Ways to Improve Public Transport in Malaysia free essay sample

Since it started operating in 1995, the KTM Komuter service has been horribly neglected. The fleet size has decreased by 50% while passenger demand has actually tripled. Poor planning and oversight has left KTMB unprepared for the expanded passenger demands. An open Parliamentary Committee would be able to review the plans of the operators and proposals and make the necessary investments to improve public transportation. 5) Only a few operators, please Competition is hurting public transportation in Malaysia. The only way that we can see real improvements is to reduce competition within the industry and focus on consolidation. The largest bus company, Konsortium Transnasional Berhad, is a good example of this consolidation. It offers express and intercity and urban bus services through its different branches and brands. Konsortium Bas Ekspres on the other hand, shows you what happens when there is consolidation without proper regulation. Konsortium Bas Ekspres has become notorious for bus crashes, underpaid and reckless drivers, and poor maintenance. We will write a custom essay sample on Ways to Improve Public Transport in Malaysia or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page The government should encourage existing operators to form properly regulated conglomerates like KTB. Under the proposed system of regulated competition, the Local Authority can even (with proper justification) invite foreign transport companies like First and Veolia and ComfortDelGro to compete for bus routes tendered in their areas. 6) Proper information Malaysians are, ironically, being restricted by companies that are supposed to provide them mobility. Bus operators and even government operators like RapidKL, KL Monorail, and KTMB are doing everything in their power to keep assengers using their services-even at the expense of passenger convenience. Bus operators only provide basic route information and only on the bus itself. RapidKL has discouraged the sale of integrated public transport maps like BastrenKL at LRT stations and bus hubs. In addition, for RapidKL to provide route information at a bus stop or give updates on the radio, they are forced to pay advertising rates. Wit h little or no comprehensive information available to public transport users, their ability to use the services and maximize their ringgit is severly limited. When the local Public Transport Authorities are created they should be expected to provide information through signs on bus stops, the internet, news-spots on broadcasting and narrowcasting, free paper guides, downloadable route maps, and sms services. This will help information reach the customers. 7) More buses and train carriages Most people would think that this should be further up in the list but I disagree. We cannot build public transportation without realistic demands and proper data. Without these vital pieces of information, our planning is reduced to If we build it, they will come. There are enough buses in the Klang Valley (shared among the major and minor bus operators) to meet all of the needs to the DBKL. These buses need to be better organized so they do not only focus on the profitable routes and do not spend most of their time waiting for passengers. Only a local public transport authority which owns the routes and controls the buses would be able to implement a successful system. If we rely on the operators themselves to organize and improve services, nothing will happen. 8) Build better public transport from the bottom up Bus lanes are not a popular solution among drivers. But we have to realize that bus lanes and bus rapid transit system are a solution that will work for the Klang Valley and throughout Malaysia. Rather than spending all our funds in the Klang Valley alone, we should be thinking about improving public transportation throughout the country. To give you an understanding of this, consider the 120km of rail lines proposed in the KLCity2020 Draft Plan. Most of these lines will cost RM200-300 million per km. It will cost a total of RM 40 billion to build all of these lines, but the capacity will be the same as the existing KL Monorail and Kelana Jaya LRT. However, if the 120km of lines were built as a mix of Bus Rapid Transit and Rapid Tram lines, they could be built for RM40-75 million per km or approximately 7-10 billion, which would spare another RM30 billion for the rest of the country! 9) A complete mass-transit network Mass-transit networks are vital for urban and suburban areas. Each economic region of Malaysia should have a complete public transport network and the backbone of this network comes from rail services. Instead of focusing on building more lines and more extensions the goal should be completing the network as quickly and effectively as possible. Once effective, rapid networks are in place, we can plan and upgrade capacity on the various lines. One day we will need more LRT and KTM Komuter in the Klang Valley, Rapid Trams in Georgetown, and Johor, and KTM Komuter Udara, Selatan and Timur, and high speed rail networks in Peninsular Malaysia and Sabah and Sarawak. But until then, we have to focus on building realistic demand for public transportation services. 10) Affordable and reasonable fares I disagree with any proposal that says that bus fares and public transport fares must be subsidized. Most people would assume that the lower-income group comprise the majority of public transport users, and therefore subsidies would be necessary. However, this only perpetuates the image that public transport is for the lower-income group and the poor. The fact is that low fares have brought us into this situation of low-quality service. Effectively, we get what we pay for. So if we wish to see public transportation improve, we will have to invest more money into our services and that includes higher fares. At the same time, higher fares do not have to be a burden. Under the system of regulated competition, the local authority would be able to run the fare system and they would be the best choice to implement the subsidy for operators. The local authority can also provide support to the needy in the form of free bus passes or discounted bus passes. They can also encourage fare-saving promotions, fare discounts for using Touch N Go, and even income tax credits for those who purchase monthly and weekly passes.

Childhood-Onset Schizophrenia Essay Sample

Childhood-Onset Schizophrenia Essay Sample Childhood Childhood The problem of schizophrenia remains one of the most important psychosomatic problems in the modern psychiatry and requires more multidisciplinary research. Schizophrenia is a brain disorder, which manifests in abnormal mental functions and behavior. Schizophrenia is characterized by the severe psychotic symptoms, such as various forms of nonsense (false beliefs), hallucinations (false perception), frustration of thinking, extremely disorganized behavior, a catatonia (motor dysfunctions: from over excitation to a full immovability), the extremely inadequate or poor emotional reactions (flat affect), and also considerable deteriorations or social functioning violations. Childhood-onset schizophrenia (COS) is similar to regular schizophrenia, however it appears at early age. It is one of the most severe forms of schizophrenia, but is not an independent disease. At present, the psychosis, which begins in children up to 10 year old, is defined as COS. Moreover, the psychosis is divided i nto the subgroups according to the age of a child accepted in pediatrics, such as the early childhood until 3 years old, pre-preschool age from 3 to 5 years and preschool from 5 to 7 years (Addington Rapoport, 2009, p. 156; Bartlett, 2014, p. 736). The given research paper describes the prevalence rates and risk factors of COS, its diagnostic criteria, clinical characteristics, as well as prevention of the disease. COS Prevalence Rates According to Bartlett (2014), the prevalence rates variate in different regions of the globe. The COS prevalence rates, extremely rarely found among children up to 12, increase in teenage years and reach its critical point at the age of 20-25: The prevalence of COS makes from 0.14 to 1.0 cases per 10 000 children; Schizophrenia occurs among the adults 100 times more often than among children; COS at earlier age (2-4 years) in boys happens twice more often than in girls. However, the specified distinctions between genders disappear at teenage years (Bartlett, 2014, p. 742). The general risk of the disease is 0.4 0.6% (4-6 cases per 1000 people). Boys and girls get sick equally, however, the prevalence of the disease in boys is explained by the general biological vulnerability of males to the neurological disorders, or different etiology (origin) of the processes in boys and girls. In adulthood, schizophrenia is met more often among the representatives of the lowest social and economic segments of the population. The symptoms in children with COS occur in the representatives of various cultures, ethnos and racial groups (Naguy Al-Mutairi, 2015). COS Risk Factors The biological conditions, family, social and cultural factors as well as drug use and alcoholism are among the risk factors of COS. At the early stage of the neuronal development, including during pregnancy, the causal factors can increase the risk of the future development of the disease. In this regard, the COS risk is dependent on a birth season, indicating that the disorder is more often observed in children born in winter and spring. Moreover, the prenatal infections increase risk, thus confirming the direct connection of the disease with the developmental disorders. Childhood-onset schizophrenia is a hereditary (familial) disease. However, the fact that not both monogerminal twins become sick in all schizophrenia cases says that not only genetic factors affect the probability of the development of schizophrenia in children. The non-genetic factors, including infections, toxins, trauma and stress during prenatal and post-natal development, also play a role in causing schizophrenia, apparently, having more mediated impact on the neurologic development (Bartlett, 2014, p. 735; Starling Feijo, 2012, p. 2). The modern views on the causes of COS are based on the vulnerability stress model, which focuses on the role of the interaction between a child’s predisposition and stressful and protective factors. The predisposition factors include a genetic risk, defects of the central nervous system, lack of the conditions necessary for training or pathological forms of family relations. The events increasing the probability of schizophrenic episodes, such as a death of a close relative, or sources of a chronic stress, such as ill-treatment of a child in a family, belong to stressors. The protective factors include the conditions reducing the probability of schizophrenic episodes in children belonging to a risk group. These factors include a highly developed intelligence, social skills or a favorable situation in a family (Addington Rapoport, 2009, p. 157). The vulnerability stress model emphasizes the role of the neuropathology in developing schizophrenia at early age. Moreover, it is confirmed by the data, which proves that psychotic symptoms expressed in motor and cognitive deficiencies and disorders of a social interaction are found in babies and children earlier than the psychosomatic symptoms, expressed in the motor and cognitive deficits and violations of the social interconnections. The neuropsychological researchers testify that attention and information processing deficiency found in the adults with schizophrenia are characteristic for the children with COS. Moreover, the record of the brain activity during the performance of such tasks testifies to the existence of the limited ability to process cognitively the information (Starling Feijo, 2012, p. 4). There is a strong influence of the genetic factors on the COS probability, which even exceeds the probability of a disease at mature age. In particular, the quantity of COS cases among the relatives of sick children approximately twice exceeds the number of the cases affecting the relatives of the adults sick with schizophrenia. This data in general confirms that COS is the most severe form of schizophrenia (Addington Rapoport, 2009, p. 158). Among the social factors, there is a stable correlation between the COS risk and the urbanization degree. The social factors include a low social status, including poverty, migration caused by social disparities, racial discrimination, problematic families, a high level of unemployment and bad living conditions. The mockeries and injuring experiences in the childhood also promote the future development of schizophrenia. The parental education does not pose a risk of COS, but the broken relationship characterized by a lack of support can make its contribution. In addition, loneliness is one of the social factors of COS (Naguy Al-Mutairi, 2015). COS occurs in all cultural, social and economic classes. There is a larger number of children with schizophrenia in lower social and economic sectors of society. This fact is explained by the downward drift hypothesis, according to which sick people either move to the lower classes, or cannot get into the higher due to the disease. The stresses endured by the representatives of the lower class are the factors promoting the development of schizophrenia. Thus, that social stresses have an impact on the development of COS (Naguy Al-Mutairi, 2015). Immigration, industrialization and tolerance to abnormal behavior existing in certain sectors of society have an impact on the etiology of schizophrenia. The high prevalence of COS among recent immigrants can cause the change of the cultural features, which, being a stressful factor contributes to the development of the disease. In addition, the spread of schizophrenia in the developing countries is caused by the interaction with more advanced equipment and culture. Some types of culture can be more or less prone to schizophrenia depending on how a patient mentally perceives stress, what his role is or what social protection system is, and how complex social communications are. Schizophrenia has more favorable forecast in less developed nations. COS and drug addiction are connected, and do not allow to trace the relationships of cause and effect with ease. There is an evidence that certain drugs are capable to cause the disease in some teenagers or to provoke the next attack. Amphetamines and alcohol stimulate the emission of dopamine, and the excess of a dopaminergic activity causes the psychotic symptomatology in schizophrenia. In addition, the excessive use of hallucinogenic and excitants can provoke COS (Starling Feijo, 2012, p. 8). COS Diagnostic Criteria and Clinical Characteristics The initial stages of COS can be manifested in a child’s inability to concentrate his/her attention, a sleep disorder, difficulty to study and avoidance of communication. The development of disease can be characterized by the incoherent speech; besides, a child can start seeing or hearing what people around cannot. After the progressing periods, may appear severest recurrence characterized by the incoherent thinking when a child starts jumping from one thought to another one without any logical communication. During the psychotic phases of COS, children can be convinced that they possess superhuman abilities or that some people constantly watch them. During a psychotic attack, a patient can start behaving in an unpredictable way, sometimes tending to aggression or a suicide (Naguy Al-Mutairi, 2015). The clinical manifestations of the disease at the age of 1- 3 are mainly presented by the monotonous excitement, circle walking, impulsiveness, unmotivated laughter and tears, run in the uncertain direction, etc. At late preschool age, the thinking disorders in the form of the nonsense-like imagination can appear. After the age of 12, schizophrenia is characterized with hallucinatory and crazy manifestations, though these symptoms can appear at the earlier age. The most severe form of COS is characterized by the alternation of the periods of motive excitement and immobility with the disintegration of the speech (a catatonic form). At teenage years, the hebephrenic form of the disorder is characterized by emotional emasculation, silliness, ridiculous â€Å"clownish† behavior and incoherent speech (Starling Feijo, 2012, p. 6). The lack of emotions when voice and look do not change in the situations assuming the emotional response is another manifestation of COS. The events, which force a healthy person to laugh or cry, do not cause any reaction in children with COS. The defective intelligence, characteristic to children, whose schizophrenic process arose at the stages of the formation of informative abilities during the first years of life, is the most severe complication of COS. The signs of the disorder should be observed continuously, for at least 6 months. In addition, after the emergence of the frustration signs in a child such symptoms as an essential lowering of the level of functioning in one or several areas, or inability to achieve the expected level of results in the interpersonal, educational or professional sphere are observed. The explanation of the observed disorders with mood, schizoaffective disorder, the use of any preparations or chemicals, and the general state of health should be excluded. In the presence of the diagnosis of autism or other severe diseases caused by developmental disorders, the additional diagnosis of schizophrenia can be made only if nonsense or hallucinations continue to occur for a month. The use of the general diagnostic criteria of schizophrenia for children and adults facilitates the comparison of COS and the schizophrenia at mature age and allows defining the cases in which the continuous course of disease throughout the entire period of individual development takes place. However, schizophrenia can be revealed differently depending on age. In particular, nonsense, hallucinations and formal thinking disorders occur extremely rarely and, thus, are unable to diagnose the disease up to the age of 7 (Starling Feijo, 2012, p. 6). The rejection of age distinctions when using the diagnostic criteria of schizophrenia can lead to the incorrect diagnosis of COS in children. However, the full form of disease does not develop until a more mature age. The other factors connected with the individual development can also matter, when making the diagnosis of schizophrenia. In particular, it is sometimes difficult to draw the line between such pathological symptoms as the nonsense and usual imaginations caused by the phantasies characteristic to many young children. In addition, it is necessary to consider the fact that unlike adults, young children do not feel discomfort and disorganizing character of the psychotic symptoms. Therefore, if they emerge at early stages of development, children may not distinguish them from the normal experiences. COS Prevention The modern prevention of mental diseases includes the concepts of primary and secondary prevention. The primary prevention of children’s schizophrenia as an endogenous disease is quite problematic. Nevertheless, the modern data on the genetic risk of COS allow giving the relevant advice on the prevention or interruption of pregnancy. Another prerequisite of the COS primary prevention includes the data of many children’s psychiatrists on the frequency of exogenous harm in the early anamnesis of the COS patients (pre-natal, perinatal and early post-natal harm). Therefore, the measures connected with health protection of pregnant women, obstetric aid improvement, and also strengthening of the health of newborns and children of early age can be conditionally related to the primary prevention of COS (Naguy Al-Mutairi, 2015; DeVylder, 2015). The COS’s psychogenesis includes the dependence of this disease on the surrounding microsocial environment, emotional deprivation, common accommodation with COS patients, etc. The measures directed on the improvement of environment and the prevention of the psychologically difficult and stressful situations are related to the COS secondary prevention (DeVylder, 2015). At present, there are no reliable markers capable to predict the development of schizophrenia. However, there are the researches estimating the possibility of the future diagnosis through the combination of genetic factors and the psychosis-like experiences. The children belonging to the high-risk group, which assumes the existence of the transit or the self-checked psychotic experiences against the family history of schizophrenia, are diagnosed with COS within a year with the probability of 20-40% chance. Various methods of psychotherapy and medicines are capable to reduce the COS development among the children of a high-risk group (Naguy Al-Mutairi, 2015). The diagnosis of COS is an area of scientific knowledge much discussed in the middle 20th century. The given research paper showed that the symptoms of the subsequent development of schizophrenia can be revealed at early stages of a child’s development. The process started in the first critical period leads to the profound changes in the ontogenesis of a child. Thus, the development of COS depends on the nature of interaction of the enduring psychobiological vulnerabilities, environmental and biological stressors, protective factors caused by the nature of a child’s development and favorable family conditions. Despite the genetic predisposition to schizophrenia, the probability of the schizophrenic episodes is high only when a person is also exposed to rather strong influence of the stressful factors, and has no sufficient resources to resist the disease.