Obesity Amongst Mexican Children Essay

Abstract: The prevalence of overweight children in the United States of Mexican descent is higher for second generation than their first generation counterparts. First generation immigrants tend to keep a healthier lifestyle by consuming more fresh fruits and vegetables, walking longer distances and smoking less than the more acculturated Mexican-Americans. Acculturation is a major contributing factor for the alarming rates of obesity within Mexican children. When children of Mexican immigrants are exposed to American society, they develop unhealthy habits such as eating pizza and hot dogs during school lunch hours, access to vending machines, and media exposure where they are constantly bombarded with food related commercials of unhealthy nature. A lower socio-economic status, such as the recently immigrated parents, is also a contributing factor for obesity within Mexican children. High calorie and high fat content foods tend to be less expensive than fresh fruits and fresh vegetables, leading to poorer, unhealthier choices. Fast food chains are prohibitory expensive in Mexico, whereas in the US they are not. As young Mexican children develop their sense of identity while they separate from their parents or caregivers and seek acceptance from their American peers, they integrate themselves into the fast food culture leading to obesity amongst Mexican-American children of second generation in the US. The incidence of obesity in Mexican adults has increased markedly over the years. Data from the 1993 National Survey of Chronic Diseases (Encuesta Nacional de Enfermedades Cronicas) showed an obesity prevalence of 21. 5%. The 2000 National Health Survey (Encuesta Nacional de Salud) indicated that 24% of adults suffered obesity. Data from the 2006 National Health and Nutrition Survey (ENSANUT 2006) revealed that 30% of adults of both sexes were obese. (Rojas,R, Aguilar-Salinas, C. , Jimenez, A. , Gomez, F. , Barquera, S. , 2012, p. 8) In the last two decades, the prevalence of childhood obesity, defined as at or above the 95th percentile of body mass index (BMI) for age and gender (Center for Disease Control, 2009), has more than doubled among children aged 6–11 years and tripled among adolescents aged 12–19 years, and here is no evidence that this trend is coming to an end (Ogden, 2002). This is a serious public health concern because obese children and adolescents are at an increased risk for various physical, mental, and emotional health problems, including impaired glucose tolerance , insulin resistance, atherosclerosis , coronary heart disease in adulthood , development of eating disorders, and low self-esteem (Seo, D. & Sa, J. , 2009). The obesity epidemic disproportionately affects racial/ethnic minority children, who are defined as American Indian, Alaska Native, Asian American, Black, African American, Hispanic, Latino, Native Hawaiian, or OBESITY AMONGST MEXICAN CHILDREN: ARE FIRST GENERATION MEXICAN CHILDREN 3 MORE PRONE TO OBESITY THAN THEIR SECOND GENERATION COUNTERPARTS? other Pacific Islander (CDC, 2009). According to estimates based on the 2001–2002 National Health and Nutrition Examination Survey (NHANES), among children aged 6–19 years, 22. 2% of Mexican American children and 20. 5% of non-Hispanic Blacks were obese as compared with only 13. 6% of non-Hispanic whites. Other studies performed by Ogden and colleagues (2002) also affirm a larger prevalence of obesity among Mexican American and Black children compared with white children. These rates of obesity are far from the 2010 national health objective of Healthy People 2010. The higher incidence of obesity among minority children is alarming because these racial/ethnic groups have a lower insulin sensitivity than white children (Seo, D, & Sa, J. 2009). Obesity is an epidemic facing millions of people across the globe, resulting in more than 300,000 deaths in the United States alone (Dishman, 2004). Historically, the majority of people affected by obesity were adults. However, in the last decade this epidemic has spread to our youth. Excess weight in U. S. children has increased in prevalence and has become a serious public health concern. Currently, about 33% of children ages 2–5 in the U. S. are overweight (BMI in the 85th percentile or above), and 12% are considered obese (BMI in the 95th percentile or above) (CDC, 2009). Overweight children have a 70–80% chance of becoming overweight or obese adults, which may lead to an increase in obesity related disease among adults (United States Department of Human Health and Services, 2007). Obesity is one of the leading risk factors for disease and fatal health conditions, such as hypertension, type II diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea and respiratory problems, and some cancers (CDC, 2009). Not only is obesity linked to clinical conditions, but it may also lead to mental health problems such as self-blame and low self-esteem ( Haboush, A., Phebus, T. , Tanata Ashby, D. , Zaikina-Montgomery, H. , & Kindig, K. , 2011). This paper will focus on the contributing factors for the alarming obesity rates amongst Mexican children. Are second generation Mexican children more prone to obesity than their first generation counterparts? Mexican immigrant parents usually don’t view obesity as a threatening health issue. In fact, some research reports that Mexican mothers see childhood obesity as a sign of good heath (Rosas et al. ) and thinness as a sigh of illness (Sosa, 2012). Acculturation, or the process of adjusting to a new culture, describes social, psychological, and behavioral changes that an individual undergoes as result of immigration (Buttenheim, A. , Pebley, A. , Hsih, K. , Chung, C. , Goldman, N. , 2012). The drastic changes in lifestyle and social interactions that immigrants encounter upon arriving to the United States often put them at risk for negative health consequences (Ogden et al. , 2009). Of the negative health outcomes associated with OBESITY AMONGST MEXICAN CHILDREN: ARE FIRST GENERATION MEXICAN CHILDREN 4 MORE PRONE TO OBESITY THAN THEIR SECOND GENERATION COUNTERPARTS?acculturation in Mexican children, obesity is significant because it has implications for development of chronic diseases such as heart disease and Type II Diabetes (CDC, 2009). Mexican children are at increased risk for obesity upon immigration to the United States and are predisposed to development of chronic diseases,(Buscemi, J. , Beech, B. , & Relyea, G. , 2011). Mexican American mothers’ views on obesity, 40% of mothers with overweight children did not identify overweight as a health issue (Ariza et al. , 2004). When weight was used as an indicator of health, parents were more concerned with the health of skinny children than overweight children. Mexican American mothers were concerned with having thin children because a thin child could become sick and die (Small, L. , Melnyk, B. , Anderson-Gifford, D. , & Hampl, J. 2009). A second and less studied mechanism linking nativity of US immigrants to obesity risk is the interconnectedness of the food environment and migration dynamics in the sending country (Buttenheim et al. , 2012). This is particularly relevant in the case of obesity risk for Mexican-origin children in the US, given the large, circular migration flows between the two countries and the well-documented nutrition transition underway in Mexico (Popkin & Udry, 1998). This transition is characterized by a shift from unprocessed and low energy density diets to highly processed, energy dense foods. The transition is due in part to new food marketing strategies and a simultaneous decrease in physical activity that has accompanied urbanization and economic development in Mexico (Popkin &Udry, 1998). Mexico’s nutrition transition has been notably rapid: Mexico now has the second highest rates of adult obesity among OECD (Organization for Economic Co-operation and Development) countries (after the US) (Rosas, 2011). A potential explanation for the increased obesity rates within the Mexican immigrants in the US is acculturative stress (Van Hook et al. , 2011). Mexican-origin immigrants, are often faced with discrimination based on race/ethnicity and immigrant status. This discrimination, in turn, leads to chronic stress and psycho-physiological stress responses, which are known to affect health over the long run . Thus, the process of integration into a society that views Mexican-origin immigrants as being of lower status than other social and racial/ethnic groups may itself result in chronic health problems, even if health behaviors remain constant over time and across immigrant generation. Why would duration of time in the US and immigrant generation affect obesity? The acculturation literature has emphasized the importance of dietary changes by duration in the US and across generation: increased acculturation is hypothesized to lead to decreased consumption of healthy foods and increased consumption of processed high OBESITY AMONGST MEXICAN CHILDREN: ARE FIRST GENERATION MEXICAN CHILDREN 5 MORE PRONE TO OBESITY THAN THEIR SECOND GENERATION COUNTERPARTS? fat/sugar foods. Gordon-Larsen et al. (2003) reported that first generation Mexican immigrant adolescents eat more rice, beans, fruit, and vegetables and less cheese and fast food than second generation Mexican-origin immigrants. Kaiser and colleagues (2007) say that acculturation seems to be a contributing factor for obesity amongst Mexican children. Acculturation can be defined as the process by which immigrants adopt the attitudes, values, customs, beliefs, and behaviors of a new culture. Two studies reported their findings on acculturation and potential implications on the nutritional status of Mexican American children. Kaiser and colleagues (2007) concluded that less acculturated mothers were more likely to provide alternate food choices when a child would not eat and use child-feeding strategies that may contribute to childhood overweight, such as bribes, threats, and punishment. Ariza, Chen, Binns, and Christoffel (2004) conducted a study to test their hypothesis that overweight was more prevalent in highly acculturated Mexican American children aged 5 to 6 years; however, the results did not substantiate an association between overweight and acculturation in this population. Duerksen and colleagues (2007) reported that increased levels of acculturation may lead to higher rates of overweight among Mexican American families if they were eating more meals at fast-food and buffet-style restaurants rather than selecting traditional, authentic Mexican restaurants. Studies indicated that less acculturated Mexican Americans consumed less fat, and more fiber, protein, vitamins A, C, E and B6, folate, calcium, potassium, and magnesium than their more acculturated counterparts (Rosas et al. 2011). Most research conducted across age groups and outcomes indicates that newly-arrived and less acculturated immigrants are healthier and live longer than natives. Unfortunately, this health advantage dissipates with duration of U. S. residence and does not extend to the next generation. In addition to the influence of parents’ acculturation on children’s behaviors, children can accelerate the acculturation process for their families as well because children are more likely to have a consistent exposure to typical American foods at school and likely to affect purchasing decisions of their parents. One of the biggest changes in children’s diets after moving to the United States has been suggested to be with the foods children consume at school. It has been reported that although Mexican American children liked the traditional ethnic foods they received at home, they preferred the American foods they were served at school (e.g. , pizza, hamburgers) (Rosas et al. 2011). Furthermore, there seemed to be a lack of awareness among children about the healthfulness of traditional Mexican foods (such as fruits, vegetables, and beans) or potential health risks of the typical American diet, which was perceived as pizza, hotdogs, hamburgers, and French fries. As children develop their own self and ethnic identities, they may seek separation from their parents and acceptance from their peers, and they may identify fast food and other less healthful food options with the United States culture. This can eventually lead to less healthful dietary patterns both for children and their families because children are likely to affect food-purchasing OBESITY AMONGST MEXICAN CHILDREN: ARE FIRST GENERATION MEXICAN CHILDREN 6 MORE PRONE TO OBESITY THAN THEIR SECOND GENERATION COUNTERPARTS? decisions in their households (Rosas et al. 2011). When looking into the influence of acculturation on food intake behaviors among children and youths, another important element of the social environment must be addressed: media exposure. Media exposure can have detrimental influences at both ends of the spectrum in terms of eating behaviors: children may adopt an unrealistically thin body image through exposure to popular culture, and unhealthy dieting practices or eating disorders may follow. Alternatively, they may increase their consumption of nutrient-poor, energy-dense foods that they are exposed to through advertisements, and this type of behavior may eventually lead to overweight status. There have been some initiatives to limit food marketing aiming at children, but nutritionally poor and energy dense foods (e.g. , high sugar cereals, candy, soft drinks, chips) still constitute the majority of the foods advertised on television (Kunkel et al. 2009). Several reports indicate that children choose advertised foods at significantly higher rates and attempt to influence their parents to purchase these foods. Unfortunately, advertisement of the nutritionally inferior food choices is not limited to television only; it is widespread through a variety of channels such as schools (vending machines, corporate sponsorship of school events and materials, etc. ), and online applications(e.g. , interactive games, sweepstakes, computer screensavers). Media exposure among children has been increasing over the past 10 years, and according to the 2009 estimates (Kunkel et al. 2009). American children spend about 7. 4 hours per day using or watching media such as television, computers, video games or movies. These estimates seem to be even higher among minorities) and individuals with lower socio economical status( SES) (Sussner et al. 2009). Hispanic youths were reported to spend about 5. 5 hours per day watching television while this estimate was 3. 5 hours per day for non-Hispanic whites in 2009. Moreover, screen time seems to increase with greater acculturation (Gordon-Larsen et al. 2003). The data from the 2003–04 National Survey of Children’s Health indicated that, in comparison to U. S. -born non-Hispanic white children with U. S. -born parents, foreign-born Hispanic children with immigrant parents were 31 percent more likely and U. S. -born Hispanic children with U. S. -born parents were 51 percent more likely to watch television. Although foreign-born Hispanics seem to be less likely to consume less healthful foods (Osypuk et al.2009), a reverse trend can be seen if these foods are more expensive in the country of origin but cheaper in the United States. For example, qualitative studies indicated that lower cost and increased availability were among the reasons for Mexican Americans to consume snacks, sweets, and fast food more in the United States . An earlier report pointed out that some foods, such as mayonnaise, margarine, and salad dressing were considered high-status items by many low-income families in Latin America (Romero-Gwynn et al. 1993). Similarly, Mexican adults living in Florida reported that in addition to fast food not being as readily available in their native country, it was more expensive than in the United States and therefore, they tended to eat fast food only for special occasions in their native OBESITY AMONGST MEXICAN CHILDREN: ARE FIRST GENERATION MEXICAN CHILDREN 7 MORE PRONE TO OBESITY THAN THEIR SECOND GENERATION COUNTERPARTS? country. Once these types of foods become more readily available and affordable for the immigrants in the United States, an increase in the consumption levels would be expected. Lower costs, widespread availability, and the convenience of fast food in the United States appear to be an enticing solution especially for time-strapped immigrant families with children (Lindsay et al. 2009). Qualitative studies among immigrants suggest a more relaxed lifestyle in Mexico versus a very busy lifestyle in the United States that leaves less time to cook or prepare foods. This type of lifestyle makes convenience foods very appealing, and it is likely to result in an increase in fast food consumption (Gray et al. 2005). In addition to the economic conditions related to the food environment, limited socioeconomic abilities of individuals also put immigrants at greater risk for unhealthy food intake patterns and entailing health issues. Higher rates of food insecurity and low SES among minorities and immigrants are likely to force individuals to purchase relatively cheaper and filling, but often nutrient-poor, energy-dense foods (Drewnowski and Darmon 2005). A binational study that was conducted in the United States and Mexico provided support for these eating patterns, and it also pointed out the country- or culture-specific variations in these associations. In the United States sample of this study, children with food insecurity were more likely to consume fat, saturated fat, sweets, and fried snacks compared to their food secure counterparts. In Mexico, however, food insecure (versus food secure) children displayed a different food intake pattern that was characterized by higher intakes of carbohydrates, dairy, and vitamin B6 (Rosas et al. 2009). One of the least studied aspects of the relationship between socioeconomic factors and food intake is the residential context and demographic makeup of the neighborhoods. One of the few studies that examined this context in a mostly Hispanic (but mixed ethnic) sample suggested that greater density of immigrants in residential areas was positively related to fruit and vegetable intake after controlling for individual factors such as age, race/ethnicity, language, country of birth, and education (Dubowitz et al. 2008). Another study also reported that high-fat/processed food intake (fats, oils, processed meats, fried potatoes, salty snacks, desserts) was lower in immigrant-dense neighborhoods even after controlling for SES, demographic factors, and acculturation (Rosas et al.2011). These results indicate beneficial dietary intake patterns for all residents (immigrant or not) residing in that area. Some of the potential factors underlying these results could be resulting from socioeconomic advantages through greater social capital, availability of stores with healthier ethnic food options, and higher consumption of healthier food intake habits, social norms, and values in the ethnically dense neighborhoods (Dubowitz et al. 2008). OBESITY AMONGST MEXICAN CHILDREN: ARE FIRST GENERATION MEXICAN CHILDREN 8 MORE PRONE TO OBESITY THAN THEIR SECOND GENERATION COUNTERPARTS? Highly acculturated Hispanic adults were more likely to have higher BMIs than their less acculturated counterparts. Similarly, second or third generation Hispanic youths were reported to be more likely overweight than their first generation counterparts (Popkin and Udry 1998). For adults, the difference in the overweight status by acculturation seems to be seen usually in a range of 10 to 21 years of residence in the United States, but interestingly, BMI differences were detectable by age two among less acculturated mothers’ children in a mostly Hispanic sample (Sussner et al. 2009). Some of the mechanisms underlying these findings could be the existence of cultural beliefs that associate overweight status among children with perception of good health (Sussner et al. 2009), failing to recognize overweight status, or acceptance of a larger body size as a desirable body image among Hispanics. Taken together, these cultural preferences can lead to obesity over time with the additional contribution of the typical environment in the United States that stimulates consumption of energy-dense foods and discourages physical activities. Certain food intake patterns (e. g., energy-dense foods) can lead to overweight or obese status as people acculturate. Although a factor analysis of nationally representative data from the NHANES 2001–02 did not indicate a specific dietary intake pattern in relationship to BMI or waist circumference (as measures of overall or central adiposity) among Mexican Americans (Carrera et al. 2007), it is possible that dietary intake might be related to obesity indirectly, or collectively with other lifestyle factors (e. g. , physical activity). It is also possible that the effects might be most pronounced at specific time periods during acculturation. Supporting this potential mechanism is the results from the National Longitudinal Study of Adolescent Health indicating that increased probability of overweight, which was related to changes in lifestyle factors (i. e. , screen time, diet), was detectable among first generation Mexican adolescents but not among second (or more) generation participants (Gordon-Larsen et al. 2003). Although social economic status (SES) is also linked to obesity, this association seems to vary depending on the SES measures used and also by race or ethnicity. For example, in a nationally representative sample of children, both education and income were negatively related to BMI among non-Hispanic whites, but only income was positively related to BMI among Hispanics (Balistreri and Van Hook 2009). As suggested by the authors, increasing education level may be a reflection of changes in knowledge, learning abilities, social class, and personal skills while higher income among immigrants might be an indicator of greater purchasing capacity, which can result in less healthful eating patterns in the absence of adequate nutrition knowledge, skills, and a healthful food environment. SES also seems to have gender-specific and long-term consequences. Data from a nationally representative longitudinal survey among adolescents indicated that there was a strong positive association between long-term (persistent) low SES and obesity among females. Among males, however, obesity rates were highest among those who had a socioeconomically disadvantaged beginning but gained autonomy, for example, home ownership later on. Most importantly, the report pointed out that the effect of SES on OBESITY AMONGST MEXICAN CHILDREN: ARE FIRST GENERATION MEXICAN CHILDREN 9 MORE PRONE TO OBESITY THAN THEIR SECOND GENERATION COUNTERPARTS?obesity was probably initiated before adolescence (Scharoun-Lee et al. 2009). Conclusion: The research has shown that second generation Mexican children are in fact more prone to obesity than their first generation counterparts. Causative factors such as media exposure, school lunch programs, socio-economic factors, and the influence of parents’ own acculturation into American society are all factors that can be addressed through various means with legislative, policy changes, and education. Then we can begin to affect positively the rising trend of obesity in second generation Mexican children in the United States. OBESITY AMONGST MEXICAN CHILDREN: ARE FIRST GENERATION MEXICAN CHILDREN 10 MORE PRONE TO OBESITY THAN THEIR SECOND GENERATION COUNTERPARTS? References: Abraido-Lanza, A. , White, K. , Vasques, E. (2004)Immigrant populations and health. In: Anderson N, editor. Encyclopedia of health and behavior. Newbury Park, CA: Sage; 2004. p. 533–537. Ariza, A. J. , Chen, E. H. , Binns, H. J. , & Christoffel, K. K. (2004). Risk factors for overweight in 5 – to 6-year old Hispanic American children: A pilot study. Journal of Urban Heath, 81 (1), 150-161. Balistreri, K. , & Van Hook, J. (2007). 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Anti Terrorism

Philosophical arguments Retribution Supporters of the death penalty argued that death penalty is morally justified when applied in murder especially with aggravating elements such as multiple homicide, child murder, torture murder and mass killing such as [terrorism], massacre, or genocide. Some even argue that not applying death penalty in latter cases is patently unjust. This argument is strongly defended by New York law professor Robert Blecker [4], who says that the punishment must be painful in proportion to the crime.It would be unfair that those who have committed these horrible crimes stay alive, even incarcerated. Abolitionists argue that retribution is simply revenge and cannot be condoned. Others while accepting retribution as an element of criminal justice nonetheless argue that life without parole is a sufficient substitute. Human rights Abolitionists believe capital punishment is the worst violation of human rights, because the right to life is the most important, and j udicial execution violates it without necessity and inflicts to the condemned a psychological torture.Albert Camus wrote in a 1956 book called â€Å"Reflections on the Guillotine, Resistance, Rebellion & Death†: An execution is not simply death. It is just as different from the privation of life as a concentration camp is from prison. [†¦ ] For there to be an equivalency, the death penalty would have to punish a criminal who had warned his victim of the date at which he would inflict a horrible death on him and who, from that moment onward, had confined him at his mercy for months. Such a monster is not encountered in private life. 5] This view contradicts classic natural rights doctrine, which stresses that the right to life can be forfeited by grave misbehavior. [3] Practical arguments Wrongful execution Main article: Wrongful execution Capital punishment is often opposed on the grounds that innocent people will inevitably be executed. Supporters of capital punishment object that these lives have to be weighed against the far more numerous innocent people whose lives can be saved if the murderers are deterred by the prospect of being executed. [6] Between 1973 and 2005, 123 people in 25 states were released from death row when new evidence of their innocence emerged. 7] However, statistics likely understate the actual problem of wrongful convictions because once an execution has occurred there is often insufficient motivation and finance to keep a case open, and it becomes unlikely at that point that the miscarriage of justice will ever be exposed. Another issue is the quality of the defense in a case where the accused has a public defender. The competence of the defense attorney â€Å"is a better predictor of whether or not someone will be sentenced to death than the facts of the crime†. 8] Also, improper procedure may result in unfair executions. For example, Amnesty International argues that, in Singapore, â€Å"the Misuse of Drugs Act contains a series of presumptions which shift the burden of proof from the prosecution to the accused. This conflicts with the universally guaranteed right to be presumed innocent until proven guilty†. [9] This refers to a situation when someone is being caught with drugs. In this situation, in almost any jurisdiction, the prosecution has a prima facie case. Racial and gender factors in the United StatesAfrican Americans, though they currently make up only 12 percent of the general population, have made up 41 percent of death row inmates and 34 percent of those actually executed since 1976. [10] According to Craig Rice, a black member of the Maryland state legislature: â€Å"The question is, are more people of color on death row because the system puts them there or are they committing more crimes because of unequal access to education and opportunity? The way I was raised, it was always to be held accountable for your actions. â€Å"[11] As of 2010, women account for only 1. % (55 people) of inmates on death row, with men accounting for the other 98. 3% (3206). Since 1976, only 1. 0% (12) of those executed were women. [12] Deterrence The existence of a deterrence effect is disputed. Studies-especially older ones-differ as to whether executions deter other potential criminals from committing murder or other crimes. One reason that there is no general consensus on whether or not the death penalty is a deterrent is that it is used so rarely – only about one out of every 300 murders actually results in an execution. In 2005 in the Stanford Law Review, John J.Donohue III, a law professor at Yale with a doctorate in economics, and Justin Wolfers, an economist at the University of Pennsylvania, wrote that the death penalty â€Å"†¦ is applied so rarely that the number of homicides it can plausibly have caused or deterred cannot reliably be disentangled from the large year-to-year changes in the homicide rate caused by other factors†¦ The e xisting evidence for deterrence†¦ is surprisingly fragile. † Wolfers stated, â€Å"If I was allowed 1,000 executions and 1,000 exonerations, and I was allowed to do it in a random, focused way, I could probably give you an answer. [13] Naci Mocan, an economist at Louisiana State University, authored a study that looked at all 3,054 U. S. counties over two decades, and concluded that each execution saved five lives. Mocan stated, â€Å"I personally am opposed to the death penalty†¦ But my research shows that there is a deterrent effect. â€Å"[13] Joanna M. Shepherd, a law professor at Emory with a doctorate in economics who was involved in several studies on the death penalty, stated, â€Å"I am definitely against the death penalty on lots of different grounds†¦But I do believe that people respond to incentives. † Shepherd found that the death penalty had a deterrent effect only in those states that executed at least nine people between 1977 and 1996. In the Michigan Law Review in 2005, Shepherd wrote, â€Å"Deterrence cannot be achieved with a half-hearted execution program. â€Å"[13] The question of whether or not the death penalty deters murder usually revolves around the statistical analysis. Studies have produced disputed results with disputed significance. 14] Some studies have shown a positive correlation between the death penalty and murder rates[15] – in other words, they show that where the death penalty applies, murder rates are also high. This correlation can be interpreted in either that the death penalty increases murder rates by brutalizing society, or that higher murder rates cause the state to retain or reintroduce the death penalty. However, supporters and opponents of the various statistical studies, on both sides of the issue, argue that correlation does not imply causation.The case for a large deterrent effect of capital punishment has been significantly strengthened since the 1990s, as a wave of so phisticated econometric studies have exploited a newly-available form of data, so-called panel data. [6] Most of the recent studies demonstrate statistically a deterrent effect of the death penalty. [16] However, critics claim severe methodological flaws in these studies and hold that the empirical data offer no basis for sound statistical conclusions about the deterrent effect. 17] Surveys and polls conducted in the last 15 years show that some police chiefs and others involved in law enforcement may not believe that the death penalty has any deterrent effect on individuals who commit violent crimes. In a 1995 poll of randomly selected police chiefs from across the U. S. , the officers rank the death penalty last as a way of deterring or preventing violent crimes. They ranked it behind many other forms of crime control including reducing drug abuse and use, lowering technical barriers when prosecuting, putting more officers on the streets,and making prison sentences longer.They res ponded that a better economy with more jobs would lessen crime rates more than the death penalty[18] In fact, only one percent of the police chiefs surveyed thought that the death penalty was the primary focus for reducing crime. [19] However, the police chiefs surveyed were more likely to favor capital punishment than the general population. In addition to statistical evidence, psychological studies examine whether murderers think about the consequences of their actions before they commit a crime.Most homicides are spur-of-the-moment, spontaneous, emotionally impulsive acts. Murderers do not weigh their options very carefully in this type of setting (Jackson 27). It is very doubtful that killers give much thought to punishment before they kill (Ross 41). But some say the death penalty must be enforced even if the deterrent effect is unclear, like John McAdams, who teaches political science at Marquette University : â€Å"If we execute murderers and there is in fact no deterrent ef fect, we have killed a bunch of murderers.If we fail to execute murderers, and doing so would in fact have deterred other murders, we have allowed the killing of a bunch of innocent victims. I would much rather risk the former. This, to me, is not a tough call. â€Å"[20] This may be construed as contradicting the traditional legal view of Blackstone and the 12th Century legal scholar Maimonides whose oft-cited maxim is: â€Å"It is better and more satisfactory to acquit a thousand guilty persons than to put a single innocent one to death. Maimonides argued that executing a defendant on anything less than absolute certainty would lead to a slippery slope of decreasing burdens of proof, until we would be convicting merely â€Å"according to the judge's caprice. † Caprice of various sorts are more visible now with DNA testing, and digital computer searches and discovery requirements opening DA's files. Maimonides' concern was maintaining popular respect for law, and he saw er rors of commission as much more threatening than errors of omission. [21] Cass R.Sunstein and Adrian Vermeule, both of Harvard law school, however, have argued that if there is a deterrent effect it will save innocent lives, which gives a life-life tradeoff. â€Å"The familiar problems with capital punishment—potential error, irreversibility, arbitrariness, and racial skew—do not argue in favor of abolition, because the world of homicide suffers from those same problems in even more acute form. † They conclude that â€Å"a serious commitment to the sanctity of human life may well compel, rather than forbid, that form of punishment. â€Å"[6] Use of the death penalty on plea bargainSupporters of the death penalty, especially those who do not believe in the deterrent effect of the death penalty, say the threat of the death penalty could be used to urge capital defendants to plead guilty, testify against accomplices, or disclose the location of the victim's body. Norman Frink, a senior deputy district attorney in the state of Oregon, considers capital punishment a valuable tool for prosecutors. The threat of death leads defendants to enter plea deals for life without parole or life with a minimum of 30 years—-the two other penalties, besides death, that Oregon allows for aggravated murder. 22] In a plea agreement reached with Washington state prosecutors, Gary Ridgway, a Seattle-area man who admitted to 48 murders since 1982 accepted a sentence of life in prison without parole. Prosecutors spared Ridgway from execution in exchange for his cooperation in leading police to the remains of still-missing victims. [23][24][25] Cost Recent studies show that executing a criminal costs more than life imprisonment does. Many states have found it cheaper to sentence criminals to life in prison than to go through the time-consuming and bureaucratic process of executing a convicted criminal.Donald McCartin, an Orange County, California Jurist fam ous for sending nine men to death row during his career, has said, â€Å"It's 10 times more expensive to kill [criminals] than to keep them alive. † [26] This exclamation is actually low according to a June 2011 study by former death penalty prosecutor and federal judge Arthur L. Alarcon, and law professor Paula Mitchell. According to Alarcon and Mitchell, California has spent $4 billion on the death penalty since 1978, and death penalty trials are 20 times more expensive than trials seeking a sentence of life in prison without possibility of parole. 27] Death penalty proponents disagree, saying the study claiming the costs of the death penalty outweigh implementing life without parole is prepared by an anti-death penalty. [28] When califonians voters voted in 2012 about proposition 34, which aimed to abolish the death penalty, the cost was the main argument of proponents of the proposition in theirs TV ads, and was also written on the ballot. The argument may have convinced some death penalty supporters, but the proposition was rejeted with 53% of the vote against it

Accident Prevention Program Essay

The committee is made up of management-designated representatives and one employee-elected representative each from the office, factory and outside sales divisions of our company. Employees in each division will elect from among themselves a representative to be on the committee. If there is only one volunteer or nomination, the employees will approve the person by voice vote at a short meeting called for that purpose. If there is more than one volunteer or nomination, a secret paper ballot will be used to elect the representative. Elected representatives will serve for one year before being re-elected or replaced. If there is a vacancy then an election will be held before the next scheduled meeting to fill the balance of the term. In addition to the employee-elected representatives, management will designate no more than three representatives but a minimum of one who will serve until replaced by management. A chairperson will be selected by majority vote of the committee members each year. If there is a vacancy, the same method will be used to select a replacement. In addition to the committee responsibilities explained above, duties of safety committee members include: A monthly self-inspection of the area they represent Communicating with the employees they represent on safety issues and Encouraging safe work practices among co-workers. The regularly scheduled meeting time is 7:30 am for one hour on the first Thursday of each month, at the employee lunchroom. This may be changed by vote of the committee. A committee member will be designated each month to keep minutes on the attached minutes form. A copy will be posted on the employee bulletin board after each meeting. After being posted for one month, the minutes will be filed for one year. The minutes form contains the basic monthly meeting agenda. (Customize by adding any additional safety committee information that you may have and/or deleting any that do not apply to your company. ) Employee Safety Meetings (Optional for employers with 10 or fewer employees or employers with 11 employees or more who are segregated on different shifts or work in widely dispersed locations in crews of 10 or less) All employees are required to attend a monthly safety meeting held on the first Thursday of each month in the lunchroom. This meeting is to help identify safety problems, develop solutions, review incidents reports, provide training and evaluate the effectiveness of our safety program. Minutes will be kept on the attached minutes form. Meeting minutes will be kept on file for one year. (Customize by adding any additional Employee Safety Meeting information that you may have and/or deleting any that do not apply to your company. ) Hazard Recognition Record Keeping and Review Employees are required to report any injury or work related illness to their immediate supervisor regardless of how serious.

Case study Example | Topics and Well Written Essays - 1250 words - 8

Case Study Example s a partnership with its major competitors like the University Hospitals Health systems (Porter and Teisberg, 12), it can gain several ideas including practices and services offered. Furthermore, there are instances when the patients prefer the main campus, an indication that the services provided at the community and county hospitals are minimal (Porter and Teisberg, 5). Therefore, Cleveland Clinic should also consider addition of new services in community branches. Generally, as a recommendation, Dr. Cosgrove should consider adopting these strategies because they will help in ensuring that the clinic offers more effective services to its patients, and also ensure satisfactory services in community and county hospitals. Cleveland Clinic’s focuses much on retaining and growing the existing clients (Exhibit B). In other words, the clinic aims at providing the best services to the patients so that it can ensure patients’ satisfaction, thereby receiving more new patients or retaining continuing patients. Generally, according to the clinic’s rationale, when it focuses much on the experience that the patient has, then it would be easier to recognize whether the patients get full satisfaction from the services provided. The clinic therefore, focuses on the â€Å"patient first† (Porter and Teisberg, 9) aspect in order to ensure the satisfaction of the patients. As a result, the clinic has applied some strategies, for instance; For years the clinic established an open record policy, but currently the clinic has created a system whereby the records are included online as personal health records. In addition, the clinic, since 2012, has ensured an elevated access to electronic patient information, starting with the lab results. As a result of these changes, patients have an online access to the physicians’ notes for review after a visit. Since the clinic made decision to make it easier for their patients to see the physicians, it came up with a system whereby the

Fact sheet Essay Example | Topics and Well Written Essays - 3000 words

Fact sheet - Essay Example The leaves are also dark green in color which is shiny on the paler underneath and at the top with its petiole section being red and long in size. In the fall, the leaves with smooth margins will usually turn yellow. Habitat: Bigleaf maple grows in moist soils and areas that are shingle and rough in nature. There is a high likelihood of the trees surviving in areas which are next to the lake, river and stream edges compared to other wet regions such as the seepage areas. [1]. The species mostly occurs in mixed group of trees with black, red alder, Douglas –fir, cottonwood, western hemlock and Western red Cedar. Mice, grosbeaks and squirrels usually eat on the seeds of this species while the elk and deer often feed on its twigs. Use: The tree can be used in making of hooks for clothes, dishes and pipes. [1]. They are also used in making of paddles; occasionally, the inner back can be used in making ropes, baskets and whisks which are used for whipping soopolallie berries [1]. Notes: In fact, the Maple flowers are one kind of food that can be eaten with salad together. It is quite sweet. For the bark of the Bigleaf maple trees, it is rich in calcium and moisture because the trees are usually in wet rainforest plant community. It should be noted that the flower of Bigleaf maple just like other Maple is one of the delicious meals that can be eaten together with salad. The bark of the tree on the other hand is rich in moisture and calcium given that they are found within the community of

Discussion part Lab Report Example | Topics and Well Written Essays - 3000 words

Discussion part - Lab Report Example Upon administration of satraplatin, a number of metabolites (JM118, JM383, JM518, JM559 and JM149) are formed (Raynaud et al. 1996). Platinum complexes can kill tumour cells owing to their ability to form various covalent adducts on DNA (Brabec, 2002). DNA conformation is affected by the formation of adducts which also impacts some of the other intracellular processes including DNA damage recognition by specific proteins, DNA polymerisation and repair, all of which contribute to the antitumour activity of the platinum-based compounds e.g., cisplatin (Johnson et al., 1989). Most of the chemotherapeutic drugs that have been found to be clinically valuable act by damaging DNA in proliferating cells. Thus, DNA damage is pivotal to the origin, progression and treatment of cancer. Also, higher the cytotoxicity of the compound, better the efficacy. In the present study, both the Comet assay and the MN technique were employed to assess the genotoxic effects of satraplatin and vinflunine. The comet assay essentially evaluates primary DNA damage, which is reparable, by measuring single- and/or double-strand breaks in individual cells (Collins et al., 1997). Hydrogen peroxide (H2O2) is an oxidising agent that is produced intracellularly during normal metabolism or when exposed to external agents such as solar UV radiation. H2O2 can cause DNA damage through sugar and base modifications (Dizdaroglu, 1992). In this study, human lymphocytes incubated for 30 min with 50ÃŽ ¼M H2O2 showed substantial DNA damage, seen as a 7-fold increase in the mean Olive Tail Moment (OTM) values compared to the control sample (Fig. 1). In those cells that were subjected to a one-hour pre-incubation with satraplatin (0.02ÃŽ ¼M - 200ÃŽ ¼M) a significant reduction in OTM values was obtained. The observed decrease in OTM, ranging from 30% - 75%, was directl y proportional to the concentration of satraplatin used. The mode of action of many

Nursing simulated lesson plan Assignment Example | Topics and Well Written Essays - 750 words

Nursing simulated lesson plan - Assignment Example g lounge so that the rules stipulated in the memo can be reviewed and a thorough checking be conducted in order to ensure that the students have obeyed them to the letter. The historical exercise of â€Å"hands on† teaching in healthcare professions, whereby students learn through practicing on real patients under supervision, may not be justifiable as the principal model for preparing healthcare experts. This challenge could be aggravated by the advance of directed health plans; patients paying for their own healthcare may refuse to serve as â€Å"teaching material,† the price traditionally paid for receiving care at a teaching hospital or public clinic. Consequently, clinical simulation training is needed to avoid of caregivers shortages under such situations ( Riley, 2008). The instructor will listen to how the other clinical students respond to a given incident and provide guidance where needed. The observational notes will be look over during the next class with all students. Clinical students learn in two ways, through text books, and by being in a hospital environment, which allows them to familiarize themselves with real life situations; as such, clinical simulations provide a way for the students to practice in an environment that is comparable to a real life situation. This will better prepare the students for their upcoming healthcare clinical studies (Loyd, Lake, & Greenberg, 2004). The main challenge faced by clinical students is that they are not familiar with carrying out proper procedures during circumstances that are covered in their textbooks, and it is for that reason that clinical students need to be able to have a way to practically apply the proper procedures of the medical field’s practices. The practice of using role-playing scenarios at random throughout a course of study considerably helped students to be prepared to act on any situation as if they were in a real situation ( Sanchez, Ferrin, Ogazon, Sepà ºlveda, & Ward,

Nestle Corporation Assignment Example | Topics and Well Written Essays - 500 words

Nestle Corporation - Assignment Example Most changes in industries are driven by the desires of customers (Doublethink, 2010). In the 1900s the company implemented second order change when the firm transformed from a domestic company into a global enterprise. The organization penetrated new marketplaces by purchasing subsidiaries in the foreign markets. Nestle aggressively targeted the U.S. marketplace during the World War II due to the increasing demand for dairy products. Another second order change that occurred at Nestle was the movement of corporate offices from Switzerland to the United States. The firm’s moves were based on the goal of increasing efficiency and productivity. In 1974 Nestle underwent another second order change when the firm decided to change its strategic approach by implementing a diversification strategy. A diversification strategy captures whatever strategic benefits that exist within a portfolio of businesses and turns them into a competitive advantage for the company (Chaneta). The firm became a major shareholder of the cosmetics company L’Oreal. A second acquisition that increased the level of diversification of the company was the purchase of Alcon Laboratories. Alcon Laboratories is dedicated to the manufacture of pharmaceutical and ophthalmic products. A first order change that the new CEO of the company, Brabech-Letmathe, implemented was the hiring of ten new executives to the executive board.

Blog - how pop culture can change language Essay

Blog - how pop culture can change language - Essay Example (Safire-blog p.355, Â ¶ 3) Blogging has added another space to the means of communication. In fact other Medias now perceive this new trend as a challenge against their business interests. In an article written in Wall street journal, Peggy Noonan explains blogging as a 24/7 opinion site which offers absolute freedom in expressing personal views, anytime anywhere in the world about anything. (Safire-blog p. 355, Â ¶ 1) Most of the other Medias of communication are not giving such freedom in expressing the personal views. Most of the medias will go through the articles and will do little bit censoring if required, before they approve it for publishing. Thus the article writer may not get absolute freedom in expressing their opinions about a topic in other forms of media compared to blogging. Moreover the blogger gets the freedom of publishing the article instantaneously once it is completed where as in other Medias, publishing of an article will take some time depends on how frequently the media engaged in pu blishing activities. For example, news papers normally will publish once in 24 hours whereas weeklies and monthlies will take much longer time for publication. The greatest concern about blogging has come from the traditional Medias. Because of the immense freedom associated with blogging in expressing and publishing personal opinions, the traditional media looks suspiciously at the growth of blogging. But most probably these concerns are meaningless since most of the people are well aware of the lack of authenticity of matters appear on blog sites. The reliability and validity of information appearing on blogs may not be as good as that appearing on traditional Medias. Personal opinions may not be correct always since it lacks supported evidences. (Safire-blog p.355, Â ¶ 4) In conclusion, blogging is one of the

Bridging the Gap Assignment Example | Topics and Well Written Essays - 250 words

Bridging the Gap - Assignment Example On nursing education, the study is vital in reviewing the techniques and physiology of wound healing. Nursing students, while still undergoing training need equipment with full information that relate to the larval therapy as a strategy in debridement of wounds (McFarland & Smith, 2014). Because of the efficiency of larval therapy in aiding treatment of chronic wounds, practicing nurses need an update on the vital features of the technique. Patients who have chronic ulcer wounds may require an enrolment on larval therapy as an intervention plan of management. As a nurse in a general surgical unit, there are diverse methodologies through which I can share the information about larval therapy. Assuming the role of a mentor to my peers in matters that revolve around larval therapy in the management of wounds is an important method (Nickitas, 2014). It will present the opportunity to showcase the procedure and the benefits associated with larval therapy. Another strategy for ensuring that the peers have the full information about larval therapy is by publishing a pamphlet that will act as guidance to the intervention

Whole Foods Essay Example for Free

Whole Foods Essay Whole Food’s chief elements of the strategy are to position the company as a market leader in the natural and organic foods, expand the brand internationally, provide the highest quality, and be the best food retailer in every community in which Whole Foods stores are located. Is Whole Foods’ strategy well matched to market conditions in the food retailing industry (one of the criteria for a winning strategy discussed in Chapter 1)? Whole Foods’ strategy is definitely well matched to market conditions. Currently, there is a huge demand for healthy food. People are more health conscious, expect taste and quality, and look for convenience in shopping. Whole Foods is able to address all the current trends through its strategic vision. The CEO John Mackey’s vision was for Whole Foods to become an international brand, carry the highest quality natural and organic foods, and be the best food retailer in every community. The products are free of pesticides, hormones, and other genetically engineered products that could affect health, community, and agriculture. In addition, Whole Foods is recognized by the USDA as being a Certified Organic grocer by Quality Assurance International. This means that all their products are grown organically; the products are grown without the usage of pesticides, fertilizers, bioengineered organisms, growth hormones, or antibiotics. Whole Foods had successfully addressed the economic conditions of 2008; as sales dropped due to the recession, Whole Foods executives changed the company’s strategy to better match the economic downturn. For instance, they reduced prices of certain foods, offered family sized meals, offered coupons, and managed to cut certain products’ costs. Based on the financial statement data in case Exhibits 9, 10, and 11, how well is Whole Foods Market performing? Use the financial ratio information in Table 4.1 of Chapter 4 (pages 98-99) to assist you in calculating a revealing set of` financial ratios and interpreting them. According to Exhibits 9, 10, and 11, there is an increase of their net income from $136,351in 2005 to $203,828 in 2006. In 2007 and 2008 Whole Foods net income decreased gradually, in 2009 net income increased to $146,804 due to the change in the company’s strategy. According to Yahoo finance net income has been increasing since 2009; in 2011 the company’s net income was $342,612. Whole foods’ balance sheet shows total assets of $3,783,388 and total liabilities of $2,155,512 in 2009. In 2011 total assets were $4,292,075 and total liabilities were $ 1,300,770. Ash The cash flow data shows a net cash provided by operating activities of $587,721 in 2009. Also, the company has invested $386,283 in 2009 as part of the growth strategy. Based on these recent information Whole Foods has recorded a strong financial performance. Fiantial Ratios 2009 Gross Profit Margin= Revenues-Cost of goods sold= $8,031,620-$5,277,310=34.3% Revenues $8,031,620 34.3% is the percentage of revenues available to cover operating expenses. Current Ratio= Current assets =$1,055,380= 1.54 Current liabilities $684,024 Since the current ratio is greater than 1, Whole Foods is able to pay current liabilities using assets that can be converted to cash in the near term. Debt to assets ratio=Total debt = $2,155,512= 0.057 Total assets $3,783,388 This ratio is very low, in other words the company’s operations are not financed through the use of debt.

Pharmacology and Medical Treatment Essay Example for Free

Pharmacology and Medical Treatment Essay Relating course content to the current health care environment is an integral part of your learning. Two (2) application papers are required in this course. These short papers will give you the opportunity to apply course content. They should be approximately 500 words in length each (2 pages). The topics for these two papers are noted below. Refer to at least one outside source in addition to your text as you prepare each of these papers. Application Paper One: New Pharmaceuticals Application Paper Two: Pain Medications The body of the papers should be approximately 500 words (2 pages); there should also be a title page and a reference page. Papers that are too brief or too verbose could be subject to large point deductions. The papers should be uploaded into the appropriate Dropbox. The file should be named [LastName]AP1.doc or [LastName]AP2.doc respectively. Use APA guidelines. APA requires double-spacing, but I will allow 1 ½ spacing if desired. All sources must be cited in APA format. The full reference should be found at the end of the paper. Links to APA reference guidelines are presented at the end of the course syllabus and an interactive tutorial is located in Week 3. Application Paper 1 (Due Week 4): New Pharmaceuticals TCO 2 deals with new experimental drugs and the steps required to bring new drugs to market. The first application paper deals with this as well. Describe the steps that are required to bring a new pharmaceutical to market. Address topics like human testing, the role of the FDA in approving new drugs, and the cost incurred by drug companies when developing new drugs. Application Paper 2 (Due Week 7): Pain Medications Your first paragraph needs to outline the different types of drug to relieve pain. Then, you ONLY select ONE type of pain medication to describe the mechanism of drug action (Pharmacology) and the therapeutic efficacy. Furthermore, you need to discuss the adverse effects, abuse potential, and  toxicities of such type of drug (if applicable). Finally, you will describe your opinion of using such type of pain medication. The two topic papers are worth 140 points (70 points each) and represent 14% of your total grade. Each paper will be graded on the following: Content50 points Grammar/spelling10 points References/citations10 points Based on the following criteria: Content (double points for this category) 1. The paper fulfills the purpose of the assignment as described in the syllabus and in this document (up to 10 points) 2. The introduction leads logically to the main idea or thesis (up to 10 points) 3. Supporting evidence is developed and analyzed sufficiently (up to 10 points) 4. Conclusion provides insightful closure (up to 10 points) 5. The content flows logically and demonstrates an understanding of the topic (up to 10 points) Grammar/Spelling 1. Sentences are grammatically correct (noun/verb agreement, punctuation, sentence structure, etc.) (up to 5 points) 2. Spelling is correct (e.g., homonyms used correctly, no misspellings) (up to 5 points) References/citations 1. Sources are cited in the body of the paper using APA format (up to 5 points) 2. Reference list is included with the paper that lists only sources cited in the document (up to 5 points) Points will be awarded for each criterion on the following scale: 5 points = few or no weaknesses found; writer satisfies the criteria with distinction 4 points = strengths outweigh the weaknesses; writer shows sound understanding of criteria 3 points = strengths and weaknesses are about equal; writer shows awareness of criteria 2 points = weaknesses outweighs strengths;  writer shows limited understanding of criteria 1 point = weaknesses far outweigh strengths; writer does not show understanding of criteria Five points (5) will be deducted for each the following: No title page included Name is not on title page or in document Insufficient number of sources cited (must have at least one in addition to the course textbook) Please refer to DeVry’s Academic Integrity Policy located in the Policies Tab under Course Home in the online classroom. Any suspected violation of the Academic Integrity Policy will be handled according to the policy.

Incorporating Theory And Practice To Achieve Competency Nursing Essay

Incorporating Theory And Practice To Achieve Competency Nursing Essay Dewey (1938) stated that all genuine education comes through experience. Certainly, in practice-based professions such as the health care professions, clinical experience should be the basis for learning. To extract learning from experience, we need to create meaning from our experiences as we interact with and react to, them. We cannot allow any experience to be taken for granted; once we do so, actions become routine and habitual, we stop noticing and enter into a rut (Stuart 2007). Critically discuss this quotation by focusing on the complexity of learning in practice, the complexity of supervisory process and the end goal of creating a competent practitioner. Table of Contents Introduction John Dewey, one of the paramount philosophers and educational theorists of this century, wrote the book Experience and Education, more than 70 years ago, toward the end of his career. The book is based on the principle that all genuine education comes about through experience. Are his ideas relevant to nursing education in this day and age? Can we develop a theory for learning in our workplace? Are all experiences educative? Should clinical experience be the basic of learning? The following assignment shall use these questions as the basis of critical discussion about the complexity of learning and supervising and the formation of competent practitioners. The Maltese Code of Ethics for Nurses and Midwives (1997) seeks to promote the highest level of care delivered by nurses and midwives to their patients. This goal can only be achieved in the nursing profession, by the confluence of the two segments of health care; science and art. It was Florence Nightingale who created the art and science model of professional nursing practice and entrusted it to future generations. Nursing as a science and a profession is characterized by a close relationship between theory and practice (Papastavrou, Lambrinau, Tsangari, Saarikoski, Lieno-Kilpi, 2010), which involves the technological and research aspect of patient care. Conversely, the art of nursing is a more holistic view and takes into account all the patients mental, physical and spiritual needs. Hence, competent professional practice requires educational theoretical knowledge, as well as knowledge gained through hands on experience. Clinical experience and learning in practice Dewey (1998) argued that all genuine education comes about through experience. If Deweys statement is accurate, then why is the number of students attending universities increasing year after year? Why youths do not find employment instead of going to universities if the essential education can be gained directly through work experience? Is it feasible to allocate students in a ward, without any background knowledge about nursing? It is a fact that the knowledge base of nursing can be found in books, journals, and media and in handbooks of practice. On the other hand, Handal and Lauvas (1983) argued that a different component of practical theories is the transmitted knowledge and understanding communicated by others. This is because we pick up others knowledge and understanding together with our own experiences. Bonwell James (1991) stated that research consistently has shown that traditional lecture methods, in which lecturers talk and students listen, dominate university classroom s. Rolfe (1998) added that although this kind of knowledge forms the foundation of the science in nursing, nurses also need to have knowledge about themselves, their own clinical practice and their individual patients, if ever nursing has to become holistic and patient centered rather than disease focused. YourDictionory.com (2010) defines experience as an activity that includes training, observation of practice, and personal participation. Therefore, experience offers opportunities to the student to live through alternative ways of approaching the practice setting. However, nursing procedures, which may initially be taught in university clinical skills laboratories, require more varied and complex skills than can be taught in classrooms. It is not sufficient for a student to learn, for example, aseptic techniques, by reading a book, attending a lecture, or performing a skill in the lab where the environment and role model are perfectly controlled. Although knowledge learnt in the lecture rooms is essential as basic information, performing the skill in real life is something different altogether. For instance, when considering aseptic technique, a student on the wards can actually observe the wound, any odour or exudates, and assess pain whilst answering patient questions. Moreover, Po lanyi (1967) argued that much of the knowledge which inheres in human skill is tacit, and can only be learnt by observation. Thus clinical practice is a combination of practice of skills, the use of tacit knowledge, the use of knowledge about the skill and the use of knowledge of the field of practice (Jarvis, 1992). Besides, Nightingale (1893) as cited by Alliggod and Marrier-Tommey (2006) believed that nursing education should be a combination of both clinical and classroom experience. She states that Neither can it (nursing) be taught in lectures or by books (alone) although these are valuable accessories, if used as such: otherwise what is in the book stays in the book (p.24). In addition, Dewey (1998) further argued that experience alone, even educative is not enough. To a certain extent, it is the meaning that one perceives in and then constructs from an experience that gives the experience value. Consequently, this leads to the role of reflection, where its function is to make meaning out of our experiences. Loughran (2002) acknowledged that reflection is continually emerging as a suggested way of helping practitioners better understand what they know and do, as they develop their knowledge of practice through reassessing what they learn in practice. Moreover, Schon (1983) emphasis that reflection is a way in which professionals can bridge the theory practice gap, based on the potential of reflection to encourage knowledge in and on action. Since reflection facilitates discussion, it promotes the concept of shared learning. Furthermore, Schon (1987) acknowledged that when clinicians are trained to make their knowing in action clear, they can inevitably use this awareness to enliven and change their practice. However, one can argue that reflection is not a natural state or known without someone introducing it, but as Schon stated these systematic processes need to be guided experiences so that practitioners can derive the best possible outcomes from them. On the other hand, Crathern (2001) asserts that once reflective skill is mastered it will not leave the person. Thus clinical supervisors should help and guide students to develop and engage in the process of reflection as a means of deriving knowledge from their clinical experience. The complexity of learning in practice Antonacopoulou (2006) declared that learning is a process as well as a product, a cause, a consequence and context in which life and work patterns are achieved, and in turn organise learning. People have been trying to understand learning for over 2000 years. However, everyone has a different suggestion how to approach learning. Some might argue that learning is an increase in knowledge, that it is memorizing, or that it is acquiring facts or procedures that are to be used. Others may say that learning is making sense or understanding the reality. On the other hand, learning theorists have provided us with a set of ideas about how people learn, to facilitate practical implications for teaching (Darling-Hammond, Rosso, Austin, Orcutt, Martin, 2001). Yet, one must keep in mind that students practice experience is one of the most important aspects of their preparation for registration. Bransford (2000) affirmed that research has found that the brain plays a role in learning. Thus we cannot assume that all students learn in the same way. One must keep in mind that different students have different needs, and the concept that one size fits all is inaccurate. Additionally, if teaching methods do not match a students strength or learning style this may affect learning and behaviour. Mentors should primarily assist students to integrate into the practice setting while continuously providing ongoing support. Through observation, interaction and discovering a students interests, mentors can determine which learning styles would best facilitate the learning process. Novice students require an approach that is supportive, facilitative and structured, where careful monitoring, observation, demonstration and teaching are essential (Benner 1987). Alternatively, more advanced students need to be empowered to provide reflective holistic care. However, communication and an effect ive working relationship is the key to success (Chan, 2002; Papp, Markkanen, von Bonsdroff, 2003; Saarikoski Leino-Kilpi, 2002; Berggren, Barbosa da Silva, Severinsson, 2005). Learning is also based on the associations or connections we make. According to the learning theorist Jean Piaget accessing prior knowledge is how we make sense of the world. We attempt to take new information and fit it into existing knowledge in order to create a schema, or mental map that fits into a specific category. This makes the information more accessible because it is more memorable. On the other hand, workplace learning is of central importance and a crucially important site for learning. Nevertheless, students need to have theoretical background knowledge before working in a ward in order to be more motivated. Additionally, Burns and Peterson (2005) acknowledged that having a good role model is beneficial for the students. However, researchers found that sometimes mentors act as poor role models, where students alleged that they have observed malpractice practice in the clinical area (Rungapadichy, Mandill, Gough, 2004). Consequently, the key to successful practice learn ing lies in the level of support and guidance that students receive from mentors (Block, Claffey, Korow, McCaffrey, 2005 Jones, Walters, Akehurst, 2001) and other healthcare professionals. Gone are the days where students only require friendly or emotional support in practice settings. Besides, they also demand and deserve good quality, appropriately delivered practice learning that challenges the professionals delivering it and develops practice based on theoretical principles (Andrews, 2007). One of Jarvis points is that professionals also learn in situations with routine actions, because they are able to ask questions both about their actions and the attitudes behind them. Along these lines, they are able to regenerate disjuncture (Jarvis, 1999). Yet, can ritualism deteriorate into alienation, where skills will be performed without meaning? Thus it is important to discuss with the students what they want to learn and express their decisions in the form of learning objectives. The sequence of learning tasks should be moved from simple to complex and adequate guidelines and feedback (Darling 1985, Elliott Higgs, 2005) should be incorporated, so that the key points of learning are reinforced. Hammnond, Austin, Orcutt, Rosso, (2001) observed that the different ways people think and feel about their own learning affects their development as learners. Glasersfeld, (1989) argued that responsibility of learning should reside increasingly with the learner. Thus social constructivism is important so that students will be actively involved in the learning process, unlike previous educational viewpoints where the responsibility rested with the lecturer to teach and where students played only a passive role. Therefore, students should be encouraged to develop critical thinking skills and not just emulate the practices they observe. Motivation is another crucial assumption where some might give all the responsibility to learn to the students confidence in their potential for learning. However, one must keep in mind that other underlying problems might be the cause, such as personal problems or stress during clinical placement. Building a good relationship with the mentee can solve such problems, because when students confide their problems, mentors can address them appropriately. This would be supported by Darlings (1984) work, where in her study, after she interviewed 50 nurses, 20 physicians and a number of healthcare executives about their experiences with mentors, she identified that there were three vital ingredients for a mentoring relationship: attraction (admiration for the other person), action (invests time and energy to the relationship) and affect (positive feelings toward the other person). In addition, Prawat and Floden (1994) believed that feelings of competence and beliefs to solve new problems are derived from firsthand experience of mastery problems in the past and are much more powerful than any external acknowledgment and motivation. Consequently, the importance of being good role models is once more being stressed where with appropriate behaviour and attitudes, and with interaction together, the mentee will be helped to achieve the state of a competent practitioner. Strengths, problems, and challenges of learning in practice The clinical environment is a strong provider of learning (Cope, Cuthbertson, Stoddart, 2000). In fact, it is the only setting in which the skills of history taking, skills practicing, clinical reasoning, decision making, empathy, and professionalism can be taught and learnt as an integrated whole. However, common problems with clinical teaching exist such as lack of clear objectives and expectations, focusing on factual recall rather than on development of problem solving skills and attitudes, passive observation instead of active participation from the student, lack of reflection, discussion, and feedback and at times teaching by humiliation. These problems may arise due to time pressure, competing demands (especially when needs of patients and students conflict) and last but not least due to the increasing number of students and lack of mentors. Complexity of supervisory process Ever since research reports appeared to suggest that a theory-practice gap existed in nursing (Alexander 1983), a search has been in progress for new roles for nurses in clinical practice and in nurse education. These roles might ensure that what is taught in the theoretical component of nurse education corresponds, at least to some degree, with what happens in clinical practice. Evidently, the key to progressing from novice to an expert is the key to excellent mentor support (Watson, 2000), otherwise the nursing student may make defective assumptions based on inadequate personal reflections. It is useless having a state of the art hospital learning environment, without having enough supportive mentors who are really interested in mentoring. Such learning environment gives students the opportunity to get the most out of their learning processes and to achieve the objectives of clinical placements. On the other hand, failure to meet students expectations can cause disappointment to students during their clinical placement, where they can proclaim that their experience was unfruitful since for learning to take place, there is the need to create meaning from the experience (1998). Thus, one can question if all mentors are enthusiastic and committed to mentoring. Alternatively, mentorship may be supported, by developing workshops (Howatson-Jones, 2003) and other tools to teach, in order to remind mentors how to optimize their skills and to promote mentors and mentorship. Some authors argue, that the choice of the mentor is crucial to a meaningful supervisory relationship, and that this relationship is integral to the whole supervision process in relation to uptake and effectiveness (Jones A., 2001a; Spence, Cantrell, Christie, Sammet, 2002). However, mentorship in Malta is still in its infancy, and there are not enough mentors to accommodate all the students in the faculty, let alone choosing their mentors. Consequently, the need for more responsible mentors arises. Llyod-Jones, Walters, Akehurst, (2001) in their study of 81 pre-registered students found that those students who did not work with a mentor, were usually not supported by any other trained staff, leading to auxiliary nurse work being delegated to the student. Nevertheless, the system in Malta overcame this problem by giving the opportunity to every student to be mentored by different mentors according to the clinical placement, in most of their clinical placements. The environment itself is a valued characteristic for students to learn, mostly characterised by co-operation among staff, and an atmosphere in which they are treated as colleagues not as an extra pair of hands. The impact of a good ward cannot be overstated, where the philosophy of nursing team affects the ward atmosphere. Pearsy and Elliot (2004) declared that if students observe mentors acting as poor role models it affects the students learning negatively. Thus the supervisor role is to assist the supervisee to apply theoretical knowledge, appropriate attitudes and therapeutic communication into practice. This can only be done through the medium of supervisory relationship, since it is through others that we develop into ourselves (Vygotsky 1981). Mentoring is founded upon relationships between people and, like all relationships, is affected by what each participant brings to the relationship. Openness, self-awareness, and a belief in the value of mentoring are important qualitie s for both mentors and mentees to possess. Competency to mentor is built on a balance of individual cognitive, emotional and relationship abilities; personal virtues or characteristics, such as integrity and empathy, and competencies both within ones field of practice and related to mentorship itself (Epstin Hundert, 2002). The success of clinical supervision depends mainly on the supervisee (Dewar Walker, 1999), and it can be useful if they look at their responsibilities in the role. It is important that students are treated with respect as an equal partner. The primary responsibility of the mentors is for their own development and willingness to learn and change, irrelevant to the extent of experience. Yet mentors serve a variety of roles, including being a professional parent, teacher, guide, counsellor, motivator, sponsor, coach, advisor, role model, referral agent, and door opener. Hence a successful mentor must be capable of blending these roles with other important characteristics such as being patient, available, approachable, respected, people oriented, knowledgeable, and secure in their position, in order to help students in the process of competency. Creating competent practitioners Ensuring competence to effectively and safely practice should be the aim of mentoring, and a critical task for the educators. Kane (1992) defines competence as the degree to which the individual can use the knowledge, skills and judgment associated with the profession, to perform effectively, in the domain of possible encounters, defining the scope of professional practice. On the other hand, domains of competence can be assessed to some degree via direct observation because it provides the opportunity to make multiple assessments over time and across different clinical circumstances. Yet, this is not always possible due to time constrains with the student. Thus the faculty must find another approach how to combine lectures and clinical practice in order to give ample time for the student to work with the mentor. Moreover, another question might arise regarding the system sufficiency in providing competent and safe practitioners. The introduction of mentorship was the first step aiming to provide better competent practitioners. However, there are strategies that both mentors and mentees can employ to ensure that they get the most out of a mentoring relationship. Yet, are there policies in place that support the selection of competent, appropriate mentors? Equally important, is the method of students assessment acceptable? Burns Peterson (2005) declared that the assessment must be on going, where the mentor provides formative assessment in line with outcomes and competencies they are expected to achieve. Thus, locally, the final four hour role play, (where students can be motivated purely by the process of assessment to adapt to what they perceive as the requirements of the assessor rather than moving towards achievement of goals such as independent thinking, problem solving and originality) should not contain too much weight in determining students competence. Hence supervision methods will be more effective if used within the context of a healthy supervisory relationship. Asadoorian Batt ( 2005) acknowledged that self assessment should be the first step in self directed learning. However, self-assessment should only complement and not replace another means of assessment. Portfolios, on the other hand, can address a wide range of competencies because it provides a reflective insight into mentees abilities to self assess and learn from experiences. Conclusion Although experience is extremely important as a means of education, theoretical knowledge must be the basic to prepare students for the clinical practice. On the other hand, the need for nurses to be able to integrate theory and practice effectively has long been recognised. Thus, competent mentors are required to help students in minimizing the theory practice gap. The gap can be bridged through reflection and critical thinking so that experience can be transformed into learning. A good relationship between mentor and mentee is important for learning. Mentees appreciate a learning environment where they have the opportunity to learn, to act professionally and to learn about the values and norms on the ward. Moreover, since nursing is a practical profession, there is a need to ensure that practical assessment systems are able to discern the true knowledge base of students. Alternatively, the key to success is to monitor both student and mentor feedback on the learning practice enviro nment.

The Slaughter House :: Description Essays

The Slaughter House â€Å"Though he was harshly treated, he submitted and opened not his mouth; like a lamb that is led to the slaughter, or a sheep before the shearers, he was silent and opened not his mouth† Isaiah 53:7 Trudging along the dirt road that led down to the abattoir, I was experiencing strong emotions. My stomach churned at the thought of the blood I was likely to encounter during the processing of lambs. I reasoned that to get a valid opinion on the subject, I had to witness the entire process, no matter how unpleasant. As I entered the abattoir I was greeted by Tim, a young graduate student who would be assisting the professor throughout the process. I was told to step into a tray on the floor filled with a disinfectant to prevent the entrance of unwelcomed germs that hid on the bottom of my shoes. I pulled on a long yellow apron and placed a hair net and hard hat on my head. A small class of animal science majors walked in who would also be viewing the slaughtering. The professor and Tim prepared for the process by thoroughly washing and sanitizing all of their instruments, sharpening their knives, and placing hooks on a track overhead that holds the sheep carcass upside down. I stepped outside and saw the four sheep that were to be killed. They were huddled together as if they knew what was to happen and were saying their goodbyes. Tim reassured me they were only afraid of being in a strange, confined space. I stood off to the side as Tim led the first of the sheep inside. The sheep gave little struggle and made no sound. Tim gripped its head tightly as the professor placed a bolt gun on the top of its skull. The bolt gun worked similar to a revolver.

The Tragic Tale of Ophelia and Hamlet Essay -- GCSE English Literature

The Tragic Tale of Ophelia and Hamlet  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     The common problem of lack of communication has plagued couples since the beginning of time. The relationship Hamlet and Ophelia share in Shakespeare’s play, Hamlet, is no more immune to these human tendencies. Throughout the drama, many misunderstandings cloud their relationship. Unspoken problems and pressures within Ophelia’s and Hamlet’s private lives lead to overlooked, unnoticed love. For Hamlet, his bond with Ophelia pales in comparison to the weight of the les talionis obligation thrust upon his soul. Ophelia faces trouble of a different nature. Having been raised to be very obedient to her father and to let him think for her, she is coerced into pushing Hamlet away and not giving into her love. It is the very lack of communication of these personal dilemmas between Ophelia and Hamlet that ultimately leads to Ophelia’s untimely demise and brings Hamlet to the verge of hysteria. In the beginning, Ophelia is first introduced as she is being warned by her brother, Laertes. He tells her to be wary of Hamlet, for his love for her may be short-lived and she is of unequal rank to him. Shortly afterward, Ophelia’s father, Polonius, joins in the crusade, but in a more forceful way. While treating her as if she was a child, he commands her to turn Hamlet away completely. After Ophelia tells him that Hamlet has expressed affection for her, Polonius replies, "Affection! pooh! you speak like a green girl / Unsifted in such perilous circumstance" (1.4.94-95). Thus Ophelia is torn in two different directions—love for Hamlet and obedience toward her father. Since she has been trained since birth, the desires of her father push all other notions aside, and she replies as she ofte... ...e / Whose violent property fordoes itself" stating that he believed Hamlet’s obsession with Ophelia was its cause (2.2.99-100). Finally, it is plainly established as Hamlet leaps onto Ophelia’s grave and declares his love for her. Their obvious love for each other is hidden, however, under a cover called lack of communication. While the couple is torn apart by forces beyond their control, they never tell each other, which leads to misunderstandings between them. To conclude, it is the very lack of communication in a relationship that can lead to misunderstandings that can obscure otherwise tight bonds. In Hamlet, Ophelia and Hamlet are a prime example of this and how it can lead to the ultimate misunderstanding—lost love. Work Cited Shakespeare, William. Hamlet. England in Literature. Eds. Helen McDonnell, et al. Glenview: Scott, Foresman, 1982. 136-201.   

Brave New World Essay -- essays research papers fc

Alduos Huxley, in his science fiction novel Brave New World written in 1932, presents a horrifying view of a possible future in which comfort and happiness replace hard work and incentive as society's priorities. Mustapha Mond and John the Savage are the symbolic characters in the book with clashing views. Taking place in a London of the future, the people of Utopia mindlessly enjoy having no individuality. In Brave New World, Huxley's distortion of religion, human relationships and psychological training are very effective and contrast sharply with the literary realism found in the Savage Reservation. Huxley uses Brave New World to send out a message to the general public warning our society not to be so bent on the happiness and comfort that comes with scientific advancements. Huxley effectively uses distortion in Brave New World in his depiction of Soma as a replacement for religion. Soma is a rationed narcotic that is emphasized by the government to help the people escape from their problems. The people of Utopia have become dependent on the drug to keep them in a constant state of pleasure. In their "perfect" society there is no escape from happiness. The primary example of the degrading effects of Soma is Linda. Brought back from the Savage Reservation after being left behind pregnant, Linda faced many moral and ethical dilemmas she chose to avoid. Her addiction to Soma, which is looked upon as a good thing by everyone except John, brings about the terrible end to her life in which she was in a state of constant delusion. Soma, as Mustapha Mond puts it, is "Christianity without tears" (244). Soma, in effect, is the key to social stability in Utopia. Soma prevents uprisings, saves revolutions and suppresses emotions. Although Hu xley's distortion of religion is powerful, there are other strong arguments in the book. Huxley also uses distortion as a way to make people "see" in his depiction of human relationships. In the book, sex is looked upon as a tool for sharing with multiple partners. The frequency with which people sleep with each other is a disturbing aspect Huxley chooses to portray. Lenina Crowne symbolizes Huxley's portrayal of the complete lack of sexual morals and self-respect. Along with Soma, sexual promiscuity is another form in which the governm... ...George Orwell. Ed. Harold Bloom. New York: Chelsea House, 1986. 52-56. Gardner, Averil. George Orwell. Boston: Twayne, 1987. Harris, Roy. "The Misunderstanding of Newspeak." George Orwell. Ed. Harold Bloom. New York: Chelsea House, 1986. 31-34. Howe, Tom. "George Orwell." British Writers Volume VII. Ed. Ian Scott-Kilvert. New York: Scribner, 1984. 273-287. Kalechofsky, Roberta. George Orwell. Boston: Twayne, 1987. Rahv, Philip. "The Unfuture of Utopia." George Orwell. Ed. Harold Bloom. New York: Chelsea House, 1986. 102-105. Read, Herbert. "1984." George Orwell. Ed. Harold Bloom. New York: Chelsea House, 1986. 86-89. Reilly, Patrick. Nineteen Eighty Four - A Student's Companion to the Novel. Boston: Twayne, 1989. Reiff, Phillip. The Complete Guide to George Orwell. New York: Chelsea House, 1983. 39-49. Roazen, Antonio. Twentieth Century Literary Criticism Vol II: George Orwell. Detroit: Gale, 1979. Williams, T.J. Reader's Guide to Periodical Literature in English: George Orwell. Chicago: FD, 1996. Woodcock, George. "Nineteen Eighty-Four." Reference Guide to English Literature Vol III. Chicago: St. James, 1991. 61-63.

McCrae and Costa’s Concept of Introversion Essay

1.According to McCrae and Costa, Neuroticism are factors or traits characterized by anxiousness, depression, tension, irrational behavior, moodiness, low self-esteem, guilt feelings, worriedness, insecurity nervousness and are high strung. Sabrina would score high in neuroticism because she possesses some of the traits or factors. In the case study, Sabrina is insecure and has a low self-esteem because she is not satisfied with her body and she wishes to have surgery to correct her supposed â€Å"defects† such as her nose too big, her small breast, she looks fat even though she is not, she also wants to look less African-American . 2.Openness to experience according to McCrae and Costa is characterized by factors such as originality, independence, creativity and a daring attitude. Sabrina would also score high on this because she is very original and creative, an example is that when Sabrina dresses up for her job as a waitress, she tries out different roles; wearing loud, flamboyant and gregarious outfits in order to perfect her acting skills. She is also very daring and independent; Sabrina likes to try new things, such as dressing in the bohemian way and incorporating African-American styles as well, she also tries different foods which include Ethiopian food, and she also loves to travel. 3.McCrae and Costa’s concept of introversion and extraversion is very similar to that of Carl Jung. They both see extraverts as outgoing, open, sociable, and lively and oriented to the external world, introverts are seen as shy people. Carl believes that everyone possesses both attitudes and can exhibit both but only one is dominant, and while Eysenck believes that these attitudes or traits tends to remain stable throughout one’s life despite the different social and environmental experiences people have.