The United States Illegal Immigration Dilemma Free Essays

The United States since its commencement has been worked by the difficult work and commitments of outsiders. Migration has consistently been an indispensable piece of the advancement of this country from Colonial days up to this point; be that as it may, Illegal Immigrations has become an issue that isn't simply talked about by the legislators in Washington, DC and those Border States that are been influenced most by it. The issue of Illegal Immigration in the course of the most recent decade or so is presently an issue that is by all accounts influencing a bigger number of parts of the Nation than most appear to know about. We will compose a custom paper test on The United States Illegal Immigration Dilemma or on the other hand any comparative theme just for you Request Now Unlawful movement has the United confronting a circumstance that it has not needed to manage in more than two centuries. The issue of unlawful migration is suggests a few conversation starters that should be tended to; how could we get ourselves in the quandary that we are in? Was it the Government Policies and Laws that were or are not being authorized? Perhaps, the absence of fringe security or could those businesses who recruit realized illicit outsiders be the reason. Another, point that should be address while considering the quandary confronting the US is; What effect does Illegal Immigration have on the nations by and large Economic System? How does this issue influence our Health Care System, our Educational Systems and Employment open doors for legitimate Tax-paying residents? The most significant subject of everything is; what is a reasonable answer for the issue of Illegal Immigration? What kind of Immigration Reform will work for all gatherings included? Will permitting States to think of their own laws, rather than depending on the Federal Laws be the correct answer, or will reexamining the fourteenth Amendment, or Amnesty is the arrangement? Congress’ significant goal while making Immigration Laws and Policies both right off the bat in US history and as of late was to achieve the few objectives; â€Å"First, to rejoin families by conceding outsiders who as of now have relatives living in the United States. Second, looks to concede laborers with explicit abilities and to fill positions in occupations esteemed to encounter work deficiencies. Third, it endeavors to give a shelter to individuals who face the danger of political, racial, or strict oppression in their nation of cause. At long last, it looks to guarantee assorted variety by furnishing admission to individuals from nations with truly low paces of migration to the United States† (Congressional Budget Office, 2006 p. 8); in any case, there are others activities, or absence of activity by government offices that appear to check the extremely aim of the laws and approaches made. One model is the absence of financing and implementation of our nations outskirt security framework. Another model is the non-requirement of laws and strategies overseeing businesses who knowing recruit illicit outsiders. Articulations like the accompanying by then President Bush, summarizes the US governments perspective and the country’s National Interest concerning the Illegal Immigration issue; â€Å"the U. S needs increasingly modest work from south of the outskirt to carry out the responsibilities Americans aren’t ready to do, there are uncalculated cost engaged with the importation of such work †open help and uninsured clinical costs† (Costs of Immigration, 2007, para. 1). Illicit Immigration’s sway on the US economy can be found in the accompanying regions: Our Health Care System, our Education System and in Employment Opportunities for lawful residents. The net monetary expense of migration ranges from $11 billion to $22 billion every year, with most government consumptions on migrants originating from state and neighborhood coffers, while most charges paid by settlers go to the administrative treasury. The net shortfall is brought about by a low degree of assessment installments by migrants, since they are excessively low-talented and along these lines gain low wages, and a higher pace of utilization of taxpayer supported organizations, both due to their relative destitution and their higher richness. This is particularly valid for unlawful migration. Despite the fact that displaced people utilize government assistance, from which they are commonly banned, the expenses of illicit movement regarding government consumptions for instruction, criminal equity, and crisis clinical consideration are huge. California has assessed that the net expense to the condition of giving taxpayer driven organizations to unlawful migrants drew closer $3 billion during a solitary financial year. The way that states must bear the expense of government disappointment turns illicit migration, as a result, into one of the biggest unfunded administrative orders. However we despite everything have the individuals who accept that illicit workers don't adversy affect the economy (â€Å"Center for Immigration Studies†, 2006, para. 1). The Health Care framework here in the US has presumably observed the greatest effect of unlawful migration when taking a gander at the general picture and thinking about the predicament all in all. A case of these impacts in Texas is the announcement made by â€Å"Rick Alleyer, executive of examination for the Health and Human Services Commission, said unlawful outsider medicinal services †for the most part crisis clinic care †cost the state over $100 million last year† (Illegal Immigrant Care, 2010, para. 5). All through the nation in states like Texas, New Mexico, Arizona and California clinics have needed to either shutting their entryways totally or declare financial insolvency as a result of governmentally ordered projects requiring free crisis room administrations to every single unlawful outsider. The impacts of illicit migration on the US instructive frameworks may not be as significant as they are for the social insurance framework, the effect is perceptible enough for teachers, legislators and state governments to consider when they get yearly reports of how ineffectively their schools are playing out, the expansion in understudy populace, and how the expense of training keeps on expanding. As indicated by Edwin Rubenstein, â€Å"Immigrant youngsters are more unfortunate than local conceived kids, and their numbers have expanded far quicker. At any rate 19 percent of all K-12 enlistments are the consequence of movement. More than 9. 2 million are outsiders or the offspring of workers. Due to their absence of language capacities, they take 25 percent of subsidizing. Out of $499. 1 billion in the 2008 school year, $125 billion was spent on remote conceived children† (Illegal Alien Education Impact, 2008, standard. 7). Notice this was simply thinking about auxiliary schools in the province of California. There are various states and schools that are remunerating illicit workers for joining up with the schools, yet they are denying similar sponsorships to legal understudies or legitimate migrants. The consistently expanding number of unlawful migrants streaming into the US consistently assumes a sensational job in uprooting American laborers, in the course of recent years it is evaluated that 1 million lawful residents have been supplanted by outsiders permit to come this nation on work visas. Another territory for concern relating to unlawful migration and its impact on business openings is, the pattern among illicit foreigners transforming from the conventional barely any modern zone and parts of the nation, coordinating themselves into all divisions of the economy all through the country. The worry here is the expanding boundless interest for their work. Having examined a portion of the territories that our nation are confronted with, and most take care of, we presently will take a gander at some potential arrangements on the best way to manage this problem. Understanding that Immigration Reform is must do, what zones should be tended to, and what changes should be made is the current issue. One of the numerous Immigration Laws and Policies that has been made throughout the years is the fourteenth Amendment and the â€Å"anchor baby† idea. This revision has been in the news and on the mouths of lawmakers nearly as much as Immigration Reform itself. The inquiry that should be tended to is will changing this correction give enough help to radically diminish the progression of illicit workers into the nation? In the event that we take a gander at the immediate impacts that the fourteenth amendment has on the nation some vibe exceptionally solid about correcting this revision. For instance some accept that cancelling the citizenship of grapple babies; â€Å"American medical clinics invite stay babies†¦Anchor babies are residents, and in a split second fit the bill for open government assistance help: Between 300,000 and 350,000 grapple babies every year become residents due to the Fourteenth Amendment to the U. S. Constitution: ‘All people conceived or naturalized in the United States, and subject to the purview thereof, are residents of the United States and the State wherein they live. ’† (Illegal outsiders undermine U. S. monetary framework, 2008, para. 12). The idea of individual states instituting their own laws and activities could be the momentary arrangement. Arizona’s AZ SB 1070 law, despite the fact that not completely actualized, is one such case of states assuming control over issues not looking out for the Federal government to authorize the laws they made. Arizona Senator Russell Pearce (2010) â€Å"characterizes the illicit migration issue as one of attack and statements the Constitution: â€Å"The United States will ensure that each State of this Union a Republican Form of Government, and will secure every one of them against Invasion† (p. ). Arizona isn't the main express that has thought of laws to help manage the illicit migration populace in their states; you have states like Colorado, Georgia, Idaho, and Oklahoma. The province of California has a bill that has started the mark procedure, the California Taxpayer Protection Act of 2010, Initiative 09-0010. This bill is for â€Å"real world residents, â€Å"The individuals of California have a chance to control the illicit movement. Numerous in California might not have seen the grass of late, bu

Kenya essays

Kenya papers Kenya is a nation on the eastern bank of Africa, directly on the equator. It is a place that is known for striking scenes, running from snow-topped Mount Kenya to rich farmlands, fruitless deserts and tropical sea shores. A previous British state, Kenya is presently comprised of eight regions in that run in geological size from the little Nairobi Province to the a lot bigger Eastern and Rift Valley Provinces. The Provinces additionally go in populace from the thickly populated Nairobi Province, to the scantily populated North East. The eight areas are: Central, Coast, Eastern, Nairobi, North East, Nyanza, Rift Valley and Western Province. Every Province is partitioned into regions. Kenya outskirts Somalia, Ethiopia and Sudan in the north, Uganda in the west, Tanzania in the south, and the Indian Ocean in the East. Kenya's capital city is Nairobi with a populace of around 1.4 million individuals. The other significant towns are Mombasa the primary port on the Indian Ocean with an expe cted populace of 1 million and Kisumu on Lake Victoria with an expected populace of 400,000 individuals. Kenya's populace is developing quickly. Most Kenyans are nation individuals - little scope, free ranchers and farmers. Just about 25% of the individuals live in urban zones, probably the most reduced rate on the planet. For a large number of years, ships have cruised to the bank of Kenya from Arabia and southern Asia abusing Africa's characteristic assets for the sole motivation behind taking cash back to their countries so their nations organizations and economies could prosper. Due to the broad misuse and reliance on other nation's materials and agribusiness, there has been a huge effect on Kenya's economy, society, and government particularly since Kenya's freedom in 1960. Prior to the turn of the twentieth century, Kenya was for the most part possessed by the African people groups and its economy was predominantly at a means level. Since cash as we probably am aware it today did... <!

Recent Questions COLUMBIA UNIVERSITY - SIPA Admissions Blog

Recent Questions COLUMBIA UNIVERSITY - SIPA Admissions Blog A few applicants have submitted inquiries regarding the application review process. Here are answers to some of the questions that have come in recently. ______________________ Does the completion date of my file impact the admission decision? . . . or stated another way perhaps . . . Why is my application not complete yet? The answer to the first question is No. The date a file is completed has no impact on the decision process. The process of completing files in the office is time consuming and we appreciate your patience as we work quickly to make sure everything has been received so that we may forward the file to the Committee for review. If we are missing any required documents we will let you know. So in response to the second part of that question, we are working as quickly as we can but still have several hundred applications that are waiting in printed batches to be reviewed. When/how will I find out about my decision? Our goal is to make decisions available in early March. We do not send out all decisions at once. As much as we would like to send all decisions at once, some files take a bit longer to review than others and we do not wait until a decision has been made on every file before starting to send decisions. When your decision is ready to view you will receive an email from our office letting you know. The email will instruct you to visit the application site to view your decision letter. I will post updates on the process on this blog so please make sure to subscribe to the blog by entering your email into the Feedburner box in the right hand menu or add this blog to your RSS reader.   I will elaborate more on the topic of informing applicants of decisions as we draw closer to releasing decisions. Are interviews a part of the admission process? With thousands of applicants applying from all over the globe, it is not possible for the Admissions Committee to conduct interviews with applicants. In rare cases I may be asked to follow up with an applicant regarding a detail in their application.   This contact would come in the form of email. Thus, after you receive an email from us noting that your file is complete, you likely will not receive another email from us regarding your file until a decision has been posted.   When the decision is posted you will receive an email indicating such. Will there be an opportunity for admitted applicants to visit SIPA? SIPA will host an Admitted Student Day on Tuesday, April 12th. It will be a full day event open to all applicants admitted to SIPA for the fall 2011 semester. We also have information sessions each Monday at 6:00 PM and Friday at Noon, with exceptions for holidays. If you wish to register for an information session, you may send an email to sipa_admission@columbia.edu. Registration for the Admitted Student Day on April 12th will take place after admission decisions have been made. Registration for Admitted Student Day takes place on a secure Web page and admitted applicants will be given access to this page (information will be in the admission letter). I received an email noting my file was forwarded to the Admissions Committee, but I have more information that I would like to include in my file, can I send it to you? The application review process at SIPA is paper based. All of the required documents are placed in a file and that file then is sent to Committee members for review. Although we know what individuals are reviewing particular files, it is not possible for us to quickly track down files once they are batched and sent out for review. As you might imagine, it would not be possible for members of our staff to try to track down a file to add additional documents as this would be incredibly time consuming. If you submitted all of the required documents and your file is complete, the Committee will have the information it needs to make a final decision.   If we feel we need more information or need to clarify information submitted we will contact you. What size of class does SIPA plan to enroll? The typical incoming class size for the MIA, MPA, and MPA-DP programs is around 475 students (all three programs combined).   Final enrollment goals may adjust slightly as time progresses, but at this point this is a good estimate of the number of students we will enroll for fall 2011: MIA: 260 students MPA: 180 students MPA-DP: 35 students Again, these numbers are estimates only and may change based upon a variety of factors the Admissions Committee takes into consideration. How does being an international student affect my consideration for SIPA fellowships? First let me say that fellowships at SIPA are mainly reserved for second year students. Unfortunately we are only able to offer roughly 10-15% of first year students fellowship funding. Approximately 70% of second year students that qualify to apply (by obtaining at 3.4 GPA at SIPA) receive a second year award and the average award is roughly $20,000. Second, SIPA fellowships are not based on citizenship. We have one fellowship budget and it is used to award funding to qualified applicants, no matter the country or origin or citizenship. Therefore, citizenship has no impact on the fellowship process at SIPA. How dry are your hands? Okay, no one actually asked that question, but with the amount of paper I have been handling I almost feel like I have chalk sticks for fingers my skin is so dry.

Oedipus The King By Sophocles - 950 Words

The people throughout Oedipus’ life trues very hard to allow him to escape his fate of killing his father and then marrying his mother. In the epic poem Oedipus the King, Sophocles tells the story of the tragic downfall of Oedipus. Although many people see the role of free will that brought upon Oedipus’ doom, no matter what choices were made throughout his life, his ultimate fate would always return. The choices made at the beginning of Oedipus’ life set him up to fulfill his prophecy. His parents learned of his destiny from the oracle and â€Å"pinned his ankle joints together, then had him left, by someone else’s hands† (Sophocles 685). Instead of killing the child themselves, they left him to the responsibility a herdsman. This choice to give the child to another person at the beginning of his life allows the gods to remain deciding Oedipus’ fate. Allowing him to live ultimately permits him to return back to his home city to fulfill his fate. The herdsman in turn had pity on Oedipus and decided to give him to the King and Queen or Corinth. This choice made by the herdsman again allowed Oedipus to continue in life to allow his destiny to live on. Oedipus ‘determinism to get away from fulfilling his destiny causes him to run right into it. The â€Å"ignorance of his own actions† led him to advance into what the oracle predicted (Fosso). After he was told of his prophecy, Oedipus decided to escape his adoptive parents without asking for answers. Instead of â€Å"delaying and possiblyShow MoreRelatedOedipus The King By Sophocles848 Words   |  4 PagesOedipus the King, written by Sophocles, follows the tragic story of a king named Oedipus who goes from an all-powerful ruler to a hopeless blind peasant. Oedipus the King was written as a play and performed in front of an audience. Sophocles shows in Oedipus the King that one cannot escape the fate of the gods. Throughout the play Oedipus struggles to find a solution and change all the troubles in his life. The play observes the story of Oedipus who defies the gods and through the journey experiencesRead MoreSophocles Oedipus The King884 Words   |  4 PagesKing of Thebes, owner of a family tree that identically resembles Medusa on a bad hair day, and the inspiration for a psychologically-riveting complex, Oedipus, tragic hero of Sophocles’ Oedipus the King, exposes troubling truths about the human condition and, acting as an exemplary precaution for the entirety of humanity, demonstrates how a self-destructive struggle between love, anger, and fate, conveyed through an unorthodox love affair between mother and son (Who gets custody in a divorce?),Read MoreSophocles Oedipus The King1714 Words   |  7 Pagesâ€Å"ideal tragedy† is the play â€Å"Oedipus the King† written by Sophocles. In this play, Sophocles utilizes the concept of tragedy as well the theory of the importance of scenes of recognition and rev ersal to create a setting, tone, and mood throughout the play. Oedipus, the mythical king of Thebes, goes through a horrendous tragedy which includes moments of recognition and reversal. These moments are key to the fame and appreciation for the play, â€Å"Oedipus the King†. Sophocles’ use of Aristotle’s conceptsRead MoreSophocles Oedipus The King992 Words   |  4 PagesThroughout tragedies in Greek literature, the hero always has one tragic flaw. In Sophocles’ Oedipus the King, Oedipus’ main flaw is his overactive hubris, which in turn clouds his overall judgment. This is evident in the Chorus’ first ode to the city of Thebes as they try to ask the Gods for the banishment of the plague. Their answer does not come from a deity, but from Oedipus himself as he enters the palace and says, â€Å"You have prayed; and you prayers shall be answered with help and release ifRead MoreOedipus the King by Sophocles1393 Words   |  6 Pages Sophocles’ play, Oedipus the King, has risen many questions concerning the main character and whether or not he acts on free will or if his future is predestined by the gods. I am going to test the theory that although Oedipus believes he is acting on his own free will, he is in fact a victim of the gods. I will analyze several different sources that discuss fate and human agency in Oedipus the King and then proceed to build my original argument on the archaic debate. There has been a great dealRead MoreOedipus The King By Sophocles904 Words   |  4 Pages In Sophocles play â€Å"Oedipus the King† a deadly plague has descended upon the kingdom of Thebes, and because of this plague a dark and iniquitous secret begins to unravel itself only to reveal a web of events connecting Oedipus and others as the culprits behind all the havoc ensued. No one is the sole source responsible for the unfortunate events that befall Thebes, as well as the royal family; In fact, those who unknowingly paved the path of destruction were themselves trying to prevent it fromRead MoreSophocles Oedipus The King Essay1960 Words   |  8 Pages This would have been excellent advice for the main character in Sophocles drama, Oedipus the King. However, the drama was written as a result of Sophocles life and the influence of the humanistic culture in which he lived. Throughout Sophocles life, he gained military knowledge as the son of a wealthy armor manufacturer and received an excellent Greek education with emphasis on Homeric poetry (textbook). Furthe rmore, Sophocles was very involved in politics and served as a treasurer, a generalRead MoreSophocles Oedipus The King871 Words   |  4 PagesThe plays written by Sophocles, â€Å"Oedipus the King â€Å"and â€Å"Antigone† are bodies of work displayed the meaning of what Aristotle defined as a tragedy. â€Å"Oedipus the King† is a story of a king trying to avoid the fate of his life that has been prophesized before his birth. In â€Å"Antigone† is story of a girl who devoted to her family, and regardless of the orders made the king Creon. In these stories the archetypes and hamartia of Antigone and Oedipus play a major role in the story. In â€Å"Antigone† the characterRead MoreOedipus The King, By Sophocles1407 Words   |  6 PagesWhen we think about a tragic play or protagonist, most people would think Shakespeare for his common theme of his plays to end with a tragedy. In Oedipus the King, written by Sophocles, tells the tale of the protagonist Oedipus. Throughout the play, Oedipus searched for his past to discover the reason why his kingdom is plagued with wilting crops and illnesses. In the end, he becomes a tragic protagonist after discovering his past was related to the previous king’s death. While the search progressedRead MoreSophocles Oedipus The King2037 Words   |  9 PagesSophocles’s Oedipus the King features a chorus that sings several odes over the course of the play. In Sophocles’s play, the chorus is composed of old Theban men and represents the population of Thebes as a whole. The chorus recites a parodos, four stasima, and a brief exodus. Through the choral odes, So phocles reflects on the events and motifs of the play, including piety and faith in the Gods, the inevitability and the uncertainty of fate, and the dichotomy of right and wrong. After Sophocles establishes

Small Talk by by James Hunter Essay - 1078 Words

In this paper I am going to analyze and comment an article written by James Hunter. My starting point will be a summary about the text in which I have been working. Next I will contextualize the topic which is â€Å"Small Talk†. Then, I will analyze different problematic issues raised in the text in which I propose proposals for solving the problems posed. Finally, I will reflect about the strengths and weaknesses of some points about this article changing some aspects of the authors proposal. ïÆ'Ëœ SUMMARY The author of this article stakes out a clear and insightful position on this educational issue and follows the specific instructions by presenting reasons to support that position. The article cogently argues that a corrective feedback can†¦show more content†¦How did this come about? It was initially studied in 1923 by Bronislaw Lalinowski, however it began as an experiment in learner-centred over 20 years ago which pretended developing the oral communication. Nowadays this methodology has been introduced into the classroom so, in a â€Å"Small Talk† class, pupils improve their speaking skill in a conversation without intervention by the teacher, and then receive feedback. Small talk can be divided into 6 steps: 1. The day before, the leader (who is responsible for choosing the topic, providing questions, vocabulary, grouping the class, etc.) announces the topic to their mates. 2. At the beginning, the leader writes on the board the questions and vocabulary and grouping the class. 3. Groups begin to discuss the theme. 4. Groups share what they are speaking about with the rest of the class. 5. The leader invite groups to tell them what are the most important points of their conversation. 6. The leader thanks and concludes the class and announces the date and leader of the following small talk Along the same line of small talk, throughout the didactics course we have learned four types of activities about oral skills as, for example, controlled practice, guided practice, free activities, and dialogues and role-play work. To put this in the same perspective, the types of activities that are more related to small talk are guided practice (This is a kind of meaningful drillShow MoreRelatedDescriptive Essay - Original Writing930 Words   |  4 Pagesher!† my mother cried. James and I yelled â€Å"Lost what?† â€Å"Your sister!† Mom cried â€Å"What?† Asked James and I. â€Å"Your sister!† Mom bawled. â€Å"How?† Asked James and I. â€Å"I don’t know, but let s look for her. Okay?† Dad and mom announced. â€Å"Okay.† James and I alerted It just felt like a blur for a few days. We have looked for her for days we even didn’t even go to school but no sign of Harper. I think my mother knew that she had died but mother didn’t want to amite it. James didn’t talk to me for about a monthRead MoreHow Does Holden Caulfield See Himself as The Catcher in the Rye?1051 Words   |  5 Pageswas like, and how my parents were occupied and all before they had me†¦Ã¢â‚¬â„¢ what Holden does not realize is that his parents are occupied even now, after they had him, this shows that he isn’t close to his parents. He doesn’t really care. When Caulfield talks about his brother D.B.’s short story, ‘The Secret Goldfish’, he says that it was about a little child that would not let anyone look at his goldfish because he had bought it with his own money. This is such a childish trait and innocent thing to doRead MoreChristianity And World Changing By James Davison Hunter1743 Words    |  7 PagesThe World, James Davison Hunter explains how this common believe is a misconception. Rather, he shows readers that, from a sociological perspective, while Christians thrive in many areas of life by reaching others individually, they fundamentally components of creating cultural change. Hunter’s first essay, titled â€Å"Christianity And World-Changing† attempts to refute the common assumption that cultures can be changed â€Å"one heart at a time† or, in other words, from the bottom up. Hunter argues theRead MoreWhy Is College So Important?1312 Words   |  6 Pagesthe twenty-first century key to success. Jobs are now being given to those who are more educated and college provides this extra education. It is not the same as high school. High school education consists of a more general knowledge, which is a small amount of information about all the topics, but college is focused on the major. College graduates have more comprehension in their area than those with a high school diploma. As President Theodore Roosevelt once said, â€Å"A man who has never gone toRead MoreEdward Teach aka Blackbeard the Pirate1354 Words   |  6 Pagesdidn’t fear him, and therefore they obeyed him). Blackbeard began his pirating career sometime after 1713, as an ordinary crewmember aboard a Jamaican sloop commanded by the pirate Benjamin Hornigold. In 1716, Hornigold supplied Teach with a small crew, and a small captured vessel to command. By 1717 Hornigold and Teach were sailing in alliance, and together were feared throughout the seas. In November 1717, Hornigold and Teach were able to capture a 26 gun French vessel called the Concorde (recent researchRead MoreEssay about The Color of Water7106 Words   |  29 Pagesthe son’s perspective, James. 2. What is the ethnic background of the author? * The ethnic background of the author is Caucasian and African-American. Chapter 1: Dead 1. Why is this chapter written in italics? * This chapter was written in Italics because it was written from a different point of view which was Ruth’s perspective who talks about her past as a child. 2. Why is the mother reluctant to talk about her family? * Ruth is reluctant to talk about her family becauseRead MoreSuperstition On The Face Of Logic By Dr. Mortimer1272 Words   |  6 Pagesinvestigation. This intersection of rational thought and irrational belief is first presented by Dr. Mortimer at the beginning of the novel. Dr. Mortimer’ introduction as a â€Å"man of science† sets a tone of intellectuality; Holmes and Mortimer make small talk of his medical practice, Holmes’ deductions, and the intricacies of Holmes’ skull structure. This is immediately skewed by the telling of the legend of the hound. The reading of this unworldly myth promptly makes the atmosphere eerie and mysticalRead MoreThe Emerging Use of Mattresses in History: Cultural Differences in Sleeping Patterns979 Words   |  4 Pagesin history: Cultural differences in sleeping patterns The way that we sleep feels so natural, it may come as a surprise that sleeping in separate beds on an elevated mattress is quite particular to specific cultures and regions. The first hunter-gatherers obviously did not have stationary places to rest upon and even the concept of an individual bedroom is fairly recent in the West. However, given the ubiquity of Western culture, many non-Western customs regarding sleeping habits have changedRead MoreThe Sherlock Holmes By Dr. James Watson1665 Words   |  7 Pages One of the things that make the Sherlock Holmes books distinctive is their point of view. The books are written as an account Sherlock Holmes’ case, written by Dr. James Watson, chronicling the achievements of the detective. This book, in particular, is unique in its point of view. The first few chapters are told in past tense, as Watson recalls the events; the next few chapters are present tense, in the form of extracts from Watson’s diary or letters sent to H olmes from the hall; the last few chaptersRead MoreAnalysis Of The Book The Things That Make The Sherlock Holmes 1366 Words   |  6 Pagesâ€Æ' Point of View One of the things that make the Sherlock Holmes books distinctive is their point of view. The books are written as memoirs of Dr. James Watson, chronicling the achievements of Sherlock Holmes. This book, in particular, is unique in its point of view. The first few chapters are told in past tense, as Watson recalls the events; the next few chapters are present tense, in the form of extracts from Watson’s diary or letters sent to Holmes from the hall; the last few chapters shift back

Neonatal Medicine CPAP and Ventilation in Neonatal Respiratory Distress Free Essays

You are reviewing Nathan, a 12 hour old neonate with respiratory distress. He is 37 weeks gestation and was born by caesarean section following failure to progress. The oxygen saturation is 94% in 50% FiO2, the respiratory rate is 80. We will write a custom essay sample on Neonatal Medicine: CPAP and Ventilation in Neonatal Respiratory Distress or any similar topic only for you Order Now There is moderate intercostal recession and an occasional grunt. Your hospital participated in the â€Å"bubbles for babies† trial and you have just started to use CPAP in your unit now the trial is finished. Your registrar suggests using CPAP on this neonate, but the nursing staff have called you to arrange transfer. Questions: Would you use CPAP or ventilate and transfer this neonate? Please give reasons for your choice with reference to the current literature. In your answer you should also consider the following main points: †¢ the benefits of CPAP over ventilation, particularly with reference to your current practice environment †¢ the potential complications of CPAP †¢ reasons why ventilation may be required even though CPAP is in situ. The baby Nathan is suffering from Neonatal respiratory distress syndrome, which is a condition most often seen in newborn babies and is characterized by a difficulty in breathing.   The condition more frequently develops in prematurely born babies as their lungs are not fully developed.   The lubricant that lines the inner membranes of the lungs (known as ‘surfactant’) is deficient, thus causing difficulty in inflating the lungs and resulting in the air sacs collapsing. Surfactant helps to lower the surface tension of water that is present on the alveoli, thus helping to prevent the lung sacs from collapsing.   Usually, the condition develops in infants born before the 38 week.   The baby is cyanosed and has difficulty in breathing.   The accessory muscles of respiration are active and a frequent grunting sound is heard.   The other symptoms that may be observed include nasal flaring, shallow breathing, swollen legs, unusual movement of the chest wall, etc. The infant may be hypoxic and the CO2 levels in the blood rise.   The symptoms usually develop at birth, or a little while after birth.   The symptoms tend to worsen and may progress to respiratory failure and death.   As the prematurity increases, so does the chance of developing this condition.   This is because surfactant is produced only during the later stages of gestation in the infant.   The diagnosis of RDS in babies is made based on the history, presence of certain risk factors, Chest X-ray, Blood tests, CSF studies, lung tests, blood gas analysis, etc (Greene, 2007 Merck, 2005). When a neonatal is born, certain signs are observed which include:- a heart rate between 110 to 150 beats per minute a respiratory rate between 40 to 70 breathes per minute absence of cyanosis, nasal flaring, grunting sounds, forceful use of accessory muscles during respiration, etc Oxygen saturation which is about 95 % the P ao2 is higher than 50 % the FiO2 is about 40 to 50 % (CCM, 2007, NGC, 2008, Millar et al, 2004) Previously, for the treatment of RDS, ventilatory support was utilized.   This may be utilized if the blood carbon dioxide levels are high, the blood oxygen levels are low, and if acidosis sets in.   To some extent ventilation helps to reduce the infant mortality rate arising from RDS, but the morbidity to develop Bronchopulmonary dysplasia (a condition characterized by oedema of the air sacs and of the connective tissues due to persistent inflammation) is high as the young neonatal lungs are damaged from ventilation. One of the treatments that have been developed in order to overcome the limitations of ventilation is Continuous Positive Airway Pressure (CPAP).   This is an advanced form of therapy in which the upper and the lower airways receive a continuous distending pressure through the infant’s pharynx and/or nose throughout the respiratory cycle.   An endotracheal tube can also be utilized.   The device is connected to a gas source that provides humidified warm air continuously (NGC, 2008, Millar et al, 2004, Tidy, 2007). CPAP has several benefits including:- helps to maintain a normal breathing pattern helps to arrive at normal functional residual capacity helps to lower any airway resistance in the upper respiratory tract helps to prevent development of apnea prevents the airways and the air sacs from collapsing helps stimulate release of surfactant helps to increase the lung volume and lung function After expiration, CPAP helps to keep the air sacs open The chances of developing lung trauma such as barotrauma and atelectotrauma are lesser (CCM, 2007, Sehgal, 2003, NGC, 2008, Millar et al, 2004). CPAP is required in several situations that arise from RDS including:- When it is difficult to maintain the Pa02 above 50 %. When the respiratory rate is above 70 breathes per minute Excessive use of the accessory muscles of respiration The oxygen saturation falls to between 90 to 95 % The presence of apnea It can be utilized along with administration of surfactant that develops out of the   Ã‚  need to treat RDS (CCM, 2007, Sehgal, 2003, NGC, 2008, Millar et al, 2004). As the patient is not suffering from a severe form of RDS and the oxygen saturation levels have not dropped to a serious extent, ventilatory support is not required, and the patient can be treated with CPAP.   Besides, the findings do not suggest that the patient is suffering from a cardiovascular complication, an upper respiratory tract abnormality or intractable apneic episodes.   Along with CPAP, several other measures are required such as using larger nasal prongs, ensuring that the baby is in a prone position and keeping a towel below the neck.   This helps to ensure that the certain areas are aerated better (CCM, 2007, Sehgal, 2003, NGC, 2008, Millar et al, 2004). CPAP has several complications including:- mucous from the upper respiratory tract may block the nasopharyngeal tube that delivers CPAP Sometimes blockages may result in the pressure rising to higher levels in the tube If the peak pressure is very high, then gastric complications can develop The nasopharyngeal tube has to be placed in exact position.   Any deviation from the position can result in fluctuation of the air pressure The nasal devices may be swallowed or aspirated resulting in severe complications Sometimes harnesses may be utilized to place the head and the neck in position.   This may cause serious dermatological and musculoskeletal complications in the infant Air leakage problems in the lungs Abdominal distention Decrease in the cardiac output Higher working of breathing pneumothoraces and air embolism can also develop Cardiac monitoring needs to be performed more closely in the case of CPAP compared to ventilation often air leaks from the nose and the mouth it may be very difficult to control the air pressure in the lower airways If CPAP is applied to an infant with normal lungs, several problems can develop Several respiratory complications such as pneumothorax, pneumomediastinum, and pneumopericardium can develop (CCM, 2007, Sehgal, 2003, NGC, 2008, Millar et al, 2004, Halamek et al, 2006) References: California College of Midwives (20080, Guidelines for Assessing the Neonate, [Online], Available: http://www.collegeofmidwives.org/Standards_2004/Standards_MBC_SB1950/Assess_HealthyNeonate_Oct2004_OOO.htm [Retrieved on: 2008, April 2]. Greene, A. (2007), Neonatal respiratory distress syndrome, [Online], Available: http://www.nlm.nih.gov/medlineplus/ency/article/001563.htm [Retrieved on: 2008, April 2]. Halamek, L. P. Et al (2006), Continuous Positive Airway Pressure During Neonatal Resuscitation, Clin Perinatol, 33, pp. 83-98. http://www.mdconsult.com/das/article/body/91421747-3/jorg=journalsource=MIsp=16080552sid=690389052/N/525142/s0095510805001235.pdf?issn=0095-5108 Millar, D., Kirpalani, H. (2004), Benefits of Non Invasive Ventilation, Indian Pediatrics, 41, pp. 1008-1017. http://www.indianpediatrics.net/oct2004/oct-1008-1017.htm NGC (2008), Complete Summary, [Online], Available: http://www.guideline.gov/summary/summary.aspx?ss=15doc_id=6516nbr=4085, [Retrieved on: 2008, April 2]. Sehgal A. Et al (2003), Improving Oxygenation in Preterm Neonates with Respiratory Distress, [Online], Available: http://www.indianpediatrics.net/dec2003/1210.pdf, [Retrieved on: 2008, April 2]. The Merck Manual (2005). Respiratory Distress Syndrome, [Online], Available: http://www.merck.com/mmpe/sec19/ch277/ch277h.html, [Retrieved on: 2008, April 2]. Tidy, C. (2006), Infant Respiratory Distress Syndrome (RDS), [Online], Available: http://www.patient.co.uk/showdoc/40000462/, [Retrieved on: 2008, April 2]. How to cite Neonatal Medicine: CPAP and Ventilation in Neonatal Respiratory Distress, Essay examples

Hippocratic Bargain and Health Information Technology

Question: Discuss about the Hippocratic Bargain and Health Information Technology. Answer: Introduction Department Of Health (2003) describes patient confidentiality as the duty of confidence a healthcare provider bears to the information provided by a patient. The authors further mention that the information provided is should only be used to support the patients healthcare. In describing this further, Rothstein (2010) introduces the Oath of Hippocrates which allowed clinicians to provide patient information openly especially in presence of men who were empowered to make decisions for the other members of the community. However, times have changed. The Data Protection Act 1998 provides a legal framework for confidentiality of information. The principles that stand out include: Fair and lawful processing of information. Protection of personal data from theft, damage or loss. That personal data should only be processed for the lawful required purposes. Issues arising in accurate confidentiality of patient records Even with the legal guidelines provided, there are some aspects to confidentiality that need be further addressed. These include: Consent from the patient. Department of Health (2003) highlights that patients are required to provide necessary information that will enable healthcare providers offer them quality care. Clinicians should provide guidelines as to what information required and for what purpose. This way, in case a patient declines to give required information, they will bear no liability. Hassol et al. (2004), they notes that accurate records amount to better medical attention. They however observe that these records are mostly between 65% - 75% accurate which may be attributed to the fact that at times patients provide incorrect information or assume its relevancy. This emphasizes the important of the practitioner performing an orientation. Department Of Health (2003) stresses that it is important to seek consent before using records provided and also respect choices patients make with regards to providing information. That aside since most practitioners share patient records, when seeing a different person, patients should still be asked whether they would like that information to be used. (Rothstein, 2010). Communication by both parties Hassol et al (2004, pg. 505) highlights that good communication between healthcare providers and patients is necessary. Rothstein (2010, pg. 8) further states that in the times of Hippocrates communication mostly occurred in person which was limiting. However, technology has made things swift. It allows patients to schedule appointments, renew prescriptions, share information and clarify where there is doubt via modern forms of communication. (ibid). This also benefits the practitioners as they are allowed to send information beforehand to ensure patients understand procedures and guidelines. Use of personal data by clinicians Department Of Health (2003) introduces the Caldicott Principles which require practitioners to justify why they are sharing patients personal data and also act within the guidelines of the Data Protection Act 2008. Further to that, this information should only be accessed when necessary and there should be minimal identification of the patient to avoid issues such as gossiping. Conclusion To sum it up, confidentiality is the responsibility of healthcare providers. Patient record should be handled in a way that uphold their basic human rights. In handling theses records, practitioners should ask themselves whether their actions are in the patients best interests. List of References Department of Health. (November 2003). Confidentiality: NHS Code of Practice. Retrieved January 20, 2017 from https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/200146/Confidentiality_-_NHS_Code_of_Practice.pdf. Gateway Ref: 1656. Hassol, A., Walker, M, J., Kidder, D., Rokita, K., et al. (Nov / Dec 2004). Patient Experiences and Attitudes about Access to a Patient Electronic Health Care Record and Linked Web Messaging. Journal of the American Medical Informatics Association; Volume 11, Number 6. Information Commissioners Office. 8 Data Protection Principles. Retrieved January 20, 2017 from https://ico.oorg.uk/media/1042048/8-data-protection-priciples-postcard.pdf Rothstein, A, M. (2010). The Hippocratic Bargain and Health Information Technology. The Effects of Health Information Technology on the Physician-Patient Relationship. Spring The Data Protection Act 1998. Retrieved January 20, 2017 from www. legislation.gov.uk.