Sexuality in Legislation

Title of pending legislation: â€Å"Denouncing the practices of female genital mutilation, domestic violence, â€Å"honor† killings, acid burnings, dowry deaths, and other gender-based persecutions, expressing the sense of Congress that participation, protection, recognition, and equality of women is crucial to achieving a just, moral and peaceful society, and for other purposes â€Å" (Lee, 2011).Advertising We will write a custom essay sample on Sexuality in Legislation specifically for you for only $16.05 $11/page Learn More Introduction The issue of sexuality and its abuse has been in the public debate for quite some time. Sexuality has always been violated and abused since ancient times for self-satisfaction, monetary gains, and political reasons. Currently, there are many crusades on empowering women against human rights violations of their sexuality globally, which are mostly committed during war times and for self-interest, political rea sons, monetary gains, customs, religious beliefs, and negative ethnicity. Subjectively, this legislation is intended to protect women against human rights violation at domestic, community, and international levels while ensuring that they are empowered to enjoy equal rights with men in terms of individual rights and representation in the governments and with proper enforcement of laws by governments to safe guard the fundamental human rights of the women worldwide. The legislation is also aimed at promoting earning level and increasing literacy levels amongst women worldwide with an aim of empowering them reach equality with men. Purpose of the Legislation The legislation is aimed at the Senate and the House of Representatives to formulate more legislation to tackle the problem of human rights violations against women globally. First, it is aimed at ensuring the congress refusal on cruel acts of female circumcision, domestic violence, acid burning, dowry deaths and other gender base d persecutions and crimes while asserting that women are not commodities to be sold, misused, trafficked and they should be given right to education, property ownership and be accorded complete participation in economic, community and political aspects (Lee, 2011). Secondly, the legislation is aimed at ensuring that these cruel practices stop and the social and organizational systems, which promote them, are abolished. In this case, all governments are urged to create laws banning these practices, with the offenders being persecuted and punished accordingly, while measure to empower women and girl child should be put in place (Lee, 2011).Advertising Looking for essay on criminal law? Let's see if we can help you! Get your first paper with 15% OFF Learn More Thirdly, the legislation is aimed at compelling the President to collaborate with other donor countries and regional authorities to promote rights, health and ensure the empowerment of women in all areas of their li ves by influencing foreign aid to developing countries and campaigning against these cruel practices against women, as well as the impunity (Lee, 2011). In addition, the legislation aims at ensuring participation, security, appreciation, stability, and equality in human rights of women and girl child in the society, thus bringing justice and peace to all. Lastly, no matter what religion, location, or nationality, women human rights should not be abused and they should always be respected, supported, and enforced to safeguard against their violation. Level of Success Given the following reasons, the legislation is likely to pass. First, the country has some of the best laws relating to sexuality and gender-based issues, while the congress members are well enlightened on gender issues and the U.S government is always in forefront in promoting democracy with observance of basic human rights. Secondly, the1998 United Nations International Criminal Tribunal for Rwanda set a precedent in international law by establishing and prosecuting rape and sexual violence in times of violent conflict as war crimes and crimes against humanity, thereby, setting the pace for government to formulate, amend and accept international laws on sexuality (Lee, 2011). In addition, there are many international organizations such as FIDA, Amnesty International, locally based NGOs, and human rights advocacy groups operating globally to champion the fight against violation of women human rights and promoting women empowerment programmes. The major challenge to this legislation globally can be the traditions and customs of communities that practice these acts as part of their way of life, while the fundamentalist religious beliefs discriminating against women are so stuck to people who practice these beliefs. Regarding sex and sexuality of the legislation’s audience, the legislation is a bit quiet because the U.S already has many laws as a country relating to sexuality and gender based issues and this legislation is intended for international relations and application.Advertising We will write a custom essay sample on Sexuality in Legislation specifically for you for only $16.05 $11/page Learn More Assumptions of the Legislation First, the legislation assumes that, with the American society being much enlightened on matters relating to sexuality and gender issues, the legislation stands to get enough support in the congress. Moreover, the legislation assumes that after passing, the international community of donors will accept it and be able to influence developing countries to adopt it. In addition, it also assumes that there is much global awareness on matters relating to sexuality violations. Advocacy Groups working for and against the Legislation The bill has been referred to the Subcommittee on Africa, Global Health, and Human Rights; thus, the bill is yet to be published. It will receive much support from Amnesty International based on the argument that it will promote human rights for women and their empowerment globally. However, the bill has received some criticism from some members of the house, some arguing that no person shall be required by the United States or by any State to participate in prayer regarding the issue of saying prayers in school in times of crisis, conflict, or terror. References Lee, J. (2011). Bill Summary Status: 112th Congress (2011 – 2012). H.J.RES.12. Library of the Congress Press. Retrieved from https://www.congress.gov/ This essay on Sexuality in Legislation was written and submitted by user Asia Lott to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Brief Psychotic Disorder essays

Brief Psychotic Disorder essays Another type of psychotic disorder is a brief psychotic disorder. This type of psychotic disorder lasts for at least one day, but not longer than one month. It has a very rapid onset. The strange part of this disease is that there is little or no forewarning that the disorder is coming. Though eventually it will seem as if the disease never existed. The person will return to their prior state of functioning. There are several different symptoms used to diagnose brief psychotic disorder. One or more of these symptoms must be present. The first of these symptoms is delusion. The second symptom is hallucinations. The third is disorganized speech. The patient may slur their words or sound incoherent when talking. The fourth and final symptom is disorganized behavior. This disturbance is very similar to and easily confused with other disorders. Some of the other disorders, which doctors must differentiate between are psychotic disorder due to a medical condition or substance induced psychotic disorder. Mood episodes, schizophreniform disorder, and personality disorder also carry many of the same symptoms. The causes for this brief, yet scary disorder are widely unknown to the medical world. The patients who develop this disorder may actually be biologically or psychologically vulnerable to developing these psychotic symptoms. Stress factors like family conflicts, divorces, accidents, and loss of loved ones can also cause the onset of symptoms. There are also some studies, which point to a genetic predisposition to developing brief psychotic disorder. There are several different types of treatment. Some of the typical antipsychotics, which are used in treating this disorder, are chlorpromazine, thiothixene, and haloperidol. There are also atypical antipsychotics, which include, risperidone and olanzapine. There are some adverse reactions to these drugs. One such reaction is neuroleptic malignant syndrome. This can happen at any ti...

3 Tips to Improve Writing in English

3 Tips to Improve Writing in English The most important rule to writing effectively is to not repeat yourself. Each of these three rules focuses on avoiding repetition in English. Rule 1: Dont Repeat the Same Word One of the most important rules in writing English is to avoid repetition. In other words, dont use the same words over and over again. Use synonyms, phrases with a similar meaning, and so on to spice up your writing stile. Sometimes, this is not possible. For example, if you are writing a report about a specific disease or perhaps a chemical compound, you will not be able to vary your vocabulary. However, when using descriptive vocabulary, its important to vary your choice of words.   We went on holiday to a ski resort. The resort was very beautiful with lots of things to do. The mountains were also beautiful, and, to be honest, there were also many beautiful people. In this example, the adjective beautiful is used three times. This is considered poor writing style. Here is the same example using synonyms.   We went on a holiday to a ski resort. The resort was very beautiful with lots of things to do. The mountains were majestic, and, to be honest, there were also many glamourous people.   Rule 2: Dont Repeat the Same Sentence Style In a similar way, using the same sentence structure by repeating the same structure over and over again is also considered bad style. Its important to know a variety of ways to make the same statement. This is often referred to as using equivalencies. Here are some examples  of similar types of sentences using different equivalencies to vary the style. The students studied hard as the test was sure to be difficult.They reviewed the grammar in great detail due to the many exceptions.Sentence structure was reviewed, for it was sure to be on the test.As they had covered all the materials, the students were assured success. In the four sentences above, Ive used four different variations on because. Sentences one and four use subordinating conjunctions. Note that the dependent clause can begin the sentence if followed by a comma. The second sentence uses a preposition (due to) followed by a noun phrase, and the third sentence uses the coordinating conjunction for.   Heres a quick review of these forms: Coordinating Conjunctions - also known as FANBOYS. Combine two simple sentences with a coordinating conjunction preceded by a comma. Coordinating conjunctions can NOT begin a sentence.   Examples The weather was very cold, but we took a walk.She needed some extra money for her vacation, so she found a part-time job.The toy was broken, for the boy had thrown it against the wall. Subordinating Conjunctions - Subordinating conjunctions introduce dependent clauses. They can be used to begin a sentence followed by a comma, or they can introduce the dependent clause in the second position without using a comma. Examples Though we need to review the grammar, we decided to take the day off for some fun.Mr. Smith hired a lawyer as he needed to defend himself in court.Well take car of the problem when John returns. Conjunctive Adverbs - Conjunctive adverbs begin a sentence linking it directly to the sentence before. Place a comma directly after the conjunctive adverb. Examples The car was in need of repair. As a result, Peter took the car into the repair shop.Its very important to study grammar. However, knowing grammar doesnt necessarily mean you can speak the language well.Lets hurry up and finish this report. Otherwise, we wont be able to work on the presentation. Prepositions - Prepositions are used with nouns or noun phrases NOT full clauses. However, prepositions such as due to or despite can provide a similar meaning to a dependent clause.   Examples Just like our neighbors, we decided to put a new roof on our home.The school decided to fire the teacher despite the students protest.As a result of poor attendance, well have to repeat chapter seven. Rule 3: Vary Sequencing and Linking Language Finally, when writing longer passages youll be using linking words and sequencing to connect your ideas. As in word choice and sentence style, its important to vary the linking language you use. For example, there are many ways to say next. If you are providing instructions, try to vary the words you use to take someone through each step in the process.   Instead of writing: First, open the box. Next, take out the equipment. Next, insert the batteries. Next, turn the device on and begin work. You could write: First, open the box. Next, take out the equipment. After that, insert the batteries. Finally, turn the device on and begin work. This is a just a short example to give you an idea. Try to vary the sequences, or linking language you use in each paragraph. If you use first, secondly, thirdly, finally in one paragraph, switch it up and use to begin with, next, after that in another paragraph. Follow the links in this article to study each of these variation types in more depth and you will quickly improve your writing style through variety.

Other than the September 11, 2001 attacks, and later than 2000, Term Paper

Other than the September 11, 2001 attacks, and later than 2000, identify and describe one event that has influenced (changed, modified, added, subtracted) homel - Term Paper Example Hurricane Katrina turned out to be the worst thing that could happen to our homeland and the pieces were left for Department of Homeland Security to pick up. Katrina was a category 4 hurricane and FEMA, part of the Department for Homeland Security, reacted to it according to a prepared plan. But nothing could have prepared Americans for the destruction brought on by the hurricane. No one had anticipated the ruin and damage (Borja 2008). Before the development of one Department of Homeland Security, these activities were carried out by more than 40 federal agencies. Although there had always been talk of bringing all of them under one banner; the need for one entity was truly felt after the 9/11 attacks. A March 2001 bill proposed that FEMA, Border Patrol, Customs along with several other offices be merged into one agency that will be responsible for all security related services for homeland. The Office of Homeland Security was announced 11 days after the 9/11 attacks. Its main purpose was to safeguard the country against any threats of terrorism is the future (Borja 2008). This report will discuss how the hurricane forever changed homeland security and led to the introduction of a whole new set of previously ignored challenges. Hurricane Katrina was unprecedented due to its sheer force and size. It was a huge challenge and the most destructive event in American history. It challenged our disaster response capabilities to the extreme and brought out the deficiencies in our nation’s preparedness and response facilities (Townsend 2006). According to a presidential address in 2002, the Department of Homeland Security had four goals that became the responsibility of four of its divisions accordingly. The Border Security Division is responsible for guarding the borders and preventing terrorists from entering the country. The Emergency preparedness and Response Centre has to work in tandem

Enhancing Employability in Marketing Essay Example | Topics and Well Written Essays - 2000 words

Enhancing Employability in Marketing - Essay Example The world has achieved tremendous grounds in the technological advancement and therefore much of the marketing is done through technology based communication (Clark 2004, p. 203). As such, a little creativity is needed which will determine whether graduates secure jobs and afterwards they can keep them by being able to perform. Bolstering a marketing degree with other professional qualifications related to finance is also important so that potential employers can be attracted to your technical capabilities in marketing (Gibbs, Steel & Kuiper 2011, p. 379). Current Employability/Graduate Trends in Marketing According to recent studies and research in the job market, marketing careers are on the increase whereas other careers are decreasing. This is a good indication that the marketing industry is growing and opening new areas for graduates to work and explore. Despite the fact that many industries have recently undergone serious cutbacks during the previous economic hard times, market ing is still an important aspect of firms. Marketing forms the basis of attracting and selling a firm to new clients while still maintaining the already existing clientele. It follows then that in the face of a shrinking economy and earnings, firms have to invest in marketing in order to keep afloat in the corporate world. Thanks to technology, the marketing can be simple or complicated depending on the amount of capital available (Bennett 2002, p. 464). Gone are the days when business directories were the major modes of advertising a business. With the advent of the internet, marketing campaigns have become relatively easy because all that a firm needs is to open a website and upload all its required information there. In the past, business firms needed to spend a lot of capital in sending mail to their customers. When potential customers go online to search for goods and services, there is are huge potential that is created for sales both now and in the future. These adverts are c reated by marketing career people because they know what the client wants and they understand their goods and services. As such, being able to understand the market trends and having IT skills is very important in the marketing filed (Achrol & Kotler 1999, p. 152). Recent changes in the way business reposition themselves for competitive advantage has led changing trends on what is required of marketers. Marketing people must also change with time and adapt to the new market demands by first becoming technology savvy. This entails being able to develop and implement all the different ways in which business can market themselves through technology. The jobs in marketing can be very vague (generalized) or specialised depending on a business’s size. In large business firms, there are many activities and campaigns that need coordination and therefore they usually need specialized marketers. On the other hand, small business outfits need a marketer who is able to handle all forms o f challenging marketing problems with no specialized training. However, some firms usually need a marketer who can popularize their goods and services to the general public without much use of resources or technology (Brousseau, Driver, Eneroth & Larson 1996, p. 59). Career Paths of a Marketing Degree Marketing as course encompasses a wide array of activities that are related to conceptions about the delivery of goods and services. In this regards, there are many options in which career paths may be oriented

Learning Outcomes Assessment for Student Nurse

Learning Outcomes Assessment for Student Nurse Learning Outcome 1 – Pre-assessment The ultimate goal of the pre-assessment is to assure that those patients identified as suitable for day surgery are properly identified while those considered unsuitable for a selected procedure are identified early enough in the process to allow for other treatment options (National Health Services, n.d.a, p. 13). Although ultimately it is a joint decision between the surgeon and anaesthetist who make the final determination (National Health Services, n.d.b), the nurse plays a vital role in the process and should be involved in the selection criteria (Royal College of Nursing 2004, p. 1). Pre-assessments of patients scheduled for day surgery are usually performed by an outreach nurse from a day surgery centre, by telephone screening, or by questionnaire (National Health Services, n.d.a, p. 9) or via appointments with day surgery staff or in specialized pre-admission clinics (Joanna Briggs Institute 2004, p.2). Many institutions are combining pre-assessment interviews with the opportunity to work with the patient in a preoperative education status in order to decrease patient anxiety, assess the needs of the patient and/or family members and to personalise information (Joanna Briggs Institute 2004, p.2). The National Health Services (n.d.a, p. 11) states this is an effective opportunity to also discuss the surgical procedure in greater detail with the patient, note special requirements for admission, surgery and/or discharge and allow the patient to choose their own date for surgery, finalizing and/or setting the appointment. According to the Royal College of Nurses (2004, p. 3), nurses performing the pre-assessments must have the option of being able to contact the anaesthesiologist of surgeon if a problem is identified that could potentially increase the risk during anaesthetic or surgical intervention.† This is critical; otherwise, there is no apparent reason for the assessment if the nurse cannot raise her concerns. The National Health Services (n.d.a, p. 9) day surgery guidelines state pre-assessments performed as soon as possible following the surgical consultation can allow for treatment of underlying physical issues that might preclude them from the day surgery procedure, such as high blood pressure and/or arrange for home care. If this is not possible, the National Health Services (n.d.a., p. 13) recommends that patients should then complete a â€Å"health-screening questionnaire before leaving the outpatient department.† According to the National Health Services (n.d.a., p. 11), incorporating the pre-assessment step in the day surgery process has been shown to reduce surgical cancellations and increase communication across the multidisciplinary team. Based on research, it is important to note that the day surgery pre-assessment is a valuable tool that can help the patient, the perioperative and surgical nursing teams as well as surgeons and anaesthesiologists. The pre-assessment is a way of initiating a comprehensive set of documentation for the entire team. Learning Outcome 2 – Effective communication According to the Joanna Briggs Institute (2004, p. 4), caseload can determine the staffing mix required. The staffing mix for a day surgery centre, however, can vary from a group of individuals who work together on a regular basis such as the case in a specialized clinic setting to a group of individuals who rely on departmental shift staffing for perioperative nurses and surgical residents in a busy teaching hospital. No matter what the group mix is, however, the need for communication is critical to patient care in all settings, especially surgical, where according to Cowen et al. (2005) communication is especially challenging for workers in environments that are high stress and time sensitive. Vazirani et al. (2003, p. 72) states that improving the level of collaboration, not just communication, can enhance job satisfaction among medical professionals while increasing the quality of care and patient satisfaction. While traditional communication techniques such as â€Å"active listening, positive voice tone, [and] reiteration to confirm understanding† are desirable goals, in the surgical setting other barriers often compound communication problems, including status and posturing between doctors versus the communication found between doctors and nurses or nurses and nurse practitioners. Vazirani et al. (2003, p. 72) discuss the care nurse practitioners took â€Å"not to violate the autonomy of residents or interns [and] did not admit patients on their own or write orders without the consent of a resident or an intern.† Essential to a multidisciplinary team is the need for collaboration, where decision-making is a shared event for doctors and nurses and that open communication between the two professionals exists (Vazirani et al. 2003, p. 73). It is important to note that research demonstrates physicians view collaboration differently than nurses, such that physicians believe collaboration implies â€Å"cooperation with follow-through† pertaining to following orders rather than sharing in the decision making process (Vazirani et al. 2003, p. 75). Vazirani et al. (2003, p. 76) also cited nurses as not being provided timely or accurate information regarding patient information when physicians autonomously make a change in their normal protocol, stating nurses need the information most as they are the ones at the patient’s bedside. Communication is a commonly sited problem and is one that, despite all the best suggestions and recommendations, from outlining roles and responsibilities, collaborating as a team or mutual team members each afforded appropriate professional respect (Vazirani et al. 2003) to developing Integrated Care Pathways (ICPs) as outlined by Fisher and McMillan (2004) is difficult to remedy. Ultimately, human emotions and professional pride create unnecessary friction that discourages open communication for fear of reprisal. Cowen et al. (2005) emphasize the need for an accurate flow of information between various disciplines as the most critical aspect in order to assure patient safety. Learning Outcome 3 – Patient selection criteria Patient selection criteria primarily focus on three primary factors: surgical, medical and social (National Health Services, n.d.a, p.11; National Health Services, n.d.b.). Surgical criteria assess whether the procedure will leave the patient dependent on others and/or if it has a statistically significant postoperative morbidity level. The National Health Service (n.d.b.) states that the surgical procedure should take less than 1 hour, involve minimal blood loss, be unlikely to produce severe post surgical pain or nausea and be unlikely to result in a loss of physical independence. When assessing social appropriateness, according to the Association of Anaesthetists of Great Britain and Ireland (cited by Joanna Briggs Institute 2004, p. 2), the pre-screening interview is an opportunity to assess the patient’s willingness to have surgery, the certainty of adult care in the home following surgery, telephone access and taking into consideration the patient’s home situation. For example, are there several young children and toddlers or infants at home requiring constant care; is the only adult available to help the patient an elderly or frail individual, or has the patient stated they feel they are being pressured into having the surgery. These are all reasons that should be presented to the surgeon, anaesthesiologist and the rest of the multidisciplinary team as reasons the patient should be precluded from day surgery. Additionally, patients with a social history of significant levels of alcohol consumption and/or who smoke are indications of potentia l preclusion or the need for additional counselling prior to surgery (National Health Service n.d.b.). The Royal of College of Nurses (2004) also states that the patient must have the availability of an escort home following surgery and that the travel time home must be within one and a half hours; and if small children are present in the home that a caregiver is available specifically to tend to the children. Medically, it is important to assess cardiac fitness, assurance of height/weight appropriateness and if they are â€Å"physiologically under 70 years of age[1].† Exclusions are usually automatic if there is uncontrolled hypertension, recent history of cardiac failure, pregnancy, angina, asthma, diabetes or epilepsy. Additional issues that require notification of the appropriate medical personnel include prior difficulties with anaesthesia or current medications that would either preclude day surgery or require either a modification and/or temporary cessation of the pharmaceutical agent, particularly warfarin. The American Society of Anaesthesiologists’ (ASA) (cited by The Royal College of Nursing 2004) uses three classifications to assess physical status: Class 1: patient is mentally and physically fit and the surgical procedure is localized without systemic disruption, for example, removal of a uterine fibroid in an otherwise healthy female or the repair of an inguinal hernia in a healthy individual. Class 2: patient suffers from mild to moderate systemic pathology that is either caused by the pathology to be treated by the day surgery or by other pathology, for example anaemia or mild diabetes or slightly limiting organic heart disease. Class 3: patient suffers from a severe mental or physical disorder from whatever cause, such as angina pectoris, moderate to severe levels of pulmonary insufficiency, vascular complications from severe diabetes or significantly limiting heart disease. Criteria used for patient evaluation and assurance of fitness for day surgery as outlined above are focused primarily on the suitability for general anaesthesia without complication. It is essential however, to couple both the individual patient status as provided by the pre-assessment with the type of surgical intervention proposed. The medical professional cannot use the same set of pre-assessment criteria for all patients for all procedures; they must simply be a guide. For example, physiological trauma, anaesthetic requirements and post-operative pain are different for those having arthroscopy as opposed to a laparoscopic cholecystectomy or partial thyroidectomy. All three are considered day surgical procedures by the Royal College of Nurses (2004, p. 2). Patient selection criteria are important for nurses to understand from many aspects. The nurse has to understand the physician’s reason for suggesting day surgery for their patient, she needs to understand the surgeon’s belief in appropriateness and she has to understand the potential risks that are often overlooked by physicians and surgeons that now become her responsibility to ascertain. Although it is often a delicate position for the nurse to be in, it is essential that she bring to the surgeon or anaesthesiologist’s attention any patient not appropriate for day surgery. This is an issue of legal liability for all professions on the multidisciplinary team and for the clinic or hospital as well as one of ethical concerns for the patient’s overall care and wellbeing. Learning Outcome 4 – Pain management According to Lipp and Yap (2005, p. 64) prior to 2003, the responsibility for post-surgical pain was the sole responsibility of the anaesthesiologist and no routine or regular pain assessments were conducted. In 2003, pain management assessments and the nursing role in pain management in the day surgery setting became the standard. The Royal College of Anaesthetists (as cited by Lipp Yap 2005, p. 64) tell us that following a day surgical procedure, less than five percent of all patients should experience severe pain while up to 85 percent will have mild or no pain following surgery. Beauregard et al. (1998, p. 309) believes that it is not unusual for pain to persist during the entire week following surgery, but that the best predictor of significant post-surgical pain following hospital discharge was inadequate pain control during the first few hours of following surgery. Research has acknowledged that the longer an individual is experiencing pain that is not attended to or interrup ted in some way, the more sensitive to painful stimuli the patient becomes (Mukherji Rudra 2006, p. 355). Ultimately, the goal of effective post-surgical pain management is to be â€Å"safe and effective, produce minimal side effects such as nausea. It was stated that the criteria for patient selection should be individualized based on patient status and type of surgery. Similarly, Mukherji and Rudra (2006, p. 355) state that patients should be identified as potentially at risk based on â€Å"age, physical status, presence of pre-existing pain, site and extent of surgery.† Additionally, researchers believe that the amount of postoperative pain a patient experiences is also a factor of the surgeon and surgical techniques used ( Mukherji Rudra 2006, p. 356; Chung et al. cited by Beauregard et al. 1998, p. 305). Mukherji and Rudra (2006, p. 355) discuss several pain assessment tools: the visual analogue scale (VAS) where pain is rated along a continuum from â€Å"no pain at all to the worst pain imaginable† and the Oucher’s scale for children. Many patients themselves downplay post-surgical pain for reasons ranging from believing that pain is part of the natural recovery process and what they are experiencing is normal (Beauregard et al. 1998, p. 209). Post-operative pain management can take different forms, including pre-emptive analgesia and prophylactic analgesia (Mukherji Rudra 2006, p. 356). There are also pharmacologic and non-pharmacologic pain management interventions. Pharmacological interventions can be opioid or non-opioids. Opioids are centrally acting and systemic in nature whereas non-opioids are also centrally acting but have a peripheral mode of action, and include codeine, metamizol, paracetamol and non-steroidal anti-inflammatory (NSAIDS) (Mukherji Rudra 2006, p. 356). Another problem cited by the Joanna Briggs Institute (2004) is that of inadequate pain management techniques and/or follow-through by the patient place additional burdens on family caretakers and the community at large. For example, Girgis and Sanders (2004, p. 66) tell us that parents generally underestimate and under treat pain; this can be extrapolated to caregivers in the adult community as well. Home caregivers failing to recognize and/or intervene in pain management is often problematic and it is the responsibility of the nurse to assure that proper discharge information is adequately communicated to the patient and/or caregiver/escort, including proper pain management techniques and interventions. To assure there is no confusion, these should be clearly documented and reviewed with the patient and caregiver verbally. References Beauregard, L., Pomp, A. Choiniere, M., 1998. Severity and impact of pain after day surgery. Canadian Journal of Anesthesia, 45 (4), pp. 304-311. Fisher, A. McMillan, R., 2004. Integrated care pathways for day surgery patients. British Association of Day Surgery [Online]. Available from: http://www.bads.co.uk/pdf%20files/IntegratedCarePathways.pdf [cited March 17, 2007]. Girgis, M. Sanders, D. 2004. Are we giving our children the right dose? The Journal of One-Day Surgery, 14 (3), pp. 65-68. Joanna Briggs Institute, 2004. Management of the day surgery patient [Online]. Joanna Briggs Institute Best Practices. Available from: http://www.adsna.info/attachments/BPISSup.2004.pdf [cited March 17, 2007]. Lipp, A. Yap, H, 2005. Is our pain relief protocol effective? The Journal of One-Day Surgery, 15 (3), pp. 64-66. Mukherji, S. Rudra, A., 2006. Postoperative pain relief for ambulatory surgery. Indian Journal of Anaesthesia, 50 (5), pp. 355-362. National Health Services, n.d.a. Day surgery pre-assessment: A brief guide [Online]. Available from www.wise.nhs.uk/surgery/NationalGoodPractice/downloads/14/14d4.doc [cited March 17, 2007]. National Health Services, n.d.b. Day surgery: A good practice guide [Online]. Available from: http://www.wise.nhs.uk/sites/crosscutting/access/Access%20Document%20Library/1/Day%20Surgery/Day%20Surgery%20Guide.pdf [cited March 17, 2007] Royal College of Nursing, 2004. Day surgery information: Selection criteria and suitable procedures [Online]. Available from: http://rcn.org.uk/publications/pdf/daysurgery_selection.pdf [cited March 17, 2007]. Society of Critical Care Medicine, 2005. Tools for effective communication [Online]. Society of Critical Care Medicine. Available from: http://www.sccm.org/SCCM/Publications/Critical+Communications/Archive/February+2005/communicationsfeb05.htm [cited March 17, 2007]. Vazirani, S., Hays, R. D., Shapiro, M. F. Cowan, M., 2005. Effect of a multidisciplinary intervention on communication and collaboration among physicians and nurses. American Journal of Critical Care, 14 (1), pp. 71 – 77. 1 Footnotes [1] According to the National Health Service (n.d.b), the phrase refers to a patient who is â€Å"independent, active and compos mentis.†

Preschool Literacy Essay

2 This paper is going to outline the myriad of benefits that high-quality preschool literacy programs will afford families, communities, school districts and the world. Today, numerous researchers are delving into HOW to establish an effective and successful pre-school program. In this paper, I hope to answer several questions: ? What is pre-school literacy? ? What benefits do participants in a preschool program receive? ? HOW do we go about establishing a high-quality pre-school literacy program? I am rather passionate about this area. Being a speech pathologist, literacy skills and communication skills are so interwoven it is difficult to separate them. I have to say that while going to school many years ago, we didn’t learn that much about literacy as it related to speech and language development. It is only recently that researchers and educators have identified the importance of how both developmental areas are linked. I feel that establishing successful and highly effective programs that incorporate family and child directed activities are crucial to the success of our young students. That being said, let’s explore pre-school literacy. What is preschool literacy? Most people hear the word ‘literacy’ and equate that with ‘reading’. This would be an adult analogy. For very young children, we don’t, nor should we, expect them to read! Early literacy skills refer to many different things, none of which is sitting down with Mom at the age of two and reading aloud for her. At the youngest ages, early literacy skills refer to children’s exposure and experience with books. The following list is derived from Schickendanz (1999) and Early Literacy (www. zerotothree. com) . It states that early literacy behaviors include: ? Book handling behaviors – handling and manipulating the book ? Looking and Recognizing- how are they paying attention to the book, pictures, words; demonstrating recognition of pictures, etc. ? Picture and Story Comprehension – Imitation of actions noted in a story, talking about a story ? Story-Reading Behaviors – verbal interactions with the books, imitating a pointing a finger at words and/or pictures. ‘Establishing strong early literacy behaviors is essential to literacy development and should be the focus of early language and literacy programs’ (Early Literacy, 2003) It is suggested that these skills develop naturally and unfold as a result of social interactions with parents and caregivers, rather than direct instruction. I agree with this statement wholeheartedly. Ideally, it is everyday interactions with infants and toddlers that include talking and book reading that help establish the crucial beginning stages of literacy development. I recently heard on a radio program (can’t cite it) that children between the ages of 0-3 years should hear approximately 30,000 words a day to build an effective vocabulary! Amazing. Todd Risley, co-author of Meaningful differences in the 3 everyday Experiences of young American children (Mangione, 2005), states that isn’t an intentional teaching of these behaviors but rather embedded in the social interactions. He believes, as do I, that oral language skills appear to be the basis of phonological processing skills, which is a strong indicator for reading readiness in kindergarten. As children move into the preschool realm, (typically described as ages 3 through 5), prereading skills are developing along a continuum, rather than as a set of discrete and separate skills. In the article Critical Issue: Addressing the literacy Needs of Emergent and Early Readers (www. ncrel. org), the authors made a very interesting point I’d like to share with you. They discussed the various stages of literacy development that are not relevant to this article, however, an important transition occurs when a child’s â€Å"‘reading’ of a story changes from sounding like oral language to sounding like written language. This demonstrates a change in ideas from thinking of reading as spoken words to understanding that reading is recreated from written text that has special wordings† (McGee & Richgels, 1996;Sulzby, 1991). It is the beginning of the child’s print recognition. With respect to specific pre-school literacy behaviors that we should see addressed in a high-quality preschool program, the most important would be: ? Oral Language- engaging in rich conversational exchange with students, developing oral vocabulary, reading aloud daily, having children develop their own stories by looking at pictures (Tomie DiPola books are excellent for this) ? General Knowledge – what prior knowledge are the student’s coming into school with that they share, encouraging questions and new experiences with in the classroom, ? Print Awareness- being exposed to various written materials, some repetition of early literacy behaviors, point/drag techniques while reading ? Alphabet knowledge – the ABC song, recognizing sounds that letters make, letter recognition. ? Phonological awareness- Increased awareness of the sounds of the letters and how to play with them through rhyme, segmenting, blending, ? Pre-writing skills – later stages of development and exposure to writing mediums (pen, pencil, crayon, markers, paint), using journals with self-made pictures, word walls. (Roskos, K; Christie, J, Richgels, D, www. naeyc. org) How do participants in high-quality preschool programs benefit? I think I could go on for days about the benefits of an excellent preschool experience. For the sake of brevity, I won’t! Numerous studies have been conducted to determine whether preschool programs are beneficial and cost effective. The majority of studies suggest the answer to that is an overwhelming YES. 4 The Chicago Child Parent Center (CPC), the High/Scope Perry Preschool Program and the Abecedarian Project are all examples of highly qualified preschool programs. The CPC is recognized by the US Department of Education as an exemplary early childhood program. A comparison of the benefits of these programs was conducted, yielding what I thought were incredible results. These programs have been in effect since the 1960’s, servicing low-income areas in Chicago and Michigan (Lee, J, www.ccsso. org). In a speech given by Dr. W. Steven Barnett of the National Institute for Early Intervention Research in 2006, three separate studies compared the results of participants enrolled in the above-mentioned preschool programs against a control group that wasn’t enrolled in any preschool program. Their longitudinal studies revealed amazing results, which are credited to the attending of the preschool programs. According to them, participants in the program (as compared with non-participants): ? Were less likely to be enrolled in special education ? Had a higher rate of high school completion ? Demonstrated higher test scores ? Were less likely to repeat a grade ? Had increased earning after completing high school ? Engaged in less criminal activities ? Had a lower incidence of smoking, pregnancy and abortion. These benefits did not stop at the poverty line. They also demonstrated that middle class children benefited from the experience as well. He discussed the well-known fact that disadvantaged children benefit more when they are in class with children from different socio-economic backgrounds. An analysis I found very interesting was that ‘For every dollar invested into the preschool programs described in this paper $7 is saved in public expenditures’ (Lee. www. ccsso. org). WOW, think what that could mean to a superintendent’s budget! When trying to determine whether a preschool program could benefit those in the middle class, the US Dept. of Education, NCES, (1997) article entitled Dropout rates in the United States:1995 determined that middle class children have fairly high rates of the problems that preschool reduces for low-income children. While benefits decrease gradually with an income increase, the overall benefits are greater when ALL children are exposed to PreK. In an evaluation of 5 state prek programs conducted by Barnett,W. S, Lamy, C. and Jung, K. (2005), results revealed that in all programs, whether universal or targeted, students demonstrated gains in language, literacy and math. While all students (various SES backgrounds) gained, the low-income students gained more. Soooooo†¦Ã¢â‚¬ ¦ 5 How do we go about establishing high-quality preschool literacy programs? In an ideal world with unlimited funding, it wouldn’t be too difficult. However, we don’t live in an ideal world and much needed financing is often diverted to other important (or not so important! ) causes. Really, what is more important than education? One resolution could be to emulate the success demonstrated by the Chicago and Michigan programs spoken about earlier in this paper. In Rockland County, some school disctricts already offer a district-based preschool program. This year, all districts were alloted slots to participate in a Universal PreK initiative. However, while that is an excellent start to establishing a much needed entity, a lot of work still exists. During my research gathering I read many, many articles that discussed the family-centered literacy approach. Such as at the CPC, involving the parents and providing them with strategies and useful techniques to help their children empowers them and makes them feel useful and successful. Without parental involvement at the preschool level, literacy development suffers. Since the institution of NCLB, many school disstricts are seeking wasys to provide needed support to their students without it becoming a ‘special ed’ component or target program. Instituting a universal prek program benefits all. Looking at the various achievement gaps that Dr. Barnett identified in his paper, while there is significantly more of an achievement gap at the lower SES levels, there are still marked gaps in the middle class level, thus further justifying why ALL students would benefit from the experience. In an effort to establish successful high-quality preschool programs in Texas, the retired CEO of Texas Instruments was aware of the huge impact the Perry Preschool Program had on its communities and he was eager to replicate that success in Texas. Therefore, after establishing a successful pilot program, the participants wanted to be able to spread the success throughout the state and a handbook â€Å"Improving Early Literacy of Preschool Children’ was developed for prekindergarten educators. The authors and editors really were able to target what a high-quality program looks like with suggestions on how to implement them into your existing programs. The following steps are indicated to improve a preschool program: ? Set goals ? Create an improvement plan ? Build a classroom library ? Train the teachers and encourage collaboration? Keep rack of student’s progress ? Inform and involve parents 6 ? Communicate with elementary schools the children will attend ? Measure and document results (Dougherty, 1999) All of these steps are so important to developing a program that is successful. It is hard to determine whether one step is more important than another. Personally, I really feel that if the teachers and the teaching assistants and/or aides are given the proper training, every interaction with a child will take on new meaning. The Margaret Cone Head Start Center in Southeast Dallas has serviced predominantly low-income populations. As part of their language enrichment program (LEAP), each teacher attends six weeks of instruction at the nearby university as well as several workshops a year. Because of these teacher trainings, Cone Center children have produced improved scores on a variety of tests targeting vocabulary, language skills and social skills. I believe that involving the parents as much as possible and having them in the classroom for a half-day a week or twice a month lets them see what is happening and provides modeling they can use at home. Obstacles that I can identify at this point to establishing high-quality preschool programs that ALL children can attend include: ? FUNDING ? Private preschool programs vs. school district based programs ? Consistent participation on the part of the parents ? Difficulty providing quality training programs for the teachers and teaching assistants/aides due to lack of funding, time, resources While I feel there are many excellent examples of qualified and successful preschool programs in Rockland County, we do not meet the needs of all the children of the preschool age. As CPSE chair, I am able to provide special education needs to many children that require it. However, there is great variability between the programs that we recommend students attend. Consistent high-quality preschool programs would be beneficial to ALL students involved, not just the special needs children. In conclusion, it is a well-documented fact that preschool literacy education benefits all children involved. The need lies in our ability to establish high-caliber programs that are consistent, with staff that is well trained and caring. I think if we can distribute the information about the long-term effects researched and prove to the masses (school boards! ) that the bottom line would be cost savings to the community, we might see some change. I look forward to that day! References 1. Schweinhart, L. J. Lasting Benefits of Preschool Programs ERIC Digest. ericdigests. org. Retrieved February 25, 2008, from http://www. ericdigests. org/1994/lasting. htm 2. Dougherty, C. , et al. Improving Early Literacy of Preschool Children – a Handbook for Prekindergarten Educators. Texas Instruments, 1999. 3. Lee, J. The Benefits of Preschool for High School and Beyond. Council of Chief State School Officers. Retrieved February 25, 2008, from http://www. ccsso. org 4. Roskos, K. A. , Christie, J. F. & Richgels, D. J. The Essentials of Early Literacy Instruction. National Association for the Education of Young Children. Retrieved February 23, 2008, from www. naeyc. org/resources/journal 5. Mangione, P. L. (2005). Creating Language and Literacy Experiences for Infants and Toddlers. PITC Graduate Conference. Berkeley, CA. 6. Johnson, D. & Sulzby, E. Critical Issue: Addressing the Literacy Needs of Emergent and Early Readers. North Central Regional Educational Library. Retrieved January 21, 2008, from http://www. ncrel. org/sdrs/areas/issues/content/cntareas/reading/li100. htm 7. Barnett, W. (2006, Jan. 10). Research on the Benefits of Preschool Education: Securing High Returns from Preschool for All Children. New York, NY. 8. Brain Wonders. Early Literacy (2003). Zero To Three. Retrieved January 24, 2008, from www. zerotothree. org/BrainWonders