and unprofessional to put a photo of yourself on your resume. (The main exception here is if youââ¬â¢re applying for a modelling or acting role, when of course it is appropriate to include a photo.) You should avoid including any other images in your resume, too: for instance, donââ¬â¢t put in company logos from the places youââ¬â¢ve previously worked. You might think it looks slick, but it can cause problems with formatting, and itââ¬â¢s frankly a waste of your time. Stick to text alone. Tip #9: Use a Professional-Looking Email Address This might seem like a tiny thing but your email address matters. If youââ¬â¢re using tequilalover@hotmail.com, itââ¬â¢s not going to create the best impression. A free email address is fine, but make sure itââ¬â¢s something sensible (probably involving your name, and perhaps a number if no version of your name is available). Some people ââ¬â and Iââ¬â¢ll admit Iââ¬â¢m one of them ââ¬â feel that a Gmail address looks better than Hotmail or Yahoo, because Gmail users tend to be a little more tech-savvy. The name of your email provider, though, really isnââ¬â¢t likely to make a lot of difference. Tip #10: Triple-Check Your Spelling and Grammar There arenââ¬â¢t many situations in life when a typo can be ruinous but sending out a resume is one of them. While most people would forgive you a tiny typo, a resume with several typos, or significant typos (like a misspelled company name) will inevitably make you look bad. Proofread your resume as carefully as you can ââ¬â there are some great tips here on Daily Writing Tips that should help. If possible, get a second pair of eyes on it too: ask a friend to look over it and make sure youââ¬â¢ve not made any mistakes. This is also a good opportunity to make sure that youââ¬â¢ve been consistent with formatting (e.g. that all your headers are the same size, font and style), and that everything looks polished (e.g. that you donââ¬â¢t have a single paragraph running over the page break ââ¬â if you do, insert a manual page break to neaten it up). Bonus tip: Make sure to check our previous article 44 Resume Writing Tips for additional points you can use.. I know thereââ¬â¢s quite a bit to take in here, and you might feel overwhelmed before youââ¬â¢ve even begun on your resume. One of the best ways to tackle any daunting writing project ââ¬â resumes included ââ¬â is to start with a small step. You might open up a fresh document and type in your contact details, for instance then youââ¬â¢ve made a start. I wish you the very best of luck with your job search, and I hope you find and land the perfect role for you. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Business Writing category, check our popular posts, or choose a related post below:20 Great Similes from Literature to Inspire YouFor Sale vs. On SaleDissatisfied vs. Unsatisfied
Sunday, February 16, 2020
Exploring an art Object Essay Example | Topics and Well Written Essays - 1750 words
Exploring an art Object - Essay Example In 1990, the Leaning Tower of Pisa was closed for public as a rigorous restoration plan starting in the following years. It was reopened in 2001 and the scientific committee revealed a recovery in inclination of the tower in August 15, 2013 (Ridet, n.pag.). Due to its unusual tilted architecture, it is a popular tourist attraction and Pisa is one of Europeââ¬â¢s most visited cities as a result. The Tower of Pisa was constructed hundreds of years ago in Romanesque style of architecture. Its construction began in 1173 soon after which it started tilting. Its name comes from an ancient Greek word which literally means marsh land. Since it was a marshy land the soil was unbalanced because of its composition. The soil contained mud, clay, and sand due to which the towerââ¬â¢s foundations began tilting towards the north. After its engineers noticed the defect, they tried to make up for the tilt by making the columns taller in the north (Harris, n.pag.). However, the tower continued t o incline and it started tilting towards the south, the direction where it still tilts till today although efforts by the engineering bodies have reduced the inclination greatly. It reached its greatest tilt in 1990 when it was being feared that the tower might fall over due to gravity. Restoration project started so as to reduce its inclination to maintain the site as a remarkable historical building. Romanesque architecture was an early medieval style of architecture that was popular in Europe during the medieval times. The form of architecture was defined by the presence of arches shaped semi circularly. Although there are various other medieval buildings in Pisa, Italy that depict a Romanesque style, perhaps the Leaning Tower of Pisa is one of the most remarkable ones due to its tilted structure. Just like a typical Romanesque building, the tower has 6 galleries that have been laid one top of the other (Stalley, 202) making a total of 8 storeys. The tower stands at a height of 5 6 meters as a bell tower or campanile. The Tower of Pisa is made up of white marbles that has been inlaid towards the outside with colored marble. It is a part of the Cathedral of Pisa which is located close by. The building techniques that have been used during the construction of the tower include load bearing masonry, cut stone construction, inlaying, and round plan. Load bearing masonry is probably one of the oldest forms of construction which involves the layering of masonries one on top of the other thereby building walls and other structures. Load bearing masonry has given the tower strength although it has been tilting since years. Also, the technique has made aesthetically beautiful walls which give a structurally rich look to the Tower of Pisa. In order to cut stones to make dimension stones for the construction for the tower, the technique of cut stone masonry construction was used by the designers. These dimension stones were the used for the making of its walls. The tow er has various galleries with columns supporting the curved arches in between. Although white marbles were used as the masonry for the construction, the exterior side of the tower was inlaid with colored marble so as to give it a creatively rich appearance. The Leaning Tower of Pisa comes under the category of Romanesque architecture. It is a building that was built as a toure de force
Sunday, February 2, 2020
Martin Luther King as a Leader Essay Example | Topics and Well Written Essays - 750 words
Martin Luther King as a Leader - Essay Example It was through bold and inspirational speeches that King established a reputation as a great orator. However, this also painted him a radical and subject to federal surveillance for the rest of his life. In addition, King is recognized for his phlegmatic way of approaching crisis as he advocated for the rights of all. Martin Luther King Jr represented the African-American community, but in essence, this translates to all minority communities who lived an oppressed life. This oppression came about following colonization and the slave trade where the rights of those perceived to a weak community were subjected to a wide range of discrimination. Segregation and discrimination with regard to race, gender and education were outlawed following advocacy for civil rights. This marks a critical step towards generating independence among communities. This clearly illustrates that even as King fought for the rights of African-Americans, the benefits would be felt across different communities both regionally and nationally. King mounted a challenge to oppression by defying the status quo, which eventually got support from other members of the community other than African-Americans. However, there still exist a wide disparity based on ethnicity, race, religion and gender in modern America. This creates the need for more activism and effective leadership to bridge the gap, eliminating existing disparities. In order to take up leadership and advocate for change, one must consider every possible angle relevant to the vision he has. This way, his vision should illustrates the benefits of the intended changes and how best to effect it. In this regard, one should develop a vision in which he firmly believes in before making it a mission. Consequently, a leader seeking to transform the beliefs held by many must establish a vivid vision of
Saturday, January 25, 2020
Global Plan to Eliminate New HIV Infections
Global Plan to Eliminate New HIV Infections Abstract The study assessed the progress of 20 priority sub-Saharan African countries in the attainment of the targets outlined in the ââ¬ËGlobal Plan for the Elimination of New HIV Infections among Children by 2015 and Keeping their Mothers Aliveââ¬â¢. The 2012 progress reports of the countries were extracted from the UNAIDS online database. The global and Prong 1, 3, and 4 targets were analysed with respect to the May 2013 targets and milestones. The 2009 to 2012 and the 2005 to 2010 mid ââ¬â point estimates were analysed respectively for global target 1 ââ¬â Reduce number of new infections among children by 90% and global target 2- Reduce AIDS-related deaths during pregnancy or within 42 days of the end of pregnancy by 50%. Estimates were calculated using Spectrum version 4.6 and Wilcoxon ranked test was used for data analysis.Between 2009 and 2012, there was 38% total reduction in global target 1 while between2005 to 2012 there was 25% total reduction in global target 2 for the 20 priority countries. Ghana and South Africa recorded the most significant reduction for global target 1 with 72% and 63% respectively while Nigeria, Chad, Congo Democratic Republic and Lesotho recorded less than 20% reduction. Only Botswana and Ethiopia recorded over 50% reduction in global target 2. There has been significant progress however; the global milestones have not been attained. More effort is needed in Nigeria, Congo Democratic Republic and Angola and sustained momentum in other priority countries to achieve the Global Plan goals and milestones. HIV infection remains one of the major cause of death in children and their mothers in Sub Saharan African (SSA) countries [1,2,3]. Transmission of HIV infection from mothers to their unborn children and infants is mostly during pregnancy, labour and post ââ¬â natally during breastfeeding period. [4,5]. There has been gradual reduction in new HIV infections among children of HIV infected mothers since the commencement of prevention of mother to child transmission programme (PMTCT) but as at 2009, a staggering 370,000 children were recorded to have became newly infected with HIV worldwide and an estimated 42,000 ââ¬â 60,000 pregnant women also died due to HIV infection and its complications. [6,7].Over 90% of the countries responsible for this high burden of HIV infection and high mother to child transmission (MTCT) rates are located in SSA. India, which is located in Asia is another country which also contribute significantly to this burden. These countries account for the bu lk of the HIV infected women requiring antiretroviral therapy (ART) in order to prevent MTCT. They also account for over 90% of the paediatric HIV infected children who need ART [7].The case of MTCT presents a big disparity globally with high income countries recording almost zero new HIV infections among children and maternal and infant mortalities due to HIV infection. However; most of the low and middle countries especially those located in SSA record new infections because the number of women accessing HIV prevention and treatment services is considerably very low. The same situation applies to their children and this exposes them to new infections and death [7].The success recorded in reducing MTCT to almost zero and keeping their mothers alive is possible globally. However, this can only be a reality if all involved will ensure that all pregnant women living with HIV and their children have easy access to antiretroviral drugs and other necessary care as indicated during pregna ncy, delivery and breastfeeding. These measures will go a long way in preventing new infections among the children and take care of the health of the mothers as well. Provision and appropriate usage of ARVs as prophylaxis has been proven to reduce HIV MTCT to less than 5% [9]. Other measures that targets HIV infection prevention among women at increased risk of HIV and the unmet family planning needs of women living with HIV will contribute significantly to reduction for subsequent antiretroviral prophylaxis and treatment need [12].In May 2009, the Joint United Nations Programme on HIV/AIDS (UNAIDS) made a call for the virtual elimination of MTCT globally. This call was supported by many other multilateral and bilateral agencies, regional coordinating bodies, national governments and their HIV/AIDS control agencies . In furtherance of this noble course, the World Health Organisation (WHO) in 2010 published new guidelines which included the best available scientific and programmatic tools to accelerate the reduction of MTCT and achieve the virtual elimination of MTCT. These guidelines also included advice for safer infant feeding. [6,7] The call for the virtual elimination of new paediatric HIV infection led to the launching of an initiative known as ââ¬Å"Global Plan Towards the Elimination of New HIV Infections among Children by 2015 and Keeping their Mothers Alive â⬠in July 2011 at the United Nations General Assembly High Level Meeting on AIDS. The Global Plan was developed through a consultative process by a Global Task Team convened by UNAIDS. The Global Task Team included experts and policy makers from 25 countries and 30 civil society organisations, private sector, networks of people living with HIV and international organisations. This plan was designed to provide the foundation for country-led movement towards the elimination of new HIV infections among children and keeping their mothers alive. The Global Plan covers all low- and middle-income countries, but with a particular focus on the 22 countries with the highest estimated numbers of pregnant women living with HIV. These countries are Angola, Botswana, Burundi, Cameroon, Chad, Cà ´te dââ¬â¢Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana, India, Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, South Africa, Swaziland, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. These countries were selected based on the fact that they account for nearly 90% of pregnant women living with HIV in need of services. These countries also need exceptional efforts to achieve this goal. The Global Plan also supports and reinforces the development of country-driven HIV national plans [7]. The Global Plan focuses on reaching pregnant women living with HIV and their children prior to pregnancy, through the time of pregnancy until stoppage of breastfeeding. The HIV prevention and treatment needs of mothers and children will be met within the existing comprehensive HIV care programmes.The implementation framework for the Global Plan is based on two global targets and broader four-pronged strategy. The strategy provides the foundation for national plans development and implementation. It encompasses ranges of HIV prevention and treatment indicators for mothers and their children, essential maternal, newborn and child health services and family planning, and as a crucial aspect of efforts to achieve Millennium Development Goals 4, 5 and 6 [10,11]. Global Target #1: Reduce the number of new HIV infections among children by 90% . Global Target #2: Reduce the number of AIDS-related maternal deaths by 50%. Prong 1: Prevention of HIV among women of reproductive age within services related to reproductive health such as antenatal care, postpartum and postnatal care and other health and HIV service delivery points. Target: Reduce HIV incidence in women 15-49 by 50%. Prong 2: Providing appropriate counselling and support, and contraceptives, to women living with HIV to meet their unmet needs for family planning and spacing of births, and to optimize health outcomes for these women and their children. Target: Reduce unmet need for family planning to zero (Millennium Development Goal). Prong 3: For pregnant women living with HIV, ensure HIV testing and counselling and access to the antiretroviral drugs needed to prevent HIV infection from being passed on to their babies during pregnancy, delivery and breastfeeding [9]. Target: Reduce mother-to-child transmission of HIV to 5%. 90% of mothers receive perinatal antiretroviral therapy or prophylaxis. 90% of breastfeeding infant-mother pairs receive antiretroviral therapy or prophylaxis. Prong 4: HIV care, treatment and support for women, children living with HIV and their families. Target : Provide 90% of pregnant women in need of antiretroviral therapy for their own health with life-long antiretroviral therapy. By the end of 2015, the estimated number of new HIV infections in children is expected to have been reduced by at least 85% in each of the 22 priority countries, the estimated number of HIV-associated pregnancy-related deaths reduced by 50% and all countries will have met the targets for elimination of new HIV infections among children and keeping their mothers alive. There is however need to measure the progress made by these countries and to address gaps and challenges identified. This study aimed to assess the progress made by twenty of the priority countries involved in the Global Plan in sub Saharan Africa. This is coming two years after the formal launching of the Global Plan with the countries making commitment towards the elimination of new HIV infections in children and keeping their mothers alive. This study looked at the progress made so far in meeting some of the targets and milestones set to be met by May 2013.We searched the UNAIDS online database of the 2012 progress reports submitted by the priority countries. The 2009 2012 mid ââ¬â point estimates were analysed for 20 of the sub- Saharan African Global Plan priority countries. The estimates were calculated using Spectrum version 4.6. The Spectrum files were developed by country teams and compiled by UNAIDS in 2013. However, the estimates from AIDS related deaths during pregnancy or within 42 days of the end of pregnancy was from 2005 to 2010 [8].Only 20 of the Global Plan priority countries data were analysed due to non availability of country ââ¬â specific data for Uganda and India. . In order assess the progress made, the global targets and Prong 1, 3, and 4 targets were quantitatively analysed with respect to the May 2013 targets and milestones. Some of the global and country targets and milestones assessed were : The estimated number of new HIV infections in children is reduced by 50% from 2010 levels in at least 10 high-burden countries. (Country target and milestone). The estimated number of new HIV infections in children is reduced by 50%. (Global target and milestone). The data was analysed using statistical package Stata version 12.1. Overall Targets Between 2009 and 2012, the number of new infections among children in the 20 Global Plan priority countries in sub-Saharan Africa countries with country-specific data was estimated to have reduced from 315570 to 197170. ( Wilcoxon ranked test ;P = 0.0001; Table 1 and 5). The total reduction in the estimated number of new HIV infections among children was 38% from 2009 levels in the high-burden countries.AIDS-related deaths during pregnancy or within 42 days of the end of pregnancy among the 20 Global Plan priority countries in sub-Saharan Africa countries with country-specific data reduced from 36000 in 2005 to 29030 in 2010.Prong 1 Target The new HIV infections among women 15ââ¬â49 years old among the 20 Global Plan priority countries in sub-Saharan Africa countries with country-specific data reduced from 687900 in 2009 to 606000 in 2012 (Wilcoxon ranked test ;P = 0.0001; Table 2 and 5 ).Prong 3 Targets The final Mother to Child Transmission rate (%) among the 20 priority countries with country-specific data reduced from 27% in 2009 to 19% in 2012 (Wilcoxon ranked test ;P = 0.0001; Table 3 and 5 ). The percentage of women receiving antiretroviral medicines (excluding single-dose nevirapine) to prevent MTCT increased from 34% in 2009 to 63% in 2012 (Wilcoxon ranked test ;P = 0.0001; Table 3 and 5). The percentage of women or infants receiving antiretroviral medicines during breastfeeding to prevent MTCT increased from 11% in 2009 to 43% in 2012 (Wilcoxon ranked test ;P = 0.0001; Table 3 and 5).Prong 4 TargetsThe percentage of antiretroviral therapy coverage among children 0ââ¬â14 years old increased appreciably from 22% to 35% in all the Global Plan priority countriesIn SSA,the percentage of pregnant women living with HIV receiving antiretroviral therapy for their own health increased from 23% in 2009 to 57% in 2012 (Wilcoxon ranked test ;P = 0.0001; Table 4 and 5). Two countries namely Ghana and South Africa have done tremendously well in achieving the highest reduction in the numbers of new HIV infections among children from 2009 to 2012 with 72% and 63% reduction respectively [8]. Others like Botswana, Malawi, Ethiopia, Zambia and Namibia had also achieved remarkable reduction with Zimbabwe, Kenya, Mozambique and Tanzania almost reaching the 50% reduction. Angola, Nigeria, Chad, Congo Democratic Republic and Lesotho are still lagging behind in the aspect of reduction of new infection in children. The case of Nigeria is really a concern considering the fact that she has the highest number and about one third of all new paediatric infection in sub Saharan Africa. Angola is also a case for concern, there has been increase in new infections rather than reduction since 2009. Furthermore , there has been reduction in the AIDS-related deaths during pregnancy or within 42 days of the end of pregnancy from 2005 to 2010, although with some exceptions like Mozambique and South Africa. There has been some reduction in new HIV infections among women 15ââ¬â49 years old in the priority countries but with some exceptions such as Angola, Cameroun, Chad, Cote Dââ¬â¢Ivoire, Mozambique, Namibia and Zimbabwe. There was reduction in the final Mother to Child Transmission rate with Botswana and South Africa leading the pack. These two countries have already reached the 5% target for the reduction in transmission rate [8]. More women are now able to access antiretroviral medicines and thereby reducing the risk of new HIV transmission to their children compared to 2009. Four countries had already surpassed the 90% target for the increase in percentage of women receiving antiretroviral medicines (excluding single-dose nevirapine) to prevent MTCT, however, Angola, Chad, Nigeria and Congo DR did poorly in this area of maternal antiretroviral coverage. The increase in the percentage of women or infants receiving antiretroviral medicines during breastfeeding to prevent MTCT among the priority countries is a commendable step because some of the countries do not have this programme in place as of 2009. There was a significant increase in antiretroviral therapy coverage for pregnant women living with HIV in the priority countries. Botwsana and Namibia had achieved above 90% antiretroviral therapy coverage for pregnant women living with HIV . These increased coverage levels of antiretroviral medicines is expected to translate into lower mother-to-child transmission rates. Over the years, there has been an increase in the number of children who are on antiretroviral therapy but this increase is still not the desired expectation with two third of eligible children been denied the needed medication in most of the priority countries. It is noteworthy that Botswana was already having above 95% paediatric antiretroviral coverage as at 2009. A major limitation of this study is the non availability of Uganda and India country ââ¬â specific data . Another challenge was in measuring the progress of the initiative because most of the priority countries do not have a direct measurement of the number of new HIV infections among children [8].There has been a significant progress among most of the sub Saharan African priority countries in the bid to eliminate new HIV infections in children as seen by the reduction in the percentage of final mother to child transmission of HIV.The success story so far include reduced number of children newly acquiring HIV infection, improved and increased access to HIV treatment for eligible women and their children, increased coverage of antiretroviral medicines for pregnant women living with HIV to prevent mother-to-child transmission from and reduction in AIDS-related deaths during pregnancy or within 42 days of the end of pregnancy. However, only seven countries has been able to achieve the 50% reduction in estimated number of new HIV infections among children thereby falling short of the expected ten countries target by May 2012 [7]. Also the number of new HIV infections in the countries declined by only 38% against the target of 50%. More effort is needed in certain countries like Nigeria, Congo Democratic Republic and Angola and sustained momentum in other priority countries in order to achieve the Global Plan goals.
Friday, January 17, 2020
The Return: Midnight Chapter 15
Bonnie woke slowly, coming up from some dark place. Then she wished she hadn't. She was in some out-of-doors place ââ¬â only buildings blocked the horizon where the sun hung forever. Around her were a lot of other girls, al approximately her own age. That was puzzling, first of al . If you took a random sampling of females off the street there would be little girls crying for their mothers, and there would be mother-aged women taking care of them. There might be a few older women. This place looked more like ââ¬â ââ¬â oh, God, it looked like one of those slave warehouse places that they had had to pass the last time they had come to the Dark Dimension. The ones that Elena had ordered them not to look at or listen to. But now Bonnie felt sure she was inside one herself, and there was no way not to look at the Stillfaces, at the terrified eyes, at the quivering mouths around her. She wanted to speak, to find the way ââ¬â there would have to be a way, Elena would insist ââ¬â to get out. But first she gathered al the Power at her command, wrapped it into a cry, and soundlessly screamed Damon! Damon! Help! I really need you! Al she heard in return was silence. Damon! It's Bonnie! I'm at a slave warehouse! Help! Suddenly she had a hunch, and lowered her psychic barriers. She was instantly crushed. Even here, at the edge of the city, the air was choked ful of long messages and short: cries of impatience, or camaraderie, of greeting, of solicitation. Longer, less impatient conversations about things, instructions, teasings, stories. She couldn't keep up with it. It turned into a menacing wave of psychic sound that was curled like a wave about to break over her head, to crush her into a mil ion pieces. And then, all of a sudden, the telepathic melee vanished. Bonnie was able to focus her eyes on a blond girl, a little older than her and about four inches taller. ââ¬Å"I said, are you okay?â⬠the girl was repeating ââ¬â obviously she'd been saying it for a while. ââ¬Å"Yes,â⬠Bonnie said automatically. No! Bonnie thought. ââ¬Å"You might want to get ready to move. They've sounded the first dinnertime whistle, but you looked so out of it, I waited for the second one.â⬠What am I supposed to say? Thank you seemed safest. ââ¬Å"Thanks,â⬠Bonnie said. Then her mouth said all on its own, ââ¬Å"Where am I?â⬠The blond girl looked surprised. ââ¬Å"The depot for runaway slaves, of course.â⬠Well, that was that. ââ¬Å"But I didn't run away,â⬠she protested. ââ¬Å"I was going right back after I got a sugarplum.â⬠ââ¬Å"I don't know about that. I was trying to run away, but they finally caught me.â⬠The girl slammed one fist into an open hand. ââ¬Å"I knew I shouldn't have trusted that litter carrier. Carried me right to the authorities and me blind and without a clue.â⬠ââ¬Å"You mean you had the litter curtains down ââ¬â ?â⬠Bonnie was asking, when a shril whistle interrupted her. The blond girl took hold of her arm and began dragging her away from the fence. ââ¬Å"That's the second service dinnertime whistle ââ¬â we don't want to miss that, because after that they shut us up for the night. I'm Eren. Who're you?â⬠ââ¬Å"Bonnie.â⬠Eren snorted and grinned. ââ¬Å"All right by me.â⬠Bonnie allowed herself to be led up a dirty stairway and into a dirty cafeteria. The blond girl, who seemed to regard herself as Bonnie's keeper, handed her a tray, and pushed her along. Bonnie didn't get any choice in what she was to have, not even to veto the noodles that were squirming slightly, but she did manage to snatch an extra bread rol in the end. Damon! Nobody was tel ing her not to send a message, so she kept on doing it. If she was going to be punished, she thought defiantly, she was going to be punished for trying to get out of here. Damon, I'm in a slave warehouse! Help me! Blond Eren grabbed a spork, so Bonnie did too. There were no knives. There were thin napkins, which relieved Bonnie, because that was where the Squirmy Noodles were going to end up. Without Eren, Bonnie would never have found a place at the tables, which were crammed with young girls eating. ââ¬Å"Shove over, shove over,â⬠Eren kept saying, until there was room for Bonnie and her. Dinner was a test of Bonnie's courage ââ¬â and also of how loud she could scream. ââ¬Å"Why are you doing all this for me?â⬠she shouted into Eren's ear, when a lul in the deafening conversation gave her a chance. ââ¬Å"Oh, Well, you being a redhead and all ââ¬â it put me in mind of Aliana's message, you know. To the reall Bonny.â⬠She pronounced it oddly, sort of swall owing the y, but at least it wasn't Bonna. ââ¬Å"Which of them? Which message, I mean?â⬠Bonnie screamed. Eren gave her an are you kidding look. ââ¬Å"Help when you can, shelter when you have room, guide when you know where to go,â⬠she said in a sort of impatient chant, then looked chagrined and added, ââ¬Å"And be patient with the slow.â⬠She attacked her food with an air of having said everything there was to say. Oh, boy, Bonnie thought. Somebody had really taken the balland run with it. Elena had never said any of those things. Yeah, but ââ¬â but maybe she'd lived them, Bonnie thought, a tingling breaking out all over her body. And maybe somebody had seen her and made up the words. For instance, that crazy-looking guy she'd given her ring or bracelet or something to. She'd given her earrings away to people with signs, too. Signs that said: POETRY FOR FOOD. The rest of dinner was a matter of picking up food with the spork and not looking at it, crunching it once, and then deciding whether to spit into her Still-writhing napkin, or to try to swallow without tasting. Afterward the girls were marched into another building, this one fil ed with pal ets, smal er and not so comfortable-looking as Bonnie's at the inn. She was now horrified at herself for leaving that room. There she had had safety, she had had food that she could actual y eat, she had had entertainment ââ¬â even the Dustbins were clothed in a golden glow of remembrance now ââ¬â and she had had the chance of Damon finding her. Here she had nothing. But Eren seemed to have some mesmeric influence on the girls around, or else they al were Aliana-ites too, because when she shouted ââ¬Å"Where's a pal et? I've got a new girl in my bedroom. Think she's gonna sleep on the bare floor?â⬠And eventual y, a dusty pal et was passed hand over hand into Eren's ââ¬Å"bedroomâ⬠ââ¬â a group of pal ets al spread with the heads together in the middle. In exchange, Eren handed over the wriggling napkin Bonnie had given her. ââ¬Å"Share and share alike,â⬠she said firmly, and Bonnie wondered if she thought Aliana had said that, too. A whistle shril ed. ââ¬Å"Ten minutes until lights-out,â⬠a hoarse voice shouted. ââ¬Å"Every girl not on her pal et in ten minutes wil be punished. Tomorrow section C goes up.â⬠ââ¬Å"All right! We're going to be bloody deaf before we're sold,â⬠Eren muttered. ââ¬Å"Before we're sold?â⬠Bonnie repeated stupidly, even though she had known what would happen from the first moment she had recognized this as a warehouse for slaves. Eren turned and spat. ââ¬Å"Yeah,â⬠she said. ââ¬Å"So you can have one more breakdown and then that's it. Only two per customer, and by tomorrow you may wish you'd saved one up.â⬠ââ¬Å"I wasn't going to have a breakdown,â⬠Bonnie said, with al the courage at her command. ââ¬Å"I was going to ask how we're going to be sold. Is it at one of those horrible public places, where you have to stand in front of a crowd in just a shift?â⬠ââ¬Å"Yeah, that's what most of us wil be doing,â⬠a young girl, who had been crying quietly through dinner and the pal et-arranging time, spoke up in a soft voice. ââ¬Å"But the ones they pick out as special items wil have to wait. They'l give us a bath and special clothes, but it's al just so we look more presentable for the clients. So the clients can inspect us more closely.â⬠She shuddered. ââ¬Å"You're frightening the new girl, Mouse,â⬠Eren scolded. ââ¬Å"We cal her Mouse, because she's always so scared,â⬠she told Bonnie. Bonnie silently screamed, Damon! Damon was decked out in his new captain of the guard suit. It was nice, being black on black, with lighter black piping (even Damon recognized the necessity of contrast). It had a cloak. And he was a ful vampire again, as powerful and prestigious as even he could have imagined. For a moment he simply luxuriated in the feeling of a job well done. Then he flexed his vampire muscles more strongly, urging Jessalyn, who was upstairs, into deeper sleep, while he sent tendrils of Power al over the Dark Dimension, sampling what was going on in different districts. Jessalynâ⬠¦now there was a dilemma. Damon had the feeling that he should leave her a note or something, but he wasn't quite sure what to say. What could he tel her? That he was gone? She would see that for herself. That he was sorry? Well, obviously he wasn't so sorry that he'd chosen not to go. That he had duties elsewhere? Wait. That might actual y work. He could tel her that he needed to check up on her territory and that if he were to stay here in the castle he doubted he'd ever get anything done. He could tel her he'd be backâ⬠¦soon. Soonish. Soonishly. Damon pressed his tongue against a canine and felt the prompt rewarding sharpness and length. He real y wanted to try out those legendary Black Ops vs. vampires programs. He wanted to hunt, period. Of course, there was so much Black Magic wine about the place that when he stopped a male servant and asked for some, the servant had brought a magnum. Damon had been having flutes every now and then, but what he real y wanted was to go hunting. And not to hunt a slave and certainly not an animal, and it hardly seemed fair to wander the streets on the chance that there was a noblewoman to get to know better. It was at that moment that he remembered Bonnie. In a matter of three more minutes he had everything he needed to do wrapped up, including the annual delivery of dozens of roses to the princess in his name. Jessalyn had given him a very liberal al owance, and already advanced for the first month. In a matter of five minutes he was flying, though that was very bad manners on the street, and doubly so in a market district. In a matter of fifteen minutes he had his hands around the landlady's neck, the one whom he had paid very well to make sure that exactly what had happened never happened. In sixteen minutes, the landlady was grimly offering him the life of her young and not very intel igent slave as recompense. He was Stillwearing his captain of guard suit. He could have the boy to kil , to torture, whateverâ⬠¦he could have the money backâ⬠¦ ââ¬Å"I don't want your filthy slave,â⬠he snarled. ââ¬Å"I want my own back! She's worthâ⬠¦Ã¢â¬ Here he came to a stop, trying to calculate how many ordinary girls Bonnie was worth. A hundred? A thousand? ââ¬Å"She is worth infinitely more ââ¬â ââ¬Å"he began, when the landlady surprised him by interrupting. ââ¬Å"Why'd you leave her in a dump like this, then?â⬠she said. ââ¬Å"Oh, yes, I know what my own lodgings are like. If she was so damn precious, why'd you leave her here?â⬠Why had he left her in this place? Damon couldn't think now. He'd been panicked, half out of his mind ââ¬â that was what being human had done to him. He'd been thinking only about himself, while little Bonnie ââ¬â fragile Bonnie, his little redbird ââ¬â had been shut up in this filthy place. He didn't want to keep thinking about it. It made him feel searing hot and icy cold at once. He demanded that a search be made of al the neighborhood buildings. Someone had to have seen something. Bonnie had been awakened too early and parted from Eren and Mouse. She immediately had an urge to lose control, to have a breakdown at once. She was shivering al over. Damon! Help me! Then she saw a girl who couldn't seem to get up off her pal et and saw a woman with arms like a man's go over with a white ash rod to administer punishment. And then something seemed to go blank in Bonnie's mind. Elena or Meredith might have tried to stop the woman, or even this huge machine they were caught in, but Bonnie couldn't. The only thing she could do was try not to have a breakdown. She had a song stuck in her head, not even a song she liked, but it repeated endlessly over and over as the slaves around her were dehumanized, broken into mechanical, but clean, mindless bodies. She was being scrubbed mercilessly by two muscular women whose whole life doubtless consisted of scrubbing grimy street girls into pink cleanliness ââ¬â at least for a night. But final y her protests led the women to actual y look at her ââ¬â with her fair, almost translucent skin scrubbed raw ââ¬â and concentrate instead on washing her hair, which felt as if it were being pul ed out at the roots. Final y, though, she was done and was given an adequate towel with which to dry off. Next, in what she was realizing was a giant assembly line, were kinder plump women who stripped off the towel and proceeded to put her on a couch and massage her with oil. Just when she was starting to feel better she was hustled up to have the oil removed, except that which had soaked into her skin. Women then appeared who measured her, cal ing out the numbers as they did, and by the time Bonnie had tramped to the wardrobe station, three dresses were waiting for her on a bar. There was a black one, a green one, and a gray one. I'l get the green for sure because of my hair, Bonnie thought blankly, but after she had tried al three on, a woman took the green and gray away, leaving Bonnie in a little black bubble dress, strapless, with a glittery touch of white material at the neck. Next was a giant sanitary room, where her dress was careful y covered with a white paper robe that kept ripping. She was led to a chair with a hair dryer and the rudiments of makeup, which a white-shirted woman used to put too much on Bonnie's face. Then the hair dryer was swung over her head, and Bonnie, with a stolen tissue, took off as much makeup as she dared. She didn't want to look good, didn't want to be sold. When she finished she had silvery eyelids, a touch of blush, and velvety rose-red lipstick that wouldn't wipe off. After that she just sat and finger-combed her hair until it was dry, which the ancient machine announced with a ping. The next station was a bit like the day after Thanksgiving at a big shoe store. The stronger or more determined girls managed to wrench shoes away from their weaker sisters and jammed them on one foot, only to start the process again the next minute. Bonnie was lucky. She saw a tiny black shoe that had a faintly silvery bow coming down the ramp and kept her eye on it while it passed from girl to girl until someone dropped it and then she swooped in and tried it on. She didn't know what she would have done if it hadn't fit. But it did fit, and she went to the next station to get its mate. As she sat waiting, other girls were trying on perfume. Bonnie saw two entire bottles go down the bodices of girls and wondered if they meant to sel them or try to poison themselves with them. There were also flowers. Bonnie was already dizzy with perfume and had decided not to wear any, but a tal woman bel owed over her head and a garland of freesia was pinned to frame her curls, without anyone asking her permission. The last station was the hardest to bear. She had on no jewelry and would have worn only one bracelet with the dress. But she was given two: slim unbreakable plastic bracelets, each with a number on it ââ¬â her identity from now on, she was told. Slave bracelets. She had now been washed, packaged, and stamped, so that she could be conveniently sold. Damon! she cried voicelessly, but something had died inside her, and she knew now that her cal s would not be answered. ââ¬Å"She was picked up as a runaway slave and confiscated,â⬠the sweetshop man told Damon impatiently. ââ¬Å"And that's al I know.â⬠Damon was left with a feeling he didn't often have. Sickening terror. He was real y beginning to believe that this time he had cut it too fine; that he would be too late to save his redbird. That any of several dreadful scenarios might have played out before he got to her. He couldn't stand to visualize them in detail. What he would do if he didn't find her in timeâ⬠¦ He reached out and without the slightest effort gripped the sweetshop man around the throat, lifting him off the floor. ââ¬Å"We need to have a little chat,â⬠he said, turning the ful force of his menacing dark eyes on the bulging ones of his prey. ââ¬Å"About just how she got confiscated. Don't struggle. If you haven't hurt the girl, you've got nothing to fear. If you haveâ⬠¦Ã¢â¬ He pul ed the terrified man completely across the counter and said very softly, ââ¬Å"If you have, then, by al means struggle. It won't make any difference in the end ââ¬â if you know what I mean?â⬠The girls were put into the largest carriages Bonnie had yet seen in the Dark Dimension, three slim girls to a seat and two sets of seats in a carriage. She got a nasty jolt, though, when instead of going forward like a carriage, the whole thing was lifted straight up by sweaty male slaves straining at poles. It was a giant litter and Bonnie immediately snatched off her freesia garland and buried her nose in it. It had the added function of hiding her tears. ââ¬Å"Do you have any idea of how many homes and dancing rooms and hal s and theaters there are where girls are being sold tonight?â⬠The golden-haired Guardian looked at him sardonical y. ââ¬Å"If I knew that,â⬠Damon said with a cold and ominous smile, ââ¬Å"I wouldn't be here asking you.â⬠The Guardian shrugged. ââ¬Å"Our job is real y only to try to keep the peace here ââ¬â and you can see how well we succeed. It's a matter of too few of us; we're insanely understaffed. But I can give you a list of the venues where girls are being sold. Still, as I said, I doubt you'l be able to find your runaway before morning. And by the way, we'l have an eye on you, because of your little query. If your runaway wasn't a slave, she's Imperial property ââ¬â no humans are free here. If she was, and you freed her, as reported by the baker across the street ââ¬â ââ¬Å" ââ¬Å"Sweet-sel er.â⬠ââ¬Å"Whatever. Then he had a right to use a stun gun when she ran. Better for her, real y, than being Imperial property; they tend to char, if you get my drift. That level's a long way down.â⬠ââ¬Å"But if she was a slave ââ¬â my slaveâ⬠¦Ã¢â¬ ââ¬Å"Then you can have her. But there's a certain mandatory punishment set before you can have her. We want to discourage this kind of thing.â⬠Damon looked at her with eyes that made her shrink and look away, abruptly losing her authority. ââ¬Å"Why?â⬠he demanded. ââ¬Å"I thought you claimed to be from the other Court. You know. The Celestial one?â⬠ââ¬Å"We want to discourage runaways because there've been so many since some girl named Alianna came around,â⬠the Guardian said, her frightened pulse visible in her temple. ââ¬Å"And then they get caught and have even more reason to try it againâ⬠¦and it wears out the girl, eventual y.â⬠There was no one in the Great Hal when Bonnie and the others were hustled off the giant litter and into the building. ââ¬Å"It's a new one, so it's not on the lists,â⬠Mouse said, unexpectedly at her shoulder. ââ¬Å"Not that many people wil know about it, so it doesn't fil up til late, when the music gets loud.â⬠Mouse seemed to be clinging to her for comfort. That was fine, but Bonnie needed some comfort of her own. The next minute she saw Eren and, dragging Mouse behind her, headed for the blond girl. Eren was standing with her back against the wal . ââ¬Å"Well, we can stand around like wal flowers,â⬠she said, as a few men came in, ââ¬Å"or we can look like we're having the best time of any of them right here by ourselves. Who knows a story?â⬠ââ¬Å"Oh, I do,â⬠Bonnie said absently, thinking of the star bal with its Five Hundred Stories for Young Ones. Instantly there was a clamor. ââ¬Å"Tel it!â⬠â⬠Yes, please tel !â⬠Bonnie tried to think of the fairy tales that she had experienced. Of course. The one about the kitsune treasure.
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