Fatty Arbuckle Scandal and Trials

At a raucous, three-day party in September 1921, a young starlet became severely ill and died four days later. Newspapers went wild with the story: popular silent-screen comedian Roscoe Fatty Arbuckle had killed Virginia Rappe with his weight while savagely raping her. Though the newspapers of the day reveled in the gory, rumored details, juries found little evidence that Arbuckle was in any way connected with her death. What happened at that party and why was the public so ready to believe Fatty was guilty? Fatty Arbuckle Roscoe Fatty Arbuckle had long been a performer. When he was a teenager, Arbuckle traveled the West Coast on the vaudeville circuit. In 1913, at the age of 26, Arbuckle hit the big time when he signed with Mack Sennetts Keystone Film Company and became one of the Keystone Kops. Arbuckle was heavy—he weighed somewhere between 250 and 300 pounds—and that was part of his comedy. He moved gracefully, threw pies, and humorously tumbled. In 1921, Arbuckle signed a three-year contract with Paramount for $1 million—an unheard-of amount at the time, even in Hollywood. To celebrate just having finished three pictures at the same time and to celebrate his new contract with Paramount, Arbuckle and a couple of friends drove up from Los Angeles to San Francisco on Saturday, September 3, 1921, for some Labor Day weekend revelry. The Party Arbuckle and friends checked into the St. Francis Hotel in San Francisco. They were on the twelfth floor in a suite that contained rooms 1219, 1220, and 1221 (room 1220 was the sitting room). On Monday, September 5, the party started early. Arbuckle greeted visitors in his pajamas and though this was during Prohibition, large quantities of liquor were  being drunk. Around 3 oclock, Arbuckle retired from the party in order to get dressed to go sight-seeing with a friend. What happened in the following ten minutes is disputed. Delmonts version:Bambina Maude Delmont, who frequently set-up famous people in order to blackmail them, claims that Arbuckle herded 26-year-old Virginia Rappe into his bedroom and said, Ive waited for this a long time, Delmont says that a few minutes later party-goers could hear screams from Rappe coming from the bedroom. Delmont claims she tried to open the door, even kick it in, but couldnt get it open. When Arbuckle opened the door, supposedly Rappe was found naked and bleeding behind him.Arbuckles version:Arbuckle says that when he retired to his room to change clothes, he found Rappe vomiting in his bathroom. He then helped clean her up and led her to a nearby bed to rest. Thinking she was just overly intoxicated, he left her to rejoin the party. When he returned to the room just a few minutes later, he found Rappe on the floor. After putting her back on the bed, he left the room to get help. When others then entered the room, they found Rappe tearing at her clothes (something that has been claimed she did often when she was drunk). Party guests tried a number of strange treatments, including covering Rappe with ice, but she still wasnt getting any better. Eventually, the hotel staff was contacted and Rappe was taken to another room to rest. With others looking after Rappe, Arbuckle left for the sight-seeing tour and then drove back to Los Angeles. Rappe Dies Rappe was not taken to the hospital on that day. And though she didnt improve, she wasnt taken to the hospital for three days because most people who visited her considered her condition to be caused by liquor. On Thursday, Rappe was taken to the Wakefield Sanitorium, a maternity hospital known for giving abortions. Virginia Rappe died the following day from peritonitis, caused by a ruptured bladder. Arbuckle was soon arrested and charged with the murder of Virginia Rappe. Yellow Journalism The papers went wild with the  story. Some articles stated Arbuckle had crushed Rappe with his weight, while others said he had raped her with a foreign object (the papers went into graphic details). In the newspapers, Arbuckle was assumed guilty and Virginia Rappe was an innocent, young girl. The papers excluded reporting that Rappe had a history of numerous abortions, with some evidence stating she might have had another a short time before the party. William Randolph Hearst, the symbol of yellow journalism, had his  San Francisco Examiner  cover the story. According to Buster Keaton, Hearst boasted that Arbuckles story sold more papers than the  sinking of the Lusitania. The public reaction to Arbuckle was fierce. Perhaps even more than the specific charges of rape and murder, Arbuckle became a symbol of Hollywoods immorality. Movie houses across the country almost immediately stopped showing Arbuckles movies. The public was angry and they were using Arbuckle as a target. The Trials With the scandal as front-page news on almost every newspaper, it was difficult to get an unbiased jury. The first Arbuckle trial began on November 1921 and charged Arbuckle with manslaughter. The trial was thorough and Arbuckle took the stand to share his side of the story. The jury was hung with a 10 to 2 vote for acquittal. Because the first trial ended with a hung jury, Arbuckle was tried again. In the second Arbuckle trial, the defense did not present a very thorough case and Arbuckle did not take the stand. The jury saw this as an admission of guilt and deadlocked in a 10 to 2 vote for conviction. In the third trial, which began on March 1922, the defense again became pro-active. Arbuckle testified, repeating his side of the story. The main prosecution witness, Zey Prevon, had escaped house arrest and left the country. For this trial, the jury deliberated for only a couple of minutes and came back with a verdict of not guilty. Additionally, the jury wrote an apology to Arbuckle: Acquittal is not enough for Roscoe Arbuckle. We feel that a great injustice has been done him. We feel also that it was our only plain duty to give him this exoneration. There was not the slightest proof adduced to connect him in any way with the commission of a crime.He was manly throughout the case and told a straightforward story on the witness stand, which we all believed.The happening at the hotel was an unfortunate affair for which Arbuckle, so the evidence shows, was in no way responsible.We wish him success and hope that the American people will take the judgment of fourteen men and women who have sat listening for thirty-one days to the evidence that  Roscoe Arbuckle  is entirely innocent and free from all blame. Fatty Blacklisted Being acquitted was not the end to Roscoe Fatty Arbuckles problems. In response to the Arbuckle scandal, Hollywood established a self-policing organization that was to be known as the Hays Office. On April 18, 1922, Will Hays, the president of the new organization, banned Arbuckle from filmmaking. Though Hays lifted the ban in December of the same year, the damage was done -- Arbuckles career had been destroyed. A Short Come-Back For years, Arbuckle had trouble finding work. He eventually began directing under the name William B. Goodrich (similar to the name his friend Buster Keaton suggested -- Will B. Good). Though Arbuckle had begun a come-back and had signed with Warner Brothers in 1933 to act in some comedy shorts, he was never to see his popularity regained. After a small one-year anniversary party with his new wife on June 29, 1933, Arbuckle went to bed and suffered a fatal heart attack in his sleep. He was 46.

Supply Chain Management in Meat Industry - 2152 Words

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Achievement Gaps, Access, Quality And Floridas Vpk Program

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Factors Affecting Uptake of ART in PMTCT in Botswana Free-Samples

Question: Discuss about the Factors Affecting Uptake of ART in PMTCT in Botswana. Answer: PMTCT Uptake in Botswana PMTCT was introduced in Botswana in 199 and the program has been widely availed in health facilities all the country. Due to the fact that a majority of pregnant women seek maternal care services in public facilities, the government incorporated routine HIV testing as an element of antenatal care (Government of Botswana, 2008). He overall objective of the programme is to improve child survival and development by reducing HIV transmission from mother to child. The program has four major components which include; preventing pregnancy among young girls, preventing unwanted pregnancy among HIV-positive women, ARV prophylaxis to prevent mother to child HIV transmission, and the provision of support for the mother and her family (Kweneng District Council, 2011; Government of Botswana, 2008). Through the years, the PMTCT programme has evidenced a fair of achievements and challenges alike. On achievements according to the government, the programme has had major achievements in the access of the programme, testing of expectant mothers, take-up pf HIV prophylaxis and treatment by HIV-positive mother, and the proportion of new-borns tested by day 42 (Government of Botswana, 2008). Other achievements for the program include successful integration of PMTCT into sexual reproductive health services, increased PMTCT testing uptake to 98% in 2010 from 49% in 2002, adoption of routine HIV testing, early infant testing rollout, increased PMTCT (AZT/HAART) uptake to 93% in 2010 from 27% in 2002. Treatment PMTCT guidelines in Botswana emphasize on the importance of HAART for all HIV positive expectant women (Ministry of Health, 2008). The defined adult criteria indicate that pregnant women who initially test negative when registering for antenatal care, they should be retested at the 36th week or when labour sets in, so as to detect intercurrent infection during the term. HIV positive pregnant women who are not yet on HAART are expected to have CD4 count and clinical screening as a priority and it should be expedited. Further on, the guidelines dictate that all pregnant women eligible for HAART should be started without exception. In no circumstance that HART should be deferred till the second semenster even if the womans immune status is poor. During labour, all women who are on HAART should be administered with high dose AZT and not sd-NVP. Those women not eligible for HAART should be put on short-course AZT 300mg BD as from the 28th week (Ministry of Health, 2008). Factors Affecting Uptake of ART in PMTCT The WHO identifies Botswana as one of the 22 priority countries that require PMTCT services (UNICEF, 2016). It is recommended that with effective scaling up of PMTCT in Botswana and the other countries can prevent over 250,000 new infections each year (World Health Organization (WHO), 2013). Whereas Botswanas PMTCT has evidenced significant achievement, it is also plagued by challenges and barriers which hamper the uptake. Botswanas PMTCT programme faces a number of challenges which include weak infant follow-up, testing and initiation on HAART, suboptimal access to HAART among all eligible patients, male involvement and participation, inadequate implementation of routine and rapid HIV testing, and inadequate implementation of Infant and Young Child Feeding (IYCF) counselling (Keapoletswe, 2010). Socio-demographic factors Knowledge and individual beliefs There is an established link between knowledge of HIV and PMTCT and the uptake of PMTCT services. Studies in Botswana (Creek, et al., 2009) and Togo (Boateng, Kwapong, Agyei-Baffour, 2013) are some examples that demonstrate this link. The studies show mixed responses on factors such as HIV testing, and acceptability of PMTCT. Poor knowledge of HIV transmission and ARV drugs has also been highlighted in several studies as one of the reasons for dropping out of PMTCT programmes (Peltzer, Mlambo, Phaswana-Mafuya, Ladzani, 2010; Kiarie, Kreiss, Richardson, John-Stewart, 2003). Pregnant mothers may also harbour doubts about the efficacy of ART in MTCT (Kiarie, Kreiss, Richardson, John-Stewart, 2003; Duff, Rubaale, Kipp, 2012), or have beliefs that ARVs can cause HIV (Towle Lende, 2008), or ARVs causes harm to the unborn child (Stinson Myer, 2012). Cultural beliefs and gender dynamics In most of Botswana, the traditional gender roles and cultural beliefs are sustained. Typically, men are the one who make decisions that determine the woman's participation in HIV testing and the corresponding uptake of PMTCT services (Avert, 2016). Just like in most African communities, in Botswana, pregnancy is viewed as a womans affair and the mans primary role is to provide financial support. Men rarely accompany their women to antenatal clinics for PMTCT services due to the stereotype. A man accompanying his wife to the antenatal clinic often evokes negative attitude from community members as reported in the case of Uganda (Byamugisha, Tumwine, Semiyaga, Tylleskr, 2010). Marital status Marital status has a mixed impact on the uptake of PMTCT. Whereas some studies report that a married marital status negatively influences the uptake of PMTCT services (Muyoti, 2007), other studies show that unmarried HIV positive expectant mothers do not access PMTCT services and acquire ARV drugs as much as married women do (Gourlay, et al., 2015). The relationship between marital status and the uptake of PMTCT among Botswana mothers is yet to be clearly established. The level of education Women with a high level of education have demonstrated more positive attitudes towards PMTCT uptake compared to their counterparts (Muyoti, 2007). Drawing on Botswanas education profile, the characteristics of PMTCT seeking behaviour can be drawn. Area Women in rural areas are generally disadvantaged in ARV uptake (Gourlay, et al., 2015). Accessing PMTCT services including ART drugs is a particular challenge to pregnant women in rural parts of African countries. this may be attributed to distance, time and cost of travel to access health services (Gourlay, et al., 2013). Patient-Related Factors Psychological factors A review of literature reveals that there are psychological barriers that affect the initiation and adherence to PMTCT services. Some studies have reported that women describe depression, shock or denial upon learning about their status during antenatal visits (Painter, et al., 2004; Stinson Myer, 2012), they also express fears about their condition and death (Nkonki, Doherty, Hill, Schaay, Kendall, 2007; Duff, Kipp, Wild, Rubaale, Okech-Ojony, 2010), and are also concerned about handling the side effects and the lifelong treatment. The desire to regain health and protect the health of the unborn child are facilitating factors to initiating and continuing with ART (Theilgaard, et al., 2011; Stinson Myer, 2012). Disease progression pregnant women tend to seek PMTCT services depending on the presentation of the disease. Studies have revealed that pregnant women suffering from the disease but lack the symptoms do not feel the need for ARVs for PMTCT (Levy, 2009; Theilgaard, et al., 2011). Personal management and supply of treatment Some patients may lose or sell the tablets, while other may forget to take them or may run out. This may affect the adherence of pregnant women to ARV (Mepham, Zondi, Mbuyazi, Mkhwanazi, Newell, 2011; Kiarie, Kreiss, Richardson, John-Stewart, 2003). There are also issues pertaining to tolerability (e.g. vomiting) (Laher, et al., 2012). Partners Some women fear disclosing their status to their partners and family members. Non-disclosure to partners has been associated with not attending HIV clinics for ART, and not ingesting ARVs (Gourlay, Birdthistle, Mburu, Iorpenda, Wringe, 2013). Lack of partner support is a hindrance whereas support serves as a facilitating factor (Awiti, et al., 2011) Drug-related factors The type of ARV regimen that one takes during pregnancy also influences adherence. For instance, according to a study in Kenya, women taking NVP are more likely to adhere when compared to those taking twice-daily AZT (Kiarie, Kreiss, Richardson, John-Stewart, 2003). Also, women on cART are more likely to adhere compared to those on NVP alone (Stringer, et al., 2010). It is also hypothesised that the increasing complexity and duration of drug regimens may be having a negative effect on access to ARVS, and subsequent adherence. Factors related to patient-health care provider The interactions between the patient and staff may also have an impact on ART-seeking behaviours. Most women have cited negative staff attitudes as a barrier to revisit the facilities (Winestone, et al., 2012; O'Gorman, Nyirenda, Theobald, 2010; Varga Brookes, 2008), and this limits the opportunity to receive ART. Fear of confidentiality breach may also serve as a hindrance factor. Notably, in most African settings, patient-staff interaction, young HIV positive pregnant mothers have expressed facing discrimination during these interactions (Gourlay A., et al., 2014). Overall, some patient does experience difficulties with clinical staff or procedures and this has a negative impact on ART uptake. Factors Related to Health Care System Botswanas health system is also characterised with factors that may hinder the uptake of ART for PMTCT. A number of studies (Duff, Kipp, Wild, Rubaale, Okech-Ojony, 2010; Painter, et al., 2004; Theilgaard, et al., 2011) have revealed that one of the major barriers to PMTCT ART uptake is the shortage of trained clinic staff. Those available are overwhelmed by the high patient volume and this contributes to extended waiting periods, staff stress, staff misunderstandings, poor quality counselling sessions, and staff fails. Another factor related to the health care system is the shortage of resources (including ARVs) (Sprague, Chersich, Black, 2011; Doherty, Chopra, Nsibande, Mngoma, 2009), poor integration of services, referrals and tracking systems (Winestone, et al., 2012), and poor record keeping (Sprague, Chersich, Black, 2011). Accessibility of services is another important factor affecting access to PMTCT among pregnant women. The distance to facilities and the frequency of visits required is a particular challenge especially for those in rural areas (O'Gorman, Nyirenda, Theobald, 2010). In addition, the costs (perceived or real) of maternity services and treatment are also a concern among many women, especially in light of the low economic status. Late presentation to antenatal clinics is also a barrier to accessing ART. Factors to Improve Improve decentralisation of PMTCT services to more rural areas Maintain regular supplies of HIV test kits and drugs Prioritise testing and enrolment for symptomatic women regardless of the symptomatic state. Promote male involvement Improve knowledge, attitudes, and practices regarding ART uptake and general PMTCT among women of childbearing age. Women should be educated on the benefits of ANC/PMTCT services and the corresponding adherence. Improve efforts to address HIV stigma, discrimination, and PMTCT. HIV stigmatisation and overall stereotyping hampers PMTCT-seeking behaviours. Fundamental health system issues such as accessibility, staffing, partner support, confidentiality, and disclosure also need addressing. Botswana can also benefit from strengthening health systems to enhance counselling and partner/community support in order to improve uptake. References Avert. (2016). Prevention Of Mother-To-Child Transmission (PMTCT) Of HIV. Retrieved from Avert: https://www.avert.org/professionals/hiv-programming/prevention/prevention-mother-child#footnote18_gr1jzep Awiti, U. O., Ekstrom, A., Ilako, F., Indalo, D., Wamalwa, D., Rubenson, B. (2011). Reasoning and deciding PMTCT-adherence during pregnancy among women living with HIV in Kenya. Culture Health and Sex, 829-40. Boateng, D., Kwapong, G. D., Agyei-Baffour, P. (2013). Knowledge, perception about antiretroviral therapy (ART) and prevention of mother-to-child-transmission (PMTCT) and adherence to ART among HIV positive women in the Ashanti Region, Ghana: a cross-sectional study. BMC Women's Health, 1-8. Byamugisha, R., Tumwine, J. K., Semiyaga, N., Tylleskr, T. (2010). Determinants of male involvement in the prevention of mother-to-child transmission of HIV programme in Eastern Uganda: a cross-sectional survey. Reproductive Health, 7-12. Creek, T., Ntumy, R., Mazhani, L., Moore, J., Smith, M., Han, G., . . . Kilmarx, P. H. (2009). Factors Associated with Low Early Uptake of a National Program to Prevent Mother to Child Transmission of HIV (PMTCT): Results of a Survey of Mothers and Providers, Botswana, 2003. AIDS and Behaviour, 356364. Doherty, T., Chopra, M., Nsibande, D., Mngoma, D. (2009). mproving the coverage of the PMTCT programme through a participatory quality improvement intervention in South Africa. BMC Public Health. Duff, P., Kipp, W., Wild, T., Rubaale, T., Okech-Ojony, J. (2010). Barriers to accessing highly active antiretroviral therapy by HIV-positive women attending an antenatal clinic in a regional hospital in western Uganda. J Int AIDS Soc. Duff, P., Rubaale, T., Kipp, W. (2012). Married men's perceptions of barriers for HIV-positive pregnant women accessing highly active antiretroviral therapy in rural Uganda. Internal Journal of Womens Health, 22733. Gourlay, A., Birdthistle, I., Mburu, G., Iorpenda, K., Wringe, A. (2013). Barriers and facilitating factors to the uptake of antiretroviral drugs for prevention of mother-to-child transmission of HIV in sub-Saharan Africa: a systematic review. Journal of the International AIDS Society, 18588. Gourlay, A., Mshana, G., Wringe, A., Urassa, M., Mkwashapi, D., Birdthistle, I., Zaba, B. (2013). arriers to uptake of prevention of mother-to-child transmission of HIV services in rural Tanzania: a qualitative study. Global Maternal Health Conference. Gourlay, A., Wringe, A., Birdthistle, I., Mshana, G., Michael, D., Urassa, M. (2014). It is like that, we didn't understand each other: exploring the influence of patient-provider interactions on prevention of mother-to-child transmission of HIV service use in rural Tanzania. PLoS One, e106325. Gourlay, A., Wringe, A., Todd, J., Cawley, C., Michael, D., Machemba, R., . . . Zaba, B. (2015). Factors associated with uptake of services to prevent mother-to-child transmission of HIV in a community cohort in rural Tanzania . Health services research, 1-8. Government of Botswana. (2008). Preventing Mother-to-Child Transmission (PMTCT). Gaborone: MOH. Keapoletswe, K. (2010). Botswana pmtct program. Gaberone. Kiarie, J., Kreiss, J., Richardson, B., John-Stewart, G. (2003). Compliance with antiretroviral regimens to prevent perinatal HIV-1 transmission in Kenya. AIDS, 6571. Kweneng District Council. (2011). PMTCT. Retrieved from www.gov.bw: https://www.gov.bw/en/Ministries--Authorities/Local-Authorities/Kweneng-District-Council/Tools-and-Services/Services/PMTCT/ Laher, F., Cescon, A., Lazarus, E., Kaida, A., Makongoza, M., Hogg, R. (2012). Conversations with mothers: exploring reasons for prevention of mother-to-child transmission (PMTCT) failures in the era of programmatic scale-up in Soweto, South Africa. AIDS Behav. , 91-98. Levy, J. (2009). Women's expectations of treatment and care after an antenatal HIV diagnosis in Lilongwe, Malawi. Reprod Health Matters, 15261. Mepham, S., Zondi, Z., Mbuyazi, A., Mkhwanazi, N., Newell, M. (2011). Challenges in PMTCT antiretroviral adherence in northern KwaZulu-Natal, South Africa. AIDS Care, 7417. Muyoti, D. (2007). Barriers to the uptake of prevention of mother-to child transmission ( PMTCT ) of HIV interventions among women in Kibera slum , Kenya. 823. Nkonki, L., Doherty, T., Hill, Z. C., Schaay, N., Kendall, C. (2007). issed opportunities for participation in prevention of mother to child transmission programmes: simplicity of nevirapine does not necessarily lead to optimal uptake, a qualitative study. AIDS Res Ther. O'Gorman, D., Nyirenda, L., Theobald, S. (2010). Prevention of mother-to-child transmission of HIV infection: views and perceptions about swallowing nevirapine in rural Lilongwe, Malawi. BMC Public Health., 354. Painter, T., Diaby, K., Matia, D., Lin, L., Sibailly, T., Kouassi, MK. (2004). 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