Social work Essay Example | Topics and Well Written Essays - 2500 words

Social work - Essay Example Difference of skin color is a major factor that affects the social and economic status of individuals in our society. This essay will take into account the impact of poverty on the life of black individuals suffering from a mental health condition. A deep insight into the causes of poverty will allow a better understanding of the nature of the issue. The work will also attempt to establish whether poverty is structural or pathological; an aspect that can provide insight into the ways that can be utilized to eradicate poverty. The essay emphasizes the need to make mental health services easily accessible to service users that belong to the selected social class i.e. black individuals suffering mental health issues. Social exclusion refers to the marginalization that is experienced by certain disadvantaged classes of a society due to their social, educational, political, and economic or health backgrounds. Individual belonging to such classes are generally deprived of access to resources that are otherwise available to all other classes of the society. One of the most common themes in this regard is income or social inequality. According to Hirsch, Davis &Smith (2009), it is a process through which some  groups have been discriminated on issues which relate to caste, creed, race, religion, gender disability, or other personal status. As far as the mentally ill black individuals are concerned, their deprivation possibly stem from two major factors: 1) their inability to function normally due to mental condition 2) their compromised social and economic status. Most black individuals having mental health conditions are unable to function in a normal fashion. For this reason they are unable to avail job opportunities that are otherwise available to common people. For many black citizens within UK, an incurable mental problem has a highly

Team Leader Interview Research Paper Example | Topics and Well Written Essays - 2000 words

Team Leader Interview - Research Paper Example The size of a team differs in every organization. This is due to the fact that different organizations and departments have dissimilar objectives, different goals and different expectations in terms of success and the final product. For every organization, to determine how many members will make up the team, different variables and factors are considered (Drouin, 2013). One major factor that is considered is the expectations that the leaders and management have on the team. Different expectations determine how big or small a group is. When the expectations are too high, an organization might decide that the best way to achieve them is by forming a large team (Avery, Walker and Murphy, 2001). In addition, it is important to consider the roles that each of the team members is going to play. If each individual in the team will handle different aspects in the task, the team size might be different as compared to when all team members will handle similar aspects in the task as noted by Mountain and Davidson (2011). Another factor that is considered is the amount and extent of cohesiveness and the level of interconnectivity that is found in a team. Cohesion and interconnectivity are pertinent towards ensuring successful teamwork. When the connection and cohesion is high, the number of members in the team can be less and when it is low, the number should be increased (Edger, 2012). It has been hard to determine the optimum team size, but researchers propose that effective memberships are made of between 4 to 11 members (Robbins and Judge, 2013). However, recommendations brought forward by researchers suggest that 7 to 12 members is an optimum number for problems necessitating high quality decisions (Drouin, 2013). Secondly, when it is important to reach a consensus on a conflict, 3 to 5 members is essential and lastly, when quality and consensus is deemed most

September 11th the terrorist attack Essay Example for Free

September 11th the terrorist attack Essay The terrorist attack on September 11 will always be remember as the most terrifying day in American History. These attacks left people around the world with feeling of disbeliefs and anger. As consequences, many of American people are blaming all Muslim citizens for the attacks, accusing them as terrorists. There are an estimated of 3 million muslins living in the United States. The majority of them practice the Islam religion. Islam is a religion that means peace with ones heart, mind and soul. It also means peace with god and to live according to the sacred book. Unluckily, most Muslim people in America share the same religion as the terrorist organization, led by Osama bin Laden, who is the primary suspect for the September 11 attack. As result, many Muslim American are paying a high price for their similarities with the terrorist. They are being humiliated, harassed and discriminated against. There are more than 200 cases of hate crimes reported in Arabic American anti Discrimination Society since the attacks. For instance, a news station reported a week after the attack an Arab American passenger was kicked off the airplane because of the way she looks. In addition, some on these incident children are the most affected. Muslim children because they are more sensible and constantly interacting with their peers, especially on public school. I have seemed discrimination against Muslim people in my classroom at PCCC. One day after the attack a classmate thought it would be funny to point at on Muslim classmate. I did not find it funny, instead I found very insulting toward her, especially because I know her and I know she is not bad. All these case are true history and people live constantly in pain. Many of them are people with dream and ambition. On September 11 every one saw how destruction could be done in a powerful nation like America. Unfortunately, these events have left many loses including lives of people and economically impact. But we also learned that not all Muslim are terrorist. They are peaceful people like you and me.

Democracy Succeed In Pakistan Politics Essay

Democracy Succeed In Pakistan Politics Essay Democracy is a form of government in which people elect their representatives themselves and the representatives of the people form government and opposition. Counseling is the base of a democratic state. The state ensures equality and equity for all citizens irrespective of their caste, color, language and race. The government performs all duties, for the welfare of all the people and is accountable to people in the performance of obligations. The opinion of each citizen is respected and given due importance. Every citizen has a right to vote to his favorite candidate, to contest election, to join any party and form his own party. That it is why democracy is defined as Rule of the people, by the people, rule for the people (Lincoln, 1) Pakistan came into being as a result of a strong democratic movement under the leadership of Quaid-e-Azam. The people of Pakistan, who faced all the problems and difficult circumstances, showed their determination for gaining freedom. They boldly faced the situation and gradually solved the problems. The Pakistani movement was based on Muslims` inalienable rights of independence and the real implementation of democracy was one of the objectives of establishment of Pakistan. It was thought to adopt the democratic structure and enforce democratic values. Quaid-e-Azam described the objective of establishment of Pakistan as Let us promote Democracy according to the Islamic principles. Unfortunately, it is a disheartening spectacle that within a period of 65 years, Pakistan has not proved itself a democratic state in its true sense. Instead of becoming a model of democracy as visualized by Quaid-e-Azam, Pakistan has become what may be best described as lame democracy (Shaikh, 1) Pakistan was governed by civil and military bureaucrats during its early years. The first democratic elections were held in December, 1970. In the constitution of 1973, a democratic parliamentary government was formed for the first time in the history of Pakistan. This first phase of democratic government continued till 1979. Second and third democratic phases were between 1988 to 1999 and 2007 to the present date respectively. In this way, Pakistan remained as a democratic state for only 24 years. Democratic traditions are not yet developed in Pakistan and during these 24 years, democracy proved itself nothing but a failure. Although implementation of democracy was one of the objectives of Pakistan however, democracy cannot succeed in Pakistan because its political leaders, bureaucrats and feudal landlords will never let democracy flourish. Moreover, basic democratic traditions of equality and freedom are not followed in Pakistan. The main responsibility for the failure of democracy lies with politicians. Firstly, they are not sincere with their jobs and are unfaithful to the state. Secondly, Pakistani political leaders are so incompetent that their policies keep failing. People vote a set of politicians with a hope that their elected representatives will act as their faithful leaders and will devote themselves wholeheartedly to the services of the mankind. But to people`s dismay, Pakistani politicians do not act as honest leaders rather they act as corrupt and disloyal politicians whom ambitions lie in filling their own pockets with public money. Political leaders are responsible for playing games with people for their own benefits. They have destroyed the purpose of creating an independent homeland of Pakistan by giving rise to favoritism and corruption. In Pakistani democratic system, the elected leaders do not regularly visit their constituencies as they are least bothered of public issues. In addition, mo st politicians contest elections on the basis of fake degrees. According to an official report, 106 politicians have been counted for contesting elections on the basis of fake degrees. (qtd. in culprits, 1) This clearly depicts dishonesty of political leaders. Confidence cannot be restored in the masses. Moreover, political leaders are incompetent and are unable to find out the solutions to the nations` problems. Political process keeps collapsing in Pakistan and policies of political parties keep changing and it is very hard for the politicians to reach unanimous stance for a particular policy. The policy of nationalization and posting of incompetent management halted democracy further. Ever since the creation of Pakistan, the same political parties have stayed in power. For example, Pakistan People`s Party came into power many times. People keep supporting the same party under the slogan of Roti, Kapra aur Makaan because of their affection for the founder of the party without even realizing the consequences of their support. Under these circumstances, democracy can never flourish in its true sense. Bureaucracy also imposes a serious threat to democracy. Practically the constitution of Pakistan is based upon the democratic principles. However, the proposals in the constitution could not be implemented because of the attitude of some people, who are not ready to leave the laws introduced by the British government. Bureaucracy has always remained powerful since the creation of Pakistan. It comprises the Central Superior Services and the Provincial Civil Services. (Piracha, 1) and the main cause which stimulated the culture of bureaucracy in Pakistan is institutional imbalance. Bureaucracy is neither in favor of giving power to anyone nor is ready to become responsible to anyone. This attitude is one of the main obstacles in the way to democracy. Most of the bureaucrats become partial and exploit resources of the country for a favorite political party. Bureaucrats of Pakistan are notorious for their corruption, inefficiency, and incompetency and thus responsible for destroying demo cracy in the country. Another main cause for the failure of democracy in Pakistan is feudal system. Pakistan has inherited feudal system from British India and this feudal system will never let democracy flourish in Pakistan. Feudal land lords have a major role in forming policies and they would never like to formulate those policies which are against their interest or are beneficial for the people. The feudal lords acted as traitors and supported British leaders for creating a moth-eaten Pakistan and now, at the present day, Pakistan is nothing but a feudal state. Most of the political leaders of Pakistan are feudal lords who have established their identities as political leaders. The feudal lords keep people at arm`s length and treat them as their slaves. The rigid nature of this class system has deprived Pakistan from educational and economic development. The farmers` community is under the control of their feudal masters. Such underprivileged and economically demoted peasants can have no other option but to vote for their masters. The famers live beyond the poverty line and cannot even express their will freely. Here, the spirit of democracy is violated. Peasants are forced to support their lords due to their fear or may be due to lack of knowledge. In this way, the elections are of no use since the peasants will only vote for their feudal lords under their pressure and democracy will be worse than oligarchy. Supremacy of feudal class is destroying democracy as well as national integration which itself essential for democracy. Democracy has been proved beneficial for the feudal land lords since it provides a cover to them and allows them to rule for as long as they want. As far as common people are concerned, they feel themselves totally neglected in such a democracy. In this situation of distorted democracy, even a thousand elections will not change Pakistans future. Democracy is based on basic traditions of equality and freedom of speech among citizens. As far as Pakistani democratic system is concerned, it has failed to achieve either equality or freedom among people and thus democracy in Pakistan is unsuccessful. This is a clear evidence of inequality when people have to pay bribes in order to get themselves a job. There exists no merit policy, while making appointments and discrimination on the basis of caste, social status and even gender has eliminated the whole concept of democracy. Rich can easily exploit the poor. For example, the wealthy people are always encouraged instead of educated people. Very few educated people join politics and assemblies. In this way, the uneducated people sitting in parliaments cannot build a democratic society on proper lines. In a democratic state, the opinion of each citizen is respected and given due importance. The citizens have full liberty to criticize the working of the government. Although freedom of speech exists to some extent in Pakistan, but due to no constitutional safeguard, it is not fully implemented. A common Pakistani citizen lacks constitutional protection and thus when any civil servant tries for the good governance; he has to face many obstacles. Whenever someone tries to raise his voice against government, he is pushed back instead of going forward. For example, many journalists of Pakistan who try to raise their voice against politicians are threatened by them. Many senior journalists have disclosed that they had received serious threats from both non-state and state actors. Similarly, many journalists have been murdered in Pakistan namely Abdul Haq Baluch, Abdul Qadir Hajiazi, Abdul Razzaq Gul, Tariq Kamal, Aurengzeb Tunio, Murtaaza Razvi, Syed Saleem Shahzad, and Mukarram Khan Aatif. (Admin, 1) Moreover, police had beaten journalists in Pakistan on Press Freedom day and while they were covering the arrival of Asif Ali Zardari. (Khan, 1) Under these circumstances , no one will dare to stand against government. When the true meaning of democracy has not been fulfilled by Pakistani government, it cannot declare itself a democratic state. Illiteracy is also one of the reasons for not letting democracy succeed in Pakistan. In Pakistan, the education sector remained neglected for a long time. In the census of 1951 the literacy rate of Pakistan was 16% that rose to 26.2% in 1981. According to the census of 1998, literacy rate of Pakistan is 43.92% and literacy rate in 2009 is calculated to be 58% which is very low as compared to the developed countries. (Admin, 1) Such underprivileged and uneducated people cannot make right choices. So maximum part of Pakistan`s population is still suffering in the darkness of illiteracy and backwardness and is unable to contribute anything towards the development of the country. High rate of literacy is important for democracy because illiteracy also leads to poverty. An illiterate and economically impoverished community cannot comprehend and follow the true spirit of democracy. In Pakistan, most of the political leaders and parties support democracy. It is argued by its advocates that in a democratic state, rulers can easily be changed without violence. This belief is false as it is evident that whenever any democratic government fails, it is overtaken by military government and the solution is never peaceful. Every military intervention that has occurred in Pakistan had always been preceded by periods of lawlessness and mismanagement by the political leaders. The politicians themselves provide opportunity to Army to intervene. Various examples of military rulers in the country include General Ayub Khan, General Zia-ul-Haq and General Pervez Musharraf. Martial law is not itself enforced, but these are the bad tactics and failed democracy of the government which are responsible for giving rise to Martial Law. Moreover, the government can come back again after re-elections, for example Pakistan People`s Party and Pakistan Muslim League came into power many ti mes. The arguments in favor of democracy in Pakistan are fine theoretically but these are inappropriate in the current political scenario. It is believed that a democracy could never survive for long in Pakistan due to the incompetent people in the so called democratic system. People support democracy in Pakistan because they believe that it is the only form of government which gives people an opportunity to make choices and whatsoever their choices are, members elected are majority people`s chosen representatives. General elections are held in true democracy from time to time. The people can easily change their rulers by electing new ones. In Pakistan, the situation is worse because members elected are not people`s representatives. The main reason to it is that only very few people in Pakistan cast their vote and unfortunately, there is very little evidence which can prove that elections in Pakistan are fair and free. Firstly, people of Pakistan are not prosperous and well-off and thus their votes can easily be purchased. It has been noticed that votes are purchased very cheaply. Secondly, there is much rigging in the election process. Kidnapping voters or candidates on elections is a common spectacle. Moreover, Pakistani political parties do not announce their Party-manifesto during the election campaign. First of all, the parties do not believe in any kind of manifesto and secondly, if they do believe so, it is so unclearly mentioned that it practically means nothing to the readers. In addition to this, voter turnout and election system have further destroyed democracy. In the National elections of 2008, the total voter turnout as recorded by the Election Commission was 41.11 percent of the total registered voters. In Punjab, 48.18 percent and in Sindh, 44.16 percent of the registered voters voted at the elections. (petitioner, 71) Such low turnout in elections is destroying the true spirit of a democratic state. Furthermore, the system of election First Past the Post which is followed in Pakistan is not democratic. According to this system, the candidate securing the highest number of votes is the winner. The winning candidate, however, does not necessarily receive an absolute majority of all casted votes. Thus, according to this system, the parliament members who claim to be representatives of people may not command the majority of the votes registered and polled. Therefore, they may not genuinely represent their electorate. In such a situation, true democratic spirit is violated and members elected are not actually the majority chosen representatives. The accountability process is very important in a democratic state which results in clean and fair working of the executive. However, there is no system of accountability in Pakistan. Every incoming government makes big claims about accountability, but no effective step has been taken in this regard. The corrupt bureaucrats and politicians always escape from punishment due to no accountability process. The government affairs are not dealt transparently and the gap between people and the government is not bridged. A large number of politicians and government servants who have been known to be allegedly involved in activities like corruption, but no effective step has been taken against them. Under these circumstances where there is no accountability process, democracy can never flourish. Pakistan is a welfare state which has been struggling for democracy since its creation. The existing government of Pakistan has been proved the worst ever in its history. It is because it has given rise to unemployment, inflation, poverty and economic crisis. Health and education sectors are in their worst conditions. There exists no equality, freedom and rule of law in the country which are the basic norms for democracy. In Pakistan, democracy has only resulted in corruption, bad governance, institutional imbalance and low living standards of people. Democracy is unsuccessful due to incompetent leadership and political policies. Moreover, bureaucracy and feudal system has abolished democracy further. Democracy is not suitable for a country like Pakistan where most of the population is underprivileged. It has also been badly failed in many other countries like Turkey, Thailand, Israel and Africa. Hence it is proved that democracy is not the successful form of government. If it is suc cessful in the United States and India, it is because of their political and social atmospheres. The socio-political atmosphere in Pakistan does not support democracy at all. Pakistani government should take the example of China and Singapore. China is not a democratic state but still the world`s second largest economy. Similarly, Singapore was also not a democratic state when it gained independence and Mr. Lee was its first president. He put Singapore on the map of the world and took it to the heights of success and prosperity. As one writer once said, Singapore has achieved the American dream, but not in the American way. This has been done through what they call a Benevolent Dictator. (Trip, 1) However, in Pakistan, good administration, accountability process and merit policy is the need of the hour. It is proved that democracy cannot succeed in Pakistan and instead of continuing the system of the state as a fragile democracy; Pakistan should either become a theocracy or a commun ist.

Formal Approach to Thomas Grays Elegy (Eulogy) Written in a Country C

Formal Approach to Thomas Gray's Elegy (Eulogy) Written in a Country Churchyard   Thomas Gray's poem "Elegy Written in a Country Churchyard" is a very structured poem with a set number of lines per stanza, and a specific rhyme scheme throughout the entire poem. The poem focuses on Gray's thoughts while he visits a country churchyard, and ends with an epitaph written on one of the tombstones in the churchyard. The setting of a country churchyard automatically gives way to a small and unknown graveyard, and those that inhabit the graveyard are not going to be well known people in the community or in American history. Gray's form and style allow for the reader to see the churchyard he is in, and the metaphors and symbolism he uses open the mind of the reader to view the world in a new way.   The form of the poem is a very standard elegy, consisting of four line stanzas and a rhyme scheme of a-b-a-b for each stanza. The form gives a visual image of a graveyard and all the plots lined up in a straight lines row after row, and in doing so puts the reader into the same setting as he is in. The setting is not only present in the form of the poem, but also in the first few stanzas. The setting is in a churchyard after sunset, and on a very still and quiet night. Gray's word choice to describe the churchyard present a vivid picture, such as "Now fades the glimmering landscape on the sight, and all the air a solemn stillness holds..."(5-6). The reader can visualize the images of the sun setting over the land and the stillness of the night air from his perspective in these lines. The rhyme scheme of a-b-a-b gives the reader a mental picture of plots in the graveyard. In the first stanza, for example, the ending words are day, lea, wa... ...eople in life might never be seen due to the environment that they are living in or born into. The irony of the poem is that the greatest things on earth might not be those things that we can see and hold to be the greatest. Gray's poem makes a reader examine one's life to truly measure the things that one holds to be great or wonderful, and to look deeper into society to find the truly great things in one's life. Also, he examines that no matter how great a person in life that they will become a just a "shapeless sculpture" (79) with a name, numbers, and a lasting quote that will sum that person's entire life up. Gray's "Elegy Written in a Country Churchyard" is a poem that truly explains that there are far greater things in life than what society holds to be great, and that one must judge for oneself what is great or not based on one's own personal experiences.

The Interplay between Emotion and Reason Essay -- Psychology Essays

The Interplay between Emotion and Reason "And this is of course the difficult job, is it not: to move the spirit from it's nowhere pedestal to a somewhere place, while preserving its dignity and importance." I cry. There is pressure behind my eyes, my skin turns blotchy and my lips tremble, and mucus clogs my airways, making it difficult to breath. I hate crying in front of others: not because I want to hide how upset I am, but because the second that most people perceive my emotional state as fragile, they assume my reasoning and mental functions are also not sound. The outward expression of an inward instability is something we save for those who we know and trust best. They do not view our emotionality as a weakness, they already know us to be strong. Crying is represented in our culture as a lack of control. When upset, the "ideal" is to keep a cool head (and a poker face), not allowing emotions to enter into the decision making process. However, I submit that without our emotional base, rationality would have no reason or foundation upon which to operate. A multitude of opinions are found on the subject: are emotions more a function of the heart or of the head? According to Antonio Damasio (1), emotions and feelings are an integral part of all thought; yet we as humans spend much of our time attempting to disregard and hide them. In the view of source (2), experience is the result of integration of cognition and feelings. In either view, it remains indisputable that emotions are not what we typically make them out to be: the unwanted step-sister of our cultural sweetheart reason. Reason in our culture denotes intelligence, cognition, and control. Emotions seems such a "scary" concept to our collective m... ...tenderness, and luster gone. Is this also reflective of some human insecurity? Not until we can bridge the illusioned gap between our emotions and our cognition can we understand fully the relationship between our brain and our behavior. References 1) A.R. Damasio, Descartes' Error, 1994 2) Thinking, Emotions, and the Brain http://www.drweitz.com/scientific/brain.htm 3) From Neurobiology to Psychopathology: Integrating Cognition and Emotion, on the NIMH website http://www.nimh.nih.gov/diva/neuropsych.cfm 4) Laughing out Loud to Good Health. http://library.thinkquest.org/25500/index2.htm?tqskip1=1&tqtime=0416 5) William Shakespeare (1564–1616). The Oxford Shakespeare. 1914. , on the bartleby website. http://www.bartleby.com/70/2041.html 6 Theories of Emotion--Understanding our own Emotional Experience. http://www.bartleby.com/70/2041.html

Multiple Births: Twins, Triplets, and Beyond Essay

Abstract The high number of multiple pregnancies is a concern because women who are expecting more than one baby are at increased risk of certain pregnancy complications, including premature birth. Multiple Births: Twins, Triplets, and Beyond References Martin, J.A., et al. Births: Final Data for 2006. National Vital Statistics Reports, volume 57, number 7, January 7, 2009. Reddy, U.M., et al. Relationship of Maternal Body Mass Index and Height to Twinning. Obstetrics and Gynecology, volume 105, number 3, March 2005, pages 593-597. Wright, V.C., et al. Assisted Reproductive Technology Surveillance–2005. Morbidity and Mortality Weekly Report, volume 57 (SS05), June 20, 2008. Practice Committee of the Society for Assisted Reproductive Technology and the American Society for Reproductive Medicine. Fertility and Sterility, volume 86, Supplement 5, November 2006, pages S51-52. American Society for Reproductive Medicine. Multiple Pregnancy and Birth: Twins, Triplets, and Higher Order Multiples: A Guide for Patients. Birmingham AL, 2004, accessed 12/16/08. Rossi, C., and D’Addario, V. Laser Therapy and Serial Amnioreduction as Treatment for Twin-Twin Transfusion Syndrome: A Metaanalysis and Review of Literature. American Jour nal of Obstetrics and Gynecology, volume 198, number 2, February 2008, pages 147-152. Lopriore, E. et al. Risk Factors for Neurodevelopment Impairment in Twin-Twin Transfusion Syndrome Treated With Fetoscopic Laser Surgery. Obstetrics and Gynecology, volume 113, number 2, February 2009, pages 361-366. Senat, M.V., et al. Endoscopic Laser Surgery versus Serial Amnioreduction for Severe Twin-to-Twin Transfusion Syndrome. New England Journal of Medicine, volume 351, number 2, July 8, 2004, pages 136-144. American College of Obstetricians and Gynecologists (ACOG). Multiple Gestation: Complicated Twin, Triplet, and Higher-Order Multifetal Pregnancy. ACOG Practice Bulletin, number 56, October 2004. Institute of Medicine. Weight Gain During Pregnancy: Reexamining the Guidelines. May 2009. New York: National Academy of Sciences, accessed 12/8/09. American College of Obstetricians and Gynecologists (ACOG). Having Twins: Patient Education Pamphlet. ACOG, Washington, DC, 2004, accessed 12/9/08. When a woman is carrying one baby, it is called a singleton pregnancy. When She is carrying two or more babies it is called multiple births. In the past 2 decades, the rate of multiple births in the United States jumped dramatically. The rate of twin births increased by 70 percent between 1980 and 2004, and the rate of higher-order multiples (triplets or more) increased four-fold between 1980 and 1998 . However, the rapid rise in multiple birth rates may be ending. In 2005 and 2006, the rate of twin births remained stable . The rate of higher-order multiple births has declined 21 percent since its peak in 1998 . Today, more than 3 percent of babies in this country are born in sets of two, three or more; about 95 percent of these multiple births are twins. The high number of multiple pregnancies is a concern because women who are expecting more than one baby are at increased risk of certain pregnancy complications, including premature birth . Premature babies are at risk of serious health problems during the newborn period, as well as lasting disabilities and death. Some of the complications associated with multiple pregnancy can be minimized or prevented when they are diagnosed early. There are a number of steps a pregnant woman and her health care provider can take to help improve the chances that her babies will be born healthy. About one-third of the increase in multiple pregnancies is due to the fact that more women over age 30 are having babies. Women in this age group are more likely than younger women to conceive multiples. The remainder of the increase is due to the use of fertility treatments, including fertility-stimulating drugs and assisted reproductive technologies (ART), such as in vitro fertilization (IVF). In IVF, eggs are removed from the mother, fertilized in a laboratory dish and then transferred to the uterus.  About 44 percent of ART pregnancies result in twins, and about 5 percent in triplets or more. Doctors now monitor fertility treatments carefully so that women have fewer, but healthier, babies. This involves limiting the number of embryos transferred during IVF. In 2006, the American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology issued updated guidelines on the best number of embryos to transfer, depending on a woman’s age and other factors . For example, the guidelines recommend that doctors transfer no more than two embryos for women under age 35, and consider transferring only one embryo for women in this age group who are considered most likely to become pregnant. Doctors monitor women taking certain fertility drugs with ultrasound. If ultrasound shows that a large number of eggs could be released during a treatment cycle, the doctor can stop the treatment and counsel the woman accordingly. The following factors can increase the chances that a woman will conceive multiples: †¢Fertility treatment †¢Age over 30 years †¢A personal or family history of fraternal (non-identical) twins †¢Obesity or taller-than-average height †¢African-American race (African-American women are more likely to have fraternal twins than caucasian women, and Asian women are the least likely to have fraternal twins) Although previous generations often were surprised by a multiple birth, today most parents-to-be learn the news fairly early. A routine first-trimester ultrasound can detect most multiples. (Sometimes a twin pregnancy that is identified very early is later found to have only one fetus. This is called â€Å"vanishing twin syndrome,† and its cause is not well understood. The surviving twin generally is not harmed.) Other factors can alert a health care provider that a woman may be expecting twins or more. These include: †¢Rapid weight gain during the first trimester †¢The uterus being larger than expected †¢Severe pregnancy-related nausea and vomiting (morning sickness) †¢More than one heartbeat heard by a provider using a hand-held ultrasound device (Doppler) †¢More fetal movement than the woman experienced in a previous  singleton pregnancy †¢Abnormal results on maternal blood screening done around 16 weeks of pregnancy to screen for certain birth defects A health care provider who suspects a multiple pregnancy most likely recommends that the woman have an ultrasound to find out for sure. Women who are expecting more than one baby are at increased risk of a number of pregnancy complications. The more babies a woman is carrying at once, the greater her risk. Common complications include: Premature birth: About 60 percent of twins, more than 90 percent of triplets, and virtually all quadruplets and higher-order multiples are born premature . The length of pregnancy decreases with each additional baby. On average, most singleton pregnancies last 39 weeks; for twins, 35 weeks; for triplets, 32 weeks; and for quadruplets, 29 weeks. Low birth weight (LBW): More than half of twins and almost all higher-order multiples are born with low birth weight (less than 5 ½ pounds or 2,500 grams). LBW can result from premature birth and/or poor fetal growth. Both are common in multiple pregnancies. Twin-twin transfusion syndrome (TTTS): About 10 percent of identical twins who share a placenta develop this complication. TTTS occurs when a connection between the two babies’ blood vessels in the placenta causes one baby to get too much blood flow and the other too little. Until recently, severe cases often resulted in the loss of both babies. Preeclampsia: Women expecting twins are more than twice as likely as women with a singleton pregnancy to develop this complication, characterized by high blood pressure, protein in the urine and generalized edema. Severe cases can be dangerous for mother and baby. In some cases, the baby must be delivered early to prevent serious complications. Gestational diabetes: Women carrying multiples are at increased risk of this pregnancy-related form of diabetes. This condition can cause the baby to grow especially large, increasing the risk of injuries to mother and baby during vaginal birth. Babies born to women with gestational diabetes also may have breathing and other problems during the newborn period. Early diagnosis and management of these complications can help protect mother and babies. Women who are expecting multiples generally need to visit their health care providers more frequently than women expecting one baby. These extra visits  can help prevent, detect and treat the complications that develop more often in a multiple pregnancy. Health care providers may recommend twice-monthly visits during the second trimester and weekly (or more frequent) visits during the third trimester. During the third trimester, the provider may recommend tests of fetal well-being. These include. Eating right and gaining the recommended amount of weight reduces the risk of having a premature or LBW baby in singleton, as well as multiple, gestations. A healthy weight gain is especially important if a woman is pregnant with multiples because they have a higher risk of premature birth and LBW than singletons. The chance of a cesarean birth is higher in twin than in singleton births. However, a pregnant woman has a good chance of having a normal vaginal delivery if both babies are in a head-down position and there are no other complications. When a woman is carrying three or more babies, a cesarean birth usually is recommended because it is safer for the babies.