• Home

Physiology homework help

Respond to at least two of your classmates’ postings. Responses should be at least 100 words or more

Week 4 Discussion Question 7/8

 

Cherelle Johnson (student’s name)

Mayo Clinic has been the staple healthcare organization whose focus are their vast network of patients. The HRM strategic plan plays a big role in why Mayo Clinic is able to provide quality care to patients and hire/recruit quality healthcare providers.  According to the assigned article, HR at Mayo Clinic has spent years perfecting their priorities and strategies.  Since Mayo Clinic has such a huge network of healthcare providers, one thing that stood out to me was how Mayo has instilled the idea of working together to prevent competition.  Working together does prevent competition, but also gives HR the tools necessary to eliminate or fix any relative issue.  In present day, Teamwork has become the norm at Mayo Clinic.  With a teamwork dynamic set in place, HR now has the ability to hire the right employee who exhibits those same values. HR looks for individuals who are team players and can advance in the company while still demonstrating empathy for others.  Empathy is an important quality any prospective employee must have, especially since company advancement is encouraged at Mayo.  

Currently, the pandemic has caused a shortage of healthcare providers at most healthcare organizations.  A lot of hospitals have taken a huge hit with the increase in patients and decrease in health care workers.  Shortages have the ability of causing healthcare organizations to be lenient on the qualities needed for a potential employee to work at a company.  Mayo will probably not face any issues with finding quality employees during this time because of the methods they have set in place with HR.  It is important for all healthcare organizations to have a similar model set in place to prevent the hiring of someone that is not up to standard.

Sources 

Ramlall, S. (n.d.). Upperiowa.brightspace.com. Retrieved April 26, 2022, from https://upperiowa.brightspace.com/content/enforced/69637-OFFR_2018-SU-A5-BA-374-5A-77/Week2BARRIERS%20IN%20MULTICULTURAL%20BUSINESS%20COMMUNICATION.pdf?_&d2lSessionVal=HxIbirq9Z2kFtNi47GYu3t3ET

Strategies to Mitigate Healthcare Personnel Staffing Shortages. (2022). Cdc.Gov. https://www.cdc.gov/coronavirus/2019-ncov/hcp/mitigating-staff-shortages.html

WEEK 4 DQ

 

meana rasheed (student’s name)

HRM strategic plan has been such an important foundation for all over-strategic plans for Mayo Clinic, which make Mayo clinic ranked as one of the top medical organizations in the world. Human resource management at Mayo Clinic used many strategies to maintain and build a culture that makes Mayo Clinic one of the best places in the world to work for. Human resource management strategies at Mayo Clinic are based on workforce management and quality assurance, the quality to select the employees, and embracing diversity to create a welcoming and inclusive environment for all the employees as Mayo Clinic is recognized as diversityInc top Health System by increasing women and minorities in its top 200 leadership role who committed to meet the needs for their employees and patients. (1)

Human resource management at Mayo Clinic significantly achieved the highest level of workforce management by focusing on teams and team development rather than the individual by providing a framework, leadership development programs, and continuous professional development programs for their employees as the main strategies for ongoing growth and success. (2) Mayo clinics are frequently using training and development programs to improve employees ‘performance. these interventions and programs include Six Sigma training and lean operations, also training sessions, and employee feedback. all Mayo Clinic employees participate in orientation programs and annual diversity instruction which is a very important strategy for perfect human resource management.

Mayo Clinic’s human resource management strategies include building a high performance and acting with integrity by selecting the “right” employees who have the loyalty and strong work ethics with outstanding performance in addition to the employee retaining strategies to decrease employee turnover by promoting teamwork through strategic rewards. Mayo Clinic offers different compensations and benefits programs to build and maintain a highly committed workforce. Mayo clinic is defined as a total rewarding program that includes retirement funded by Mayo, income protection, regular increase in salary, and comprehensive benefit plans at low costs. (3)

Many other successful strategies were implemented at Mayo clinic regarding hiring, retaining, rewards, training, developing, and rewarding programs that become the core of the strategic plans of human resource management at Mayo clinic.

Mayo clinic is a global responder to the pandemic challenges, as they adopted and developed different strategies to overcome workforce challenges and create a transformation in how healthcare is being delivered also by ensuring regulatory compliance.

Strategic plans are very important to overcome COVID19 challenges, as the sudden changes developed new trends which include new ways to engage employees and how employee wellness is a priority, focusing on reskilling the employees, more data-driven HR, moving towards continuous performance management, deeper role in corporate strategy, focusing on internal talents and retaining employee by offering more benefit to boost retention, increase investment in leadership development, As HR roles become more complicated, more organizations seek to make their HR departments more efficient. Interestingly, this contributes to a shift towards outsourcing HR functions to professionals with the required expertise in understanding the growing market for human resource outsourcing as research findings corroborate this trend, as the global market for human resource outsourcing is expected to reach $43.8 billion by 2024. (4)

 

References:

1-Mayo Clinic No. 7 in DiversityInc’s Top Hospitals and Health Systems ranking. (2020, May 7). Mayo Clinic News Network. https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-no-7-in-diversityincs-top-hospitals-and-health-systems-ranking/

2-PROGRAM OFFERINGS Workforce Learning #WeAreMayoClinic. (n.d.). Https://Connect.employees.mayo.edu/. Retrieved April 25, 2022, from https://connect.employees.mayo.edu/page/workforcelearning/tab/program-offerings/

3-Retirement Benefits Connect #WeAreMayoClinic. (n.d.). Https://Connect.employees.mayo.edu/. https://connect.employees.mayo.edu/page/benefits/tab/retirement/

4-20 New HR Trends & Predictions for 2021/2022 You Should Be Thinking About. (2019, December 3). Financesonline.com. https://financesonline.com/hr-trends/

Physiology homework help

· Responses should be at least 200 words or more. Each initial post must contain at least one outside reference beyond that of the text or video to include citations, with page numbers, parenthetical style (Author, Date: page#), and the source listed APA style at the end of the post.

· Be sure to answer ALL QUESTIONS.

The following article “Strategic Planning at Mayo Clinic (SEE ATTACHMENT):  A Case Study” provides an overview of the importance of Human Resources and their HRM Strategic Plan as a foundation for the over-all Mayo Clinic Strategic Planning process.

1.  For the purposes of our discussion question, read pages 13 through the first half of page 21 of the Case Study. (Feel free to read the whole thing on your own – it is really good!)

2. Explain why the HRM Strategic Plan has been such an important foundation for the over-all strategic plan for Mayo Clinic.

3. Given how things will change following the pandemic, explain why a strategic plan for HRM will be so important to all organizations moving forward.

4.
Strategic HRM at the Mayo Clinic
(SEE ATTACHMENT)

Physiology homework help

Week Four learning Activity

Top of Form

Instructions: PROVIDE AT LEAST ONE OUTSIDE SOURCE BESIDES THE VIDEO.

Week Four Activity

Closing Thoughts – on inspiring our most important resource – our Human Resources!

We are living through extraordinary times. 

We know that the future will be very challenging for health care leaders.

How will you be able to maximize your ability to lead and support your staff?

1.  Watch the attached video, “How Great Leaders Inspire Action”. https://youtu.be/qp0HIF3SfI4

2.  Based on your course learnings, what are your key takeaways from this TED presentation?

3.  How might they inform your future role as a health care leader?

Bottom of Form

Physiology homework help

Week Three Learning Activity

Top of Form

Instructions

Week Three Learning Activity – Leading in Times of Constant Change

As we move through the current global pandemic and on to the “new normal” in health care – we will be in a state of constant change.

 The following video, “5 ways to lead in an era of constant change” give us some insights on how to accomplish that in the most productive way.

1.  Watch the attached video. https://youtu.be/cjBPnIXK60U

2. Choose one of the 5 actions/concepts he presents for leaders.

3. Share why you chose this action/concept.

4. Appy how you would use that action/concept in your leadership role in the health care “post pandemic” working environment.

A picture containing text, person, person, music  Description automatically generated

Jim Hemerling is a leader in Boston Consulting Group’s People & Organization and Transformation practices, as well as the firm’s behavior and culture topic. He is also a BCG Henderson Institute Alumni Fellow.

Bottom of Form

Physiology homework help

Project: Delta Care Hope Foundation After School Program

Goal: Delta Care Hope Foundation/ Empowerment works explicitly with less fortunate children and adults who struggle with poor academic performance. The agency is geared towards improving the quality of the student’s educational outcomes, school attendance, social and emotional learning, and quality of life by providing a comprehensive range of services centered on the client’s strengths and uniquely tailored to meet their needs. The agency serves male and female children and youth in the pre-K through grade 12 levels.


INPUTS

ACTIVITIES

OUTCOMES

What we invest

What we do

Who we reach

Why this project: short-term results

Why this project: intermediate results

Why this project: long-term results

· Staff

· Interns

· Funding

· Material

· Equipment

· Technology

· Training

· Space

· Meals

· Collaborations

· Mentees

· Advertise

· Programs/tools/resources

that promote the

development of social skills

· Staff with knowledge, skills,

and strategies to promote

social skills

· Trained adult and peer

mentors

· Partners to support service

learning

· Partners to support career

readiness and college

preparation

· 50 students who need services to enhance their vocabulary and reading comprehension skills.

· 10 mentees

· Community development

• Students

recognize that

help and

resources are

available

• Increased

participation in

after-school

Improved time

management

and study skills

• Increased

engagement in

learning

• Higher school

attendance

rates

• Improved

homework

completion

rates

(quality &

quantity)

• Improved class

participation

• Improved

communication

skills (listening,

verbal, writing)

Improved

academic

performance

• Acquisition and use

of independence

learning skills

• Better attitudes

towards school

• Higher aspirations

for the future

• Improved ability to

work as a team

• Improved problem-solving skills

Assumptions:

· Students’ academic performance will improve

·  health and wellness and social-emotional development

· drug- and violence-prevention

· youth leadership activities

· volunteer and community

External Factors:

· Staff trained in tutoring techniques and homework support.

· Experiential and project-based learning.

· Enrichment activities linked to in-school activities.

· Active recruiting efforts for student participation

Physiology homework help

Running head: PROGRAM EVALUATION PROPOSAL 1

PROGRAM EVALUATION PROPOSAL 1

PROGRAM EVALUATION PROPOSAL

Shandrika Frierson

Mississippi Valley State University

SW 650: Needs Assessment and Program Evaluation

Dr. Carter

April 18, 2022

PROGRAM EVALUATION PROPOSAL

Table of Contents

Executive Summary………………………………………………………………………….

Organizational Background………………………………………………………………….

Social Issue Problem Formulation…………………………………………………………..

Need Statement……………………………………………………………………………..

Goals and Objective……………………………………………………………………………..

Logic Model………………………………………………………………………………………

Research Methods and Designs………………………………………………………………..

Evaluation Discussion…………………………………………………………………………..

Sustainability (Strengths & Limitation) …………………………………………………………

Conclusion……………………………………………………………………………………….

References………………………………………………………………………………………..

PROGRAM EVALUATION PROPOSAL

Delta Care Hope Foundation program aims to respond to the increasing numbers of homeless children, adults, and families in the Mississippi Delta area and the need for a more comprehensive approach to serving them. The agency is geared towards improving the quality of the student’s educational outcomes, school attendance, social and emotional learning, and quality of life by providing a comprehensive range of services centered on the client’s strengths and uniquely tailored to meet their needs. Delta Care Hope Foundation Afterschool program is an opportunity for students to reinforce classroom learning. Students who meet grade and test score eligibilities are selected after the first nine weeks of school. School district teachers and assistant teachers staff the afterschool program two to three days per week for 90-120 minutes. Afterschool staff assist students with homework and augment lessons learned during the regular school day.

Executive Summary:

Improved academic achievement.

• Enrichment services that complement the academic program.

• Family literacy and related educational development services.

Evaluation Criteria and Procedures

Our ASES program evaluation consists of two principal components. They are:

• Local evaluations that aim to find how the existing program is progressing towards

improving and strengthening its services to the students and their families. The local

Evaluation for year 2008‐2009 included the following three surveys:

o Parents’ survey.

o Students’ survey

o Administrator/staff survey

• The state‐mandated evaluation, which presents and analyzes the annual outcome‐based

data. It includes measures of academic performance and attendance throughout the

2020‐2021 academic year such as:

o Academic performance using Statewide evaluation requirement

o Teachers’ survey and analysis.

Physiology homework help

Respond to at least two of your classmates’ postings. Responses should be at least 100 words or more

Week Three

Mario Enriquez (students name)

In the article “1,000 U.S. Hospitals are Critically Short on Staff – And More Expect To Be Soon”, we see that the United States had a shortage of hospital staff all over the 50 states. It was reported that states were suffering such as North Dakota, where 51% of the hospitals reported saying that they are facing shortages. As a future healthcare leader, there is a huge challenge to increase these numbers and it will continue to be that way. In the Military healthcare system, we are seeing a shortage of hospital workers as well, for the first time in a while, we are undermanned with medical personnel. We have seen an increase of burnout and an increase in personnel needing mental health care. Another challenge that has come from the pandemic is trust. There have been many times where hospitals required staff so badly that if you may have been a close contact with COVID-19, they would still put you to work. In fact, the CDC recommended that if you were positive for COVID-19, you would be isolated for 5 days instead of 10 (if asymptomatic). People started distrusting their leadership and quit because of situations like this. 

As healthcare leaders, we will definitely need a change to bring people back into healthcare. One way that we can bring people back in is by incentives. If we offer high bonuses and benefits, people will come back. These benefits have to include paid time off, better pay, access to healthcare services, and more training. We need to invest into our employees to make them feel like they are wanted and they are a family. We also need to work on leadership tactics to make sure that we don’t lose trust.

References

Centers for Disease Control and Prevention. (n.d.). Interim guidance for managing healthcare personnel with SARS-COV-2 infection or exposure to SARS-COV-2. Centers for Disease Control and Prevention. Retrieved April 20, 2022, from https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html

Covid-19 as Catalyst. Deloitte Insights. (n.d.). Retrieved April 20, 2022, from https://www2.deloitte.com/us/en/insights/industry/health-care/health-care-workforce-trends.html

McMinn, S., & Simmons-Duffin, S. (2020, November 21). 1,000 U.S. hospitals are ‘critically’ short on staff – and more expect to be soon. NPR. Retrieved April 20, 2022, from https://www.npr.org/sections/health-shots/2020/11/20/937152062/1-000-u-s-hospitals-are-short-on-staff-and-more-expect-to-be-soon 

Candice Huffsteter (students name)

As the nation continues to grapple with the COVID-19 pandemic, hospitals and health systems nationwide have stepped up in many ways to serve the needs of their communities. Though hospital volumes have seen a sluggish recovery to pre-pandemic levels, there has been growing demand for services with an associated rise in patient acuity. Yet, this increased demand has not been met with an increased supply of staff, creating a staffing shortage that has forced hospitals to incur significant costs to recruit and retain employees. Some of the challenges and reasons I can see for health care staffing shortages are also emotional health and well-being of staff as a leader it will be important to create opportunities to check in with staff and give them opportunities to have wellness check-in and take care of themselves. The level of burnout coupled with ongoing COVID-19 surges, as well as other existing health care workforce pressures, has left hospitals across the country to contend with critical staffing shortages. While government support to date has been critical in helping hospitals weather the early financial challenges they have faced, the current staffing shortage presents a whole new set of challenges that will undoubtedly strain an already precarious financial situation.

References

Nancy Ochieng, P. C. (2022, April 4). Kaiser Family Foundation. Retrieved from KFF.ORG: https://www.kff.org/coronavirus-covid-19/issue-brief/nursing-facility-staffing-shortages-during-the-covid-19-pandemic/

Young Entrepreneur Council. ( 2018, September 25). Forbes.com. Retrieved from Forbes.com: https://www.forbes.com/sites/theyec/2018/09/25/12-traits-bad-bosses-have-in-common/?sh=2450eefe6266

Hyacinth, B. (2017, December 27). Employees don’t leave companies, they leave managers. Retrieved from https://www.linkedin.com/pulse/employees-dont-leave-companies-managers-brigette-hyacinth/

Physiology homework help

Respond to at least two of your classmates’ postings. Responses should be at least 100 words or more

Week Three

Mei Zhang (students name)

After read the attached article, I agree with author’s perspective. That means good leadership can make the entire climate of organization safe and keep employees stay longer. If leaders are not helpful and supportive, there is a lack of opportunity for career, the working schedule is not flexible or poor fit to the role.

I had a bad situation happened when I just joined the Navy. I was E3 (seaman) at deck department. I am an immigrants who original from China. My English was not good at that time so my supervisor treated me different. He always say he doesn’t understand what I am talking, he never explain to me, just let me do this do that instead of giving me proper training. I working over 10 hours every day and also need to stand watch, I tried my best to work, to study, to get qualification, etc. I knew my English was not good, I have accent all the time. People from different states have accent, military accepts diversity, people from all of the world, they all have accent too. My supervisor only pointed to me do extra work, overnight watches. I was so scared to see him whatever I did, he never satisfied. I was super sad and wanted to give up until I got a chance to transfer to another department.

So I realized a leader who manages tends to shape a toxic workplace. Fear replaces motivation and innovation. When good work is not recognized, people will stop putting in the effort to work to the best of their ability. Managers who don’t appreciate their employees will be blamed for a lack of career progression. It is crucial that managers make their people feel their contributions are appreciated, otherwise employees will look where for the challenge and recognition they desire.

During the COVID-19 pandemic, strong and decisive leadership is crucial for time-critical decision-making. The virus has affected different places at different time phase without any warning or notice. In such a situation, the main aim of leaders has been to provide for advanced planning and preparation as well as central strategy for taking necessary action. Fighting a pandemic requires containing and suppressing infections until the relevant vaccines and drugs become available. This must be done in a manner that minimizes human casualties and limits the impact on economic activity.

The following steps I will take as a leader:

1. Define and find the problem

2. Think of as many solutions as possible

3. Choose a solution to try

4. Plan how you are going to implement the chosen solution

5. Carry out the solution

6. Review how it went and may there is any problems

7. Repeat the process if the chosen solution does not solve the problem

Reference

A. S. Bhalla (11 Feb 2021) https://www.orfonline.org/research/leadership-challenges-and-the-covid-19-pandemic/

Hyacinth, B. (2017). Employees don’t leave companies, they leave managers. LinkedIn. December, 27.

McConnell, C. (2021). Chapter fourteen Human Resource Management in Healthcare: Principles and Practices (3rd edition)

Charles Lawless (students name)

Hello everyone,

            Found the article (2017) to be correct through my own experiences, and it follows a continued theme we have been talking about, that organizations are nothing without the individuals that staff them and that staff will give it their all when they are happy with their jobs. The four types of ‘bad bosses’ were enjoyable to read about and I found the names for them to be highly accurate and humorous, and unfortunately have witnessed all four at least once. All of my experiences have been with the Navy, so I will be pulling from those and I am not fully aware on how different they are from non-military positions though it never appears to be too much. Unfortunately I have had several friends/coworkers that wanted to stay in the Navy or they were on the fence and very poor leadership (was actually just one member of leadership) became the catalyst in them deciding to get out and wanting nothing more to do with Navy, which ultimately also reduced their overall productivity until they got out. The unfortunate part is that the military, Navy especially, currently has a toxic leadership problem (Delloue, 2021), and unlike many other jobs it leaves members basically being held hostage during deployments and operations, leading to stress, fatigue, and mental health concerns. The pandemic has resulted in poor leadership only becoming worse, with some not able to manage the pressure correctly, some blaming their staff for the extra work, or simply not being able to rise to occasion, which unfortunately only comes down to the staff and patients suffering. The only thing that I can really do is continue to try my best to develop my abilities as a leader, learn from the mistakes of the poor leaders that I have seen and experiences, and ensure that I don’t let past negative experiences occur again.

 

References

Delloue, T. (2021, December 15). No Shortage of Bad Leaders: Sailor Recalls Hostile Captain Who Set a Toxic Tone. Retrieved from The War Horse: https://thewarhorse.org/bad-military-leadership-set-toxic-tone-navy-officer-recalls/

Hyacinth, B. (2017, December 27). Employees Don’t Leave Companies,They Leave Managers. Retrieved from Linkedin: https://www.linkedin.com/pulse/employees-dont-leave-companies-managers-brigette-hyacinth/

 

Physiology homework help

Part A:How Beliefs Govern Our Lives

Where do beliefs come from about how we should look or live our lives? Think of two faulty
beliefs you may hold about something and how these faulty beliefs impact the way you think or
behave on a daily basis. Think about how long you have held these faulty beliefs, how they
have impacted your life negatively, and most importantly how you can apply theory to help you
resolve these issues.

Part B:

Terms Defined

Define these terms in your OWN words. Knowledge of these terms will assist you in
understanding the material presented.

Anorexia nervosa
Bulimia nervosa
Binge eating disorder
Leptin
Grehlin
Serotonin
Risk factors for eating disorders
Family behaviors and eating disorders
Personality disorder types
Psychological treatment for obese patients
Adolescent treatment for anorexia
Personality disorders:
Borderline
Histrionic
Narcissistic
Paranoid
Schizoid
Schizotypal

Part C:

Genetic Determinant

The role of genes and weight gain appears to be highly correlated in many studies. Write a 500
word paper in APA style examining how the determinant of weight gain is based on these genes
and what interventions can be done to prevent excessive weight gain despite these genes.
Include in your discussion the role of nature and nurture.

Physiology homework help

4. PROGRAM EVALUATION PROPOSAL (DUE: April 14, 2022)

Create a program evaluation proposal for a program that is under development or an area of

unmet need relevant to the current needs of a selected community, agency, or organization.

Students will come up with a practical evidence-based evaluation research model (for example,

pre-test and post-test evaluation or post-test customer satisfaction survey, etc.) that could be

useful in a specific known real-world setting. It is expected that students will integrate and apply

program evaluation concepts covered in class and course readings. This assignment consists of a

program evaluation proposal that includes the following sections: (1) formulation of a specific

social issue facing clients or individuals in students’ selected community, an agency, or

organization; (2) development of a client-centered program model (logic model) designed to

address the specified social issues using existing evidence-based practices (this could be an

existing program at their field placement, a modification of an existing program or a program

under development); and (3) apply research concepts and methods to evaluate the impact of the

program on specified client outcomes. Students are expected to work on an evaluation that is

relevant to the field of social work.

The assignment should be structured as indicated below:

Executive summary (1 page)

o Provide an overview of the purpose of your evaluation.

o Present key evaluation questions

o Discuss the research utilized or proposed to conduct your evaluation

Social issue problem formulation (1-2 pages)

Area should introduce the social issue chosen by integrating research and literature along

with relevant stats about the social problem. For example, if I was proposing an

evaluation regarding teenage pregnancy. I will introduce the social issue of teen

pregnancy, discuss the historical context of teen pregnancy, discuss why it is considered a

social problem, discuss the stats from a national standpoint, state standpoint, and lastly

local.

Organizational Background (or background statement) (2-3 pages)

o Provide an overview of the agency that you are evaluating or the agency that you

plan to evaluate. It should include historical context relative to the social problem

as well as a discussion of the agency’s proposed goals, mission, and purpose.

Also considered how the agency has or has not addressed the social issue(s) in

relation to their goals, mission and purpose.

Goals and Objectives (1 page)

o Discuss and list your intended goals and objectives relative to the evaluation

proposal. What do you intend to accomplish short-term, mid-term, and long-

term?

Needs Assessment (1- 2 pages)

o This section should discuss needs based on your identification and assessment of

current needs within the program and how to effectively close the gap between

what is current in the program and what is needed to make the program more

successful. This can be done through observations, focus groups, surveys, and

interviews. However, since, this is a proposal; you can make the observations of

the needs of the program that you are addressing.

Logic Model (document inserted)

o You will insert the logic model from the assignment that you will complete and

present on February 8, 2021.

Research Methods and Design (1-2 pages)

o You will discuss the research methodology that you will utilize to conduct the

program evaluation.

Evaluation Discussion (1-2 pages)

o Provide a discussion relative to the program that you identified to evaluate and the

plan that you will implement to evaluate the program or how did you evaluate the

program. Indicate material learned throughout the evaluation process.

Sustainability (strengths and limitations) (1 page)

o Discuss the perceived strengths and limitations of your program evaluation

proposal.

Conclusion (not to exceed 1 page)

References (minimum of 10)

Appendices (copies of instruments, etc.)

o Please include your instruments that you developed to carry out the program

evaluation.

Physiology homework help

Unit 3 Scientist Summary

Throughout this unit we have included some biographies of scientists working in the fields of study that we have covered in this class. We would like to hear what you think about their work, their story, and how it relates to your life. Please choose one scientist from the unit and write a short reflection paragraph in your own words (less than 250 words).

This is a reflection, not a test of knowledge. We are most interested in hearing why you chose the scientist and why their work is meaningful or interesting to you. PLEASE DO NOT repeat their academic history.

​​Cynthia Beall

Dr. Beall is a physical anthropologist whose research focuses on human adaptation to high-altitude hypoxia, particularly the different patterns of adaptation exhibited by Andean,

Tibetan, and East African highlanders. Her current research deals with the genetics of adaptive traits and evidence for natural selection, the role of nitric oxide in

oxygen delivery at high altitudes, and with the human ecology of high-altitude Tibetan nomads.

Beall is a Distinguished University Professor and S. Idell Pyle Professor of Anthropology at Case Western Reserve University where she began teaching and research in 1976. She received a Ph.D. in 1976 and an M.A. in 1972 from The Pennsylvania State University.

Professor Beall is a member of the U.S. National Academy of Sciences, American

Philosophical Society, and the American Academy of Arts and Sciences.

Click here for information on Professor Beall’s Research



https://www.bbc.com/future/article/20170227-how-tibetans-survive-life-on-the-roof-of-

the-world

Rubric

Scientist Summary Rubric (3)

Criteria

Ratings

Pts

This criterion is linked to a Learning Outcome

Scientist

1 pts

Full Credit

Identified a scientist of interest from the assigned unit.

0 pts

No Credit

Did not identify a scientist of interest from the assigned unit.

1 pts

This criterion is linked to a Learning Outcome

Research Area

1 pts

Full Credit

Provided a very brief summary of the scientist’s research area.

0 pts

No Credit

Did not provide a summary of scientist’s research area or summary is incorrect.

1 pts

This criterion is linked to a Learning Outcome

Personal Relevance

1 pts

Full Credit

Explained why you picked this scientist and how their work is relevant to you.

0 pts

No Credit

Did not explain why you picked this scientist or how their work is relevant to you.

1 pts

This criterion is linked to a Learning Outcome

Logic/Coherence

1 pts

Full Credit

Explanation of your own thoughts on scientist’s work is coherent and logical.

0 pts

No Credit

Summary is shallow, incoherent, illogical, or lacks effort.

1 pts

Total Points: 4

Physiology homework help

bur64509_fm_i-xxiv.indd i 05/10/17 05:03 PM

Ethical Choices
An Introduction to Moral Philosophy

with Cases

��

bur64509_fm_i-xxiv.indd ii 05/10/17 05:03 PM

bur64509_fm_i-xxiv.indd iii 05/10/17 05:03 PM

Ethical Choices
An Introduction to Moral Philosophy

with Cases

��
RICHARD BURNOR

Felician University

YVONNE RALEY

New York Oxford

O X F O R D U N I V E R S I T Y P R E S S

S E C O N D E D I T I O N

bur64509_fm_i-xxiv.indd iv 05/22/17 09:05 PM

Oxford University Press is a department of the University of Oxford. It furthers the University’s
objective of excellence in research, scholarship, and education by publishing worldwide. Oxford is a
registered trade mark of Oxford University Press in the UK and certain other countries.

Published in the United States of America by Oxford University Press
198 Madison Avenue, New York, NY 10016, United States of America.

© 2018 by Oxford University Press
Published by Oxford University Press, Inc.
198 Madison Avenue, New York, New York 10016
http://www.oup.com

Oxford is a registered trademark of Oxford University Press.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system,
or transmitted, in any form or by any means, without the prior permission in writing of Oxford
University Press, or as expressly permitted by law, by license, or under terms agreed with the
appropriate reproduction rights organization. Inquiries concerning reproduction outside the scope
of the above should be sent to the Rights Department, Oxford University Press, at the address above.

Library of Congress Cataloging-in-Publication Data

Names: Burnor, Richard, author. | Raley, Yvonne, author.
Title: Ethical choices : an introduction to moral philosophy with cases /
   Richard Burnor, Felician College, Yvonne Raley, Felician College.
Description: Second [edition]. | New York : Oxford University Press, 2017.
Identifiers: LCCN 2016049781| ISBN 9780190464509 (student edition) | ISBN
   9780190464516 (instructor’s edition) | ISBN 9780190464530 (course website)
   | ISBN 9780190464547 (instructor’s manual (arc))
Subjects: LCSH: Ethics—Textbooks. | Ethical problems—Textbooks.
Classification: LCC BJ1012 .B755 2017 | DDC 170—dc23
   LC record available at https://lccn.loc.gov/2016049781

9 8 7 6 5 4 3 2 1
Printed by LSC Communications Inc.

bur64509_fm_i-xxiv.indd v 05/10/17 05:03 PM

To the reader, whose intrinsic moral worth has been and
continues to be our most important reason for writing this book.

bur64509_fm_i-xxiv.indd vi 05/10/17 05:03 PM

vii

bur64509_fm_i-xxiv.indd vii 05/10/17 05:03 PM

B R I E F C O N T E N T S

preface xv
guidelines xxiii

part i INTRODUCTION: THEORY
AND PRACTICE 1

Chapter One Ethics and Values 5
Chapter Two Moral Relativism 25
Chapter Three Personal Autonomy and Moral Agency 46
Chapter Four Making Moral Judgments 70
Chapter Five Moral Psychology and Egoism 87

part ii ETHICAL THEORIES AND
PERSPECTIVES 107

Chapter Six Consequentialist Ethics: Act Utilitarianism 111
Chapter Seven Consequentialist Ethics: Rule Utilitarianism 134
Chapter Eight Deontological Ethics 150
Chapter Nine Natural Law Theory 178
Chapter Ten Social Contracts and Rights 198
Chapter Eleven Virtue Ethics 223
Chapter Twelve Feminism and Care Ethics 249
Chapter Thirteen Ethics and Religion 276

bur64509_fm_i-xxiv.indd viii 05/10/17 05:03 PM

part iii INTRODUCTION:
ETHICAL PLURALISM 297

Chapter Fourteen Pluralism in Theoretical and Applied Ethics 301

glossary 337

index 348

viii B R I E F C O N T E N T S

ix

bur64509_fm_i-xxiv.indd ix 05/10/17 05:03 PM

C O N T E N T S

preface xv

guidelines xxiii

part i INTRODUCTION: THEORY AND
PRACTICE 1

Chapter One Ethics and Values 5
I. Extraordinary and Ordinary Morals 5
II. The Nature of Values 8
III. Moral vs. Non-Moral Values 10
IV. Foundational and Instrumental Values 14
V. Explanation and Foundational Values 15

Chapter Assignment Questions 18
Case 1: Breastfeeding in Public 19
Case 2: The Real Price of Coffee 20
Case 3: Jurassic Kitty: Should I Clone My Cat? 22
Case 4: Sex Selection 23

Chapter Two Moral Relativism 25
I. Introduction 25
II. Three Views of Ethics 26
III. Evaluating Subjectivism 28
IV. Supporting Popular Relativism 30
V. Against Relativism 33
VI. A Matter of Tolerance 36

**

x C O N T E N T S

bur64509_fm_i-xxiv.indd x 05/10/17 05:03 PM

VII. Can Relativism Supply What Objectivism Cannot? 38
Chapter Assignment Questions 39

Case 1: Arranged Marriage 40
Case 2: Female Genital Mutilation 40
Case 3: Religious Exemption and the

Death of Matthew Swan 42
Case 4: Women in the Middle East 43

Chapter Three Personal Autonomy and
Moral Agency 46

I. Introduction 46
II. Personal Autonomy 47
III. Implications of Autonomy 51
IV. Moral Agents 52
V. Other Conceptions of Autonomy 56
VI. Relational Autonomy 59

Chapter Assignment Questions 61
Case 1: The Drunk Driver 62
Case 2: Elizabeth Bouvia 62
Case 3: Should the Drinking Age Be Eighteen? 64
Case 4: The Living Will 66
Case 5: Buy Now, Pay Later:

Student Credit Card Debt 68

Chapter Four Making Moral Judgments 70
I. Introduction 70
II. Conflicts 71
III. Characterizing Moral Claims 73
IV. Moral Reasoning 74
V. Moral Reflection 78

Chapter Assignment Questions 80
Case 1: Mr. Research 81
Case 2: Who’s Not Coming to Dinner? 82
Case 3: Who’s Responsible for Obesity? 84

Chapter Five Moral Psychology and Egoism 87
I. Introduction 87
II. Moral Character 89
III. Social and Cultural Influences 93
IV. Ethical and Psychological Egoism 96
V. Egoism and Moral Psychology 99

Chapter Assignment Questions 102
Case 1: Declaring Wages 103

**

**

Contents xi

bur64509_fm_i-xxiv.indd xi 05/10/17 05:03 PM

Case 2: The Scratched Bumper 104
Case 3: Job Competition 104
Case 4: Human Trafficking 105

part ii ETHICAL THEORIES AND
PERSPECTIVES 107

Chapter Six Consequentialist Ethics:
Act Utilitarianism 111

I. Introduction 111
II. Utility and Consequentialism 112
III. Utility and Mill’s Account 114
IV. Act Utilitarianism 116
V. Attractions and Problems 119
VI. Beyond Classical Utilitarianism 124

Chapter Assignment Questions 126
Case 1: Charity vs. iPad 127
Case 2: Sponsoring a Child 128
Case 3: Should Your Next Car Be a Hybrid? 129
Case 4: Factory Farming and Animal Suffering 130
Case 5: Torture Lite 132

Chapter Seven Consequentialist Ethics:
Rule Utilitarianism 134

I. Introduction 134
II. Rule Utilitarianism 135
III. Rule vs. Act Utilitarianism 137
IV. Problems with Rule Utilitarianism 139
V. Justice and Rights Again 143

Chapter Assignment Questions 144
Case 1: Transgender Students at College 145
Case 2: Curbing Grade Inflation 146
Case 3: Universal Healthcare 148

Chapter Eight Deontological Ethics 150
I. Introduction 150
II. Ross’s Ethics 152
III. Kant’s Good Will 155
IV. Kant’s Principle of Ends 157
V. Kant’s Principle of Universal Law 160
VI. The Principle of Autonomy 164
VII. Attractions and Problems 166

**

**

**

**

**

xii C O N T E N T S

bur64509_fm_i-xxiv.indd xii 05/10/17 05:03 PM

Chapter Assignment Questions 169
Case 1: A Demanding Honor Code 169
Case 2: The Ayala Case 171
Case 3: Internet Bride—Straight from Asia 172
Case 4: A Personal Decision 174
Case 5: Beefy Burgers and a Lean Future 175
Case 6: Suicide 177

Chapter Nine Natural Law Theory 178
I. Introduction 178
II. Natural Law Theory 179
III. Forfeiture 181
IV. Double Effect 183
V. Problems For Natural Law Theory 186

Chapter Assignment Questions 189
Case 1: Relieving Pain in a Dying Patient 190
Case 2: Birth Control 191
Case 3: Just War Theory and the

Killing of Noncombatants 193
Case 4: Permanent Vegetative State:

The Case of Terri Schiavo 195

Chapter Ten Social Contracts and Rights 198
I. Introduction 198
II. Locke 200
III. Hobbes 202
IV. Rawls 205
V. Assessing Social Contract Theory 208
VI. Assessing Rights 212
VII. Kinds of Rights 215

Chapter Assignment Questions 217
Case 1: Socrates’s Imprisonment 218
Case 2: Lord of the Flies 219
Case 3: Locke and Load: Lockean

Rights and Gun Control 220

Chapter Eleven Virtue Ethics 223
I. Introduction 223
II. The Heart of Virtue Ethics 224
III. Aristotle’s Virtue Ethics 226
IV. Critiquing Principle-Based Ethics 230
V. Classifying the Virtues 233
VI. Problems With Virtue Ethics 235

**

**

Contents xiii

bur64509_fm_i-xxiv.indd xiii 05/10/17 05:03 PM

Chapter Assignment Questions 239
Case 1: The Unlikely Rescue 240
Case 2: Video Games 241
Case 3: Compulsive Gambling and the Internet 243
Case 4: Moral Luck 245
Case 5: Democracy in Switzerland 247

Chapter Twelve Feminism and Care Ethics 249
I. Introduction 249
II. Feminist Ethics 251
III. The Care Perspective 253
IV. Foundations of an Ethics of Care 257
V. Care and Virtue 261
VI. A Blueprint for Reform 263
VII. Problems 264
VIII. A Concluding Reflection 269

Chapter Assignment Questions 269
Case 1: The International Gemstone Trade 270
Case 2: Parent Responsibility Toward

Their In Utero Child 271
Case 3: The Nestlé Boycott 273
Case 4: Absolute Poverty 274

Chapter Thirteen Ethics and Religion 276
I. Introduction 276
II. Kant on Autonomy and Religion 278
III. Divine Command Theory 281
IV. An Alternate Dependency Account 282
V. Objections and Elaborations 285
VI. Completeness 289

Chapter Assignment Questions 290
Case 1: By Divine Command? 291
Case 2: Religious Symbols and Public Schools 292
Case 3: A Question of Authority 294

part iii ETHICAL PLURALISM 297

Chapter Fourteen Pluralism in Theoretical and
Applied Ethics 301

I. Kinds of Ethical Pluralism 301
II. Medical Ethics: Futility 303
III. Environmental Ethics: Anthropocentrism

and Ecocentrism 310

**

**

**

**

xiv C O N T E N T S

bur64509_fm_i-xxiv.indd xiv 05/10/17 05:03 PM

IV. Business Ethics: Whistle-Blowing 317
V. The Personal Dimension: How Can I

Make Morally Right Choices? 323
Chapter Assignment Questions 326

Case 1: Infant Medical Futility 328
Case 2: Climate Change and Oil 328
Case 3: National Parks 331
Case 4: Surfer, Sailor, Whistle-Blower 332
Case 5: The Diesel Dupe 334
Case 6: The Snowden Leak 334

Glossary 337

Index 348

xv

bur64509_fm_i-xxiv.indd xv 05/10/17 05:03 PM

P R E FA C E

TO THE READER

We are pleased to be able to offer the second edition of Ethical Choices to both
students and the general reader. In preparing this new edition, we have worked to
preserve and improve upon what many reviewers have considered to be the special
strengths of the book.

Many parts of ethics are not exactly easy to understand, but we haven’t wanted
to add to your difficulties by poor writing. By adopting a deliberately informal
style and conversational tone, we have sought to make this book clear, readable,
and accessible regardless of whether or not you’ve previously studied ethics or phi-
losophy. Since we don’t want you to feel that ethics is tedious, we have shortened
unduly long sentences, removed jargon, and reduced the number of technical
terms. Ideally, our hope is that when you read this book, your experience will be
something like having a pleasant conversation with an especially intriguing friend.

This book differs from most ethics introductions in several useful and ap-
pealing ways. Most of all, we intend this book to make ethics engaging for you.
Not surprisingly, we find ethics captivating; we’d very much like you to find it so
as well. Achieving this, it seems to us, requires that we relate ethical topics to your
own life, experiences, and interests. For instance, each chapter includes at least one
opening narrative or scenario meant to grab your attention, boost your interest
in what follows, and illustrate what the chapter is about. Some of these stories are
true; others are at least true to life; they often portray quite ordinary and everyday
experiences. To further engage you in your ethics reading, each chapter is also
followed by a number of practical cases. Again, many of these portray actual situ-
ations; all of them invite you to discover how ethical theory can apply directly to
moral problems. Most of these cases are not about global or national policy issues;
instead, they describe problems and issues that you can probably relate to in your
own life. It’s gratifying to us that, after examining a particular case, students have
sometimes told us that they’ve just gone through a similar experience themselves.

xvi P R E FA C E

bur64509_fm_i-xxiv.indd xvi 05/10/17 05:03 PM

To aid you further in your study of ethics, we have included a number of
helps:

• Immediately following this Preface are the Guidelines for a Case Study Anal-
ysis. These propose a set of steps to follow as you analyze a case or even
work through a personal moral problem. These are also discussed more
informally in the last section of the book.

• Important terms appear throughout the book in boldface where they are
first presented and explained. These “technical” terms will often be used
again. Master these, as they are essential to your “internalizing” concepts
and ideas you need to fully understand ethics.

• Each section of each chapter is usually followed by a set of questions For
Discussion. Whether instructors select any of these as class discussion
topics, you can consider how you would answer them for yourself. This will
help you think more deeply about that section’s material; it may also reveal
how that material relates to other issues that interest you.

• Each section is also followed by a brief Summary; whenever the section
introduces important terms, there is a list of Key Terms together with their
definitions as well. Both can help you reinforce your understanding of what
you’ve just read; they can also be very useful for doing a quick review of that
section and of essential terms and concepts.

• At the end of each chapter, you will find another set of questions labeled
Chapter Assignment Questions. These are more comprehensive than the
questions For Discussion but can serve several of the same purposes.

• Every chapter includes a collection of Additional Resources. Some of these
are links to short YouTube-type presentations on parts of that chapter.
Others take you to an interesting video clip or trailer relating to that
chapter’s topics. A number are links to original works referred to in the
chapter.

• Be sure to refer often to the book’s detailed Table of Contents and its Index;
both can help you find material you need to look at or want to review.

• There is a glossary near the end of the book. This can serve as your first
resource for reviewing and further clarifying the meanings of important
terms.

• A website has been set up specifically for this book. The site provides sev-
eral additional tools: (a) outlines of each chapter, (b) flashcards for learning
key terms, (c) practice quiz questions, (d) PowerPoint presentations of each
chapter’s material, and so on.

Do check out these helps for yourself. Also, thumb through the book to see
how it’s laid out, where you can find help, and how you can best use everything
it makes available to you. We think that many of these things can benefit you
greatly.

Our best wishes are with you as you start your discovery of what the ancient,
fascinating, urgent, and dynamic field of ethics is about!

Preface xvii

bur64509_fm_i-xxiv.indd xvii 05/10/17 05:03 PM

TO THE INSTRUCTOR

This book is primarily intended to serve as an introduction to ethics for college
students who don’t have much familiarity with ethics or philosophy. (It can also
serve as a handy review text for more advanced students and even for graduate stu-
dents.) It provides a survey of major ethical theories and perspectives that we think
is highly accessible even as it remains philosophically accurate and also attempts to
stay up to date. The book’s underlying theme is that of choices. It invites readers to
rationally evaluate a wide range of ethical perspectives, theories, and insights and
to decide which they find to be the most compelling. It also encourages readers to
apply what ethics has to offer to a variety of moral problems as well as to their own
moral predicaments. What particularly sets this book apart from other ethics texts
is its large number of student-relevant “real-life” cases, which can be used to help
students make the transition from theory to application. In addition, each chapter
includes at least one illustrative story or scenario (usually in its opening section) to
pique the reader’s interest and set the stage for what follows.

This book takes the approach that has worked best with our students. We
particularly aim at presenting ethics so that it will resonate with the experiences,
beliefs, and thinking of today’s post-modern-minded students. For instance, it has
become increasingly clear that teaching can be more effective when supplemented
or even largely replaced by relevant stories and narratives that have affective as
well as cognitive force.1 To use the text to best promote the reader’s engagement
and understanding, therefore, we urge you to make systematic use of the book’s
case studies. We also suggest that you draw upon the many narratives appear-
ing in most chapters—along with the accompanying For Discussion questions—to
jump-start class discussions. These will not only engage your students but also
provide valuable opportunities for you to interject comments and even “mini-
lectures” about the material. If you feel even bolder, you might try teaching pri-
marily through class discussions that afford you plenty of opportunities to correct,
reinforce, and extend what students have previously read in the text. We have pro-
vided the For Discussion questions as suggestive starting points for leading such
discussions.

There are several things to mention about the book’s cases. First, a few case
discussions introduce material not presented in the main text (e.g., “Just War
Theory,” “Locke and Load”). These allow you to take your students to a deeper
level in thinking about issues raised by those particular cases. Second, cases have
been deliberately matched to particular theories, chapter by chapter. Nevertheless,
this does not preclude using one chapter’s cases with another chapter’s material.

1Joanna Szurmak and Mindy Thuna, “Tell Me a Story: The Use of Narrative as a Tool for Instruc-
tion,” paper presented at the annual conference of the Association of College and Research Libraries
in Indianapolis, Indiana, April 10, 2013, accessed October 2, 2016, http://www.ala.org/acrl/sites/ala.
org.acrl/files/content/conferences/confsandpreconfs/2013/papers/SzurmakThuna_TellMe.pdf. Philo-
sophical pioneers in the instructional use of stories include Kieran Egan and Gareth Matthews, among
many others. Several other relevant resources are available online.

xviii P R E FA C E

bur64509_fm_i-xxiv.indd xviii 05/10/17 05:03 PM

In fact, many cases may be effectively used with several different theories. The
book’s online website (see more in the following discussion) offers additional sug-
gestions for pairing cases to chapters and theories. Third, the cases following each
chapter proceed (more or less) from shorter and simpler cases to more challeng-
ing and multi-faceted ones. Next, each case is followed by a collection of Thought
Questions. Many of these provide opportunities for applying the concepts and
theory introduced in the chapter to that case. Others extend or even challenge
the theories. To encourage the comparison of different accounts, some allude to
previous theories as well. All of these questions are designed to inspire students
to think beyond their initial or “gut” reactions and to develop more carefully con-
sidered and defensible viewpoints of their own. We have made no attempt to limit
case problems to the easy or uncontroversial. As in real life, many of the prob-
lems raised by the cases pose challenging moral dilemmas that admit to having no
straightforward moral answer.

The Guidelines for a Case Study Analysis immediately follows this preface;
you may want your students to follow these guidelines in doing their case analy-
ses. If you’d rather they not take such a formal approach, you might assign just
selected parts of the guidelines to ensure some structure to student analyses,
or you might use them simply as a source of ideas when you create your own
assignments. We have found the guidelines to be helpful to our students; never-
theless, they may also be completely ignored. None of the book’s cases explicitly
requires their use.

If you have used the first edition of this book, you will find that we have
preserved and even added to its pedagogical tools. Many of these have just been
mentioned or are discussed in the part of this preface directed to the reader. In
addition, note that you can refer to each section’s Summary and Key Terms to de-
termine or remind yourself what that section covers. Further, you should know
that each section’s For Discussion questions tend to be informal and personal; the
more substantive Chapter Assignment Questions, meanwhile, can be used for as-
signments or to suggest assignment ideas. Further, you may find that some of the
Additional Resources include videos and other types of presentations that might
usefully supplement your classes.

Depending on the chapter, these might include videos or movie trailers re-
lated to the chapter’s material, short presentations of portions of that chapter’s ma-
terial, other texts that also cover the chapter’s material particularly well, or, when
available, links to relevant online primary sources in ethics (e.g., Plato’s Republic
or Hobbes’s Leviathan). You might want to use some of the primary source links
to have students do readings in the original works (without having them buy a
supplementary text). All of these resources enable readers to pursue many topics
more fully as they wish.

As many reviewers approved of the text’s organization, we have largely pre-
served that while adding some additional flexibility. On the most local level, each
chapter still divides into clearly delineated sections. You may thus assign readings

Preface xix

bur64509_fm_i-xxiv.indd xix 05/10/17 05:03 PM

by section, or you might assign students to read only certain sections rather than
an entire chapter. Sections that go beyond essential material or that are more spe-
cialized or advanced are also still marked (by ** in their headings). These may be
excluded from a course without jeopardizing student understanding of later sec-
tions or chapters.

On a more global level, the book discusses more theories and cases than most
courses can accommodate. It thus allows considerable leeway in what topics you
want to include in a course. Most chapters are fairly self-contained, though some
unavoidably must refer to preceding material. When such references are made, the
relevant chapter and section is identified. This not only helps in reviewing earlier
material but also allows you to entirely skip an earlier chapter and then assign one
of that chapter’s sections as background for a topic introduced in a later chapter.
Several chapters may simply be skipped entirely. Chapters that seem more dis-
cretionary include Chapter Five: Moral Psychology and Egoism; Chapter Seven:
Consequentialist Ethics: Rule Utilitarianism; Chapter Nine: Natural Law Theory;
Ten: Social Contracts and Rights; Twelve: Feminism and Care Ethics; and Chapter
Thirteen: Ethics and Religion. Another chapter you might elect to skip is Chapter
Three: Personal Autonomy and Moral Agency, although some of this must be cov-
ered if you wish to include Chapter Fourteen’s §II: Medical Ethics: Futility, since
the latter relies heavily on concepts of autonomy and agency. A knowledgeable
instructor can also present many of the chapters in different orders with relatively
little inconvenience.

CHANGES IN THE SEC OND EDITION

The book has been completely overhauled stylistically in an effort to simplify and
streamline the presentation, to reduce the number of “key terms” and other tech-
nical jargon, to standardize terminology, and to achieve a friendlier conversational
tone. Occasional corrections have also been made (e.g., the discussion of Kant and
absolutism has been corrected and further elaborated). Besides these, a number of
other quite substantial changes have been made:

• Changes in organization:
º Material from the previous Chapters One, Two, and Five has been re-

arranged, simplified, and consolidated into Chapters One and Four.
Chapter One now begins with values, which we think provides a more
intuitive route to understanding morality and ethics; our characteriza-
tion of moral claims and an expanded discussion of moral thinking then
appears in Chapter Four.

º The chapter on Moral Relativism (Chapter Two) now precedes the chap-
ter on Personal Autonomy and Moral Agency (Chapter Three).

º The previous Chapter Six on egoism has been removed, though some
material from that chapter has been incorporated in the new Chapters

xx P R E FA C E

bur64509_fm_i-xxiv.indd xx 05/10/17 05:03 PM

Five and Six. This change connects egoism to related topics in moral psy-
chology rather than to consequentialist theories in general.

º The previous edition’s chapter on natural law and natural rights has been
divided into separate chapters. The new Chapter Nine is devoted exclu-
sively to natural law theory; the new Chapter Ten treats rights more com-
prehensively as part of its exposition of social contract theory.

• Additional content:
º Added to the generalist, principle-based pattern of “moral reasoning” of

the previous edition is a contrasting particularist pattern of “moral re-
flection.” See the new Chapter Four, which now presents both patterns
of moral thinking.

º A largely new Chapter Five explores major themes in moral psychology,
some of which is related to ethical and psychological egoism.

º The largely new Chapter Ten, Social Contracts and Rights, presents the
social contract theories of Locke, Hobbes, and Rawls while also expand-
ing the previous edition’s presentation of rights.

º A synopsis of feminist ethics and its development has been added to
Chapter Twelve, Feminism and Care Ethics.

º A largely new final Chapter Fourteen, Pluralism in Theoretical and Ap-
plied Ethics, has been added. This chapter revises the previous edition’s
presentation of ethical pluralism and adds three major new sections in
applied ethics: §II Medical Ethics: Futility, §III Environmental Ethics:
Anthropocentrism and Ecocentrism, §IV Business Ethics: Whistle-
Blowing. The chapter closes with a revised section that discusses the ap-
plication of ethics to one’s personal life.

• Added pedagogical tools:
º Sixteen new cases have been written for this edition, making for fifty-

seven cases total. Most of the previous cases have also been updated to re-
flect more recent developments; a few have been dropped, and a few have
been altered significantly (e.g., “Guess Who’s Not Coming for Dinner,”
“Climate Change and Oil”).

º Each chapter section is now accompanied by a set of For Discussion
questions.

º A glossary of terms is now included at the end of the book.

A Companion Website at www.oup.com/us/burnor is available. This provides
several resources for both students and instructors. Besides what is previously
mentioned in “To the Reader”, instructors will also find sets of quiz questions,
suggestions for alternate uses of the cases, and an additional applied ethics chap-
ter on moral responsibilities toward future generations. More cases may be added
from time to time.

Preface xxi

bur64509_fm_i-xxiv.indd xxi 05/10/17 05:03 PM

ACKNOWLED GMENT S

Our special thanks go to Robert Miller, Donald Casey, Irfan Khawaja, George
Abaunza, and Vicky Burnor as well as to the many students, colleagues, and review-
ers who provided suggestions, corrections, and criticisms of the many drafts that
have ultimately culminated in this book. For their invaluable reviews, we would es-
pecially like to thank Mark Alfano, Australian Catholic University; Luke Amentas,
Kingsborough Community College, CUNY; Christopher Baker, Armstrong State
University; Kate Bednar, University of Kansas; Jason Borenstein, Georgia Institute
of Technology; Julien M. Farland, Anna Maria College; Bob Fischer, Texas State
University; Dana R. Flint, The Lincoln University; Lisa Jorgensen, Vanier College;
Shawn McKinney, Hillsborough Community College; Christian Perring, St. John’s
University; Peter Simpson, The Graduate Center, CUNY; Daniel Star, Boston Uni-
versity; Peter B. Trumbull, Madison College; Bas van der Vossen, University of
North Carolina, Greensboro; Andrea Veltman, James Madison University; and
Julius L. Wynn, St. Petersburg College. Finally, we thank Felician University for its
funding and support of this project over many years and in many ways.

bur64509_fm_i-xxiv.indd xxii 05/10/17 05:03 PM

xxiii

bur64509_fm_i-xxiv.indd xxiii 05/10/17 05:03 PM

G U I D E L I N E S F O R A C A S E S T U D Y A NA LY S I S

A case study analysis provides a powerful tool for sorting through and resolv-ing an ethical problem, regardless of its specific subject. A complete case
analysis consists of the following five steps:

1. Summarize the main problem and its setting.
What are the essential elements of the situation, and what is the ethical problem
at issue? Summarize the case in your own words, writing as though you were ex-
plaining it to someone who is not familiar with it. Some helpful questions: Who
are the key players? Who is affected by the outcome? Are there other important
facts that are

Physiology homework help

D O I N G
E T H I C S

‘’
Moral Reasoning and Contemporary Issues

F I F T H E D I T I O N

Lewis Vaughn

n
W . W . N O R T O N & C O M P A N Y , I N C .

N E W Y O R K • L O N D O N

W. W. Norton & Company has been independent since its founding in 1923, when William Warder
Norton and Mary D. Herter Norton first published lectures delivered at the People’s Institute, the
adult education division of New York City’s Cooper Union. The firm soon expanded its program
beyond the Institute, publishing books by celebrated academics from America and abroad. By
midcentury, the two major pillars of Norton’s publishing program— trade books and college texts—
were firmly established. In the 1950s, the Norton family transferred control of the company to its
employees, and today— with a staff of four hundred and a comparable number of trade, college,
and professional titles published each year— W. W. Norton & Company stands as the largest and

oldest publishing house owned wholly by its employees.

Copyright © 2019, 2016, 2013, 2010, 2008 by W. W. Norton & Company, Inc.

All rights reserved
Printed in the United States of America

Editor: Ken Barton
Project Editors: Taylere Peterson, Katie Callahan, and Sujin Hong
Editorial Assistant: Katie Pak
Manuscript Editor: Norma Sims Roche
Managing Editor, College: Marian Johnson
Managing Editor, College Digital Media: Kim Yi
Production Manager: Benjamin Reynolds
Media Editor: Samantha Held
Media Assistant: Ava Bramson
Marketing Manager, Philosophy: Michael Moss
Design Director: Rubina Yeh
Permissions Manager: Megan Schindel
Permissions Associate: Elizabeth Trammell
Composition: SixRedMarbles—Brattleboro, VT
Manufacturing: LSC Communications—Crawfordsville, IN

Permission to use copyrighted material is included as a footnote on the first page of each reading.

ISBN: 978-0-393-64026-7

W. W. Norton & Company, Inc., 500 Fifth Avenue, New York, NY 10110-0017

wwnorton.com

W. W. Norton & Company Ltd., 15 Carlisle Street, London W1D 3BS

1 2 3 4 5 6 7 8 9 0

iii

C O N T E N T S

‘’
P r e f a c e x i x

P A R T 1 : F U N D A M E N T A L S

C H A P T E R 1 Ethics and the Examined Life 3

The Ethical Landscape 5

The Elements of Ethics 6

The Preeminence of Reason 6

Quick Review 7

The Universal Perspective 7

The Principle of Impartiality 7

The Dominance of Moral Norms 8

Religion and Morality 8

Believers Need Moral Reasoning 9

When Conflicts Arise, Ethics Steps In 9

Moral Philosophy Enables Productive Discourse 9

Critical Thought—Ethics, Religion,
And Tough Moral Issues 1 0

SUMMARY 1 1

KEY TERMS 1 2

REVIEW QUESTIONS 1 2

DISCUSSION QUESTIONS 1 2

ETHICAL DILEMMAS 1 3

FURTHER READING 1 3

R E A D I N G S

What Is the Socratic Method? by Christopher Phillips 1 4

The Euthyphro by Plato 1 6

C H A P T E R 2 Subjectivism, Relativism, and Emotivism 2 0

Subjective Relativism 2 1

Quick Review 2 1

Judge Not? 2 2

Cultural Relativism 2 3

Critical Thought—“Female Circumcision”
And Cultural Relativism 2 4

Emotivism 2 8

SUMMARY 3 0

KEY TERMS 3 1

REVIEW QUESTIONS 3 1

DISCUSSION QUESTIONS 3 1

ETHICAL DILEMMAS 3 2

FURTHER READING 3 2

R E A D I N G S

Anthropology and the Abnormal by Ruth Benedict 3 3

Trying Out One’s New Sword by Mary Midgley 3 5

P A R T 2 : M O R A L R E A S O N I N G

C H A P T E R 3 Evaluating Moral Arguments 4 1

Claims and Arguments 4 1

Arguments Good and Bad 4 3

Critical Thought—The Moralit y
Of Critical Thinking 4 4

Implied Premises 4 7

Quick Review 4 7

Deconstructing Arguments 48

Moral Statements and Arguments 5 1

Testing Moral Premises 5 4

Assessing Nonmoral Premises 5 5

Quick Review 5 5

Á CONTENTSiv

Avoiding Bad Arguments 5 6

Begging the Question 5 6

Equivocation 5 7

Appeal to Authority 5 7

Appeal To Emotion 5 7

Slippery Slope 5 8

Faulty Analogy 5 8

Appeal to Ignorance 5 8

Straw Man 5 9

Appeal to the Person 5 9

Hasty Generalization 5 9

Quick Review 6 0

Writing and Speaking about Moral Issues 6 0

SUMMARY 6 2

KEY TERMS 6 2

REVIEW QUESTIONS 6 3

DISCUSSION QUESTIONS 6 3

ARGUMENT EXERCISES 6 3

FURTHER READING 6 4

C H A P T E R 4 The Power of Moral Theories 6 5

Theories of Right and Wrong 6 5

Moral Theories Versus Moral Codes 6 6

Major Theories 6 7

Consequentialist Theories 6 7

Nonconsequentialist Theories 6 8

Quick Review 6 9

Evaluating Theories 7 0

Criterion 1: Consistency with Considered Moral Judgments 7 1

Considered Moral Judgment s 7 2

Criterion 2: Consistency with Our Moral Experiences 7 2

Critical Thought—A 100 Percent All-Natural Theory 7 3

Criterion 3: Usefulness in Moral Problem Solving 7 3

CONTENTS Á v

Quick Review 7 4

Devising a Coherent Moral Theory 7 4

Moral Common Sense 7 4

Building a Moral Theory 7 5

Prima Facie Principles 7 6

Three Rules 7 7

Self-Evidence 8 0

SUMMARY 8 1

KEY TERMS 8 1

REVIEW QUESTIONS 8 1

DISCUSSION QUESTIONS 8 2

ETHICAL DILEMMAS 8 2

FURTHER READING 8 2

P A R T 3 : T H E O R I E S O F M O R A L I T Y

C H A P T E R 5 Consequentialist Theories: Maximize the Good 8 5

Ethical Egoism 8 5

Applying the Theory 8 6

Evaluating the Theory 8 7

Can Ethical Egoism Be Advocated? 8 9

Quick Review 9 1

Utilitarianism 9 1

Applying the Theory 9 4

Peter Singer, Utilitarian 9 5

Quick Review 9 6

Evaluating the Theory 9 6

Learning from Utilitarianism 1 0 0

Social Contract Theory 1 0 0

Critical Thought—Cross-Species Transplant s: What Would A
Utilitarian Do? 1 0 1

Hobbes’s Theory 1 0 1

Evaluating the Theory 1 0 2

Á CONTENTSvi

CONTENTS Á  vii

SUMMARY 1 0 4

KEY TERMS 1 0 5

REVIEW QUESTIONS 1 0 5

DISCUSSION QUESTIONS 1 0 5

ETHICAL DILEMMAS 1 0 6

FURTHER READING 1 0 6

R E A D I N G S

Egoism and Altruism by Louis P. Pojman 1 0 7

Utilitarianism by John Stuart Mill 1 1 1

A Theory of Justice by John Rawls 1 1 5

The Entitlement Theory of Justice by Robert Nozick 1 2 2

C H A P T E R 6 Nonconsequentialist Theories: Do Your Duty 1 3 2

Kant’s Ethics 1 3 2

Critical Thought—Sizing Up The Golden Rule 1 3 4

Applying the Theory 1 3 5

Evaluating the Theory 1 3 6

Kant, Respect, And Personal Right s 1 3 7

Learning from Kant’s Theory 1 3 8

Natural Law Theory 1 3 9

Applying the Theory 1 4 1

Quick Review 1 4 1

Critical Thought—Double Effect
And The “Trolley Problem” 1 4 2

Evaluating the Theory 1 4 2

Learning from Natural Law 1 4 3

SUMMARY 1 4 4

KEY TERMS 1 4 4

REVIEW QUESTIONS 1 4 4

DISCUSSION QUESTIONS 1 4 5

ETHICAL DILEMMAS 1 4 5

FURTHER READING 1 4 6

R E A D I N G S

Fundamental Principles of the Metaphysic of Morals
by Immanuel Kant 1 4 6

Summa Theologica by St. Thomas Aquinas 1 5 5

Morality as a System of Hypothetical Imperatives by Philippa Foot 1 6 5

C H A P T E R 7 Virtue Ethics: Be a Good Person 1 7 2

The Ethics of Virtue 1 7 2

Critical Thought—Learning Virtues
In The Classroom 1 7 3

Virtue in Action 1 7 4

Evaluating Virtue Ethics 1 7 4

Critical Thought—Warrior Virtues And Moral
Disagreement s 1 7 6

Quick Review 1 7 7

Learning from Virtue Ethics 1 7 7

SUMMARY 1 7 7

KEY TERMS 1 7 8

REVIEW QUESTIONS 1 7 8

DISCUSSION QUESTIONS 1 7 8

ETHICAL DILEMMAS 1 7 8

FURTHER READING 1 7 9

R E A D I N G S

Nicomachean Ethics by Aristotle 1 7 9

The Need for More Than Justice by Annette C. Baier 1 8 8

Á CONTENTSviii

C H A P T E R 8 Feminist Ethics and the Ethics of Care 1 9 6

Feminist Ethics 1 9 7

Critical Thought—Feminist Ethics In History 1 9 7

The Ethics of Care 1 9 8

Quick Review 1 9 9

SUMMARY 1 9 9

KEY TERMS 1 9 9

REVIEW QUESTIONS 1 9 9

DISCUSSION QUESTIONS 2 0 0

ETHICAL DILEMMAS 2 0 0

FURTHER READING 2 0 0

R E A D I N G S

Feminist Ethics by Alison M. Jaggar 2 0 1

The Ethics of Care as Moral Theory by Virginia Held 2 0 9

P A R T 4 : E T H I C A L I S S U E S

C H A P T E R 9 Abortion 2 2 1

Issue File: Background 2 2 1

Abortion In The United States: Fact s And Figures 2 2 3

Moral Theories 2 2 4

Majorit y Opinion In Ro e V. Wa d e 2 2 5

Abortion And The Scriptures 2 2 6

Moral Arguments 2 2 7

Quick Review 2 2 7

State Abortion Laws 2 2 9

Critical Thought—Fact-Checking Abortion Claims 2 3 1

CONTENTS Á ix

SUMMARY 2 3 3

KEY TERMS 2 3 4

REVIEW QUESTIONS 2 3 4

DISCUSSION QUESTIONS 2 3 4

FURTHER READING 2 3 5

ETHICAL DILEMMAS 2 3 5

R E A D I N G S

A Defense of Abortion by Judith Jarvis Thomson 2 3 7

On the Moral and Legal Status of Abortion by Mary Anne Warren 2 4 7

Why Abortion Is Immoral by Don Marquis 2 5 6

Virtue Theory and Abortion by Rosalind Hursthouse 2 6 8

Abortion Through a Feminist Ethics Lens by Susan Sherwin 2 7 4

C H A P T E R 1 0 Euthanasia and Physician-Assisted Suicide 2 8 5

The Death Of K aren Ann Quinlan 2 8 6

Issue File: Background 2 8 6

Landmark Court Rulings 2 8 8

Quick Review 2 8 9

Moral Theories 2 8 9

Critical Thought—Dr. Kevorkian
And Physician-Assisted Suicide 2 9 1

Moral Arguments 2 9 1

Public Opinion And Euthanasia 2 9 3

SUMMARY 2 9 5

KEY TERMS 2 9 6

REVIEW QUESTIONS 2 9 6

DISCUSSION QUESTIONS 2 9 6

FURTHER READING 2 9 6

ETHICAL DILEMMAS 2 9 7

Á CONTENTSx

R E A D I N G S

Active and Passive Euthanasia by James Rachels 3 0 0

The Wrongfulness of Euthanasia by J. Gay-Williams 3 0 4

Voluntary Active Euthanasia by Dan W. Brock 3 0 7

Euthanasia by Philippa Foot 3 1 5

Killing and Allowing to Die by Daniel Callahan 3 2 9

Euthanasia for Disabled People? by Liz Carr 3 3 2

C H A P T E R 1 1 Delivering Health Care 3 3 4

Issue File: Background 3 3 4

Health Care By Country 3 3 6

Critical Thought—Comparing Health Care Systems 3 3 7

Moral Theories 3 3 8

Moral Arguments 3 3 9

Quick Review 3 4 0

SUMMARY 3 4 0

KEY TERMS 3 4 1

REVIEW QUESTIONS 3 4 1

DISCUSSION QUESTIONS 3 4 1

FURTHER READING 3 4 2

ETHICAL DILEMMAS 3 4 2

R E A D I N G S

Autonomy, Equality and a Just Health Care System by Kai Nielsen 3 4 4

The Right to a Decent Minimum of Health Care by Allen E. Buchanan 3 5 0

Is There a Right to Health Care and, If So, What Does It Encompass?
by Norman Daniels 3 6 3

CONTENTS Á xi

C H A P T E R 1 2 Animal Welfare 3 7 1

Issue File: Background 3 7 2

Critical Thought—Using Animals To Test Consumer
Product s 3 7 4

Moral Theories 3 7 5

Critical Thought—Should We Experiment
On Orphaned Babies? 3 7 7

Quick Review 3 7 8

Moral Arguments 3 7 8

SUMMARY 3 7 9

KEY TERMS 3 8 0

REVIEW QUESTIONS 3 8 0

DISCUSSION QUESTIONS 3 8 0

FURTHER READING 3 8 0

ETHICAL DILEMMAS 3 8 1

R E A D I N G S

All Animals Are Equal by Peter Singer 3 8 4

The Case for Animal Rights by Tom Regan 3 9 4

Difficulties with the Strong Animal Rights Position
by Mary Anne Warren 4 0 1

The Case for the Use of Animals in Biomedical Research by Carl Cohen 4 0 7

How to Argue for (and Against) Ethical Veganism by Tristram McPherson 4 1 4

C H A P T E R 1 3 Environmental Ethics 4 2 9

Issue File: Background 4 3 0

Climate Change—How We Know It’s Real 4 3 2

Moral Theories 4 3 4

Quick Review 4 3 5

Moral Arguments 4 3 5

Critical Thought—Should Pandas Pay The Price? 4 3 6

SUMMARY 4 3 8

KEY TERMS 4 3 8

Á CONTENTSxii

REVIEW QUESTIONS 4 3 9

DISCUSSION QUESTIONS 4 3 9

FURTHER READING 4 3 9

ETHICAL DILEMMAS 4 4 0

R E A D I N G S

People or Penguins by William F. Baxter 4 4 2

It’s Not My Fault: Global Warming and Individual Moral Obligations by Walter
Sinnott-Armstrong 4 4 6

Are All Species Equal? by David Schmidtz 4 5 8

The Land Ethic by Aldo Leopold 4 6 5

C H A P T E R 1 4 Racism, Equality, and Discrimination 4 7 0

Issue File: Background 4 7 1

Critical Thought—White Privilege 4 7 4

Critical Thought—Are Legacy Admissions R acist? 4 7 9

Moral Theories 4 8 0

Critical Thought—Are Whites-Only Scholarships Unjust? 4 8 1

Quick Review 4 8 2

Moral Arguments 482

SUMMARY 484

KEY TERMS 485

REVIEW QUESTIONS 485

DISCUSSION QUESTIONS 486

FURTHER READING 486

ETHICAL DILEMMAS 4 8 6

R E A D I N G S

Racisms by Kwame Anthony Appiah 4 8 9

Racism: What It Is and What It Isn’t by Lawrence Blum 4 9 9

Dear White America by George Yancy 5 0 8

Uses and Abuses of the Discourse of White Privilege by Naomi Zack 5 1 1

The Case Against Affirmative Action by Louis P. Pojman 5 1 4

In Defense of Affirmative Action by Tom L. Beauchamp 5 2 6

CONTENTS Á xiii

C H A P T E R 1 5 Sexual Morality 5 3 6

Issue File: Background 5 3 6

Sexual Behavior 5 3 6

Vital Stat s—Sexual Behavior 5 3 7

Campus Sexual Assault 5 3 8

Critical Thought—Proving Sexual Assault 5 4 0

Moral Theories 5 4 1

Moral Arguments 5 4 2

Quick Review 5 4 4

SUMMARY 5 4 4

KEY TERMS 5 4 5

REVIEW QUESTIONS 5 4 5

DISCUSSION QUESTIONS 5 4 5

FURTHER READING 5 4 6

ETHICAL DILEMMAS 5 4 6

R E A D I N G S

Plain Sex by Alan H. Goldman 5 4 8

Sexual Morality by Roger Scruton 5 5 7

Why Shouldn’t Tommy and Jim Have Sex? A Defense of Homosexuality
by John Corvino 5 6 4

Seduction, Rape, and Coercion by Sarah Conly 5 7 1

Sex under Pressure: Jerks, Boorish Behavior, and Gender Hierarchy
by Scott A. Anderson 5 8 2

C H A P T E R 1 6 Free Speech on Campus 5 8 9

Issue File: Background 5 9 0

Critical Thought—Who Can Say The N-Word? 5 9 1

Microaggressions 5 9 3

Moral Theories 5 9 4

Critical Thought—Is Hate Speech Violence? 5 9 5

College Student s And Free Speech 5 9 6

Quick Review 5 9 7

Á CONTENTSxiv

CONTENTS Á  xv

xv

Moral Arguments 5 9 7

SUMMARY 5 9 7

KEY TERMS 5 9 8

REVIEW QUESTIONS 5 9 8

DISCUSSION QUESTIONS 5 9 8

FURTHER READING 5 9 9

ETHICAL DILEMMAS 5 9 9

R E A D I N G S

Why It’s a Bad Idea to Tell Students Words Are Violence
by Jonathan Haidt and Greg Lukianoff 6 0 1

Restoring Free Speech on Campus by Geoffrey R. Stone and Will Creeley 6 0 5

Speech Codes and Expressive Harm by Andrew Altman 6 0 6

What “Snowflakes” Get Right About Free Speech by Ulrich Baer 6 1 5

The Progressive Ideas behind the Lack of Free Speech on Campus
by Wendy Kaminer 6 1 8

C H A P T E R 1 7 Drugs, Guns, and Personal Liberty 6 2 1

Issue File: Background 6 2 1

Drugs: Social Harms versus Personal Freedom 6 2 1

Critical Thought—Does Legalizing Medical Marijuana
Encourage Use Among Teenagers? 6 2 2

Diverse Views On Legalizing Marijuana 6 2 3

Gun Ownership: Security versus Individual Rights 6 2 4

Vital Stat s—Guns In The United States 6 2 5

Survey—Views Of U.S. Adult s On Gun Policy 6 2 6

Moral Theories 6 2 6

Moral Arguments 6 2 8

Quick Review 6 3 0

SUMMARY 6 3 1

KEY TERMS 6 3 1

REVIEW QUESTIONS 6 3 1

Á  CONTENTSxvixvi

DISCUSSION QUESTIONS 6 3 2

FURTHER READING 6 3 2

ETHICAL DILEMMAS 6 3 2

R E A D I N G S

The Ethics of Addiction by Thomas Szasz 6 3 4

Against the Legalization of Drugs by James Q. Wilson 6 4 3

Gun Control by Hugh LaFollette 6 5 2

Political Philosophy and the Gun Control Debate: What Would Bentham,
Mills, and Nozick Have to Say? by Stacey Nguyen 6 6 3

C H A P T E R 1 8 Capital Punishment 6 6 6

Issue File: Background 6 6 6

Moral Theories 6 6 8

Critical Thought—The Moralit y Of Botched
Executions 6 7 0

Quick Review 6 7 2

Moral Arguments 6 7 3

Critical Thought—Different Cases,
Same Punishment 6 7 4

SUMMARY 6 7 5

KEY TERMS 6 7 6

REVIEW QUESTIONS 6 7 6

DISCUSSION QUESTIONS 6 7 6

FURTHER READING 6 7 6

ETHICAL DILEMMAS 6 7 7

R E A D I N G S

The Ultimate Punishment: A Defense by Ernest van den Haag 6 7 9

Justice, Civilization, and the Death Penalty: Answering van den Haag
by Jeffrey H. Reiman 6 8 4

The Case Against the Death Penalty by Hugo Adam Bedau 6 9 0

A Life for a Life by Igor Primoratz 6 9 8

CONTENTS Á  xvii

C H A P T E R 1 9 Political Violence: War, Terrorism, and Torture 7 0 5

Issue File: Background 7 0 5

Critical Thought—Preemptive War On Iraq 7 0 8

Moral Theories 7 1 5

Moral Arguments 7 1 7

Quick Review 7 2 1

SUMMARY 7 2 1

KEY TERMS 7 2 2

REVIEW QUESTIONS 7 2 2

DISCUSSION QUESTIONS 7 2 2

FURTHER READING 7 2 3

ETHICAL DILEMMAS 7 2 3

R E A D I N G S

Reconciling Pacifists and Just War Theorists by James P. Sterba 7 2 6

Drones, Ethics, and the Armchair Soldier by John Kaag 7 3 5

Can Terrorism Be Morally Justified? by Stephen Nathanson 7 3 7

The Case for Torturing the Ticking Bomb Terrorist by Alan M. Dershowitz 7 4 5

My Tortured Decision by Ali Soufan 7 5 4

C H A P T E R 2 0 The Ethics of Immigration 7 5 6

Issue File: Background 7 5 6

Critical Thought—Deporting Children 7 6 0

Quick Review 7 6 0

Moral Theories 7 6 1

Critical Thought—Accepting Or Rejecting Refugees 7 6 1

Moral Arguments 7 6 2

SUMMARY 7 6 3

KEY TERMS 7 6 3

REVIEW QUESTIONS 7 6 3

DISCUSSION QUESTIONS 7 6 3

FURTHER READING 7 6 4

ETHICAL DILEMMAS 7 6 4

Á  CONTENTSxviii

R E A D I N G S

The Morality of Migration by Seyla Benhabib 7 6 6

The Moral Dilemma of U.S. Immigration Policy Revisted: Open Borders vs. Social
Justice? by Stephen Macedo 7 6 8

Selecting Immigrants by David Miller 7 8 1

Immigration and Freedom of Association by Christopher Heath Wellman 7 8 7

Freedom of Association Is Not the Answer by Sarah Fine 8 0 8

C H A P T E R 2 1 Global Economic Justice 8 2 0

Issue File: Background 8 2 0

Moral Theories 8 2 2

Vital Stat s—The Planet’s Poor And Hungry 8 2 2

Moral Arguments 8 2 3

Quick Review 8 2 5

SUMMARY 8 2 6

KEY TERMS 8 2 6

REVIEW QUESTIONS 8 2 6

DISCUSSION QUESTIONS 8 2 6

FURTHER READING 8 2 7

ETHICAL DILEMMAS 8 2 7

R E A D I N G S

Famine, Affluence, and Morality by Peter Singer 8 2 9

Lifeboat Ethics by Garrett Hardin 8 3 5

A Critique of Lifeboat Ethics by William W. Murdoch and Allan Oaten 8 4 1

The Case for Aid by Jeffrey Sachs 8 5 0

G L O S S A R Y G – 1

A N S W E R S T O A R G U M E N T E X E R C I S E S A – 1

N O T E S N – 1

I N D E X I – 1

P R E F A C E

‘’

This fifth edition of Doing Ethics contains the most
extensive additions, updates, and improvements
of any previous version. The aims that have shaped
this text from the beginning have not changed: to
help students (1) see why ethics matters to society
and to themselves; (2) understand core concepts
(theories, principles, values, virtues, and the like);
(3) become familiar with the background (scientific,
legal, and otherwise) of contemporary moral prob-
lems; and (4) know how to apply critical reasoning
to those problems— to assess moral judgments and
principles, construct and evaluate moral arguments,
and apply and critique moral theories. This book,
then, tries hard to provide the strongest possible
support to teachers of applied ethics who want stu-
dents, above all, to think for themselves and compe-
tently do what is often required of morally mature
persons— that is, to do ethics.

These goals are reflected in the book’s extensive
introductions to concepts, cases, and issues; its
large collection of readings and exercises; and its
chapter- by- chapter coverage of moral reasoning—
perhaps the most thorough introduction to these
skills available in an applied ethics text. This latter
theme gets systematic treatment in five chapters,
threads prominently throughout all the others,
and is reinforced everywhere by “Critical Thought”
text boxes prompting students to apply critical
thinking to real debates and cases. The point of all
this is to help students not just study ethics but to
become fully involved in the ethical enterprise and
the moral life.

NEW FEATURES

• A new chapter on campus free speech, hate
speech, speech codes, speech and violence,
and news- making conflicts: Chapter 16—Free
Speech on Campus. It includes five readings by
notable free speech theorists and commentators.

• A new stand- alone chapter on an increasingly
influential approach to ethics: Chapter 8—
Feminist Ethics and the Ethics of Care. It
includes two new readings by important
theorists in the field.

• A new chapter on the justice of health care—
who should get it, who should supply it, and
who should pay for it: Chapter 11—Delivering
Health Care.

• A new chapter on immigration, immigration
policy, and contemporary conflicts over the
treatment of immigrants: Chapter 20—The Eth-
ics of Immigration. It includes recent research
on some widely believed but erroneous ideas
about U.S. immigration, as well as five readings
that represent contrasting perspectives on the
subject.

• A substantially revised chapter on social
equality, now covering race, racism, racial
prejudice, discrimination, white privilege,
and affirmative action: Chapter 14—Racism,
Equality, and Discrimination. It includes
four new readings on racism and inequality
by prominent participants in the ongoing
debates.

xix

xx Á PREFACE

• A revised chapter on sexuality, now including
examinations not only of sexual behavior but
also of campus sexual assault, rape, harass-
ment, and hookup culture: Chapter 15— Sexual
Morality.

• A greatly expanded chapter on personal liberty,
now including discussions and readings on
using drugs and owning guns: Chapter 17—
Drugs, Guns, and Personal Liberty.

• New sections in Chapter 4—The Power of
Moral Theories, on social contract theory and
one called “Devising a Coherent Moral Theory”
that shows by example how one might develop
a plausible theory of morality.

• A new focus on climate change in the envi-
ronmental ethics chapter and more emphasis
on torture and drone warfare in the political
violence chapter.

• Eleven new readings by women writers.

• Thirty- seven new readings in all to supplement
the already extensive collection of essays.

• New pedagogical elements: the inclusion of key
terms at the end of each chapter; the addition
of end- of- chapter review and discussion ques-
tions; and several new “Cases for Analysis”—
now called “Ethical Dilemmas.”

ORGANIZATION

Part 1 (Fundamentals) prepares students for the tasks
enumerated above. Chapter 1 explains why ethics is
important and why thinking critically about ethical
issues is essential to the examined life. It introduces
the field of moral philosophy, defines and illustrates
basic terminology, clarifies the connection between
religion and morality, and explains why moral rea-
soning is crucial to moral maturity and personal
freedom. Chapter 2 investigates a favorite doctrine
of undergraduates— ethical relativism— and exam-
ines its distant cousin, emotivism.

Part 2 (Moral Reasoning) consists of Chapters 3
and 4. Chapter 3 starts by reassuring students that
moral reasoning is neither alien nor difficult but
is simply ordinary critical reasoning applied to
ethics. They’ve seen this kind of reasoning before
and done it before. Thus, the chapter focuses on
identifying, devising, diagramming, and evaluat-
ing moral arguments and encourages practice and
competence in finding implied premises, testing
moral premises, assessing nonmoral premises, and
dealing with common argument fallacies.

Chapter 4 explains how moral theories work
and how they relate to other important elements
in moral experience: considered judgments, moral
arguments, moral principles and rules, and cases
and issues. It reviews major theories and shows how
students can evaluate them using plausible criteria.

Part 3 (Theories of Morality, Chapters 5–8) cov-
ers key theories in depth— utilitarianism, ethical
egoism, social contract theory, Kant’s theory, nat-
ural law theory, virtue ethics, feminist ethics, and
the ethics of care. Students see how each theory is
applied to moral issues and how their strengths and
weaknesses are revealed by applying the criteria of
evaluation.

In Part 4 (Ethical Issues), each of thirteen chap-
ters explores a timely moral issue through discus-
sion and relevant readings: abortion, euthanasia
and physician- assisted suicide, health care, animal
welfare, environmental ethics, racism and equality,
sexual morality, free speech on campus, drug use,
gun ownership, capital punishment, political vio-
lence, terrorism, torture, immigration, and global
economic justice. Every chapter supplies legal,
scientific, and other background information on
the issue; discusses how major theories have been
applied to the problem; examines arguments that
have been used in the debate; and includes addi-
tional cases for analysis with questions. The read-
ings are a mix of well- known essays and surprising
new voices, both classic and contemporary.

xxiPREFACE Á 

PEDAGOGICAL FEATURES

In addition to “Critical Thought” boxes and “Ethi-
cal Dilemmas,” the end- of- chapter questions, and
the key terms, there are other pedagogical devices:

• “Quick Review” boxes that reiterate key points
or terms mentioned in previous pages

• Text boxes that discuss additional topics or
issues related to main chapter material

• Chapter summaries

• Suggestions for further reading for each issues
chapter

• Glossary

RESOURCES

This Fifth Edition is accompanied by InQuizi-
tive, Norton’s award- winning formative, adaptive
online quizzing program. InQuizitive activities,
written by Dan Lowe of University of Colorado
Boulder, motivate students to learn the core con-
cepts and theories of moral reasoning so that they’re
prepared to think critically about ethical issues.
The text is also supported by a full test bank, lecture
slides, and a coursepack of assignable quizzes and
discussion prompts that loads into most learning
management systems. Access these resources at
digital.wwnorton.com/doingethics5.

EBOOK

Norton Ebooks give students and instructors an
enhanced reading experience at a fraction of the
cost of a print textbook. Students are able to have
an active reading experience and can take notes,
bookmark, search, highlight, and even read offline.
As an instructor, you can even add your own notes
for students to see as they read the text. Norton
Ebooks can be viewed on— and synced among— all
computers and mobile devices. Access the ebook
for Doing Ethics at digital.wwnorton.com/
doingethics5.

ACKNOWLEDGMENTS

The silent partners in this venture are the many
reviewers who helped in countless ways to make
the book better. They include Marshall Abrams
(University of Alabama at Birmingham), Harry
Adams (Prairie View A&M University), Alex Aguado
(University of North Alabama), Edwin Aiman
(University of Houston), Daniel Alvarez (Colorado
State University), Peter Amato (Drexel Univer-
sity), Robert Bass (Coastal Carolina University),
Ken Beals (Mary Baldwin College), Helen Becker
(Shepherd University), Paul Bloomfield (Univer-
sity of Connecticut), Robyn Bluhm (Old Dominion
University), Vanda Bozicevic (Bergen Community
College), Brent Braga (Northland Community and
Technical College), Joy Branch (Southern Union
State Community College), Barbara A. Brown
(Community College of Allegheny County),
Mark Raymond Brown (University of Ottawa),
David C. Burris (Arizona Western College), Mat-
thew Burstein (Washington and Lee University),
Gabriel R. Camacho (El Paso Community College),
Jay Campbell (St. Louis Community College at Mer-
amec), Kenneth Carlson (Northwest Iowa Commu-
nity College), Jeffrey Carr (Illinois State University),
Alan Clark (Del Mar College), Andrew J. Cohen
(Georgia State University), Elliot D. Cohen (Indian
River State College), Robert Colter (Centre Col-
lege), Timothy Conn (Sierra College), Guy Crain
(University of Oklahoma), Sharon Crasnow (Norco
College), Kelso Cratsley (University of Massachu-
setts, Boston), George Cronk (Bergen Community
College), Kevin DeCoux (Minnesota West Com-
munity and Technical College), Lara Denis (Agnes
Scott College), Steve Dickerson (South Puget Sound
Community College), Nicholas Diehl (Sacramento
City College), Robin S. Dillon (Lehigh University),
Peter Dlugos (Bergen Community College), Matt
Drabek (University of Iowa), David Drebushenko
(University of Southern Indiana), Clint Dunagan
(Northwest Vista College), Paul Eckstein (Bergen
Community College), Andrew Fiala (California

Physiology homework help

2004; 84:336-343.PHYS THER.
Dinçer and Geert JMG van der Heijden
Yesim Kurtais Gürsel, Yasemin Ulus, Ayse Bilgiç, Gülay
Placebo-Controlled Trial
Disorders of the Shoulder: A Randomized
Adding Ultrasound in the Management of Soft Tissue

http://ptjournal.apta.org/content/84/4/336found online at:
The online version of this article, along with updated information and services, can be

Collections

Randomized Controlled Trials
Physical Agents/Modalities

Injuries and Conditions: Shoulder
in the following collection(s):
This article, along with others on similar topics, appears

e-Letters

“Responses” in the online version of this article.
“Submit a response” in the right-hand menu under

or click onhere To submit an e-Letter on this article, click

E-mail alerts to receive free e-mail alerts hereSign up

by guest on August 13, 2013http://ptjournal.apta.org/Downloaded from

Adding Ultrasound in the
Management of Soft Tissue Disorders
of the Shoulder: A Randomized
Placebo-Controlled Trial

Background and Purpose. There is still a lack of evidence about the
beneficial effects of ultrasound (US) intervention for the management
of soft tissue problems. Thus, this study was designed to assess the
effectiveness of US over a placebo intervention when added to other
physical therapy interventions and exercise in the management of
shoulder disorders. Subjects and Methods. Forty patients who were
diagnosed by ultrasonography or magnetic resonance imaging to have
a periarticular soft tissue disorder of the shoulder were randomly
assigned to either a group that received true US (n�20; mean time
since onset of pain�8.7 months, SD�8.8, range�1–36) or a group that
received sham US (n�20; mean time since onset of pain�8.1 months,
SD�10.8, range�1– 42). Besides true or sham US (10 minutes),
superficial heat (10 minutes), electrical stimulation (15 minutes), and
an exercise program (15–30 minutes) were administered to both
groups 5 days each week for 3 weeks. Results. Subjects showed
within-group improvements in pain, range of motion, Shoulder Dis-
ability Questionnaire scores, and Health Assessment Questionnaire
scores with the intervention, but the differences did not reach signif-
icance when compared between the groups. Discussion and Conclu-
sion. The results suggest that true US, compared with sham US, brings
no further benefit when applied in addition to other physical therapy
interventions in the management of soft tissue disorders of the
shoulder. [Kurtaiş Gürsel Y, Ulus Y, Bilgiç A, et al. Adding ultrasound
in the management of soft tissue disorders of the shoulder: a random-
ized placebo-controlled trial. Phys Ther. 2004;84:336 –343.]

Key Words: Physical therapy, Randomized clinical trial, Shoulder, Soft tissue disorders, Ultrasound.

Yeşim Kurtaiş Gürsel, Yasemin Ulus, Ayşe Bilgiç, Gülay Dinçer, Geert JMG van der Heijden

336 Physical Therapy . Volume 84 . Number 4 . April 2004

Re
se

ar
ch

Re
po

rt �

������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������

���
���

���
���

���
���

���
���

���
���

���
���

���
���

���
���

���
���

���
���

���
���

���
���

by guest on August 13, 2013http://ptjournal.apta.org/Downloaded from

S
houlder pain is a major reason that patients
seek consultations with physicians. Pain restricts
shoulder motion and limits daily activities, caus-
ing disability.1,2 In general, soft tissue impair-

ments and pathologies such as inflammation of the
tendons and bursae surrounding the glenohumeral joint
are often diagnosed even in patients without a history of
trauma.3 Management of these patients includes the use
of analgesics and nonsteroidal anti-inflammatory drugs
(NSAIDs), steroid injections, thermal modalities, ultra-
sound (US), and exercise programs. Systematic reviews
of clinical trials on shoulder disorders show little benefit
from NSAIDs and steroid injections.4,5

Ultrasound is used as a therapeutic modality for many
conditions in many countries6 and for soft tissue disor-
ders. When US enters the body, it can exert effects on
the cells and tissues via thermal and nonthermal mech-

anisms, of which some are still inconclusive.6,7 Ultra-
sound is believed to differ from superficial heating
modalities by heating deeper tissues when applied with
appropriate intensity and frequency.6 Nonthermal
effects are claimed to promote healing, although this has
not been proven with in vivo studies.7 Systematic reviews
of clinical trials on shoulder disorders have shown US to
be ineffective in achieving success in the interven-
tion.8 –11 The effect of US in the management of soft
tissue disorders of the shoulder was found to be of little
or no clinical benefit in some studies.12,13 Some stud-
ies,14 –16 however, have shown US to be effective in
improving the symptoms. In our experience and con-
trary to the published data, US seems to be of some value
in the management of shoulder problems. These con-
flicting results led us to plan this placebo-controlled
study. The aim of our study was to evaluate whether US,

Y Kurtaiş Gürsel, MD, is Assistant Professor, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, University of Ankara,
Ankara, Turkey. Address all correspondence to Dr Kurtaiş Gürsel at Sedat Simavi Sok, MESA 6.Blok 37/32 Çankaya, Ankara, Turkey
(ykurtais@ttnet.net.tr).

Y Ulus, MD, is Specialist in Physical Medicine and Rehabilitation, Department of Physical Medicine and Rehabilitation, Bayındır Hospital, Ankara,
Turkey.

A Bilgiç, MD, is Assistant Professor, University of Ankara, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, University of
Ankara.

G Dinçer, MD, is Professor, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, University of Ankara.

GJMG van der Heijden, PhD, is Clinical Epidemiologist and Physiotherapist, Julius Center for Health Sciences and Primary Care, University
Medical Center, Utrecht, the Netherlands.

Dr Kurtaiş Gürsel and Dr Dinçer provided concept/idea/research design. Dr Kurtaiş Gürsel and Dr van der Heijden provided writing. Dr Kurtaiş
Gürsel, Dr Ulus, and Dr Bilgiç provided data collection, and Dr Kurtaiş Gürsel provided data analysis. Dr Kurtaiş Gürsel, Dr Ulus, Dr Bilgiç, and
Dr Dinçer provided subjects. Dr Kurtaiş Gürsel and Dr Dinçer provided project management. Dr Kurtaiş Gürsel and Dr Ulus provided
facilities/equipment. Dr Dinçer provided institutional liaisons. Dr Ulus was responsible for patient assessment and provided clerical support. Dr
van der Heijden provided consultation (including review of manuscript before submission).

The study protocol was approved by the ethics committee of the İbn-i Sina Hospital, University of Ankara.

This article was received December 30, 2002, and was accepted October 20, 2003.

Physical Therapy . Volume 84 . Number 4 . April 2004 Kurtaiş Gürsel et al . 337

���
���

���
���

���
���

���
���

���
���

���
���

���
���

���
���

���
���

���
���

���
���

���
���

���
���

���
���

���
���

���
���

���
���

by guest on August 13, 2013http://ptjournal.apta.org/Downloaded from

when combined with hot packs and interferential cur-
rent, enhances the outcomes of intervention.

Method

Subjects
Patients with soft tissue disorders of shoulder were
considered for the study from the outpatient clinic and
examined by the researchers, who are all senior physical
medicine physicians. Physical, laboratory, and radiolog-
ical examinations were used to confirm the diagnosis
and rule out other conditions. The following selection
criteria were used in our study:

1. Shoulder pain and limitation of movement for at least
4 weeks prior to the study (to eliminate acute pain
that may recover quickly and spontaneously after a
few physical therapy sessions).

2. Diagnosis of a soft tissue disorder of the shoulder (eg,
bicipital tendinosis, rotator cuff tendinosis [including
rotator cuff tears], subacromial bursitis) by ultra-
sonography or magnetic resonance imaging (through
which calcific tendinitis was excluded).

3. Absence of direct trauma to the shoulder or the
memory of trauma (to exclude probable fractures or
resorbing hematoma).

4. Absence of underlying neurologic, inflammatory
rheumatic disease, notably rheumatoid arthritis, sys-
temic lupus erythematosus, or extrinsic diseases such
as cervical spondylosis with referring pain to the
shoulder. These other diseases were ruled out by
physical examination and further laboratory exami-
nations whenever needed.

5. No physical therapy for the shoulder was given in the
4 to 5 weeks prior to the study.

Forty patients who fulfilled the selection criteria and
signed informed consent statements were enrolled in
the study and were randomly assigned by the use of
random numbers to either a group that received true US
or a group that received sham US. The selector (GD),
who did not perform any assessment, was aware of the
randomization scheme and opened the codes at the
statistical evaluation stage. The assessor (YU) and the
subjects, however, were not informed about the true
nature of US application. The treating physical therapist
was aware of the nature of this intervention and the
physical findings of the subjects, but did not change the
intervention according to the symptoms during the
study. Two subjects (one from each group) withdrew for
personal reasons at the beginning of the study. The

demographic characteristics of the remaining 38 sub-
jects are shown in Table 1.

Procedure
The true-US group received continuous US using a
Petsan 250 device* that, according to the manufacturer,
operated at a frequency of 1 MHz and at an intensity of
1.5 W/cm2. The transducer head had an area of 6.2 cm2 ,
an effective radiating area of 5 cm2 , and a beam non-
uniformity ratio of 1:6. While sitting on a table, each
subject placed an arm with the hand supinated in his or
her lap. Using slow circular movements, the treating
physical therapist applied the transducer head over the
superior and anterior periarticular regions of the sub-
ject’s glenohumeral joint, covering an area of approxi-
mately 15 cm2. The treatment duration was 10 minutes.
For the sham-US intervention, the device was set to the
“off” mode. The transducer head was applied to the
same area using the same machine, and Aquasonic
transmission gel† was used.

All patients had pain and limitation of motion; there-
fore, we did not believe we could treat the sham-US
group without additional interventions. Other physical
therapy interventions were applied to subjects in both
groups. Superficial heat was administered by use of hot
packs (60°C) for 10 minutes. Interferential current was
delivered using Medi-Link Model 71,‡ which operated
with a carrier frequency of 4,000 Hz, with an amplitude-
modulated frequency of 100 Hz. Rubber bipolar plate
electrodes (6�8 cm) were placed again over the supe-

* Petaş, Ankara, Turkey.
† Parker Laboratories Inc, 286 Eldridge Rd, Fairfield, NJ 07004.
‡ EMS, Oxfordshire, United Kingdom.

Table 1.
Demographic Characteristics of Subjects

True-
Ultrasound
Group
(n�19)

Sham-
Ultrasound
Group
(n�19)

Age (y)
X 54.16 54.00
SD 8.22 9.80
Range 38–69 35–69

Time since onset of pain (mo)
X 8.68 8.11
SD 8.84 10.81
Range 1–36 1–42

Sex (female/male) 12/7 14/5

Diagnosis (n)
Supraspinatus tendinosis 6 6
Supraspinatus partial rupture 11 7
Rotator cuff rupture 1 3
Biceps tendinosis 8 7

338 . Kurtaiş Gürsel et al Physical Therapy . Volume 84 . Number 4 . April 2004 by guest on August 13, 2013http://ptjournal.apta.org/Downloaded from

rior and anterior periarticular regions of the glenohu-
meral joint. The intensity was set according to the
sensory threshold level of each patient, and the treat-
ment duration was 15 minutes.

Exercise for the shoulder girdle included the active and
passive range of motion (ROM) exercises, stretching,
Codmann exercises, and isometric and isotonic exer-
cises. The exercises were applied to all of the subjects by
the same physical therapist. The duration of exercise was
a minimum of 15 minutes and a maximum of 30
minutes. At the start of the therapy, or when a subject
had severe pain, passive restricted ROM exercises and
gentle stretching were used. At a later phase or when
pain lessened, exercise shifted toward active ROM exer-
cises, and gradually isometric and dynamic resistance
exercises were added, resulting in a longer duration of
intervention.

The duration of physical therapy intervention was 15
days (5 days each week), which is the usual treatment
regimen in our department’s practice. The treatment
protocol was not changed during the study in order to
standardize intervention for all subjects. After the study
period ended, the subjects’ physical therapy interven-
tions were changed, if needed. The subjects were not
allowed to take medications other than a simple analge-
sic (paracetamol, maximum of 500 –1,000 mg daily due
to their pain).

Outcome Measures
Pain intensity at rest and with motion was measured
using a 4-point Likert scale (0�no pain, 1�mild pain,
2�moderate pain, 3�severe pain). Passive and active
ROM in flexion, extension, abduction, adduction, and
medial (internal) and lateral (external) rotation was
measured using a goniometer. All of the measurements
were done while the subjects were positioned supine
except for ROM in extension, which was measured while
the subjects were sitting erect in a chair. Before the study
began, the assessor (YU) performed repetitive goniomet-
ric measurements of the shoulder joints of 10 subjects
with no known pathology or impairments to enhance
the reliability of her assessment, but no other reliability
study was performed. The Health Assessment Question-
naire (HAQ)17 was used to assess activities of daily living,
and only items regarding upper-extremity function were
included. The HAQ was shown to be sensitive for
detecting changes in patients with rheumatoid arthritis
and patients who had undergone joint replacement
surgery, but no further studies have been done to
evaluate the sensitivity of the tool in patients with
shoulder disorders.18,19 Shoulder disability was assessed
with the Shoulder Disability Questionnaire (SDQ),
which was shown to be responsive to changes in symp-
toms and physical findings.20,21 When the study began

and on the day following the last day (15th day) of
intervention, the same physician (YU), who was masked
to the randomization, took all of the measurements.

Data Analysis
Differences between baseline and postintervention mea-
surements for each studied outcome were analyzed
within and between the groups. Repeated measurements
obtained before and after intervention were analyzed
within groups by a Wilcoxon rank sum test. Postinterven-
tion changes in categorical data within groups were ana-
lyzed by chi-square test with Yates correction. Between-
group comparisons of differences after intervention were
performed by a Mann-Whitney U test at a .05 level of
significance.

Results
Seventeen subjects (89%) in the true-US group and 16
subjects (84%) in the sham-US group completed the
15-day intervention program. One subject from the
true-US group and 1 subject from the sham-US group
withdrew from the study because they could not spare
time for the physical therapy sessions. Another subject
from the true-US group and 2 other subjects from the
sham-US group withdrew without any explanation.

Baseline and postintervention measurements are dis-
played in Table 2. No differences between groups were
observed in the baseline measurements, and variability
was relatively limited for almost all measurements; that
is, standard deviations of the observed means of the
changes over time were relatively small. For the true-US
group, there were preintervention-postintervention dif-
ferences for pain, ROM (except for passive abduction),
and HAQ and SDQ scores. For the sham-US group,
improvement was detected for pain, ROM (except for
passive lateral rotation), and HAQ and SDQ scores. The
preintervention-postintervention differences in the mea-
surements, however, did not show any statistical differ-
ence between groups (Tab. 3).

Discussion
In the management of soft tissue disorders, US has been
used for more than 30 years.22,23 Increased blood flow,
vascular permeability, and cell metabolism; enhance-
ment of fibrous tissue extensibility; and muscle relax-
ation are the purported physiologic effects of US. Ultra-
sound is proposed to promote healing and regeneration
in inflamed tissue, to reduce pain, and to improve
ROM,24,25 and this is the rationale for the use of US for
the management of soft tissue disorders in all joints,
including the shoulder. In our experience, US is com-
monly prescribed in addition to other interventions such
as electrical stimulation and exercise. We used interfer-
ential current in our study because it is believed by some
authors26 –28 to have analgesic effects, but these effects

Physical Therapy . Volume 84 . Number 4 . April 2004 Kurtaiş Gürsel et al . 339

���
���

���
���

���
���

���
���

���

by guest on August 13, 2013http://ptjournal.apta.org/Downloaded from

Ta
b
le

2
.

A
ss

es
sm

en
tP

ar
am

et
er

s
of

Tr
ue

-U
ltr

as
ou

nd
an

d
Sh

am
-U

ltr
as

ou
nd

G
ro

up
s

Be
fo

re
an

d
A

fte
r

In
te

rv
en

tio
n

V
a
ri

a
b
le

a

Tr
u
e
-U

lt
ra

so
u
n
d

G
ro

u
p

(n

1
7

)

P

S
h
a
m

-U
lt
ra

so
u
n
d

G
ro

u
p

(n

1
6
)

P

B
e
fo

re
In

te
rv

e
n
ti
o
n

A
ft

e
r

In
te

rv
e
n
ti
o
n

B
e
fo

re
In

te
rv

e
n
ti
o
n

A
ft

e
r

In
te

rv
e
n
ti
o
n

X
S
D

R
a
n
g
e

X
S
D

R
a
n
g
e

X
S
D

R
a
n
g
e

X
S
D

R
a
n
g
e

Pa
in

ra
tin

g
(o

n
0

–3
Li

ke
rt

sc
al

e)
A

tr
es

t
2
.4

0
.5

1
–2

1
.0

0
.1

1
–1

.0
0

1
b

1
.8

0
.7

1
–3

1
.3

0
.4

1
–2

.0
0
7

b

W
ith

m
ot

io
n

2
.4

0
.5

2
–3

1
.9

0
.2

1
–2

.0
0

5
b

2
.7

0
.4

2
–3

2
.1

0
.2

2
–3

.0
0
1

b

Fl
ex

io
n

A
RO

M

)
1
2
7
.6

4
.9

8
0

–1
6

0
1

5
6

.4
1

2
.6

1
2

0
–1

7
0

.0
0

1
b

1
2

3
.7

2
4

.3
9
0
–1

6
0

1
6
0
.3

1
2
.0

1
4
0
–1

8
0

.0
0
0
1

b

PR
O

M

)
1
4
5
.3

2
4
.0

1
0

0
–1

8
0

1
6

8
.2

1
1

.7
1

3
0

–1
8

0
.0

0
1

b
1

4
9

.1
1

8
.9

1
1
0
–1

7
5

1
7
2
.8

1
0
.3

1
5
0
–1

8
0

.0
0
0
1

b

A
bd

uc
tio

n
A

RO
M


)

1
0
5
.5

2
9
.4

6
0
–1

5
5

1
5

0
.2

2
0

.0
1

0
0
–1

8
0

.0
0

0
1

b
1

1
3

.4
3

7
.0

6
0
–1

8
0

1
6
2
.2

1
6
.7

1
2
0
–1

8
0

.0
0
1

b

PR
O

M

)
1
2
7
.3

2
5
.4

8
0
–1

6
5

1
6

0
.6

1
6

.7
1

2
0
–1

8
0

.0
0

0
1

b
1

4
1

.5
2

5
.9

1
0
0
–1

8
0

1
7
4
.4

1
0
.7

1
4
0
–1

8
0

.0
0
1

b

La
te

ra
lr

ot
at

io
n

A
RO

M

)
6
5
.8

4
.0

2
0
–7

0
8

1
.4

1
5

.5
3

0
–7

0
.0

0
5

b
7

4
.1

2
2

.7
2
0
–7

0
8
7
.8

5
.4

6
0
–7

0
.0

1
2

b

PR
O

M

)
7
7
.3

1
7
.9

4
0
–7

0
8

4
.7

1
2

.1
4

0
–7

0
.0

1
b

8
2

.5
1

6
.9

4
0
–7

0
8
9
.3

2
.5

7
0
–7

0
.0

6
6

M
ed

ia
lr

ot
at

io
n

A
RO

M

)
4
8
.2

4
.0

2
0
–6

0
7

1
.4

1
8

.7
4

0
–6

0
.0

0
1

b
5

2
.8

2
2

.8
2
0
–7

0
7
2
.2

1
3
.4

5
0
–7

0
.0

0
1

b

PR
O

M

)
6
8
.2

2
0
.5

3
0
–6

0
8

0
.6

1
5

.3
5

0
–6

0
.0

1
b

7
4

.1
1

7
.2

4
0
–7

0
8
8
.1

7
.5

6
0
–7

0
.0

0
7

b

Ex
te

ns
io

n
A

RO
M


)

4
3
.5

9
.9

3
0
–6

0
5

1
.7

9
.0

3
5

–6
0

.0
0

8
b

4
5

.6
1

1
.5

3
0
–6

5
5
7
.2

7
.9

4
5
–6

5
.0

0
1

b

A
RO

M

)
5
5
.0

7
.0

4
0
–6

5
5

7
.9

8
.1

4
0

–7
0

.1
2

5
6

.8
6

.3
4
5
–6

5
6
0
.3

6
.1

5
0
–7

0
.0

1
b

H
A

Q
1

0
.5

0
.2

–2
.5

0
.3

0
.2

0
–0

.8
.0

0
0

1
b

1
.2

0
.5

0
.6

–2
.5

0
.4

0
.2

0
.1

–0
.8

.0
0
0
1

b

SD
Q

7
6
.1

1
1
.7

4
6
–1

0
0

4
1

.5
2

0
.3

6
–8

0
.0

0
0

1
b

7
5

.0
1

1
.8

4
0
–1

0
0

3
8
.2

1
5
.6

4
–7

3
.0

0
0
1

b

a
A

R
O

M

ac
ti

ve
ra

n
ge

o
f

m
o

ti
o

n
,

P
R

O
M


p

as
si

ve
ra

n
ge

o
f

m
o

ti
o

n
,

H
A

Q

H
ea

lt
h

A
ss

es
sm

en
t

Q
u

es
ti

o
n

n
ai

re
,

SD
Q


Sh

o
u

ld
er

D
is

ab
il

it
y

Q
u

es
ti

o
n

n
ai

re
.

b
St

at
is

ti
ca

ll
y

si
gn

if
ic

an
t

d
if

fe
re

n
ce

(s
ta

ti
st

ic
al

le
ve

l
o

f
si

gn
if

ic
an

ce
:

.0
5,

W
il

co
xo

n
si

gn
ed

ra
n

ks
te

st
).

340 . Kurtaiş Gürsel et al Physical Therapy . Volume 84 . Number 4 . April 2004 by guest on August 13, 2013http://ptjournal.apta.org/Downloaded from

are yet to be determined because of the inconclusive
results obtained by other researchers.29,30

In our study, US was applied in addition to the use of
superficial heat because of the often-used hypothesis
that US further affects healing in people with soft tissue
diseases. Our study did not allow us to determine
whether the heating effect of US was masked by the
application of superficial heat. The results of our masked
study demonstrated that at the end of the intervention
period, our subjects with soft tissue disorders of the
shoulder showed improvements in pain, ROM, and
HAQ and SDQ scores when either true US or sham US
was administered in addition to superficial heat, inter-
ferential current, and exercise, but neither group was
compared with a group that received no intervention.
Our groups were similar after randomization, with few
dropouts, and there were no differences between the
groups at our short-term follow-up. Whether the changes
we observed would remain over time cannot be
determined.

In a systematic review of randomized clinical trials for
patients who received physical therapy for soft tissue
disorders of the shoulder, 6 trials on the effects of US
were found to be of acceptable methodological quality.8

However, US did not seem to be effective in placebo-
controlled trials and was no better than cold therapy,
steroid injections, NSAIDs, acupuncture, or transcutane-
ous electrical stimulation. In another systematic review,
van der Windt et al9 showed a lack of sufficient data to
support positive results about the effectiveness of US for
musculoskeletal disorders, including soft tissue prob-
lems of the shoulder.

Several authors12,13,31 have reported that there were no
differences between subjects with soft tissue disorders of
the shoulder who received true US and those who
received sham US. Studies by other researchers14 –16
support the efficacy of US therapy in improving pain,
activities of daily living, and quality of life. The subjects
in these studies varied from another. For instance,
Ebenbichler et al,15 who reported no effects of US on
pain and disability in the long term, found changes in
the calcific deposits of their subjects with calcific tendi-
nitis of the shoulder. We excluded patients with calcific
tendinitis of the shoulder in our study; therefore, our
study is not comparable to that of Ebenbichler et al.

Despite various suggestions provided in classical text-
books on physical treatments,24,25 there is no accepted
standardized method for US application. Yet, although

Table 3.
Change Over Time in Measurements From the True-Ultrasound and Sham-Ultrasound Groups

Variablea

True-Ultrasound Group (n�17) Sham-Ultrasound Group (n�16)

Pb

Preintervention-
Postintervention
Difference

Preintervention-
Postintervention
Difference

X SD Range X SD Range

Pain rating (on 0–3 Likert scale)
At rest 0.7 0.4 0–1 0.5 0.6 0–2 .36
With motion 0.4 0.5 0–1 0.6 0.4 0–1 .21

Flexion
AROM (°) 29.4 23.6 0–70 36.5 25.5 5–90 .39
PROM (°) 22.9 20.1 0–60 23.7 16.4 5–60 .87

Abduction
AROM (°) 44.1 24.6 10–90 48.7 29.9 0–100 .65
PROM (°) 33.2 22.7 5–80 32.8 26.3 0–80 .85

Lateral rotation
AROM (°) 15.5 16.9 0–50 13.7 18.3 0–50 .69
AROM (°) 7.4 12.0 0–40 6.8 15.3 0–50 .45

Medial rotation
AROM (°) 24.4 17.1 0–70 28.7 17.3 0–55 .28
PROM (°) 14.7 16.1 0–60 14.1 16.0 0–50 .79

Extension
AROM (°) 10.0 8.4 0–25 11.5 8.1 0–25 .55
PROM (°) 4.1 6.6 0–25 3.4 6.2 0–25 .82

HAQ 0.6 0.5 0.1–2.3 0.8 0.5 0.2–2.3 .27

SDQ 34.5 19.0 1–12 36.7 18.1 1–12 .71

a AROM�active range of motion, PROM�passive range of motion. HAQ�Health Assessment Questionnaire, SDQ�Should Disability Questionnaire.
b Statistical level of significance: .05, Mann-Whitney U test.

Physical Therapy . Volume 84 . Number 4 . April 2004 Kurtaiş Gürsel et al . 341

���
���

���
���

���
���

���
���

���

by guest on August 13, 2013http://ptjournal.apta.org/Downloaded from

there is no evidence from well-designed studies that one
method of application outperforms another, we cannot
be sure which method is the best. Treatment intensity,
duration, and frequency and localization of US applica-
tion were not the same in all the trials cited. In 2
studies,13,14 the frequency of US was the same as in our
study (1 MHz). Commonly, US is applied as a
co-intervention. The co-interventions in the cited studies
also were very different. Ginn et al32 reported that
subjects who received a program of exercise aimed at
restoring force, length, and control of muscles demon-
strated better outcomes than did subjects who received
no intervention. A comparison of groups that received
either true or sham US with a group that did not receive
US, however, did not show results favoring the use of US,
either on short- or long-term follow-up.12 A recent
overview of research on shoulder disorders has shown
that evidence for an effect of physical therapy on the
long-term outcome of shoulder disorders is lacking.33

The results of our study showed that there were no
differences between the outcomes of 2 groups. Our
study provided no evidence that true US, as compared
with sham US, is beneficial when applied in addition to
some commonly used interventions, including modali-
ties such as exercise therapy. This result seems to be in
concordance with the findings of many other studies.
Due to our small sample size, however, our results lack
statistical power. In addition, the between-group differ-
ences were too small to be clinically relevant. Given the
lack of between-group differences at short-term follow
up, it is unlikely that with evaluation of effects at a longer
term an effect in favor of true US would be observed.

Conclusion
Based on the literature and the results of our study, we
conclude that there is insufficient evidence to merit wide
use of 1-MHz US in combination with other interven-
tions in the management of painful shoulder conditions.
In our opinion, with the guidance of randomized con-
trolled trials, it is time to use interventions tha

Physiology homework help


Assignment
– Choose a pathophysiological disease/disorder/condition that interests you and write a full report on its symptoms, causes, the detailed
physiological changes it creates, organ system (s) it effects, and available treatment options. If there are interesting experimental treatments, you may include that as well.


Paper should include:

1) A detailed description of your chosen disease/disorder and its associated symptoms. Example: “Disease X is transmitted by mosquitoes and infected patients experience colorful hallucinations, intense GI tract pain, followed by paralysis. The disease is always fatal, infects 10% of people living in tropical areas”….etc etc etc

2) A detailed description of the pathophysiology of the disease/disorder in the organ system(s) it effects. Example: if your chosen disorder causes involuntary skeletal muscle contractions – indicate HOW it is causing them. Faulty ion channels, miscommunication with nerve axons, neurotransmitters not being broken down….etc.

3) A description of treatment options and how they work. Example: “Treatment for this disease involves taking drugs that inhibit break down of cAMP in the cells, which results in…..”etc etc etc….

The paper should be well organized, written in complete sentences with correct spelling and grammar.

You MUST cite the sources you use both in the text where the information appears, and at the end in a “literature cited” section. ALL INFORMATION THAT IS NOT CONSIDERED COMMON KNOWLEDGE MUST BE CITED. At least one source should be from the peer-reviewed literature. Not all your sources need to be peer reviewed – but they do need to be reliable and scientific. Wikipedia is NOT an allowed source, and you will not receive full credit if your information comes from websites of questionable origin. The textbook is allowed as a source.

Citation Example: Sensory information from the photoreceptors in the eyes travels along the optic nerve and is processed in the visual cortex (Widmaier et al 2019).

Literature Cited:

Widmaier, E., H. Raff, and K. Strang. 2019. Vander’s human physiology: The mechanisms of body function. 15ed. McGraw Hill Education, New York. 709pp.

I have to be able to find your sources. I suggest APA format citations, but you may use another format as long you stay consistent.

Grading Rubric:

(1) Description of the disease/disorder and its symptoms 5 points

(2) Detailed pathophysiological description for all effected organ systems 10 points

(3) Treatment Options 5 points

(4) spelling, grammar, citations 5 points

Physiology homework help

Week Three Pop-up Extra Credit Opportunity!

We are learning this week that the best way to avoid employee problems and challenges is 
prevention
!

What are some ways the best organizations “prevent” employee problems?

1.  Watch the following video – “This is what makes employees happy at work”. https://youtu.be/PYJ22-YYNW8

2.

3. Which concept do you like best?

4. Why did you choose this, and how might you apply this as a future health care leader?

Physiology homework help

RUNNING HEAD: EVALUATION PROPOSAL 1

Program Evaluation Proposal

Raven Jones

Mississippi Valley State University

SW 650 Needs Assessment and Program Evaluation

Candace Carter, Ph.D.

November 14, 2021

EVALUATION PROPOSAL 2

EVALUATION PROPOSAL

TABLE OF CONTENTS

Executive Summary —————————————————————————–Pg. 4

Organizational Background ———————————————————————Pg. 5-6

Social Issue Problem Formulation————————————————————-Pg.6

Need Statement ————————————————————-Pg.6-7

Goals and Objective —————————————————————————— Pg.7-8

Logic Model ————————————————————————————— Pg.8

Research Methods and Designs —————————————————————– Pg.9

Evaluation Discussion —————————————————————————–Pg.9-10

Sustainability (Strengths & Limitations) ——————————————————–Pg.10

EVALUATION PROPOSAL 3

Conclusion —————————————————————————————— Pg.10-11

Appendices —————————————————————————————— Pg.12-16

References——————————————————————————————-Pg. 17

A. Client Satisfaction Questionnaire ———————————————————–Pg. 14

EVALUATION PROPOSAL

EVALUATION PROPOSAL 4

The Substance Abuse and Mental Health Services Administration (SAMHSA) is a

federal agency within the United States Department of Health and Human Services (HHS) that

coordinates public health efforts to improve the nation’s behavioral health and the lives of people

with mental and substance use disorders and their families.

Executive Summary

To have an effective service within your program you have to work with no time wasted. Healthy Minds,

Healthy Lives: Doorway to Acceptance staff will work hard every day to do the right thing when it comes to

servicing the clients. An executive summary should summarize the key points of the report. It should restate the

purpose of the report, highlight the major points of the report, and describe any results, conclusions, or

recommendations from the report (Ashley University, 2020). Healthy Minds, Healthy Lives provides many services

to clients with the community and also outside as well. The Staff, volunteers, and the intern will help to establish the

goals and plans that are in place for the program facility.

The facility has a staff that includes an abuse therapist, nurse practitioner, clinical social worker, licensed

social worker, crisis counselor, drug/ alcohol counselor, self-sufficiency case manager, teachers, and security,

administrator clerk, pastors, and interns. This program provides serves such as daily around the clock, workshop

meetings, transportation, peer group, basic needs, case management, treatment plan, awareness, education, and

internship. The purpose of Healthy Minds, Healthy Lives is to mend the mindsets and reduce the death rate of

individuals battling with mental health disorders. Healthy Minds, Healthy Lives will provide life skills workshops to

build self-esteem, empower, and promote self-sufficiency to the clients.

Healthy Minds, Healthy Lives will provide support groups to individuals that are suffering with alcohol and

drugs and also mental illnesses as well. This proposal will cover the organizational background, statement of need,

goals, and objective, logic model template, research methods, and design, evaluation discussion, the sustainability of

the strengths and limitations, and conclusion. This proposal will also include the appendixes section of a survey and

a grant application.

Organizational Background

EVALUATION PROPOSAL 5

The name of this program is Healthy Minds, Healthy Lives located in Greenville, Mississippi. The program

facility will be placed in Greenville due to driving distance for clients in need. The Mississippi Delta only has two

mental health facilities located in Greenville, Mississippi but the social work students know that many individuals

really don’t like their services due to the way they are treated. Life Help serves the counties of Bolivar, Holmes,

Humphreys, Leflore, Sunflower, and Washington in Mississippi. The reason the social work student is placing her

program in Greenville, MS is so that many individuals will be able to get services that are not being serviced

through Life Help and other agencies such as Mississippi Behavioral Health Services.

Healthy Minds, Healthy Lives aims to help individual battling with all mental health illnesses. Healthy

Minds, Healthy Lives facility will work to provide twenty-four hours’ crisis. Healthy Minds, Healthy Lives will be

funded through grants, programs and donors such as a nonprofit organization. This program will request $ 80,000

from Kroger community grant proposal to provide a safe environment and facility where individuals battling with

mental illnesses can come to better themselves by having things to do and individuals to talk to that are willing to

listen to them and help them. The program will provide professionally skilled individual to help the clients, this

program will also offer internship experiences and supervision for graduate and undergraduate students in programs

such as the social work program and the counseling program for students to intern.

The mission statement for this program is to increase awareness of triggers related to drug and alcohol use

dependency and to stability when it comes to mental illnesses. The vision statement for Healthy Minds, Healthy

Lives is to ensure that each client that receives services will get the help they need and will be treated with the

upmost respect regardless of their mental status. We will have a vehicle that will transfer the clients to and from

their destination. Healthy Minds, Healthy Lives will provide a variety of services that will help individuals with the

issues. Healthy Minds, Health Lives will provide a safe and confidential services.

This facility will be open from 8:00 am until 10:00 am or 1:00 pm until 5:00 pm. We will provide

individualized service plans focusing on developmental and behavioral problems. We will provide different therapy

and in-person crisis intervention to determine therapeutic goals to address. Information and referrals for clients

during their stay will be provided. The case manager will conduct weekly case management meetings to review their

stabilization and their mental status. We will provide individualized service plans focusing on identifying service

needs.

144540000000000244

EVALUATION PROPOSAL 6

The care manager/ nurse or nurse practitioner will be facilitating any injections or meds needed for each

client. The case managers will help the clients create a budget plan with case manager weekly to help them manage

money more efficient. The facility and facility’s hotline services will be open twenty-four hours for crisis and on-

call assistance for the clients or community member they may need servicing.

Social Issue Problem Formulation

The agency that I decided to innovate my program by was “SAMSHA” in Rockville, MD. The Substance

Abuse and Mental Health Services Administration (SAMSHA) is an agency that is within the United States

Department of Health and Human Services that leads public health efforts to promote behavioral health for the

nation (SAMSHA, 2021). SAMSHA was founded on July 92’ (SAMSHA, 2021). SAMSHA is sponsored and

funded through many different services from The Department of Health and Human Services. If you or someone

needs help you can contact 1-877-726-4727.

Mental Health happens everywhere, in all walks of life, to all ethnic groups and all genders of all ages

(SAMSHA, 2021). SAMSHA’s vision is “to provide leadership and resources – programs, policies, information and

data, funding, and personnel – advance mental and substance use disorder prevention, treatment, and recovery

services in order to improve individual, community, and public health” (SAMSHA, 2021). SAMSHA’s mission is to

“reduce the impact of substance abuse and mental illness on America’s communities” (SAMSHA, 2021).

The reason I decided to innovate “Healthy Minds, Healthy Lives” after “SAMSHA” located in Rockville,

MD since many people are not able to travel to get help at this facility. Also, the community may not want to be

served by the two local agencies I mentioned earlier such as Life Help or MS Behavioral Health Services. The social

problem as well as the barriers is the distance that people have to travel for help, how long it takes for a someone

dealing with drug and alcohol abuse and mental illness person to seek help, the people or clients that the facility

serves. SAMSHA serves mostly clients that deal with alcohol and drug abuse but “Healthy Minds, Healthy Lives

will serve not only individuals that are battling with alcohol and drug abuse but also mental illnesses.

Statement of Need (Need Analysis)

There is a big need for individuals dealing with alcohol and drug abuse and mental illness facility in the

Mississippi Delta area that will treat their clients as humans that are in need.

144540000000000244
144540000000000244
Do not use “I” in scholarly papers.

EVALUATION PROPOSAL 7

According to research, on average, nearly 24.6 million individuals aged 12 or older were recently illicit

drug users in the year of 2013 (SAMSHA, 2014). During the same year, nearly 1 in 5 adults aged 18 or older had a

mental illness in the past year (SAMSHA, 2014). There are two mental health facilities in Greenville, Mississippi

but there is a big need for many other mental health facilities in Mississippi due to traveling distance and many other

factors. According to statistics, is an estimate of 20.2 million individuals needed treatment for an illicit drug or

alcohol use problem but did not receive treatment at a specialty facility in the past year (SAMSHA, 2014).

In my community we have mental health facilities that we can go to but most individuals with mental

health issues do not want to go to these specific facilities because of the lack of confidentiality. If the program that I

am creating can expand I will place this agency in many areas throughout the Mississippi Delta. This agency will

serve all race, ethnic group, and counties in the surrounding areas. The program is needed because it serves many

individuals battling with mental illnesses and drug and alcohol abuse. According to statistics, in 2013 there were

34.6 million adults aged 18 or older (14.6 percent of the population aged 18 or older) received mental health care

during the past 12 months (data not shown) (SAMSHA, 2014).

Goals and Objective

Healthy Minds, Healthy Lives: Doorway to Acceptance goal aim is to mend mindsets and reduce the death rate of

individuals battling with mental disorders. They also have trained staff such as the therapist, nurse practitioner,

clinical social worker, licensed social worker, crisis counselor, drug/ alcohol counselor, self-sufficiency case

manager, and security and administrator clerk. The staff will help provide life skill workshops to build self-esteem,

empowerment, and to promote self-sufficiency to the clients. This program provides a safe and confidential facility

that provides adequate service, counseling and medication. Healthy Minds, Healthy Lives also finds clients program

within a 7-14-days that will help them with drug and alcohol abuse.

Healthy Minds, Healthy Lives has multiple goals and objectives for the staff and most importantly the

clients. A short-term goal for the clients is stability to improve the client’s future ability to have a relapse and to

avoid having to return to their back to their old habits. The objective is to help the clients overcome barriers to

maintain stability through education in AA programs, therapy and counseling. Another short-term goal is for the

clients to learn new ways to cope with stressors and management skills. The objective is for the staff to help the

clients through counseling, group therapy, individual counseling, and workshops. An intermediate goal is decision-

making skills for the clients.

EVALUATION PROPOSAL 8

The objective is to educate the client so the individual can be able to make decisions of their own. The

client will also be able to live alone without feeling the need to have someone to feel independent. A long-term goal

for the client is to have better health and to live longevity. The objective of the goal is to help the client identify

ways of empowerment to move forward. Another goal is to reduce the death rate. The objective is to educate the

client through different counseling and workshops to prevent future risk of drug and alcohol abuse and mental

illnesses.

Outputs Outcomes – Impact
Inputs

Activities Participation Short Medium Long

 Staff

 Volunteers

 Funds

 Equipment

 Facilities

 Interns

 Programs

 Training

 Peer
Groups

 Daily
Around
the Clock

 Provided
Transporta
tion

 Case
Manageme
nt

 Therapist
 Provide

Treatment
Plans

 Workshop
Meetings

 Basic
Needs
Provided

 Internships
Provided

 AA
Groups

 Work with
others

 Train

 Clients
 Communit

y Based
Organizati
ons

 Participant
s

 Agencies
 Civilians

 Financial
Independence

 Management
Skills

 Assessments
 Immediate

Assistance,
Knowledge, and
Support
 Comprehension

Services
 Bring

Awareness

 Access to
Community
Groups

 Access to
community
services

 Advocacy
 Service
 Safety

Planning Skills
 Decision

Making
 Improving

Resiliency
 Clients will be

continuing
their free
services

 Economy
 Reduce the

Death rate
 Increasing

awareness and
knowledge

 Longevity
 Prevent future

Risk
 Better Mental

Health
 Increase in

social abilities

EVALUATION PROPOSAL 9

Research Methods and Designs

The data that will be collected in this study to represent the design of the research is called mixed methods

which is when quantitative and qualitative. Quantitative will gather data in a numerical form that can be put into

categories, ranks, or measured in units of measurements (Johnson & Christensen, 2000). Quantitative aims to

establish general laws of behavior and contexts. Qualitative is data in the form of words, pictures, values, and

appearances (Pickell, 2019). A qualitative research design will be used to establish answers to why client is afraid to

seek help because they feel like nothing is wrong with them. Also, a questionnaire survey is used for the clients to

evaluate the program.

Questionnaires and surveys will be the method used for this design. Questionnaires are designed so that

they can be answered without assistance and interview assistance in the questions that directly aim to the

respondents (Dejong, Monette, & Sullivan, 2018). The reason I chose questionnaires and survey is to understand

how the client feels about their service at Healthy Minds, Healthy Lives. The purpose of the two-research design is

to examine and breakdown the understanding of the underlying reasons, opinions, and motivations. Another purpose

is to provide insights into the problem and helps to develop ideas for potential research for mental health and alcohol

and drug abuse clients.

Evaluation of Discussion

Healthy Minds, Healthy Lives will have a conference every five months, workshops every month, and

different meetings every two weeks to ensure the clients and staff feedback. A meeting will be conducted through

data to ensure our organization is increasing its numbers. After one year of growing our successful organization, we

will market and advertise to gain more potential clients. We will utilize the qualitative methods by surveying the

client’s whether individually or as a family to determine if the program meets their expectations. We are determined

to serve the community and ensure our clients are receiving the treatment care.

Every six months we will set a goal to make sure we are improving our numbers of the participant to

receive the service they need. The purpose of so many meetings is to ensure that the program is safe and they are

receiving adequate services, and the clients feels safe and confident. The evaluation will be a questionnaire that the

clients will have to fill out. Through training, conferences, meetings, and workshops all evaluation responses will be

EVALUATION PROPOSAL 10

updated to make sure the facility is giving the client the best possible service. The evaluation survey will be included

in the appendix section.

Sustainability (Strengths & Limitations)

Healthy Minds, Healthy Lives will be a great facility for any and all clients seeking help. This facility has

many strengths that include the backbone of the staff to make sure the facility is in order. Another strength is this

facility will provide adequate services. We have trained staff that will help the clients if needed to continue their

counseling, therapy and AA meeting interventions. The facility will have a client as volunteers and guest speakers

that has made it through the program and that is still on their journey to recovery. Healthy Minds, Healthy Lives will

do referrals through other agencies if need by the client. Many other agencies such as Life Help, Mississippi

Behavioral Health Services, Doctor’s Office/Clinics, and etc.

Clients will learn new ways to cope with stressors and management skills. The clients will gain immediate

assistance and support by accessing requested/or needed information. The clients will improve their future stability

and avoid having to return back to their old habits. Another strength for the clients is that they will overcome

barriers to drug and alcohol abuse. The facility will help the client/clients to achieve independence to be able to live

alone without feeling like they will revert back to their old habit or not being able to live on their own because they

have a mental illness. I have listed many strengths for Healthy Minds, Healthy Lives facility, staff, and clients.

A limitation for this facility will be if the client doesn’t trust coming to this program for service. The client

may feel that they may not ever be able to overcome their illness. The client may even want to leave the service. The

client may also feel like they will always and forever be on and addicted to drugs and alcohol. The client just may

not want to quit using. Another limitation would be for another facility that wants to compete with Healthy Minds,

Healthy Lives. If the plan doesn’t work out for this facility to be approved for grants by Kroger we will reach out for

donations through our nonprofit organization.

Conclusion

Healthy Minds, Healthy Lives is a very beneficial facility that will work diligently for its clients. Healthy

Minds, Healthy Lives will reach out to other agencies if possible, to ensure the clients the best serve. This program

will help the clients to feel safe and even provide counseling to individuals that do not want help. The approach is to

save lives while reducing the death rate and to help individuals with their mental illnesses. The client will have a

EVALUATION PROPOSAL 11

safe place to come to discuss what they go through on a daily basis and to clear their thought in peace. The program

will help them with their addictions and to become knowledgeable about their mental illness. This program will

offer counseling, education, training, and workshops to its clients. This will be a great project once it has the funds

to expand and be developed.

EVALUATION PROPOSAL 12

Appendix A “Application”

Kroger Application for Community Grant

Return completed form to the Kroger Store or where you obtained this application

Location Use Only

Location #: ___________ City: ___________________________ ST: _______

Type: WM / Sam’s / DC / TO _______________________ Amount Requested: $___________________

Managers Name (signed and printed):_____________________________________ Date: ___/___/________

Community Involvement Associate: __________________________________________Date: ___/___/________

This application must be completed and kept on file for record retention of three years at your location

To be completed by the Organization:

Select one:

IRS designated ____ 501 (c) (3) * organization OR: _____Public School Federal, _____State or Local Government

Agency

Organizations with current tax-exempt status under Section 501(c) (3) of the Internal Revenue Service Code
and that are also public charities under Section 509(a)(1) or 509(a)(2). Organizations must be listed in the
most current IRS 50 State Master File at the time of application.

Organization Name:

____________________________________________________________________________________________

Federal 501 (c) (3) Tax ID #: (9 digits) ____________________________

Public Charity Status: ______509(a) (1) ________509(a) (2)

Address: __________________________________________________ City: ______________________________

ST: _____ Zip: _______________ Contact Name: _____________________________________________

Contact Phone: ______-_______-_______

Specifically, how will funds from this grant be utilized in your local community?

_____________________________________________________________________________________________

_____________________________________________________________________________________________

What service does your organization provide to the community?

_____________________________________________________________________________________________

EVALUATION PROPOSAL 13

_____________________________________________________________________________________________

Will these grant funds directly benefit your LOCAL community? ______ Yes ______No

Which of the following groups will this funding primarily benefit? “This information is used solely to track our

funding to specific diverse community groups and is NOT considered during the grant review or approval process.”

Please select only the most appropriate: _____ Hispanic _____African American _____Asian American

_____Native American _____Caucasian _____General Population (benefits the entire community)

Organization Representative: “By signing below I acknowledge that this form represents a funding request, and is

not a guarantee of funding. Final approval is subject to the guidelines of the Kroger Foundation. All organizations

requesting grant funding must abide by the rules and guidelines set forth by the location, Kroger Stores, Inc., and the

Kroger Foundation. This request will not be processed unless completed and signed by all parties.”

Signed: _________________________________Printed: ___________________________ Date: ___/___/______

EVALUATION PROPOSAL 14

Appendix B

Healthy Minds, Healthy Lives

Client Satisfaction Questionnaire

Thank you for taking the time to complete this survey. Your responses
will be used to help ensure that our program continues to be
responsive and sensitive to the needs of all program participants. If
there are any questions that you do not feel comfortable answering,
please feel free to skip and move to the next one. THIS SURVEY IS
COMPLETELY CONFIDENTIAL. PLEASE DO NOT WRITE YOUR NAME ON THIS
QUESTIONNAIRE.

Gender (check one): Male Female Transgender/Transsexual
Decline to state

Age: _______________ What is your primary language?
______________________________

Ethnicity (check one):

African-American (Black, non-Latino)
Asian/Pacific Islander (Specify:

___________)

Euro-American (White, non-Latino) Latino (Specify:
________________________)

Native American/Alaskan Native Multi-racial/Other (Specify:
________________) Decline to State

Number of individuals in family: Adults: _________________
Children/Ages: ___________________________

INTAKE PROCESS

Who referred you to this program? Self Hospital Clinic
Other

Was the intake process clear (Circle One)? Very Clear Somewhat Clear
Not Clear At All

Where were you being services before being accepted into HMHL?
Life Help MBH NONE

Residential Treatment Program With Family/Friend DV Shelter
THP Program Other: ___________

Where are you living currently? City? Living Situation?
_____________________________________________________________________________
________________

EVALUATION PROPOSAL 15

Have/had you ever rented an apartment before receiving this subsidy? Yes
No

Did the intake process give you a clear idea of what to expect in the
program?
_____________________________________________________________________________
________________

What was surprising or different once you were accepted into the program?
_____________________________________________________________________________
________________________________________________________________

Please list any suggestions that you may have regarding how to make the
intake process clearer, easier to access or more efficient:
_____________________________________________________________________________
______

SERVICE DELIVERY

Who is/was your case manager? ______________________________________

On a scale from 1-10, how satisfied are you with being involved with Healthy
Minds, Healthy Lives?
1 2 3 4 5 6 7 8 9 10

How often do/did you make it to your meeting with your case manager?

Every time Occasionally Sometimes Not very often

What suggestions would you give to your case manager on clients in the
future?
_____________________________________________________________________________
___________________________________________________

CLIENT INPUT

What suggestions do you have Healthy Minds, Healthy Lives for ?
__________________________________________________

_____________________________________________________________________________
________________

How has your experience accessing our services compared with other mental
health services you’ve accessed?
_____________________________________________________________________________
________________

Please evaluate each of the following areas of your service from Healthy
Minds, Healthy Lives (check one for each):

EVALUATION PROPOSAL 16

Excellent Good Average
Poor Unsure

Treatment by HMHL

Treatment by Case Manager

Staff Knowledge & Sensitivity about
Drug & Alcohol Abuse/ Mental Illnesses

Accessibility of Location

Quality of Overall Service

Staff Cultural Competency: Do you feel that Healthy Minds, Healthy Lives has
been sensitive to your ethnic and cultural background while providing
services to you? Please

(check one).

Yes No

Thank you for your input!

EVALUATION PROPOSAL 17

Reference

About Us. SAMHSA. (2021, September 17). Retrieved November 13, 2021, from

https://www.samhsa.gov/about-us.

Dejong, C., Monette, D., & Sullivan, T (2018) “Applied Social Research” Levels of

Measurements 111-112

Kroger Foundation. (2020). “Local Community Grants”. https://kroger.org/how-we-

give/local-community-grants

Pickell, D. (2019). “Qualitative vs Quantitative Data – What’s the Difference?”.

https://learn.g2.com/qualitative-vs-quantitative-data

SAMHSA, C. for B. H. S. and Q. (2014, September 4). Substance use and mental health

estimates from the 2013 National Survey on Drug Use and Health: Overview of findings.

The NSDUH Report: Substance Use and Mental Health Estimates from the 2013 National

Survey on Drug Use and Health: Overview of Findings. Retrieved November 13, 2021,

from https://www.samhsa.gov/data/sites/default/files/NSDUH-SR200-RecoveryMonth-

2014/NSDUH-SR200-RecoveryMonth-2014.htm.

EVALUATION PROPOSAL 18

Who we are. SAMHSA. (2021, May 5). Retrieved November 13, 2021, from

https://www.samhsa.gov/about-us/who-we-are.

Physiology homework help

Journal of Human Resources Education 13 Volume 3, No. 3, Summer 2009

STRATEGIC HRM AT THE MAYO CLINIC:
A CASE STUDY

Sunil Ramlall
Hamline University

Tripp Welch, Jennifer Walter, and Daniel Tomlinson

The Mayo Clinic

ABSTRACT

For many decades, Mayo Clinic has been ranked as one of the top medical institutions in the
world. The entire health care industry has been experiencing immense challenges. Given the
current and historic success of Mayo, what does Mayo need to do from an HR perspective to
maintain this standard of excellence? This case identifies the strategies used by Mayo to achieve
excellence in employee and patient satisfaction. The case describes how this complex service
organization fosters a culture that exceeds customer expectations and earns deep loyalty from
both customers and employees. The role of HR is analyzed to explain how strategic HRM
enables the organization to achieve its strategic business objectives.

INTRODUCTION

Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world.
Doctors of every medical specialty work together to care for patients, joined by common systems
and a philosophy that “the needs of the patient come first.” More than 3,300 physicians, scientists
and researchers and 46,000 allied health staff work at Mayo Clinic, which has sites in Rochester,
Minnesota, Jacksonville, Florida, and Scottsdale/Phoenix, Arizona.

For many decades, Mayo Clinic has been ranked as one of the top medical institutions in
the world. Over the past few years, the entire health care industry has been experiencing
immense challenges. Mayo is not immune to these challenges and faces the risk of losing critical
components of its culture and overall tradition of excellence that have been at the core of its
success. Given the current and historic success of Mayo, what does Mayo need to do from a
human resource (HR) perspective to maintain this standard of excellence?

Journal of Human Resources Education 14 Volume 3, No. 3, Summer 2009

This case study examines the core components of HRM at Mayo and details the
respective HR strategies used to sustain Mayo’s highly touted culture. The case describes how
this complex service organization fosters a culture and practices that exceeds customer
expectations and earns deep loyalty from both customers and employees. Specifically, the case
will enable you to:

1. Study Mayo’s organizational strategies and be able to articulate the relevance of
organizational culture as part of the business strategy.

2. Understand the value of organizational culture in helping an organization to build
its brand.

3. Critique HR practices using logic and reasoning to identify the strengths and
weaknesses of alternative solutions, conclusions or approaches to problems.

4. Identify relevant value-added strategies necessary to deliver services at the
highest quality.

Currently, the HR team at Mayo is a major player in helping to maintain and build a

culture of teamwork. Workforce planning, employee recruitment and selection, training and
development, compensation and benefits, and performance management are key areas in which
HR strategies are used to develop and reinforce Mayo’s Model of Patient Care.

The founders of Mayo have established the mission to “provide the best care to every

patient every day through integrated clinical practice, education and research.” It therefore
supports a comprehensive research department to “bring the bench to the bedside” and the Mayo
College of Medicine to teach and prepare tomorrow’s medical professionals. In doing so, the
premise of teamwork has been at the root of the culture, and subsequently human resource
management (HRM) strategies have been designed to maintain these values.

[ Case begins on next page ]

Journal of Human Resources Education 15 Volume 3, No. 3, Summer 2009

STRATEGIC HRM AT MAYO CLINIC: THE CASE

The role of human resource management (HRM) in organizations continues to be of
stronger importance and relevance (Bartel, 2004; Becker & Huselid, 1998; Cascio, 2003). Like
other progressive organizations, Mayo Clinic has created a unique organization and continues to
thrive even in a challenging economy and increasing costs of providing healthcare. Not only
does Mayo provide quality healthcare, but it is regarded as one of the premiere healthcare
institutions in the world (Lee, 2008). Mayo may have started out as a small outpatient facility,
but now, a century later, the Mayo Clinic is one of the top-ranked hospitals. Medical
professionals from every medical specialty work together at Mayo to care for patients, joined by
common systems and a philosophy of “the needs of the patient come first.”

The Mayo Clinic is the first and largest integrated, not-for-profit group practice in the

world. It is an organization where medical professionals from every medical specialty work
together to care for patients, joined by common systems and a philosophy of “the needs of the
patient come first.” More than 3,300 physicians, scientists and researchers and 46,000 allied
health staff work at Mayo Clinic, which has sites in Rochester, Minnesota, Jacksonville, Florida,
and Scottsdale/Phoenix, Arizona. Collectively, the three locations treat more than half a million
people each year.

Mayo’s mission is to “provide the best care to every patient every day through integrated

clinical practice, education and research.” It therefore supports a comprehensive research
department to “bring the bench to the bedside” and the Mayo College of Medicine to teach and
prepare tomorrow’s medical professionals. Healthcare institutions have faced significant
challenges over the past few years.

A Brief Overview of Mayo Clinic

Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world.
Doctors from every medical specialty work together to care for patients, joined by common
systems and a philosophy of “the needs of the patient come first.” More than 3,300 physicians,
scientists and researchers and 46,000 allied health staff work at Mayo Clinic, which has sites in
Rochester, Minn., Jacksonville, Fla., and Scottsdale/Phoenix, Arizona.

As other progressive organizations, Mayo Clinic has created a unique organization and
continues to thrive even in a volatile economy and during a time when costs of providing
healthcare are increasing. Medical professionals from every medical specialty work together at
Mayo to care for patients, joined by common systems and a philosophy of “the needs of the
patient come first.”

Mayo’s mission is to “provide the best care to every patient every day through integrated
clinical practice, education and research.” It therefore supports a comprehensive research
department to “bring the bench to the bedside” and the Mayo College of Medicine to teach and

Journal of Human Resources Education 16 Volume 3, No. 3, Summer 2009

prepare tomorrow’s medical professionals. Healthcare institutions have faced significant
challenges over the past few years.

MAYO MODEL OF PATIENT CARE

The fundamental elements of the Mayo Model of Care include:

– A team approach that relies on a variety of medical specialists working together to provide the
highest-quality care

– An unhurried examination of each and every patient with time to listen to the patient

– Physicians taking personal responsibility for directing patient care in partnership with the
patient’s local physician

– The highest-quality care delivered with compassion and trust

– Respect for the patient, family and the patient’s local physician

– Comprehensive evaluation with timely, efficient assessment and treatment

– Availability of the most advanced, innovative diagnostic and therapeutic technologies and
techniques

Significant Achievements

The Mayo Clinic name is so widely recognized that it may be the only true national brand
name in American medicine. Rather than the result of a carefully crafted advertising campaign,
its’ reputation has been built by word-of-mouth on more than a century of quality patient care. It
is the quality of care that Mayo Clinic patients appreciate and that makes the organization stand
out from the many healthcare centers that also provide excellent care. Ever since its creation, the
focus of Mayo Clinic has been on delivering the highest level of care to all patients. In achieving
this dream, Mayo has steadily focused on teams rather than individual contributors. The Mayo
Model of Care provides the framework in which all employees perform their responsibilities.

Aligning HRM and Business Strategy at Mayo

Mayo has accumulated many achievements over its history. Indeed, a major component
of its strategies has been the workforce management. The HR function of Mayo has been a
leader in helping to deliver the Mayo Model of Care. Given the trends facing the healthcare
industry and the need to create and maintain high performance organizations such as Mayo, the
role of the workforce and HR becomes even more critical.

The human factor is central to healthcare, yet its proper management has remained

beyond the reach of healthcare organizations (Khatri, Wells, McKune, & Brewer, 2006). A
central tenet of high performance organizations is the measurement of the impact of HR practices
and policies on organizational performance (Godard, 2004). A major problem in the healthcare

Journal of Human Resources Education 17 Volume 3, No. 3, Summer 2009

sector is the contentious nature of the measurement of performance, with international studies
attempting to link people management practices to patient mortality in acute hospitals (Bartram,
Stanton, Leggat, Casimir, & Fraser, 2007). The need to always identify and implement HR
practices to the mission of the organization is absolutely critical. Mayo’s strategic plan identifies
the workforce as the key to success. Therefore, the HR function which is responsible for the
hiring, rewarding, and retaining the employees becomes a core role of the strategic plan.

Primary Value: The needs of the patient come first
Mission: Mayo Clinic will provide the best care to every patient every day through

integrated clinical practice, education, and research
Vision: Mayo Clinic will be the premier patient-centered academic medical organization

Satisfy Our Patients Achieve Mission-Advancing Financial Performance

Improve and Demonstrate Quality, Safety, Service, and Value

Attract, Develop, and Retain the Best People

Mayo Clinic Strategic Plan

• Achieve the highest levels of patient service
and satisfaction

• Demonstrate Mayo Clinic as the choice
destination medical center

• Achieve operating margin target
• Achieve sufficient and stable sources

of funding for Research and Education

• Achieve the highest levels of quality care and safety
• Develop high-value care models targeted to specific patient populations

• Improve staff satisfaction, training, retention,
and recognition

• Increase diversity of all staff

• Strengthen leadership development
• Establish a culture of innovation and discovery

V
IS

IO
N

E
X

E
C

U
TI

O
N

P
R

IO
R

IT
IE

S

Quality
Integration

Science of
Health Care Delivery

Individualized
Medicine

Since the concept of HRM emerged in the early 1980s, two basic paths of research have

been developed in investigating the relationship between HR practices and organizational
performance (Chand & Katou, 2007). The first was based on the assumption that there is a direct
relationship between individual HRM practices and/or internally consistent HRM systems of
HRM practices, and organizational performance, e.g. (Arthur & Boyles, 2007; Huselid, Jackson,
& Schuler, 1997; Jackson & Schuler, 1995).

The second was based on the assumption that there is an indirect relationship between

individual HRM practices and/or HRM systems, and organizational performance e.g. (Belanger,
Edwards, & Wright, 1999; Ferris et al., 2007). Similarly, critical outcomes include patient
satisfaction, employee satisfaction and commitment, and operational efficiency at Mayo Clinic.

Journal of Human Resources Education 18 Volume 3, No. 3, Summer 2009

A Focus on Quality

Quality can be defined and measured in many ways. At Mayo Clinic, quality is not just a
simple measure. Quality is a comprehensive look at all aspects of a patient’s experience. Mayo’s
patients seek excellence in care, the best medical knowledge and experience, the best technology
available and the kindness and hope offered by the staff. Quality can be measured in the
outcomes achieved such as mortality rates and surgical infections; in the compliance with
evidence-based processes known to enhance care; in the volume of patients successfully treated
who have complex diagnoses and procedures; and in the safety record of the institution. Quality
and service can also be measured in other ways such as the amount of time spent with each
patient; making sure each patient is treated with respect, kindness and dignity by every member
of the Mayo team; making sure appointments are on time and that all test results and other
patient information are available to every doctor whenever it is needed. Quality at Mayo Clinic
involves the totality of a patient’s experience — from the first phone call to the last appointment.

Today, many organizations measure quality in health care using varying criteria.

Evaluating this information can be difficult and time-consuming since not all measures reflect
the same information from one report to another. However, it is important for patients to ask
questions and look at quality information to ensure they are getting the efficient and effective
care they need. Mayo’s HR function continues to work diligently towards helping the
organization to meet its mission. Following are some of HR’s core strategies and priorities.

Developing Teams and a Culture of Teamwork

Quick (1992) explained that cultural values become the platform for specific and concrete
actions designed to meet difficulty and challenge. The author argued that we cannot think of
organizational culture as a substitute for responsible, problem-solving behavior on the part of
leadership. Culture becomes the vehicle through which problems and challenges become
addressed, defined, reframed, and ultimately solved. When cultural values do not work in this
fashion, they must be modified or jettisoned. The culture is not the end or goal but rather the
means. It may be the focus of attention, but as in the case of the magician, something quite
substantive and important may not be meeting the eye. At the core of Mayo’s culture is
teamwork.

Because of the Mayo brothers’ innovative approach to medicine, the Mayo Clinic system

has also become well known for its use of a multidisciplinary model in caring for patients and
finding new treatments and protocols (Strom, 2001). In the Mayo system, you’re expected to try
to get along and/or you’re someone who has been identified as a person who can get along with
the rest of the team. The Mayo brothers fostered an atmosphere of cooperation and working
together with minimal squabbling. Yet again, one of the factors that help to make this happen is
a salaried system without incentives. It eliminates competition among employees, while
fostering a deeper cooperation for the greater good of all stakeholders.

Today, Mayo enjoys and benefits from a workforce where teamwork is the absolute

norm. Typical of the Mayo Clinic is its century-old team approach to treating patients.
Physicians work in teams, with each team driven by the medical problems involved in a case and

Journal of Human Resources Education 19 Volume 3, No. 3, Summer 2009

by the patient’s preferences. Occasionally, a team will be expanded or even taken apart and
reassembled. At Mayo, diagnosing a complex problem, proposing treatment and slotting the
patient for surgery can happen within 24 hours of the diagnosis. The overall effect at Mayo is
one of orderliness, function and, above all, vigor.

This is an industry that is dominated by increasingly powerful (and increasingly

expensive) technology. Mayo’s biggest innovation is its way of working — especially its way of
working in teams. To be sure, other medical institutions use teams. But Mayo has incorporated
collaborative methods into everything that it does — from diagnosis and surgery to policy
making, strategic planning, and leadership. At Mayo, the art of medicine is the epitome of
teamwork (Roberts, 1999). While most other companies focus on the bottom-line, Mayo’s focus
continues to be on the patient and patient satisfaction.

Employee Recruitment and Selection

Attraction and retention of employees is an increasingly significant aspect of building
organizational capabilities to ensure sustained competitiveness. As practiced at Mayo, one of the
most important aspects of the HR function is to select the “right” employee for every opening.
Mayo uses value-based hiring, looking for team players who have the ability to advance within
the organization, demonstrate empathy for others, and can handle ambiguity. Employees must
be flexible, but firm when necessary. Employees must not be rules-driven and must adhere to
the utilitarian principle of the greatest good.

Rather than viewing HR as a critical driver of organizational strategy and outcomes, most

health care organizations see HR as a drain on the organization’s bottom line. Only by aligning
HR with the organizational strategy will HR leaders truly get a seat at the leadership table.

HR leaders have stated that, in hiring new employees, loyalty, a strong work ethic, and

the ability to be an outstanding team player are among the criteria Mayo seeks. Mayo has
subsequently benefited from incredibly low turnover rates and the ability to retain employees
who possess the expertise, passion, and empathy to deliver the best patient care to all patients.

In its’ 2007 Annual Report, Mayo’s HR team explained that effective recruiting is vital to

achieving Mayo’s strategic plan and reported that 6000 allied health positions were filled in
2007. Furthermore, its quality initiative within the department resulted in a reduction in time to
fill a job from a median of 35 days to 29 days. Potential increases in the number of patients,
however, may provide additional increases in recruitment and labor costs.

Diversity is another area of high importance in Mayo’s recruitment strategy. In 2007,

12% of the employees hired were minorities. This figure far exceeds the percentage of qualified
individuals in the respective geographic locations, though Mayo continues to work diligently to
increase this number.

As Mayo deals with the current industry trends and economic challenges, HR is faced

with the continuing challenge of recruiting and retaining skilled employees. The health care
industry, which employs more than 11 million workers, faces significant workforce challenges.

Journal of Human Resources Education 20 Volume 3, No. 3, Summer 2009

So while it is relatively easy to tout previous successes, the challenge facing Mayo is
unprecedented. As a result, Mayo’s HR function must continually explore innovative ways to
recruit in order to meet its need for skilled professionals.

Promoting Teamwork through Strategic Rewards

An effective compensation system can lead to organizational competitiveness and higher
levels of profitability. It can also help to motivate employees. Mayo emphasizes compensation
strategies to foster the attitudes and behaviors that fit with the Mayo Model of Patient Care.

Mayo prides itself in hiring long-term employees who are team players. Supporting this

compensation philosophy, Mayo does not employ a performance-based compensation system.
Mayo argues that a standard of excellence is expected of everyone. Typically, employees are
paid at the 60th percentile of the market range. In addition, employees are given a
comprehensive benefits program that includes medical, dental, tuition reimbursement, defined
benefit pension plan, and other retirement options.

Over the years, HR compensation professionals at Mayo have:

• Created a framework for titling management jobs and reviewed options for

changing the management job salary structure
• Conducted a comprehensive market review of Administrator positions and made

recommendations to leadership
• Designed leadership development programs for leadership transitions
• Focused on reviewing jobs to ensure everyone is paid at the desired levels
• Conducted internal surveys to ensure employees are satisfied with their pay

While Mayo has historically provided an outstanding example of compensation strategies

aligned to business strategies to achieve a standard of excellence, the question arises as to
whether this philosophy would be relevant in hiring more employees where fewer qualified
candidates are available. Furthermore, as opportunities become available with greater
frequencies, Mayo’s HR function questions if employees are likely to leave for the opportunity
to earn more through incentive based compensation.

Building and Maintaining a Highly Committed Workforce

Through deliberate efforts such as teamwork, focus on employee well-being, minimal
incentive-based compensation, and providing a great work environment, Mayo has benefited
from incredibly low turnover rates and the ability to retain employees who are the ones
possessing the expertise, passion, and empathy necessary to deliver the best patient care to all
patients. Mayo’s turnover is approximately 5% annually.

A report published by the Gale Group stated that the cost of employee turnover is roughly

$4.1 billion annually and on average, there is a 45% average annual turnover rate in a long-term
care workforce of roughly 2.6 million, with an average turnover cost of $3,500 per employee,
including indirect and direct costs (Edwards, 2005). The HR staff at Mayo works diligently to

Journal of Human Resources Education 21 Volume 3, No. 3, Summer 2009

support recruitment efforts through various retention strategies. The focus continues on ensuring
employee satisfaction. Frequent employee surveys, meetings with employees, and observations
help to gauge employee satisfaction.

As a specific means to attracting and retaining employees, Mayo has defined a Total

Rewards program that is quite attractive to most. The rewards program is based on the principle
that no one is big enough to be independent of others and is comprised of:

• Paid time off
• Work life balance
• Competitive total compensation
• Comprehensive benefit plans at a relatively low cost
• Retirement funded by Mayo
• Income protection
• Professional development
• Regular salary increases

Mayo has identified the personal attributes that best fit its culture and philosophy. In

particular, it looks for people who are committed to high-quality care and service; convey a
positive attitude; are enthusiastic, resourceful, and honest; have a strong work ethic unconnected
to extrinsic rewards; demonstrate understanding of cultural diversity; and aspire to collaborative
work. Mayo invests in a time-consuming, collaborative hiring process to find staff who will
thrive in the Mayo system (Berry, 2004). It is through these hiring practices, its culture, and total
rewards that have proven to be critical in helping to have such stellar retention rates over its
history.

Challenges Facing the Healthcare Industry

There is no shortage of reports about the rising costs of healthcare. As the healthcare

industry continues to grow and as more focus is placed on healthcare costs, there will be a need
for more strategic models for management of hospitals, clinics, and practice groups (Wooten &
Decker, 1996).

Industry Trends

A report by the American Hospital Association’s Society for Healthcare Strategy and

Market Development and the American College of Healthcare executives, cosponsored by VHA
Inc., stated that the major trends facing healthcare organizations include the following:

a) Providers and insurers are poised to create new, consumer-sensitive innovations
designed to meet individual needs.

b) Payers and the government will continue to push for better disclosure on what
services cost and on the quality of patient care, making transparency an expectation.
That is likely to be a divisive force among providers and within integrated groups.

c) CEOs and other senior executives will be increasingly held accountable for achieving
high performance with measured results.

Journal of Human Resources Education 22 Volume 3, No. 3, Summer 2009

d) Increasing numbers of physicians will demand reimbursement for input, call and
other activities.

e) Hospitals will continue to increase the use and expand the scope of advanced practice
nurses and physician assistants.

f) Hospitals will continue to take advantage of the current period of relative financial
stability to make capital investments (Wooten & Decker, 2006).

Demand for Service

Mayo is faced with the likely prospect of an increase in demand for service given the
aging population of the U.S. There may even be a shortage of physicians. This is a concern for
many administrators. The Association of American Medical Colleges underscored this problem
in 2006 when it compiled studies from at least 16 states, citing shortages in physician specialty
fields. The report highlighted that even with substantial increases in medical education and
training capacity, it is unlikely that all of the increased demand for health services can be met
with physicians.

Many of these reports pointed to shortages in specialties such as allergy and immunology,

cardiology, child psychiatry, dermatology, endocrinology, neurosurgery and psychiatry, in
addition to primary care. The bottom line is that the country is not producing enough physicians
to keep pace with the demands of a growing, aging population. Given its outstanding reputation,
Mayo wonders if it will be able to maintain the highest quality as more patients flock to its doors
to be treated. Will they be able to adequately and effectively hire healthcare professionals who
fit its culture?

Diversity

The Mayo brothers saw the value of bringing people with different skills, backgrounds

and beliefs together to better serve the patient. Today, the clinic’s goal is to create a caring
service environment where individual differences are valued, allowing all staff to achieve and
contribute to their fullest potential.

Mayo defines diversity as all the characteristics which distinguish individuals or groups

from one another. Formally, the definition includes distinctions based on race, color, creed,
religion, gender, age, national origin, marital status, sexual orientation, veteran’s status,
disability, or status with regard to public assistance. The benefits of this approach include a
workforce that:

• Offers a broad pool of talent
• Contributes different viewpoints and perspectives in concepts, initiatives and decision

making
• Generates energy and creativity
• Better represents and responds to our patients and our colleagues

Support for diversity is comprehensive through Mayo Clinic’s structure, with broad

leadership provided by the executive leaders on Mayo Clinic’s Board of Trustees and the

Journal of Human Resources Education 23 Volume 3, No. 3, Summer 2009

Trustees’ appointed Mayo Clinic Diversity Advisory Committee. The Diversity Advisory
Committee serves as a forum for review and promotion of diversity activities undertaken at all
Mayo sites. These efforts are supported at each clinic location by a site-specific diversity
committee. Resources available to these leadership committees include the departments of
Human Resources, Education Services, Research Services, Legal, and the Personnel Committee.

Mayo’s diversity initiatives represent a cogent approach to integrate diversity into

Mayo’s overall strategy for growth. Collectively they contribute to a diverse Mayo Clinic.
When looking at the percentage of people of color in the 18 and over population of their
respective Metropolitan Statistical Areas (MSAs), the number of minorities employed at each
Mayo site is more than one-half of that percentage. More importantly for Mayo, over 40 percent
of these minority employees work in positions classified as management and professional, the
feeder pipeline for highest-level leadership positions.

Diversity in healthcare, seen at all organizational levels, includes people from differing

cultures, races, religions, gender, physical ability, backgrounds, and values (Ivancevich &
Gilbert, 2000). Once an organizational decision is made to value and promote diversity among
staff, the challenge lies in trying to manage this diversity through “systematic and planned
commitment…to recruit, train, reward, and promote a heterogeneous mix of employees.”
(Ivancevich & Gilbert, 2000).

Many approaches have been used in healthcare to manage diversity. The most common

are training sessions, subordinates’ feedback, performance appraisals, and reward systems.
Whatever strategies are used, common goals are fostering staff commitment to diversity,
recruiting and empowering staff champions, identifying the value added to the system by group
differences, and empowering staff through skill development.

Operational Efficiency

Several factors are forcing health care organizations to streamline their operations. These
factors include competitive pressures, increased consumerism, regulatory requirements, and
others. Process improvement techniques traditionally used in manufacturing and other industries,
such as Six Sigma and lean processes, are gaining popularity in health care. Operational
efficiency is about increasing productivity and improving quality and consistency which can
seem overwhelming to healthcare facilities with declining reimbursements.

Today, Lean and Six Sigma may be buzzwords within the Fortune 500 business circles,

but that doesn’t mean health organizations can’t leverage their principles to address their own
financial challenges. Lean principles improve patient care by reducing rework and waste. Six
Sigma tools are also transforming management philosophy in healthcare. Six Sigma is a
statistical approach that measures process capability— mainly in terms of accuracy and standard
deviation. It helps companies strive for customer satisfaction by consistently meeting or
exceeding their commitments. It can reduce double payments to vendors, savings in net income
and produce effective billing and

Physiology homework help

Research_AssignPT105.docx

Unit 7 Assignment – Journal Article Review – 25 points

*This is NOT a group project and is to be completed individually!

Read and critically analyze the provided article in Unit 7: “Adding ultrasound in the
management of soft tissue disorders of the shoulder” and answer the prompts below.

1. List 3 terms that were unknown to you when reading the article and provide their
definition.

2. Answer the following prompts to demonstrate understanding of the full article:

a. What type of research does this article characterize? Where is this on the
research hierarchy?

b. Describe the methods used in the study. Is there room for bias?
c. Describe the subjects throughout the study.
d. What were the inclusion and exclusion criteria?
e. Variables: What were the independent variables?
f. Variables: What were the dependent variables?
g. Results: What were the final results?
h. Find the alpha level. Is it significant (look in the narrative & chart)?
i. Conclusion: What did the researchers conclude?
j. What do you take from the article?
k. References: How many references are used? Year of the most current reference?

Year of the oldest reference?
l. What are the names of the authors? What country are they from?

  • Unit 7 Assignment – Journal Article Review – 25 points

Physiology homework help

Module 04

Scoring Rubric: Developing a Philosophy of Nursing

Criteria

Weight

Discusses beliefs and attitudes about nursing

3

Explains beliefs about being a nurse

2

Describes personal approach to caring for others

2

Meets 1-page requirement

1

Accurate APA format (including providing sources when appropriate, references, and in-text citations)

1

Accurate Grammar (including capitalization, punctuation, spelling, word usage, no run-on sentences, no sentence fragments, and/or paragraphing errors)

1

Total

10

Physiology homework help

MY TOPIC:

How different models discussed in the book, (Employee Training and Development 8th edition) can improve the U.S. Army Patient Administration department. Define the patient administration department and list duties it entails in the intro so readers can know what the organization is like before talking about ways to improve please. Models could be ISD Training model, needs assessments, learning and transfers of training, etc. Some are listed below for further instruction. Please do not plagiarize because I will first have to submit it through turnitin. Thank you again.

Book reference:

Noe, R. A. (2020). Employee training and development (8th ed.). Mcgraw-Hill.

PAPER REQUIREMENTS

* The Term Paper (Development of a Training Program) is to be 8 – 10 pages in length excluding references, and is due March 2, 2022. This project will include conducting a needs assessment; assessing the relative characteristics of learners; analysis of work setting characteristic; performance of job, task and content analysis; developing performance measures, writing performance objectives; specifying instructional strategies; designing instructional materials, and methods of evaluation. (NO EXTENSIONS WILL BE ALLOWED). 

In developing your paper, please utilize instructions I have indicated over the several weeks of this term. As to references, I see that I did not give a number on the syllabus. Of course, you will use the textbook and other sources as applicable. Ten would be good but an minimum of 8 will suffice given that the main source of content will be your book.

PATIENT ADMINISTRATION DUTIES

Provide quality patient care; Provide Customer Service (Telephone); Answer telephone calls to one of 3 lines; Provide Customer Service (Front Desk); Greet visitors to the Patient Admin front desk; Provide Registration support by registering patients in Composite Health Care System (CHCS); Determine eligibility for care; Establish and create Electronic Medical Record using Essentris; Run medical Records and ensure Medical Charts are taken to patient’s rooms and signed; Trigger Reports (Transfers) by accessing to ADT Trigger Report email group for order processing; Provide Patient Admission support; Maintain and run Medical Charts; Conduct Ward Rounds and verify the wards admitted patients with each Charge nurse and Document patient discharges and ward transfers; Provide “Provider One Call” support; Provide Medical Evacuations (MEDAVAC) logistics and transportation support; Provide Decedent Affair and Birth Registry support; Man the APU Pre-screen Patient Admin desk to provide basic Patient Administration functions for the APU; Man the America Building Satellite office when assigned and Independently perform basic A&D functions in satellite office; Assist with training new personnel; Participate in ongoing Process; Improvement/Performance Optimization (PI/PO) initiatives in the Division and provide recommendations for PI/PO to Division Leadership; Support the provisions of the Health Insurance Portability and Accountability Act (HIPAA), Privacy Act and other such directives.

MEDICAL RECORD TECHNICIAN, WALTER REED NATIONAL MILITARY MEDICAL CENTER

Knowledge of regulation, guidelines and policies related to patients and the authority under which the Ambulatory Data System (ADS); and Corporate Information System (CIS) are applied and how they function. Experience in a hospital setting utilizing medical records systems such as Composite Health Care System (CHCS), Armed Forces Health Longitudinal Technology Application (AHLTA), and Essentris; Maintains all patients’ records, either electronic or paper, according to Health Insurance Portability and Accountability Act (HIPPA) regulation insuring each entry contains proper patient and health care proper identification; Correctly files original medical documentation in the patient record and copies of medical documentation into research files as necessary.

Physiology homework help

Systems thinking applied to social justice in public health

 

Erika (students name)

Many organizations are pushing for the application of systems thinking to reach social justice in public health. Without systems thinking, unintended consequences can occur, which are negative implications of our actions (CDC, 2017).

Public health improvements have been made at the cost of social justice. While trying to improve one area, we have unfortunately created unintended consequences in another area due to a lack of systems thinking. A “quick fix” may seem more time or cost effective, however this “linear thinking” needs to be turned into systems thinking if we really want to tackle issues in the moment and down the road (Stroh, 2015). To tackle racial equity or racial equity in public health, we must address the root causes of racial equity including education, health, and housing. For example, jumping to create a program to lower blood pressure in an underserved community where hypertension is a prevalent issue may seem like a beneficial program, however it’s more important to approach the issue with systems thinking and look at the education of the population, their housing, and other health disparities they are facing to make the best short and long term solution. 

Through tackling social justice with systems thinking, we can solve many issues facing public health as well. 

References

Centers for Disease Control and Prevention (CDC). (2017, October 26). The Value of Systems Thinking. YouTube. Retrieved February 20, 2022, from 
https://www.youtube.com/watch?v=Fo3ndxVOZEo

Stroh, D. P. (2015). Systems Thinking for Social Change. PND by Candid. Retrieved on February 20, 2022 at 
https://philanthropynewsdigest.org/off-the-shelf/systems-thinking-for-social-change
.

Week 4 systems thinking discussion

 

Valentina (students name)

Systems’ thinking allows for individuals to look at the big picture when trying to solve issues; it is the understanding of the way in which things work in a particular setting. It is important to use systems thinking when trying to address an issue. This is because it allows us to examine the topic as a whole and then help us think of strategies that will help formulate successful plans.

As discussed by Paul Farmer, global health pioneer and Partners in Health co-founder, when applying systems thinking individuals are drawing on the evidence of the literature along with personal drive and empathy to help in the decision making of a topic in health care. An example was used for social justice. When individuals fight for social justice, the successful way to address social justice issues are taking the time to study and analyze how the system of a certain place works. After taking the time to analyze the system, individuals can incorporate what they’ve learned with studied literature, use their own personal empathy and drive for change and then begin creating a plan for the change envisioned. However, if systems thinking is not used to analyze how a place works and to assess the systems already in place, any plan or policy created, may not be successful in the end. (Farmer, 2009)

Reference

 

Farmer, P. (Darthmouth). (2009).  Paul Farmer-The need for “systems thinking” in health care.  
https://www.youtube.com/watch?v=ukRjaQwGM3E

Physiology homework help

6.2: Medical Humanitarianism and the “Four Cultures” of Global Health

1

Exam study topics

Describe the 4 “cultural roots” of the current global health system, including the main health and economic orientations of each root.

Given a case study about a global health issue, identify the particular culture/s at play in the situation

Understand the origins and differences between the ICRC and MSF

Describe the moral and ethical dilemmas involved in the medical humanitarian response to the Rwandan refugee crisis

What is “temoignage” (bearing witness) and why is it an important element of MSF’s mandate?

List the kinds of things that go into a humanitarian kit for a refugee camp

2

19th-century roots:
“The four cultures” of global health

Adapted from Brown, P. J. (2019), in Foundations of Global Health, eds. Brown and Closser.

3

International Health Regulation

Disaster and War Victim Relief

Military Medical Research & Hygiene

Medical Missionaries

Recap of Lecture 5.3:
Eras of International Health Activity

“Bureaucratization and Professionalization,” 1946–1970

Permanent health organizations founded

Large scale training of personnel

Global disease campaigns in the context of the Cold War

“Contested Success,” 1970–1985

Vertical campaigns (e.g., smallpox) versus horizontal health and social infrastructure efforts (e.g., primary health care)

“Evidence and Evaluation,” 1985–present

Demand for measurable successes and “evidence-based” interventions

Reinforcement of technical and cost-effective global health initiatives

Renewal of countering paradigm stressing social justice, infrastructure, human rights

Birn, et al2017, p. 52

Here’s what we looked at in lecture 5.3 at the end. The main message was that there are multiple approaches and ideologies influencing global health right now. Sometimes these priorities are compatible but others times, they are not… [go back to previous slide]

4

Adapted from Brown, P. J. (2019), in Foundations of Global Health, eds. Brown and Closser.

“Miasmists” vs. germ theorists  origins of modern biomedicine

Collection of vital statistics  revolutionary

Cholera interrupting trade and commerce

International Sanitary Conferences (11 held between 1851-1903)

Origins of the WHO

1. Regulation: goes back to the debate between “miasmists” and “germ theoriests” – the latter is the foundation of modern biomedicine. Based on microbiological discoveries and hospital-based experiments, and the new practice of collecting vital statistics. Remember John Snow? He was the vanguard of the germ theorists. Cholera was a scourge at the time, especially because it was interrupting international trade. Ships often had to sit in bays of foreign ports undergoing lengthy and costly quarantine. Many foreign ports has strict laws on quarantine. Germ theorists thought those laws were too onerous.

There were annual international “Sanitary Conferences” held to deal with these things, to generate international cooperation and to maintain epidemiological boundaries (quarantine, vaccination, and inspection of foreign travelers and immigrants). These international conferences were the basis for the founding of the WHO in 1948!

5

International Health Regulation

Adapted from Brown, P. J. (2019), in Foundations of Global Health, eds. Brown and Closser.

Humanitarian aid began in the mid-19th c. in response to war, famine

New weapons technology changed warfare (swords  machine guns)

Red Cross/Red Crescent societies and Geneva conventions established

Professionalization of nursing, based on biomedicine and duty to alleviate suffering

Often work in tandem with military establishment

Key to humanitarian aid: principle of neutrality

6

Disaster and War Victim Relief

Adapted from Brown, P. J. (2019), in Foundations of Global Health, eds. Brown and Closser.

New killing technologies  better treatments for wounded soldiers

Colonial armies in tropical areas had high morbidity and mortality rates

Advances in the smallpox vaccine technology allow it to be used in tropical areas

In the colonial home front: cost-effectiveness was the rationale for sanitary laws

CDC originated from the “Malaria Control in War Areas” agency

Chloroquine and DDT developed during WWII by military medical-scientific research program

7

Military Medical Research & Hygiene

Adapted from Brown, P. J. (2019), in Foundations of Global Health, eds. Brown and Closser.

Heyday of Protestant missionaries in South Asia and sub-Saharan Africa: 19th and 20th c.

Long-term view, permanent outposts to “serve the natives” mind, body and soul

Demonstration of Christian kindness and mercy and…

…the superiority of Western Christian society, culture and science

~60% of health services in Kenya today through Faith-Based Organizations

8

Medical missionaries

Health Orientations

Public health

Research

Prevention

Disease Specific

Clinical care

Action

Cure

Comprehensive Health

Adapted from Brown, P. J. (2019), in Foundations of Global Health, eds. Brown and Closser.

International Health Regulation

Disaster and War Victim Relief

Military Medical Research & Hygiene

Medical Missionaries

Economic Orientations

Public funding

Economic rationality

Measurement/statistics

Research grant funding

Private funding

Human rights over cost/benefit

“Not everything that counts can be counted, not everything that can be counted counts”

Charity fundraising

Adapted from Brown, P. J. (2019), in Foundations of Global Health, eds. Brown and Closser.

10

International Health Regulation

Disaster and War Victim Relief

Military Medical Research & Hygiene

Medical Missionaries

Founded 1849, in response to Crimean War and Battle of Solferino (Italy)

Founder (Henry Dunant) received the first Nobel Peace Prize, 1901

Dunant heavily influenced by witnessing events during WWI

Crimea, Solferino battles – horrible wounds to soldiers

ICRC became institutionalized as the civilian auxiliary to national armies

Strict doctrine of neutrality and discretion

Necessary to operate on the battlefield

Problematic during Holocaust – moral authority of ICRC challenged

Not much to say about colonialism or conflict outside Europe at founding

Medical Humanitarianism:

11

Founded 1971 in response to Biafran crisis (Nigeria) and flood/independence struggle in Bangladesh

Heavily influenced by the age of genocide and decolonization/independence movements of the 1960s and 70s

Combined a “realist rejection of utopian politics and a romantic rejection of authority”

Today: an international movement of 19 loosely inter-connected groups

A “more engaged and daring version of the Red Cross”

Nobel Peace Prize, 1999

Balance operational neutrality with a willingness to speak out

Medical Humanitarianism:

12

What do they have in common?

Both emerged in response to conditions created by conflict

Both later expanded their scope of work to address the “expanding horizon of disaster”

How do we define a “disaster”?

What is the difference between development and humanitarianism?

Both respond to suffering through the health framework (rather than poverty or hunger)

13

14

Moral and ethical questions of medical humanitarian aid to Rwandan refugees

Is it acceptable for MSF to assist people who had committed genocide?

Should MSF accept that its aid is instrumentalised by leaders who use violence against the refugees and proclaim their intention to continue the war in order to complete the genocide they had started?

For all that, could MSF renounce assisting a population in distress and on what basis should its arguments be founded?

From: Binet, Laurence. 2013. “Rwandan Refugee Camps in Zaire and Tanzania, 1995-1995.” Médecins Sans Frontière.

15

MSF and témoignage (bearing witness)

Témoignage = Not just to witness, but also to speak out

“MSF never asks the permission of a given population to speak out on its behalf.”

Best understood as a secondary effect of medical humanitarian action – but one that is essential and unavoidable

16

“Temoignage Toolbox”

quiet diplomacy

transfer of information

denunciation

accusation

withdrawal of a mission

17

Transformation of MSF, 1970-2001

In 1970, an original “community of friends” offered “love to Third World populations” along with residual Maoist principles and hallucinogenic substances. By 1980, “mercenaries” of a private organization offered food aid to “Ethiopians, Afghans, and other victims of the Moscow Olympics boycott.” In 1990, a “profitable multinational company quoted on the unlisted securities market” offered assistance to populations victimized by disasters and was so overwhelmed as to “no longer know where help is needed most.” By 2000, the e-charter of MSF.com championed both the 35-hour work week and the right to “full and free on-line access for anti-retroviral drugs.”

– From Redfield (2005: 332), “Doctors, Borders and Life in Crisis”

18

In the news:

March 2017 – WHO delivers cholera kits to Yemen

July 2020 – Oxfam delivers cholera kits to Yemen

19

The “humanitarian kit”

Basic building block: 1 unit = 625 treatments; Weighs 6,000 kg

Drugs: 6,500 oral rehydration salt packets, 10,000 tablets of a broad-spectrum antibiotic

Materials to take patient samples (dissecting forceps, permanent black markers)

Materials for performing basic medical procedures (surgical gloves, tunics, trousers, boots of several sizes, ten 500g rolls of cotton wool, 25 arm splints, catheters and bandages)

100 buckets, 100 disposable razors, notebooks, pens, wire ties, 2 staplers

Land Cruisers (cold or warm-weather) + stickers & flags

Guidelines and “how-to” information booklets, in several languages:

Set up a simple water sanitation system

Conduct minor surgery in a war zone

Build a pit latrine

Blood transfusion in a nutshell

Look after a refrigerator

“Human rights in a nutshell”

20

Physiology homework help

Running head: ABBREVIATED TITLE HERE IN ALL CAPS (Note: include the words 1 Running head: on the first page only as shown.)

INSERT ABBREVIATED TITLE HERE IN ALL CAPS

Insert the Title of Your Paper Here on the Upper Half of Title Page

Insert Your Name Here

National University

Insert due date of paper here

Abstract

The abstract provides a brief, comprehensive summary of the paper. Abstracts should not exceed 120 words, unless otherwise stated, and should note the major ideas of the paper. The abstract appears on a page by itself, (page 2), with title Abstract, as shown above, centered on the first line of the page and is not bolded. Unlike all other paragraphs in the research paper, it is not indented. The Abstract should be one long paragraph with no indentations.

Insert the Title of Your Paper Here Again (centered, exactly as on title page, bolded)

These instructions are based on APA 7th ed. Begin the first paragraph of the body of your paper here (indented). Introduce your reader to your topic and why you are writing about it. The introduction does not need the heading Introduction to label it due to its location in the paper. When writing a research paper, you should strive to write in the third person. Avoid using words like I, or this researcher will. Relative to formatting, APA dictates that there are now two spaces after punctuation marks at the end of sentences. All text in your paper from beginning to end, including the References page, should be double-spaced. Set your margins to one inch all around.

Beginning on your title page, double click in the header to place an abbreviated title of your paper in all capital letters. This is called the Running head and should be flush left with the margin. Then using the page insert function, insert your page numbers starting page 1 on the title page, located at the upper right margin. Your page numbers will automatically fall in proper order.

Insert a New Major Heading Here (bolded)

This is where you will continue the body of your paper, citing some background or history on the subject you have chosen for your paper. Titles that are centered and bolded are called Level I Headings. You will most likely need to use subheadings like the one below, to indicate that you are changing the focus of your discussion. It is not APA compliant to underline headings, or any other text for that matter, so do not underline any text anywhere. Also, do not use any colors anywhere in your paper, just plain black and white. Some templates use colors and blocks around page numbers. This is not APA compliant.

Level Two Heading (subheading)

As above, subheadings are left justified (not indented) and they need to be in upper and lower case letters and bolded. Do not underline headings. Each main word is capitalized. Throughout your entire paper use 12-point font, either Times New Roman or Arial only (although others might be easy to read or look pretty, nothing else is acceptable). Make sure your entire paper is left justified (align text left), not center justified (center text). Center justified text stretches text out evenly across the page, but is not APA compliant.

In Text Citations

In-text citations are required in your paper and must be APA compliant relative to formatting. If you are not familiar with how to format in-text citations, refer to your APA Publication Manual to appropriately cite references in your text. Do not use URL’s as in-text citations. URL’s should only be used in your References page to indicate where you retrieved information.

Conclusion

Conclude your paper by briefly summarizing what you have already said throughout your paper. This is where it would be appropriate to cite your opinions or to talk about what you learned about the topic you have researched and written about. The References page should be on a page by itself. What that means, is regardless of where your Conclusion ends, always start your References page on a new page, and type the word References, centered, not bolded, on the very first line. Do not use the words Resources, Reference (singular), Works Cited, etc. Use References.

References

American Psychological Association. (2009). Publication manual of the American Psychological Association (6th ed.). Washington, DC: Author.

Cohen, L., Chávez, V., & Chehimi, S. (2007). Prevention is primary: Strategies for community well-being. San Francisco: Jossey-Bass.

Schneiderman, N., Speers, M. A., Silva, J. M., Tomes, H., & Gentry, J. H. (Eds.). (2001). Integrating behavioral and social sciences with public health. Washington, DC: American Psychological Association.

NOTE: Your reference page is always last and begins on a new separate page like this. The title is just as you see it above. The following applies:

· All references are double spaced like the rest of your paper with the first line flush left with the margin and all lines after the first line (of each individual reference) is indented as above. This is also referred to as a hanging indent.

· There are specific components for each of the various types of references used, (books, journals, magazines, websites, etc.) depending on the type of reference you are listing. Check the APA Publication Manual to make sure you include all the appropriate components for your references. Review the proper use of italics as demonstrated on the examples above.

· All references must be alphabetized A to Z, regardless of type of reference. See your APA Publication Manual for examples.

· If you cite a reference in the body of the text of your paper, the reference must be listed on this page and vice versa. If you have a reference listed here, make sure you have cited it in your paper somewhere.

Physiology homework help

Assignment Overview

· Case study: PIH ch. 7: “Swasthya: The Politics of Women’s Health in Rural South India,” by Suneeta Krishnan, pp. 128-147.

After reading the assigned text, compose a 400-500 word reflection and submit it to the Canvas discussion board.


Content and Grading

In your reflections, address the following 3 questions.

1. What are the author’s main messages/arguments? What is the main takeaway of this case study? What is the essential background information that we need to understand it? (2.5 points)

2. How does the case study relate to concepts from the course (including lectures, readings and videos)? Connect themes in the case study to at least 2 concepts from the course.  Put these concepts in bold so that we can easily find them when grading, and be sure to explain or elaborate on HOW the case study illustrates, complicates or is connected to that topic. (4 points)

3. Share your personal reaction or stance on the issues developed in the case study. Has it changed your opinion on the topic? Does it relate to your own personal experiences? Does it connect to things you have studied in other courses, or articles you’ve been reading in the news lately? (2.5 points)

4. Proper citations (1 point)

Citations

You must include proper academic citation in your case study reflections. This is a good habit to get into generally. Visit this page for the 
general course citation guidelines.

· When referring to required course material, use a shortened version of the APA’s author-date, in-text parenthetical citation system, e.g. (Marmot 2010). You can abbreviate our course textbooks to RGH and PIH, or use the case study author’s last name. Be sure to spell the author’s name correctly! Lectures can be cited by the number, e.g. (Ryan lecture 4.2). Videos can be cited by the primary speaker or a shortened version of the title, e.g. (Bad Sugar) or (Rosling).

· When referring to outside articles or sources, use the APA’s author-date, in-text parenthetical citation system, e.g., (Washington Post 2021) and include a hyperlink or full citation to your original source at the end of your submission. Connecting the case studies to outside sources is always welcome, but be sure you are also

· You do not need to write a full bibliography for case study reflections.

Physiology homework help

Week One: Written Assignment

Top of Form

Instructions

Advantages and Limitations of the U.S. Health Care Delivery System (CLO 1, 3, 7)

No country in the world has a perfectly balanced health care delivery system. Certain aspects of a healthcare system may be advantageous to some stakeholders, while presenting inefficiencies or challenges to other groups. The United States has a unique system of healthcare delivery, with loosely coordinated subsystems that encompass public and private payers and multitudes of providers. Without a central governing body, the U.S. health care system is shaped by many different stakeholder interests.

For this assignment, identify three advantages of the U.S. health care delivery system, and three limitations. Next, consider those who are affected by these advantages and limitations, and analyze the implications of each with regard to:

1. Healthcare costs

2. Addressing disparities in access to healthcare

3. Achieving reliable quality of healthcare

4. For each advantage that you identified, who are the individuals or groups that benefit?

5. For each limitation you described, how does the limitation drive the need for change or reform to the health care system?

Provide your analysis in 2-3 pages, double spaced (not including cover sheet, abstract, or references), and provide at least three (3) scholarly references to support your assessment (including the textbook). Apply APA format for all your formatting, citations, and references, unless otherwise indicated. All papers should include:

· Title page;

· Abstract; 

· Use of Level I and II headings (if applicable);

· Introduction section;

· Conclusion section;

· In-text citations;

· References page

Please use the sample APA paper template (with instructions) (provided below) for all paper assignments:


APA paper template – Word Document
(SEE ATTACHMENT)

Bottom of Form

Physiology homework help

Chapter 8
Creating a Meaningful Vision

Vision Board Presentations.

Create a Power Point

Provide a Mission Statement

Create 5-10 slides of your Vision for the Future.

Where are we now

Vision Board Presentations

TRANSPERSONAL PSYCHOLOGY

Explores the overlap between the realms of psychology and spirituality.

What’s your VISION

Living Beyond Your Limits: AMY Purdy

http://www.youtube.com/watch?v=N2QZM7azGoA

How to write a Personal Mission Statement

https://www.youtube.com/watch?v=6i0z7WV-o8I

Theoreticians

Stanislov Grov (1985, 1988), Ken Wilbur (1979), Charles Tart( 1986)

Actively pursuing ideas like the reality of the soul, reincarnation, and the whole realm of paranormal phenomenon.

Life Is A Mystery

Life is ultimately a mystery that won’t ever be solved no matter how big you build your bonfires.

Form a relationship with the mystery (God, Goddess, the fates or whatever you choose to name it)

Ask the question you’ve always wanted to ask.

The real key to success is listening.

12

Life Is A Mystery

Life Is Uncertain

Life Is Trouble

Everything Is Connected

– Whatever you do, you do it to yourself

– Do not burn your own house down

Everything Is Connected

alison davis () –

Everything

Is

Connected

Life Is Trouble

Life very often involves dealing with problems

Trouble cannot be avoided

Me, myself and my conscience

http://www.youtube.com/watch?v=TfB9I2gjtdw

Life Is Uncertain

THINGS CHANGE

This Too Shall Pass.

VISION QUEST

Destiny.

Dreams and Fantasies

Compassion

Excitement

Peace

Your heart is a compass that will point to your path.

$The successful life requires constant questioning and attending to how you answer those questions, moment to moment.

What’s stopping you from achieving your goals.

https://www.youtube.com/watch?v=XZRw91uNMq0

Eudemonic Life

A life not merely filled with pleasantries but filled with meaning.

Visualization

A method of deliberately using imagery, visual and otherwise, to alter your feelings, your behavior, and even your physiology.

Begin with the end in mind.

Getting Clarity: The Goal of the GOAL!

The goal must be stated in positive terms and in a way that you can achieve it yourself regardless of the behavior of others.

Make certain you know how will know that you have reached your goal.

Describe your goals as specifically as you can.

Are your goals compatible with each other?

Assess what you already have and what you are going to need in order to reach your goals.

Make a plan.

HOW VISUALIZATION WORKS

Albert Bandura (1977) Social Cognitive Learning Theory

 

$Modeling Principle: the ability of humans to learn how to do something simply by observing others…………aka

Observational Learning

College… What do we do now? How well do you know your parents?

http://www.youtube.com/watch?v=8ITlyEC6K_8

Under the bed… Who have you misjudged?

http://www.youtube.com/watch?v=j6cqHbF-3qE

Who do you treat differently?

http://www.youtube.com/watch?v=gVKt44zMSOM

Unconscious Mind

$mental imagery, the primary medium that your mind represents and stores information.

Freud (1924) Psychodynamic Theory: the concept of the unconscious mind to describe the part of the mind containing aspects of functioning of which we are totally unaware.

.MsftOfcThm_Accent1_Fill {
fill:#4472C4;
}
.MsftOfcThm_Accent1_Stroke {
stroke:#4472C4;
}

.MsftOfcThm_Accent1_Fill {
fill:#4472C4;
}
.MsftOfcThm_Accent1_Stroke {
stroke:#4472C4;
}

.MsftOfcThm_Accent1_Fill {
fill:#4472C4;
}
.MsftOfcThm_Accent1_Stroke {
stroke:#4472C4;
}

.MsftOfcThm_Accent1_Fill {
fill:#4472C4;
}
.MsftOfcThm_Accent1_Stroke {
stroke:#4472C4;
}

.MsftOfcThm_Accent1_Fill {
fill:#4472C4;
}
.MsftOfcThm_Accent1_Stroke {
stroke:#4472C4;
}

Physiology homework help

Assignment:

Organismic Psychological Needs

· Become familiar with the questions below:

1. Why is the person-environment dialect important?

2. What are the benefits from autonomy support (both giving and receiving)?

3. How does optimal challenge and flow determine if a person will repeat an activity?

4. Why are different types of feedback needed for different situations? Describe the types.

5. Is it necessary to build a tolerance for failure?

Write an essay paper discussing:

1. An explanation of organismic psychological need and the main components: autonomy, competence, and relatedness.

2. An analysis of each question (a-e above) with scholarly support and connection to class readings.

3. Write a detailed explanation of various activities (engagement) and the need which is met. Describe why these relationships are important to understand.

Your essay should be 2000- words and should include at least four (4) citations. Follow the guidelines for APA writing style, including proper headings for each section you are addressing. The title page and references page do not count toward the minimum word amount for this assignment.

Physiology homework help

Peer and family influence on self-esteem

Imagine you have been asked to speak to a group of parents about promoting self-esteem in school-age children. You need to research the topic and prepare a visually appealing PowerPoint slideshow to accompany your presentation. Your PowerPoint slideshow will need to:

1. Have a title slide.

2. Contain 5-10 content slides that include Speaker Notes which provide supporting details to use when elaborating on the slide contents.

3. Address the following questions:

A. How does level of self-esteem typically change during middle childhood? What factors contribute to this change?

B. What are some influences on school-age children’s self-esteem?

c. Does very high self-esteem always have positive effects on children’s adjustment? Why or why not?

d. What are the typical consequences of low self-esteem?

e. What are some other strategies that parents and teachers can use to promote children’s self-esteem? What behaviors should adults avoid, and why?

4. Be written using proper spelling/grammar.

5. Cite at least 3 academic references and present the sources in APA format on a References slide.

For information about creating PowerPoint presentations or how to add Speaker Notes, consult the resources below.

Physiology homework help

Portrayal of families and relationships

As societal norms evolve, a variety of popular entertainment media (books, movies, TV shows, etc.) feature stories of characters who are a part of traditional and non-traditional family or relationship structures. Examples include but are not limited to: traditional families, cohabitation, single-parent households, blended families, same-sex couples, and grandparents as the primary caregivers for their grandchildren.

In a 3-page paper, written in APA format using proper spelling/grammar, address the following:

1. Describe a book, movie, or TV show that you are familiar with which features characters in families or personal relationships.

2. Select at least two families/relationships from your chosen story and explain the relationship characteristics and dynamics between individuals.

3. Apply terminology presented within the module when analyzing the relationships. Be sure to include APA citations for any resources you used as references.

Physiology homework help

Discussion Board posts should be at minimum 250 words.  You are expected to conduct independent research on the subject and use two scholarly sources in addition to the textbook. Provide in-text citations and list of references to support your post as required. Use APA writing format.

*** ENSURE YOU ANSWER ALL THE QUESTIONS***

Week Three: Discussion

Must post first.

Health Services and Settings Encountered by a Patient with a Critical Illness. (CLO 3, 6, 7)

Please review the scenario provided in the below case study:

· Jim’s Experience! – HTML (If the link fails, please copy/paste the URL below into your browser for Jim’s Experience:) 

http://d2jw81rkebrcvk.cloudfront.net/assets.navigate/issa/MHA/healthcare_industry/LB5/Core_Lesson/media.
html

Next, consider a patient who has a severe but undiagnosed disease, illness, or injury. Based on your knowledge of this disease, illness, or injury, ask yourself the following questions:

· What steps might the patient have to go through to determine a diagnosis?

· What types of health care settings and services might they be exposed to during this process?

· What barriers or challenges might they encounter when attempting to access and pay for health services in these settings?

· How might the patient’s experience differ in health settings with high quality service vs. low quality service?

· Post your answer, adding insights based on Jim’s experience from the case study as well as your own personal or professional experiences. 

Physiology homework help

Discussion Board posts should be at minimum 250 words.  You are expected to conduct independent research on the subject and use two scholarly sources in addition to the textbook. Provide in-text citations and list of references to support your post as required. Use APA writing format.

*** ENSURE YOU ANSWER ALL THE QUESTIONS***

Week Two: Discussion One

Evaluate the necessity for the Affordable Care Act (ACA) and the three aims of access, cost, and quality in the US healthcare system. (CLOs 1. 3. 8) (20 Points)

The United States’ health care delivery system has a triad of aims related to access, cost, and quality. Evaluate the extent to which the Affordable Care Act (ACA) has achieved the primary aims of enabling its population–approximately 320 million people–to receive health services when needed, while simultaneously containing costs and assuring that health services meet standards of quality.

To prepare for this discussion, please reflect on the learning resources and the media below, as well as your personal and/or professional experiences you have had with health care delivery in the United States and answer the questions that follows:

· US healthcare Delivery System – HTML

http://d2jw81rkebrcvk.cloudfront.net/assets.navigate/issa/MHA/healthcare_industry/LB1/Core_Lesson/media.html

· As you form your ideas, consider:

· How has the provisions of ACA changed the U.S. health care delivery and access to care? Be specific about the provision(s) that you are discussing – explain the provision(s) and the effects.

· In your discussion, address why is it that despite public and private health insurance programs, some U.S. residents are without health care coverage?

· What are some of the effects of not having health insurance on personal and national levels?

· Identify possible approaches to improve population health and address health inequities.

Physiology homework help

Module 2.1 Neurons: The Body’s Wiring

Module 2.2 The Nervous System: Your Body’s Information Superhighway

Module 2.3 The Brain: Your Crowning Glory

Module 2.4 Methods of Studying the Brain

Module 2.5 The Divided Brain: Specialization of Function

Module 2.6 The Endocrine System: The Body’s Other Communication System

Module 2.7 Genes and Behavior: A Case of Nature and Nurture

2.1

2.2

2.4

2.3

Module 2.1

Neurons:
The Body’s Wiring

2.6

2.5

2.7

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Myelin
Sheath

Axon

Terminal Buttons and Synapses

Dendrites

© Cengage Learning

Soma

There are two major types of cells in the nervous system: glial and neurons. Glial cells are a kind of “glue” that helps nourish neurons and helps hold them together, among other functions. Glial cells also make up the myelin sheath that insulates the axons of many neurons.

Neurons are cells that receive, integrate, and transmit information. In the human nervous system, the vast majority are interneurons-–neurons that communicate with other neurons. There are also sensory neurons, which receive signals from outside the nervous system, and motor neurons, which carry messages from the central nervous system to the muscles that move the body. A third type of neuron, called an interneuron, connects two other neurons. In the brain, they process information from sensory organs and control higher mental functions, such as planning and thinking. In the spinal cord, they connect sensory neurons and motor neurons.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

Soma

The soma, or cell body, contains the cell nucleus and much of the chemical machinery common to most cells.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

Dendrites

The branched structure is called a dendritic tree, and each individual branch is a dendrite. Dendrites are the parts of a neuron that are specialized to receive information

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

Axon

The long fiber is the axon. Axons are specialized structures that transmit information to other neurons or to muscles or glands.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

Myelin Sheath

Most human axons are wrapped in a myelin sheath. Myelin is a white, fatty substance that serves as an insulator around the axon and speeds the transmission of signals. In people suffering from multiple sclerosis, some myelin sheaths degenerate, slowing or preventing nerve transmission to certain muscles.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

Terminal Buttons and Synapses

The axon ends in a cluster of terminal buttons, which are small knobs that secrete chemicals called neurotransmitters. These chemicals serve as messengers that may activate neighboring neurons.

The points at which neurons interconnect are called synapses. A synapse is a junction where information is transmitted from one neuron to another.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Glial Cells

© Cengage Learning

More numerous than neurons, glial cells come in a variety of forms. Their main function is to support the neurons by, among other things, supplying them with nutrients and removing waste material. In the human brain.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

Axon

Inside
Electrode

Outside
Electrode

The neuron at rest is a tiny battery, a store of potential energy. Inside and outside the axon are fluids containing electrically charged atoms and molecules called ions. Positively charged sodium and potassium ions and negatively charged chloride ions are the principal molecules involved in the nerve impulse.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

Axon

Inside
Electrode

Outside
Electrode

50

0

-50

-100

Milliseconds

Millivolts

When the neuron is not conducting an impulse, it is said to be in a resting state. The cell membrane is polarized–negatively charged on the inside and positively charged on the outside. The charge difference across the membrane can be measured with a pair of microelectrodes connected to an oscilloscope. In a resting neuron, this difference, called the resting potential, is about –70 millivolts.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Click to play animation. Make sure volume is turned up.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Axon

Inside
Electrode

Outside
Electrode

© Cengage Learning

50

0

-50

-100

Milliseconds

Millivolts

When the neuron is stimulated, channels in its cell membrane open, briefly allowing positively charged ions to rush in. For an instant, the neuron’s charge becomes less negative and momentarily shifts to a positive charge. This change in polarization is called an action potential.

An action potential is a very brief shift in the neuron’s electrical charge that travels along an axon.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

Here we see a representation of how positively charged sodium (Na+ ions) enter the cell, which has the effect of temporarily changing the cell’s charge from negative to positive, which results in propagation of an action potential. As the action potential passes, the cell restores its negative charge by closing sodium gates and pushing positively charged potassium ions (K+) through the membrane.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Action Potential

No Action Potential

OR

50

0

-50

-100

Milliseconds

Millivolts

50

0

-50

-100

Milliseconds

Millivolts

The size of an action potential is not affected by the strength of the stimulus—a weaker stimulus does not produce a weaker action potential. If the neuron receives a stimulus of sufficient strength, it fires, but if it receives a weaker stimulus, it doesn’t. This is referred to as the “all-or-none” principle.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

Synaptic Gap

Terminal Buttons and Synapses

The neural impulse is a signal that must be transmitted from one neuron to other neurons.

This transmission takes place at special junctions called synapses, into which chemical messengers called neurotransmitters are released by the terminal buttons.

The two neurons are separated by the synaptic gap, a microscopic gap between the terminal button of one neuron and the cell membrane of another neuron. Signals have to cross this gap for neurons to communicate.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

Synaptic
Vesicles

Neurotransmitter
Molecules

Neurotransmitters are chemicals that transmit information from one neuron to another.

Within the terminal buttons, neurotransmitters are stored in small sacs called synaptic vesicles.

Note that neurotransmitters can have both excitatory and inhibitory effects.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

The neurotransmitters are released when an action potential causes sacs or vesicles at the end of the axon to spill its contents of neurotransmitters into the synaptic gap. After their release, neurotransmitters diffuse across the synaptic cleft to the membrane of the receiving cell, which stimulates the receiving (postsynaptic) cell to propagate an action potential of its own.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

1

Storage of neurotransmitter

Molecules in synaptic vesicles

2

Release of neurotransmitter
molecules into synaptic cleft

3

Binding of neurotransmitters
at receptor sites on
postsynaptic membrane

© Cengage Learning

5

Reuptake of neurotransmitters
absorbed by the
presynaptic neuron

4

Inactivation (by enzymes)
or removal (drifting away)
of neurotransmitters

After producing postsynaptic potentials, some neurotransmitters either become inactivated by enzymes, or drift away. Most neurotransmitters, however, are reabsorbed into the presynaptic neuron through reuptake – a process in which neurotransmitters are sponged up from the synaptic cleft by the presynaptic membrane.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

Here we see a schematic representation of the process of neural transmission from one neuron to another and the reuptake process in which excess molecules of neurotransmitters are reabsorbed by the transmitting neuron.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Agonists

Stimulants (caffeine, amphetamine, cocaine)

Antianxiety drugs

Antidepressants

Morphine, heroin

Antagonists

Antipsychotic drugs

Psychoactive drugs can be classified in terms of their effects on neurotransmitter functioning. Agonists mimic the effects of certain neurotransmitters or increase the availability of neurotransmitters. Antagonists work in the opposite fashion by blocking receptor sites for particular neurotransmitters. The specific neurotransmitters targeted by these drugs are discussed in the textbook.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Neurotransmitters

Related Disorders

Dopamine

Parkinson’s disease

Schizophrenia

Norepinephrine

Depressive disorders

Serotonin

Depressive disorders

Obsessive-compulsive disorder

Eating disorders

GABA

Anxiety disorders

Specific neurotransmitters work at specific kinds of synapses – the study of which has led to interesting findings about how specific neurotransmitters regulate behavior.

Here are a few examples of physical and mental disorders linked to irregularities or dysfunction of neurotransmitter functioning.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Module 2.2

The Nervous System:
Your Body’s Information Superhighway

2.1

2.2

2.4

2.3

2.6

2.5

2.7

2.8

© Cengage Learning

The multitudes of neurons in your nervous system have to work together to keep information flowing effectively. The nervous system consists of two major parts, the central nervous system (brain and spinal cord) and the peripheral nervous system (the network of nerve pathways that connect the central nervous system to the muscles, glands, and other parts of the body).

2.1

2.2

2.4

2.3

2.6

2.5

2.7

2.8

© Cengage Learning

The central nervous system, or CNS, consists of the brain and spinal cord. We can see that the CNS is situated centrally in the body.

The spinal cord houses bundles of axons that carry sensory information from the peripheral nervous system to the brain and conveys commands from the brain to the peripheral nervous system.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Spinal Cord

A column of nerves between the brain and peripheral nervous system

Brain

Divided into three major parts: the lower part or hindbrain, the midbrain, and the forebrain

Central Nervous System

The body’s master control unit

Here we see how the peripheral nervous system is organized. The autonomic nervous system is comprised of two divisions, the sympathetic and the parasympathetic nervous systems. These two divisions have largely opposite effects.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

Sometimes it’s best not to use your brain before you act. A spinal reflex is controlled at the level of the spinal cord, allowing you to respond more quickly than would be case if the signal needed to be transmitted to the brain for processing.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

The withdrawal reflex is another example of a spinal reflex.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

The peripheral nervous system is made up of all the nerves that lie outside the brain and spinal cord. Nerves are bundles of neuron fibers or axons that are routed together in the peripheral nervous system.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

Autonomic Nervous System

Somatic Nervous System

The peripheral nervous system can be divided into two parts.

The somatic nervous system is made up of nerves that connect to voluntary skeletal muscles and sensory receptors. They carry information from receipts in the skin, muscles, and joints to the CNS, and from the CNS to the muscles.

The autonomic nervous system is made up of nerves that connect to the heart, blood vessels, smooth muscles, and glands. It controls automatic, involuntary, visceral functions that people don’t normally think about, such as heart rate, digestions, and perspiration.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Somatic Nervous System

Carries information from sensory organs
to the central nervous system and relays motor (movement) commands to muscles

Sympathetic
Nervous System

Mobilizes bodily resources in response to threat by speeding up heart rate and respiration and drawing stored energy from bodily reserves

Parasympathetic
Nervous System

Replenishes bodily resources by promoting digestion and slowing down other bodily processes

Autonomic Nervous System

Regulates involuntary bodily processes, including heart rate, respiration, digestion and pupil contraction; operates automatically without conscious direction

Here we see how the peripheral nervous system is organized. The autonomic nervous system is comprised of two divisions, the sympathetic and the parasympathetic nervous systems. These two divisions have largely opposite effects.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

Parasympathetic vs. Sympathetic Control

Pupils constricted

Pupils dilated

Salivation stimulated

Salivation inhibited

Bronchial passages constricted

Bronchial passages dilated

Decreased respiration

Increased Respiration

Decreased heart rate

Increased heart rate

Digestion stimulated

Digestion inhibited

Secretion of adrenal hormones

Bladder contracted

Increased secretion

by sweat glands

Hair follicles raised;

goose bumps

Bladder relaxed

When a person is aroused, automatic bodily functions speed up. This speeding up is controlled by the sympathetic division of the autonomic nervous system. The effects of sympathetic activation on shown on the right side of the diagram.

The sympathetic nervous system mobilizes the body’s resources for emergencies and creates the fight-or-flight response.

The parasympathetic nervous system, on the other hand, conserves bodily resources to save and store energy, as in the process of digestion. Parasympathetic effects are shown on the left side of diagram.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Module 2.3

The Brain:
Your Crowning Glory

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

The Brainstem

Thalamus

Midbrain

Pons

Medulla

Spinal cord

Cerebellum

Medulla

Pons

The brain is organized in three major parts: the hindbrain, the midbrain, and the forebrain.

The hindbrain includes the cerebellum and two structures found in the lower part of the brainstem: the medulla and the pons.

The cerebellum is critical to the coordination of movement and to the sense of equilibrium, or physical balance. Damage to the cerebellum disrupts fine motor skills, such as those involved in writing or typing.

The pons contains several clusters of cell bodies that contribute to the regulation of sleep and arousal.

The medulla, which attaches to the spinal cord, has charge of largely unconscious but essential functions, such as regulating breathing, maintaining muscle tone, and regulating circulation.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

Midbrain

The midbrain is mostly concerned with relaying sensory information to the forebrain.

The midbrain helps to control the voluntary movement of the eyes. It is part of the brainstem, and also contains the reticular formation (or the reticular activating system, or RAS).

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

The Reticular
Formation

Running through both the hindbrain and the midbrain is the reticular formation. Lying at the central core of the brainstem, the reticular formation is best known for its role in the regulation of processes of attention, alertness and arousal. It helps to screen visual and auditory sensory input so that irrelevant information is filtered out and not processed in the higher processing centers of the brain.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

Forebrain

The forebrain is the largest and most complex region of the brain, encompassing a variety of structures, including the thalamus, hypothalamus, limbic system, and the two cerebral hemispheres.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Thalamus

Hypothalamus

© Cengage Learning

© Cengage Learning

The thalamus is a structure in the forebrain through which all sensory information, except smell, must pass to get to the cerebral cortex. This way station is made up of a number of clusters of cell bodies, or nuclei. Each cluster is concerned with relaying sensory information to a particular part of the cortex. The thalamus also receives information from the basal ganglia, which play a key role in regulating voluntary movement.

The hypothalamus performs many functions, including regulation of hunger, sleep, and the body’s stress response. As we will see later, it is also crucial in regulating the functions of the endocrine system.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© Cengage Learning

The limbic system is a loosely connected network of structures involved in emotion, motivation, memory, and other aspects of behavior. The structures of the limbic system include the amygdala, the hippocampus, parts of the thalamus and hypothalamus, and other nearby structures.

The amygdala is a set of two structures that trigger the emotional response of fear when we encounter a threatening stimulus.

The hippocampus is located just behind the amygdala and is involved in the formation of new memories.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Occipital

Parietal

Frontal

Temporal

© Cengage Learning

The cerebral cortex is so large that it is divided into two halves, or hemispheres. These halves are connected by a thick, tough band of nerve fibers called the corpus callosum.

Each cerebral hemisphere is divided by deep fissures into four parts called lobes. To some extent, each of these lobes is dedicated to specific purposes.

The occipital lobe includes the primary visual cortex, which is a cortical area where most visual signals are sent and visual processing is begun.

The parietal lobe includes the primary somatosensory cortex, an area that registers the sense of touch.

The temporal lobe contains the primary auditory cortex, an area devoted to auditory processing.

The frontal lobes are the site of higher mental functions, including thinking, calculating, planning, problem solving, and decision making.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

The Lobes of the Cerebral Cortex

Structure Functions
Occipital lobes Process visual information, giving rise to sensations of vision
Parietal lobes Process information relating to sensations of touch, pressure, temperature (hot and cold), pain, and body movement
Frontal lobes Control motor responses and higher mental functions, such as thinking, planning, problem solving, decision making, and accessing and acting on stored memories
Temporal lobes Process auditory information, giving rise to sensations of sound

Here we have a nice summary of the general functions controlled by each lobe of the cerebral cortex.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Exciting new work on mirror neurons is discussed in this video.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Module 2.4

Methods of Studying
the Brain

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Lesioning

Electrical recording

Electrical stimulation

Investigators also use more invasive means of studying brain functioning in laboratory animals used in experimental research.

Lesioning involves the destruction of a piece of the brain in order to observe what happens.

Electrical recording involves placing electrodes in brain structures to measure the electrical activity of various parts of the brain.

Electrical stimulation involves sending a weak electric current into the brain to observe the effects on particular brain structures.

EEG (electroencephalograph)

CT (computed tomography) scan

Also called a CAT scan

PET (positron emission tomography) scan

MRI (magnetic resonance imaging)

fMRI (functional MRI)

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Physicians today use many different types of brain imaging to diagnose neurological or brain disorders. Investigators use these technique to learn more about brain functioning.

In EEG (an electroencephalograph) a device that uses electrodes is attached to the scalp to measure brain wave activity

A computer tomography (CT) scan is a computer-enhanced X-ray that provides images of the internal brain structures.

A positron emission tomography (PET) scan uses computer-generated images of the brain, formed by tracing the amounts of glucose used in different parts of the brain during different types of activity.

A magnetic resonance imaging (MRI) produces computerized images of the brain and other body parts by measuring the signals they produce when placed in a strong magnetic field.

A newer form of MRI is called functional magnetic resonance imaging, or fMRI, which takes snapshots of the brain in action. It is used to assess both the function and structures of the brain.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

CT Scan

X-ray
Source

X-ray
Detectors

Fan
Shaped
Beam

© Cengage Learning

CT Scan

The CT scan provides a three-dimensional X-ray image of bodily structures. It can reveal structural abnormalities in the brain that may be associated with blood clots, tumors, brain injuries, or psychological disorders such as schizophrenia.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Pascal Goetgheluck/Science Source

PET Scan

The PET scan measures the metabolic activity of the brain. More active regions are highlighted in yellow and red while less active regions appear as blue and green. This PET scan shows a patient suffering from withdrawal from alcoholism. As you move from the top to the bottom rows you can see how more brain activity appears as more time without alcohol in the system passes.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

© 2001 American Association for the Advancement of Science

fMRI

The red areas of these fMRI images indicate parts of the brain that are more active when a person is shown pictures of faces. The blue areas denote parts of the brain that are more active when the viewer is shown an image of buildings.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Can functional magnetic resonance imaging (fMRI) help researchers to “read the minds” of subjects?

This video discusses how fMRI is helping to predict what people see and what they are paying attention to.

Also, how fMRI is helping neuroscientists to better understand the human visual system and related cognitive processes.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Module 2.5

The Divided Brain: Specialization of Function

Left hemisphere: Specialized for language abilities, logical reasoning, and problem solving.

Right hemisphere: Specialized for nonverbal processing.

But note that people are not “left-brained” or “right-brained.” Information passes back and forth along the corpus collosum.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Stimulus in Left
Half of Visual Field

Fixation Point

Left Eye

Left Hemisphere
(Control of Right Hand)

Optic Nerves

Information Delivered
to Left Visual Processing Area

Stimulus in Right
Half of Visual Field

Right Eye

Right Hemisphere
(Control of Light Hand)

Severed Corpus Callosum

Information Delivered
to Right Visual Processing Area

© Cengage Learning

Lateralization refers to the division of functions between the right and left hemispheres of the cerebral cortex.

Each hemisphere’s primary sensory and motor connections are to the opposite side of the body – the left hemisphere controls and communicates with the right hand, arm, etc. and the right hemisphere controls and communicates with the left side.

Vision is more complex. Stimuli in the right half of the visual field are registered by receptors on the left side of each eye that send signals to the left hemisphere.

Similarly, stimuli in the left half of the visual field are registered by receptors on the right side of each eye that send signals to the right hemisphere.

2.1

2.2

2.4

2.3

2.6

2.5

2.7

Production
of Speech

Broca’s Area

© Cengage Learning

In recent decades, an exciting flurry of research has focused on cerebral lateralization—the degree to which the left or right hemisphere handles various cognitive and behavioral functions.

However, hints of cerebral specialization were found as early as the late 1800s.

In 1861, Paul Bro

Physiology homework help

Beijing + 5: What Can International Conferences Achieve for Women’s Health?

Page 1 of 19

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 02 March 2022

The Practice of International Health: A Case-
Based Orientation
Daniel Perlman and Ananya Roy

Print publication date: 2009
Print ISBN-13: 9780195310276
Published to Oxford Scholarship Online: September 2009
DOI: 10.1093/acprof:oso/9780195310276.001.0001

Beijing + 5: What Can International
Conferences Achieve for Women’s Health?
Nuriye Nalan Sahin Hodoglugil

DOI:10.1093/acprof:oso/9780195310276.003.05

Abstract and Keywords
This chapter presents some thoughts about the significance of the United
Nations Beijing +5 Conference. In 1995, when the Fourth World Conference for
Women was held in Beijing, women came from all over the world to discuss
pertinent issues such as health, economic and political power, and violence and
oppression. The final document produced at this conference was the Platform for
Action, which described the overall status of women internationally based on
these issues. The Beijing +5 meetings was organized by the UN’s Division for
the Advancement of Women to assess the current situations of women globally
and to make relevant changes to the Platform for Action while also reaffirming
commitment to the original document.

Keywords:   conferences, women’s rights, women’s issues, gender equality

According to the maps, the United Nations headquarters was only a few blocks
from my hotel. Still, I set out early that day, and took my time strolling up First
Avenue. As I drew closer, I caught sight of the immense skyscraper rising above
the sea of other buildings. Although it was late spring and the sun was well
above the horizon, the morning air was chilly, and I pulled my jacket close to my
body as I walked. My stomach was jumping with nerves; to ignore it, I forced
myself to look around at the city. The streets of Manhattan were just waking up
along with me. If I were at home, in Ankara, I too would be moving with the
throng of people, headed for the School of Public Health, consumed with my
agenda for the day ahead. Being here felt very different as I watched men and

Beijing + 5: What Can International Conferences Achieve for Women’s Health?

Page 2 of 19

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 02 March 2022

women in spotless suits disappear into the tinted doors of office buildings—I had
no idea what to expect from the upcoming morning.

I reached the entrance plaza and gardens within minutes. I shielded my eyes
with my hand and looked up at the impossible building. It was so big that, up
close, I could no longer see it all at once. Around me, tourists were snapping
pictures. Moving through the wide glass entrance, I saw more of the same—they
swarmed the lobby, and a long line had already gathered behind a small sign
reading simply, “Tours.” I drew a breath and squeezed by the line of people.
Their guide, I had read, would lead them past the highlights of the building and
through the common areas.

My destination was not so public. Following a discreet sign, I turned into a
hallway which led me to a lower level of the building. Soon I turned and followed
another hallway. I was now a few floors below the ground level. The walls were
(p.98) lined with a dark brown wood, and soft, low bulbs were placed every few
feet, casting a dull, artificial light. This was in sharp contrast with the large
windows and sunshine that had filled the main lobby.

People walking brusquely in both directions passed me by without a glance.
They seemed to take no notice of the absence of light. Some were dressed in
brightly colored traditional outfits and the rest wore business suits. My own
outfit, in comparison, felt neutral and unimportant. I had tried my best to look
both serious and professional, donning a black dress and black leather shoes,
but despite the confidence I had felt when my mentor at the university, Dr.
Meliha, had asked me to attend the meetings in her place, my insides had been a
jumble of nerves ever since I had arrived in New York. Even my dress, at that
moment, was a cause of anxiety.

As I continued down the hallway, I tried to quell my worries by reminding myself
of my qualifications and of my initial excitement at accepting such an
opportunity. As a physician and researcher in Turkey, I was certainly prepared to
discuss women’s health needs within my country. Having worked in family
planning clinics, I had inserted thousands of IUDs and worked with countless
married women to address their health needs.

Just then, I saw a small break in the wood paneling on my right. A placard,
stationed next to a small gate, read “General Assembly Conference Room.” The
closed door was plain and unadorned, and I pushed it open quickly. The room
that spread out in front of me made me catch my breath.

The room was split into two levels, the first of which was designed like an
amphitheater. A polished stage stood in front, with the seats spreading outward
in rows of semicircles, like the layers of a cinnamon roll. Tags for each country
marked off sections of seats, moving along the rows in alphabetical order. Each

Beijing + 5: What Can International Conferences Achieve for Women’s Health?

Page 3 of 19

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 02 March 2022

country’s section was equipped with a microphone and multiple sets of
earphones for listening to the simultaneous translations.

I looked to the second level, which was divided from the first by a high wall and
could only be accessed by a separate entrance. Later, I would learn that these
seats were reserved for spectators, persons from nongovernmental
organizations (NGOs) and others, who, since they were not named as official
delegates, were forbidden from directly participating in the meetings. I walked
slowly to the center of the amphitheater, searching for Turkey’s tag. A few
people sat casually in some of the seats, but the vast majority of the room was
empty.

In 1995, when the Fourth World Conference for Women was held in Beijing,
women came from all over the world to discuss pertinent issues such as health,
economic and political power, and violence and oppression. The final document
produced at this conference was the Platform for Action, which described the
overall status of women internationally based on these issues. In very strong
language, it outlined suggestions to improve gender equality. The Beijing + 5
meetings, which would all take place in the huge room where I was standing,
had been organized by the UN’s Division for the Advancement of Women to
assess the current (p.99) situations of women globally and to make relevant
changes to the Platform for Action while also reaffirming commitment to the
original document.

I spotted my country’s tag, between the signs for Trinidad and Tobago and
Tuvalu. Our seats were empty; I was the first of my delegation to arrive. Instead
of going directly to our section, I hovered in the center of the room, my head
tilted back as I stared at the top rows of the second level. For a second, I wanted
to scream “Can you hear me?” out into the vacant seats. As children, we would
do this every time we visited one of the many ancient amphitheaters scattered
along the Mediterranean coast. One would yell “Can you hear me?” to which
someone else, poised at the top, would respond “Yes! I can hear you ….” The
acoustics amazed us: after screaming the first time, we would drop our voices
again and again until we were using only whispers, to see what could still be
heard. The important thing was the sense that somebody was listening.

I made my way up the steps to await the arrival of my codelegates. After a few
minutes, more and more people began filtering into the room, coming through
the same unimposing doorway that I had used. I watched them file in, greeting
each other, making their way to various sections. I noticed a group of three
women making their way up the stairs, walking directly toward where I sat. They
reached me quickly and before I could stand up, the leader, a short, heavy, dark-
haired woman with large glasses, stepped forward and put out her hand,

Beijing + 5: What Can International Conferences Achieve for Women’s Health?

Page 4 of 19

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 02 March 2022

Nuriye Nalan Sahin Hodoglugil.

introducing herself as Cemile. She had a strong, clear voice and held herself in
an authoritative

(p.100) manner. It was obvious
that she knew who I was, probably
having been in contact with Dr.
Meliha, because without waiting
for an introduction, she used the
cordial, official “Mrs. Nalan” to
address me. I tried to shake her
hand firmly but was struck by her
impressive voice—she spoke with
the formal emphasis of a
government official or television
newscaster, and her tone was very
serious. She turned to the others
and began introducing them,
continuing to use the same formal
voice.
Nuran was nearly Cemile’s physical opposite—petite and blonde. She wore a
light-colored suit and struck me as having a soothing, motherly attitude. Despite
Cemile’s command of the situation, Nuran was actually her supervisor at the
General Directorate of Women’s Status and Problems in Turkey. On the other
side of Cemile was Sevgi, a woman who gave me a big smile. Although I did not
know her, she was a teacher in the department of Gender and Women’s Studies
in Ankara. Behind Sevgi stood Aylin, whom Cemile introduced last. She was
younger than the others, had dark, flashing eyes, and wore heavy lipstick.

We shook hands and greeted one another warmly. I smoothed my dress with my
palms while the others set their bags down and filed past me into the seats of
our section. These would be the women I would be working with, day and night,
for the next few weeks.

Just then, a loud banging noise filled the room, and the static of a microphone
turning on crackled over the speaker system. The five of us turned; on the
polished stage at the center of the room stood a tall woman in a crisp gray suit,
leaning into the podium and looking out at the rows of chairs expectantly. The
banging noise had come from a long wooden gavel she held in one hand. She
poised it over the podium and brought it down again, three staccato raps that
amplified out over the audience. A hush fell over the room, followed by the
sound of shuffling papers and bodies shifting in chairs. I looked out over the
sections below us and craned my neck to see the rows behind. Most of the chairs
were filled; however, there were some countries, such as Tuvalu, next to us, that
had only empty seats. It was not until that evening, back in my hotel room, that I
came to realize that this was because these countries were too impoverished to
send delegates.

Beijing + 5: What Can International Conferences Achieve for Women’s Health?

Page 5 of 19

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 02 March 2022

The woman cleared her throat into the microphone. Across the room, delegates
lifted earphone sets and adjusted them on their heads. “Welcome,” the woman
began, “to the United Nations Beijing +5 Conference….” While I listened to the
opening remarks, I scanned the crowd. If I turned to the side, I could see into
the higher sections, where the NGO participants sat leaning forward, some with
their arms resting on the top of the dividing wall. We all had, I presumed, been
given a copy of the draft outcome document, put out by the UN’s Division for the
Advancement of Women (DAW). DAW had asked all countries to submit an
assessment of the past 5 years, describing their accomplishments, problem
areas, and future plans of action for improving women’s rights. These
assessments were put together to create the Outcome Document for Beijing +5.
This document would be the focal point for the entirety of the conference—after
the World Women’s (p.101) Conference in Beijing, 1995, DAW had taken
suggestions from every country and added them to the old platform, coming up
with a draft that would be debated and reworked throughout this conference,
ending 5 years later. The specific changes each country had requested—most
often, it had looked to me, to be deletions, additions, or simple rewording of
phrases or single sentences—had been added in bold type.

I listened dutifully to the rest of the opening speech. Next to me, Aylin tapped
her foot and shifted in her seat. I wondered what my codelegates had thought
about the draft outcome document; we had not gotten that far in our chatting.
Mentally, I recounted the changes in the draft that had been suggested by
Turkey: honor crimes, abortion, etc. Most likely these changes were made
directly by Cemile and Nuran’s Office of Women’s Status, which would have
received the draft from DAW.

The woman at the podium began explaining the details of how the conference
would be run. The draft document would be read aloud to the conference room,
and each time a change had been suggested, the moderator would pause and
open the floor for debate. The country that had suggested the change would
speak first, followed by any other country that had input. If there was
disagreement, the debate would continue until a consensus had been reached.
To complicate things, DAW had allowed for additional changes to be suggested
during the conference proceedings. The deadline for submitting these written
changes, she announced loudly, was 2 days away. Oral changes, the woman
continued, could be suggested by a country at any point during the conference.
It dawned on me then that the number of potential changes that could be made
—if each country had even more additions or deletions to the document—was
staggering.

After the opening session had concluded, the five of us made our way to the
cafeteria. Like the hallways, it was dim and poorly lit. We carried small trays of
food and situated ourselves at one of the square tables. Around us, I saw that
numerous other delegates, mostly middle-aged women in suits and formal attire,

Beijing + 5: What Can International Conferences Achieve for Women’s Health?

Page 6 of 19

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 02 March 2022

were doing the same thing. Interspersed were groups of regular UN employees,
whom I quickly learned to recognize by the plastic badges hanging around their
necks.

Cemile wasted no time. Without touching her sandwich, she moved her tray
aside and dug into her briefcase, withdrawing her copy of the outcome
document and a legal pad for notes. On one side of me Aylin lit a cigarette,
setting the used match in an empty ashtray at the center of the table. I watched
as Sevgi followed suit, pulling out a box from her purse and lighting up. She
pulled deeply on the filter while she watched Cemile and waited.

Cemile spread the papers out in front of her and looked up. “We need to make a
plan as soon as possible, so that we can begin working tonight and tomorrow.”
She ran her fingers along the first pages of the draft document, which was
divided into 12 subjects: women and poverty, women and violence, women and
health, women and the economy, etc. “We should split up the sections based on
our specialties, and review them.”

(p.102) Aylin tapped her cigarette on the rim of the ashtray, and spoke up. “I
agree.” she said, leaning forward. “We should come up with a list of priorities
from each section—those changes that are most important for Turkey to
advocate for.”

The smoke from the cigarettes snaked hazily up towards the ceiling. My eyes
already felt parched and itchy. Until about a year before, I too, had been a
smoker. When I started smoking, it had been a sign of being a liberal woman in
Turkey—all of my activist friends were smokers. At the time, it was considered
abnormal for women to smoke in public, and my friends and I would
intentionally stand on the street and smoke in protest. It was a small form of
activism for us. Now, however, I had grown unaccustomed to it, and I blinked as
Aylin continued: “We have to act quickly, decide on the changes as soon as
possible, in order to give the committee our written suggestions.” At this she
stubbed out her cigarette and pulled out her own copy of the platform draft.
Cemile frowned.

“Yes,” she said, “but we can submit our changes orally as well, for many of the
subjects, during the meetings.” I thought quickly back to the opening speaker’s
instructions. It was true, she had specified that new changes could be suggested
both orally and in writing.

“If you don’t write your suggestions down formally, they won’t count,” Aylin said,
her voice full of authority. “If you want the changes to be taken seriously, you
have to write them down. And the deadline being so soon, we should begin
tonight.”

Beijing + 5: What Can International Conferences Achieve for Women’s Health?

Page 7 of 19

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 02 March 2022

Cemile shook her head. “We have to prioritize, Ms. Aylin. If we write something,
we will have to argue for it orally during the meetings. There will be many, many
arguments going on. Turkey does not need to participate in all of them,
particularly the ones that are not pertinent to our country.”

I looked around the table. Nuran was still reading, and Sevgi sat stonefaced. I
felt myself torn between the two sides of the argument. Cemile’s stubbornness
reminded me of the attitude typical of Turkish officials and of how much of
government seems to work: Don’t poke your nose into things too much, go at the
pace that is expected. However, we were dealing with a writing culture, and I
understood Aylin’s point about being taken seriously.

At Cemile’s words, Aylin sat up straighter in her seat. “Yes, I understand that,”
she said, “but we should still try. No one will listen to an oral intervention, and
it’s important that we make a strong statement about Turkey’s position on all the
issues.”

Cemile nodded curtly at her. “Of course your ideas on all the issues are
important, Ms. Aylin. But we cannot focus on too many things at the same time,
and we cannot go to extremes either. Turkey should have a lead role in
supporting certain issues, such as reproductive rights, and in including the
prevention of honor crimes. My General Directorate is also strongly supporting
women’s role in politics, and in relation to the economy. But that’s all. For the
rest, we can offer support if we like the idea, and withhold support if we don’t.
They are not directly related to us and our problems.” She paused. “We should
write, of course, but not on all issues. As the head of the delegation, I feel it is
more important to focus on two or three issues that are most important to us.”

(p.103) Aylin opened her mouth to respond, but Cemile cut her off. “Ms. Aylin,”
she said, “we are losing time. Prepare as many written statements as you want
to. Do you have a laptop?”

At this, Aylin looked, for the first time, hesitant. “No,” she responded.

We decided to use the computer laboratory at the UN the following day, after
each reading over the outcome document that evening. We quickly reviewed the
12 sections, then gathered our things to leave. As we cleaned the table, I looked
at our trays. Most of the food remained untouched.

That night I read over the document again, paying special attention to the
sections on women and health and violence against women. The subsections on
reproductive health would be especially contentious. Throughout the section
where birth control was mentioned, bold type suggested replacing contraception
with family planning. The change had been suggested by the Holy See, the
delegation from the Vatican.

Beijing + 5: What Can International Conferences Achieve for Women’s Health?

Page 8 of 19

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 02 March 2022

Working in the field, in Turkey, my colleagues and I often used the two terms
interchangeably. However, in the politics of population policy, family planning
implies that birth control is only for a married male and female couple—not for
adolescents and unmarried women. In Turkey, too, this is a difficult issue. Sex
within the institution of marriage is celebrated in Islam, but anything outside of
wedlock is considered unacceptable. I am constantly aware of this in my
professional life: often, when teaching at the university or working in a clinic, I
am approached by young, unmarried women seeking contraceptives or
treatment for sexually transmitted diseases. Even within marriage, too many
Turkish women do not have the means or resources to control the number of
their pregnancies. I thought briefly of my sister’s mother-in-law, who, like many
women living in rural and Eastern Turkey, was a good example of this. When I
met her she was 75 years old and told me “I was like a man, I did not menstruate
for 30 years.” A tiny woman from a small village in the east, she had delivered
10 children, 6 of whom survived. She spent 2 or 3 years breast-feeding each
child, only to find that she was pregnant again before even restarting her
menstrual cycle.

Abortion would be another important topic for Turkey. It has been legal for
Turkish women since 1983 and is generally not considered a highly sensitive
topic. It is, however, utilized as a method of contraception in place of birth
control itself. I was proud that Turkey had been the country responsible for
suggesting an important change on this part of the document. The draft platform
read that women should have access to “safe, legal abortions in countries where
it is not against the law.” Turkey had suggested the deletion of the phrase “those
countries where it is not against the law.” Although my efforts as a reproductive
health practitioner in Turkey were focused on contraception, my attitude, and
the attitude of every colleague I know in Turkey, is that the matter of abortion is
for each woman to decide independently. In fact, most educated professionals
within Turkey seem to support this, making it appropriate for Turkey to assume
a leadership role in advocating for safe and legal abortions in the international
arena, such as the Beijing +5 conference. (p.104) I was surprised when I
learned that things are very different in the United States, and abortion
practitioners are sometimes murdered by those opposing legal abortions.

I carefully wrote out a persuasive argument to be submitted and also a draft of
Turkey’s oral argument for the issue’s debate during the meetings. I tried to
ignore the butterflies that flapped around in my gut at the thought of reading
these arguments out loud in that gigantic room. Crumpled papers littered the
floor of my hotel room. Surely we could drum up support for the
recommendation of safe abortion practices even in places where it was still
forbidden. As a doctor, I knew that despite a country’s legal restrictions, women
would still have abortions, and if there were no access to safe ones, they would
resort to methods that often caused serious physical illness and death. I had
detailed some of these as examples in my argument for the deletion, and I

Beijing + 5: What Can International Conferences Achieve for Women’s Health?

Page 9 of 19

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 02 March 2022

fervently hoped that these arguments would bloom to full fruition at the
meetings, influencing the other delegates to agree with Turkey.

The last section I reviewed before the meetings began was the section entitled
“Violence against Women,” which referred to honor crimes. This change had
been suggested by the European Union (EU) delegation, which included Turkey
in its regional preparatory meetings because Turkey was a candidate for EU
membership. Aylin had attended and had pushed for the EU’s support on
including the issue in the platform. The EU had agreed, and in the draft
document it had been added in as follows:

Develop, adopt, and fully implement laws and other measures, as
appropriate, such as policies and educational programs, to eradicate
harmful customary and traditional practices, including female genital
mutilation, early and forced marriage, and so-called honor crimes, which
are violations of the human rights of women and girls….

Aylin had also taken the important step of making individual connections within the
EU, people who would verbally support the inclusion of honor crimes when the issue
arose for debate. As I read over this paragraph, I felt unsettled. As the document
noted, honor crimes were considered a traditional practice; although I disagreed with
it very strongly, I saw it differently than many western theorists seemed to. The
western perspective often condemns honor crimes and “other harmful traditional
practices” without having an understanding or sense of the tradition involved. I
certainly did not approve of honor crimes, but the question for me was more “When
does a traditional practice become coercive?” I set the document on my lap and looked
out the window, remembering my year of compulsory service after medical school. I
went to work in a tiny village and rented a room in an apartment building where there
were several other professional women who were also doing their year of service in
the same area. One of these women, whose name was Gulsum, had a long-term
boyfriend from college with whom she had broken up. They had not seen one another
in 3 or 4 years. However, one weekend while I was out of town, he showed up. He
professed his love for her and promised marriage. (p.105) She slept with him then,
the first time for her. He left, promising to come back, but disappeared. Only later did
she find out that he was already married, with a child. Gulsum was devastated. She
believed that the situation had been her fault and that she had lost her honor. I don’t
think that she will marry for the rest of her life. Furthermore, she can tell no one about
her experience. She comes from a traditional family in Eastern Turkey. If she told
anyone in her family what had happened, she would put both herself and the man in
danger. Depending on the strength of her brother’s reaction, the man could be beaten
or killed, and if Gulsum was thought to have consented to the relationship, the same
risks applied to her.
Certainly, it was important that honor crimes be recognized in the final
document, and it seemed that Aylin had done an important service in bolstering
support for Turkey’s position. I wondered how the subject would go over during
the debates. If honor crimes were to be included, the document would serve as
recognition of the problem and as a point of reference for activists to advocate

Beijing + 5: What Can International Conferences Achieve for Women’s Health?

Page 10 of 19

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 02 March 2022

from. However, I could not help but wonder if the careful wording was unrelated
to actually lowering the incidence of honor crimes. After all, the outcome
document would not ensure that the governments of participating countries
actually did anything about the issues included.

Within a few days, the debates were in full swing. By the middle of that first
week, I had learned that the majority of my time as a delegate would be spent
watching and waiting. The experience reminded me of the few baseball games I
had attended: nothing of interest happened for long stretches of time and then,
suddenly, some excitement. But here, instead of a home run, the excitement
came in the form of an especially charged topic.

The session on women and the family exemplified this. For hours, most of the
suggested

Physiology homework help

Case Study Reflection Guidelines

Assignment Overview

After reading the assigned text, compose a 400-500 word reflection and submit it to the Canvas discussion board.

Content and Grading

In your reflections, address the following 3 questions.

1. What are the author’s main messages/arguments? What is the main takeaway of this case study? What is the essential background information that we need to understand it? (2.5 points)

2. How does the case study relate to concepts from the course (including lectures, readings and videos)? Connect themes in the case study to at least 2 concepts from the course.  Put these concepts in bold so that we can easily find them when grading, and be sure to explain or elaborate on HOW the case study illustrates, complicates or is connected to that topic. (4 points)

3. Share your personal reaction or stance on the issues developed in the case study. Has it changed your opinion on the topic? Does it relate to your own personal experiences? Does it connect to things you have studied in other courses, or articles you’ve been reading in the news lately? (2.5 points)

4. Proper citations (1 point)

Citations

You must include proper academic citation in your case study reflections. This is a good habit to get into generally. Visit this page for the 
general course citation guidelines.

· When referring to required course material, use a shortened version of the APA’s author-date, in-text parenthetical citation system, e.g. (Marmot 2010). You can abbreviate our course textbooks to RGH and PIH, or use the case study author’s last name. Be sure to spell the author’s name correctly! Lectures can be cited by the number, e.g. (Ryan lecture 4.2). Videos can be cited by the primary speaker or a shortened version of the title, e.g. (Bad Sugar) or (Rosling).

· When referring to outside articles or sources, use the APA’s author-date, in-text parenthetical citation system, e.g., (Washington Post 2021) and include a hyperlink or full citation to your original source at the end of your submission. Connecting the case studies to outside sources is always welcome, but be sure you are also

· You do not need to write a full bibliography for case study reflections.

Physiology homework help

Discussion Board posts should be at minimum 250 words.  You are expected to conduct independent research on the subject and use two scholarly sources in addition to the textbook. Provide in-text citations and list of references to support your post as required. Use APA writing format.



Week One: Discussion

Compare the healthcare system in the U.S. to other developed countries with universal coverage. (CLOs 1, 2) (20 points)

Select a country of your choice that provides universal coverage and compare access, delivery, and financing of healthcare in that country to the U.S. Use the concepts of market justice and social justice to evaluate the two systems. Address how the population health outcomes compare between the two country using measures such as life expectancy, maternal mortality, infant mortality, etc.

Physiology homework help

Discussion Board posts should be at minimum 250 words.  You are expected to conduct independent research on the subject and use two scholarly sources in addition to the textbook. Provide in-text citations and list of references to support your post as required. Use APA writing format.

*** ENSURE YOU ANSWER ALL THE QUESTIONS***

Week Two: Discussion Two

Discuss and evaluate the U.S. healthcare system’s financing, including the different methods for payments and reimbursement. (CLO 1, 2, 3) (20 points)

In broad terms, in the US healthcare system financing includes the concepts of financing, insurance, and payment. Financing enables people to obtain health insurance, and the payment function determines reimbursement and undertakes the actual payment for services received by the insured. 

For this discussion, use the information in the textbook and in your learning resources to assess the effect of different financing and reimbursement methods and reflect on the following questions:

· How do different types of insurance plan (public, private, HMO, etc.) determine access to healthcare?

· Consider how different reimbursement methods (fee-for-service, bundled payments, capitation, etc.) may influence provisions of care offered by healthcare providers and the goal of patient-centered care.

· Consider how these different methods (different insurance plans/lack of insurance) affects the consumer?

Week Two – Additional Reading Resources

These are additional resources for this course. These readings have been selected from a variety of resources.

Additional Reading Resources:

· Poor health: Assumptions, Facts, Opportunities – Abdul El-Sayed (Duration: 15:01) – Video File https://www.youtube.com/watch?v=s84Rw2WU0q8

· How to Understand U.S. Healthcare? Follow The Money – 2018| Dr. Jonathan Burroughs (Duration: 16:55) – Video File https://www.youtube.com/watch?v=mTXVcwVVjoQ

· US Healthcare Delivery System (Duration: 10:24) – Video File

http://d2jw81rkebrcvk.cloudfront.net/assets.navigate/issa/MHA/healthcare_industry/LB1/Core_Lesson/media.html

· Mechanic, D. (2012). Seizing opportunities under the Affordable Care Act for transforming the mental and behavioral health system. Health Affairs, 31(2), 376-382. – PDF Document

· Griffith, K., Evans, L., & Bor, J. (2017). The Affordable Care Act reduced socioeconomic disparities in healthcare access. Health Affairs, 36(8), 1503-1510. – PDF Document

Physiology homework help

Nomads and Nationalists in the Eritrean Sahel

Page 1 of 17

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 20 February 2022

The Practice of International Health: A Case-
Based Orientation
Daniel Perlman and Ananya Roy

Print publication date: 2009
Print ISBN-13: 9780195310276
Published to Oxford Scholarship Online: September 2009
DOI: 10.1093/acprof:oso/9780195310276.001.0001

Nomads and Nationalists in the Eritrean Sahel
Assefaw Tekeste Ghebrekidan

DOI:10.1093/acprof:oso/9780195310276.003.01

Abstract and Keywords
This chapter presents an account of the plight of the people living in the Sahel,
one of Eritrea’s most inaccessible regions. It describes the devastation wrought
by thirty years of war. It recounts experiences serving as a medical cadre among
the pastoralist communities, particularly describes the impromptu cooperation
between a liberation front and a marginalized population totally unaware of
politics.

Keywords:   nomads, pastoralists, Eritrea, medical personnel, health services, health care, public
service, public health practice

Shielded by high mountain ranges that make a dramatic descent into the
western lowlands and Red Sea plains, the Sahel is one of Eritrea’s most
inaccessible regions. It is a land of two winters, with June to September rains in
the highland plateau and November to February rains in the lowlands, which
draw the 27 clans of the Tigre ethnic group like a magnet. They travel along arid
paths from the highlands of the Sahel in groups of three or four families, taking
different routes to ensure that all their livestock have sufficient grazing room.
The women are wrapped in brightly colored dresses with only the sun-darkened
skin around their eyes showing; the men, tall and thin, herd goats across the
dusty ground; children trek alongside their parents, likewise tending to the
herds. In June, they pack up and return to the Sahel for the rainy season there.
The Tigre pastoralists make this trek every year, stopping only a few weeks at a
time in any one place. Because their livestock is their primary asset and serves
for everything from their daily livelihood to dowry payments, they follow the

Nomads and Nationalists in the Eritrean Sahel

Page 2 of 17

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 20 February 2022

rainy season to wherever the grass is green. They have lived this life for
generations. They would not live any other way.

In 1972, a new “clan” came to the Sahel: the Eritrean People’s Liberation Front
(EPLF). The EPLF chose this inaccessible region as a base for guerrilla
operations against Ethiopia, which had illegally annexed Eritrea as a province.
The war went on for over 30 years—the span of an entire generation—during
which Ethiopia was backed by the United States and provided with modern
weaponry from 1961 to 1975 and by the Soviet Union thereafter. In 1993, after a
national referendum supervised by the United Nations produced an almost
unanimous vote for its independence, Eritrea was proclaimed a sovereign state.

(p.20) The guerrillas’ mobility was compatible with the nomadic life of the
pastoralists, but unlike the latter’s, the guerillas’ movements were not dictated
by the need for grass; instead, they were governed by the strategic rules of
warfare. Their lives depended on blending in with the pastoralists. Their
ideology was one of social change, with emphases on literacy, self-reliance, and
women’s rights. They lived the nomadic life for less than one generation. It was
a step toward living in a completely different way.

Thirty years of war were unthinkably ruinous and tragic for Eritrea. I was there,
yet even I can scarcely conceive of the devastation wrought in terms of lives,
suffering, and property damage. Although I will never forget the horrors I
witnessed, serving as a medical cadre among the pastoralist communities is one
of my most cherished memories. The beauty of the impromptu cooperation
between a liberation front and a marginalized population utterly unaware of
politics has forever changed me.

I was born at the northern flanks of the central highlands, where the lands of
farmers merge with the trails of the nomadic pastoralists. At age 19, I went to
Ethiopia to study medicine. The hospital where I was placed after graduating
from medical school, in the port of Massawa, was not far from my home in the
highlands, and I lived comfortably. As one of only 16 doctors in Eritrea at the
time, I had my own home and a car, luxuries that most of the population could
not afford. This ended for me, though, after my arrest by the Ethiopian
government.

I had been a clandestine member of the EPLF since the age of 19. From the time
I began working as a physician in Massawa, through my promotion to hospital
director, until I was uprooted and sent back to Ethiopia, I had been meeting
secretly with Tegadelti (liberation fighters), who would sneak into the city in the
dark of night.

I would meet with Tegadelti in my home to talk about the marvels in the Field,
and I would hand off medicine, microscopes, and other necessary provisions for
the camouflaged hospital in the Filfil, a nearly inaccessible region in north

Nomads and Nationalists in the Eritrean Sahel

Page 3 of 17

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 20 February 2022

central Eritrea, shielded by high mountain ranges and thick forest that
descended dramatically into the coastal plains.

Not long after my arrest, I was contacted by the Front to plan my escape from
Ethiopia. They arranged for me to fly back to Asmara, the capital city of Eritrea,
via a circuitous series of local flights. I then met up with a man who guided me
north, and we began our walk that very day toward the base of the Front. It was
a long walk across rocky terrain, throughout the afternoon and into the evening,
with a 4-hour rain that pelted my skin and soaked my clothes.

We finally stopped walking when we saw light from the house of semisedentary
farmers. The woman inside gave me dry clothes and a plate of sorghum
porridge, all the while quietly continuing her work. Finally she looked up at me
and said simply, “Why are you here?” Her hands were tough, their papery skin
dry against the stones she used to grind sorghum for the next day’s meal:
sorghum bread, more sorghum porridge. She eyed me from her place on the
floor mats, (p.21) where she’d been on her knees, grinding endlessly. “Look at
you. Your skin is so soft. Why did you come to this misery?” Her eyes narrowed,
her mouth turned down. I tried to explain to her about our position as a
colonized people, that life without liberty is worthless. My explanation did not
impress her. “Why don’t you just go live somewhere else as a doctor? You can
live comfortably,” she said. In the morning I thanked her for her hospitality and
continued my journey toward the Sahel and the spartan life of poverty that
awaited me.

There were a number of new recruits heading north to join the Front, and we
were lucky that our guides knew the route well. We had camels to carry all of
our supplies—food, drink, everything. However, we were forced to walk at night,
as it was imperative that we avoid the Ethiopian army and the merciless heat of
the lowlands. Although our guides were knowledgeable, their task became
difficult when winter clouds passed by overhead, rendering navigation by the
stars nearly impossible. But the camels knew their direction, and their inner
compass led us safely to our destination.

The first night of our journey was intolerable. Many of the recruits whispered to
the guides that they needed water. I understood. My own thirst was desperate.
Being in the lowlands made it worse, and our dehydration was fierce. We each
had a cup that held barely more than three handfuls of water. “You will drink one
of these at a time and only when needed most,” the guide explained, holding his
own cup up against the moonlit panorama of desert. “But no more.” He kept to
his word.

Nomads and Nationalists in the Eritrean Sahel

Page 4 of 17

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 20 February 2022

Assefaw Tekeste in an underground
health center in 1985. (Photo: Peter
Wolff.)

(p.22) There it was, the
guerilla base in the Sahel, and I
found that a friend of mine was
already there. I sat with him,
grateful for a moment’s rest
after so many days of walking,
and we talked. It surprised me
when he very suddenly took off
his trousers. I watched him,
silent for the moment, as he
began to pick tiny lice from the
cloth, killing them in the heat of
the afternoon.

“You know,” I told him, “Having
lice doesn’t make you a
revolutionary. There’s no reason for this. Simple cleanliness is all it takes to
avoid lice.” My arms were draped across my knees, and my own clothes were
free of contamination.

My friend laughed and squashed yet another louse between thumb and
forefinger. “Take your time, maybe few months, Assefaw,” he said. “You will do
what I am doing and a newcomer will ask the same question to you.”

In less than 3 months my hair, clothes, and everything were covered with lice.
With no running water and the opportunity to bathe arising only once every 6 or
7 months, it was impossible to keep the bugs from communing on my body, on
my single shirt and only pair of trousers. It was simple to be an idealist back in
the city. In practice, it was uncomfortable to say the least. This was the life I had
chosen, one of blending in willingly with the poor, surrendering fleeting personal
leisure for a permanent, gratifying communal life in a liberated country. And so I
shared the poverty, and despite the inconveniences it posed, I felt alive to the
fullest.

AN UNLIKELY ALLIANCE
Morning in the Sahel bled the bone-aching cold of night into the blistering heat
of day. Days rolled into months. The underground hospital served as our base.
The nature of our struggle forced us to work from the most difficult and barely
accessible locations—the terrain was inhospitable but defensible. It did not take
long before that stony land became our home. We lay low during the day, coming
back to life at night, between dry valleys and mountains slippery with erosion.

The paths of the nomads were ample, winding throughout Eritrea in the
highlands and down the mountain flanks into the lowlands. Some of the clans
crossed to the Sudan, oblivious of the borders, while others stayed only within
the country. There were spots where the tribes would stay for months, where

Nomads and Nationalists in the Eritrean Sahel

Page 5 of 17

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 20 February 2022

there were ample grasses to sustain their livestock. The pastoralists’ sense of
cultural identity is deeply rooted in this way of life, an inextricable mix of age-old
tradition and necessary adaptations to the exacting conditions of the
environment. Neither the term pastoralist nor nomad fully describes the
complexity and diversity of their economic and social adaptations. Inevitably,
their paths crossed our own—a meeting that sparked the beginning of change
for all of us.

Historically, the pastoralists have had little if any access to modern health
services. When the Front arrived in the region, it provided primary health care,
then secondary and finally tertiary care. Those pastoralists who crossed into the
empty lowlands of Sudan, had no health-care options. In the beginning, few but
(p.23) major ailments were treated by the barefoot doctors of the Front.
Despite the pastoralists’ skepticism, their recovery was convincing. Eventually a
mutual bond was established.

One afternoon, some men came to the hospital from a pastoralist village where a
woman had been in labor for 3 days. It took me hours to walk there under the
sun of the Sahel, and when I arrived the husband looked at me and said, “I was
expecting a woman. You cannot go inside the tent.” I tried to explain that I could
help her, that there was a strong possibility that she could die. An elder came
and apologized for my having walked so far, and I was sent back to the hospital.
But that night they came back, and again I made the trek, this time cold beneath
the moon. Inside the tent, the woman held onto a rope that dangled from the
ceiling, her legs bent into a squat. Her eyes were focused on the rope and her
teeth clenched against screams; women in Sahel never utter a sound while
giving birth. I could tell immediately that she was anemic. Her skin, her hands,
her tongue, everything was so pale. There were five women gathered around,
including a traditional birth attendant who was rubbing some butter onto the
woman’s belly.

I needed more space to do a vacuum extraction, so I told them, “She needs to be
in the supine position. That’s the only way this will work.” The women refused. It
was not the way they did things in the Sahel. Her husband told them to let me do
my job, so we stretched her out into the supine position and I could see then that
her hips were too small—the baby’s head was stuck. I put on my gloves, washed
her, and placed the cup over the fetus’ tiny skull. The mother was very strong
despite being anemic and in so much pain; she listened carefully, pushing when
told. Her courage and tolerance to pain were remarkable. That facilitated the
vacuum extraction, and the baby was born blue, not breathing, and nearly
lifeless.

I placed my mouth over his tiny face coated in birthing fluid and breathed. I
pressed on his tiny chest, his 7-pound body so slight under my hands, and after 3

Nomads and Nationalists in the Eritrean Sahel

Page 6 of 17

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 20 February 2022

or 4 minutes he was resuscitated. He lived, they never forgot about it, and that
was how the trust between us was built.

Before the war, several of my colleagues had not known the Eritrean nomad
community. Growing up in the cities, they assumed that all people were settled.
Although I had known of the pastoralists before the war, I didn’t know much
about them. Like my colleagues, I thought that they simply didn’t know a better
way of life. With disdain, we sought to change them. We thought that settlement
(the only way of life we knew) would be for their own good—they would have
access to health care, education, and all the things we felt would solve their
problems, make their lives better.

They intensely challenged our attempt to impose change. “We love our way of
life. Don’t interfere,” the elders told us. “We didn’t come to you. You came to us.”
And it was true. We had moved into their lands, we had been fed and protected,
our wounded had been helped by them, and above all they had taught us how to
live in that desolate terrain. We knew our position was that of learners.

(p.24) Slowly, their world became intertwined with ours. Their camels carried
most of our food and artillery. They were a natural target for the Ethiopian
bombs that rained down on their livestock and their tents. Often, our fighters
were carried into medical facilities by the nomads, open wounds dripping blood
onto their clothing. Survival in the face of a common enemy linked us together.
The nomads paid for liberation as much as we did, if not more.

One such case involved a child who had wandered with a baby goat a short
distance from his family. He stepped on a land mine, and his delicate rib cage
became a cave of bone fragments and muscle tissue. Blood spread slowly up his
shoulder and across his abdomen. Miraculously, he survived.

The boy’s parents carried him to the hospital. His younger sister was slung
across the mother’s chest and, as the boy lay unconscious, her screams were
more deafening than anyone’s. It was a delicate procedure—we had to treat this
wound very carefully, tweezing the smallest bits of dead tissue and shrapnel
from his flesh, which were placed into a shallow metal pan at the side of the
operating table. It was then that I wondered about this war. How many Ethiopian
children have starved in their poverty-stricken country to pay for the bomb that
had injured this innocent child? The war of liberation was the only means of
bringing an end to such atrocities. Fortunately, the shrapnel did not penetrate
deeply enough to be fatal, and although it was a painful recovery, eventually the
boy grew strong once again, with a thick scar braided over his chest and the loss
one leg.

The Front, although initially few in number, had a medical service almost from
the very beginning. We started by training medics who traveled with the military
units and eventually developed a mobile service tailored to their needs. By 1982,

Nomads and Nationalists in the Eritrean Sahel

Page 7 of 17

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 20 February 2022

we had over 20 mobile health teams, each consisting of a nurse, about five
health workers, and—when available—an assistant midwife and several armed
guards.

Although pastoralists in Eritrea make up one-third of the total population of 4
million, they are historically a forgotten people living on the margins of a colony.
The center of power forgets them, and they forget the center. The presence of
the EPLF in the Sahel represented, in many ways, a reversal of the status quo:
for the first time there was a political center—that of the independence
movement—located in the pastoralist region. Political power was concentrated
at the margins. For both the pastoralists and for us, this shift was revolutionary.
It meant that after liberation, the national government had to recognize the
pastoralists for the first time. It meant that our ethnic groups—the Tigre
pastoralists and the EPLF—had truly joined forces.

MEDICINE ON THE MOVE
In the beginning, there were no liberated areas. There were only guerillas
moving across Eritrea’s tough terrain, constantly changing location to avoid
being targeted by the Ethiopian army. However, small areas were soon liberated
and we were free (p.25) to set up bases—hospitals and stationary health clinics
—to which fighters and civilians alike could come for free health care. Although
those fighting for independence no longer needed mobile health teams, we kept
them intact and sent them out among the nomads to provide care for them
during their long treks in search of greens for their livestock.

Having worked with the pastoralists for some time, we had become increasingly
familiar with the health problems they faced. Endemic falciparum and vivax
malaria sapped their strength by depleting their blood and overtaxing the supply
of iron to their bodies. We also noticed that many of the nomads suffered from
undernourishment. Their basic diet consisted of sorghum porridge with milk.
Fruits were unknown to them, and the meager vegetables available were given
to the livestock. Despite this, micronutrient deficiencies such as scurvy, goiter,
and beriberi were rare; however, during periods of drought, when livestock died
and the milk supply decreased, undernourishment among the children rose
quickly. Community health was intimately linked to the health of the livestock—if
the animals suffered, the people suffered.

They became afflicted by a variety of illnesses that could have easily been
prevented if even the simplest of measures had been implemented appropriately.
The extremes of temperature in this desert land coupled with undernutrition
increased the people’s vulnerability to respiratory tract infections, particularly
pulmonary tuberculosis and pneumonia, the primary causes of death among
children. Schistosomiasis, which had previously not been prevalent, was
spreading quickly with the altered movement of the people during the war, and
cases were arising in areas that had not been previously affected. Other vector-

Nomads and Nationalists in the Eritrean Sahel

Page 8 of 17

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 20 February 2022

borne diseases, such as leishmaniasis, were common, and epidemics of
meningococcal meningitis and cholera occasionally affected the western
Eritrean lowlands.

The nomadic way of life also has many healthy aspects to it. Communicable
diseases due to overcrowding—such as dysentery, typhoid, typhus, trachoma,
and intestinal parasites—were rare. The people lived spread thin, denying the
bugs passage from one person to the other.

Despite these complex issues surrounding health provision for the pastoralists,
they led a very simple life. It took some time for me to understand the appeal of
this wandering from place to place, although a friend I made was very influential
in helping to make this knowledge sink in. Each year, this friend from Biet-
Abrehe passed by in search of the rainy season, his family in tow. One day he
arrived on his way back from Sudan, a bottle of milk for me in hand. I thanked
him for the gift, and we sat in a patch of shade with the underground hospital
beneath us.

“You know,” I said to him, “each year you pass by from highland to lowland. Your
family is always walking along with you. Why don’t you at least leave your wife
and children here? We have the school, the hospital. They could get an
education, medical treatment if they get sick. …”

He smiled at me and remained quiet for a moment. When he spoke, his voice
was rough, like his callused hands. “You know, every time I go to the lowland
end, (p.26) you are here. I come back, and you are still here. What a boring
life,” he laughed, pointing to the underground bunker where I lived.

“Here’s the thing. …” He lifted his left hand, gestured at the goats grazing on
the hillside. “The goats are also a family. That goat, well, she has kids. I can take
care of the adults, but the small goats, my wife has to take care of, and my
children. So, we cannot split up. It’s a family of goats as we are a family of
people.” It was wisdom gained by life experience.

What he told me made sense: they hadn’t chosen the nomadic life for
themselves, it had been dictated to them by nature. They could not be farmers in
that arid land because there was not enough rain to support agriculture. While
sedentary people often viewed them with contempt, no one can deny the
productivity of the pastoralists: livestock became the main or only export
commodity after Eritrean independence. And how can anyone scorn the
pastoralists’ lifestyle?

However, while I learned to respect the pastoralist way of life, I still could not
come to terms with certain social and cultural practices that have a bearing on
their health, particularly the health of women. Nomadic society, rooted in a
patriarchal order that greatly circumscribes women’s rights and power in the

Nomads and Nationalists in the Eritrean Sahel

Page 9 of 17

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 20 February 2022

community, dictates that lineage and inheritance, thereby the transfer of rights
and resources, travel along the male line. I would see the women in their
seasonal villages grinding cereals between two stones to mill the seeds for
porridge or bread, a task that often kept them busy until 3 or 4 o’clock in the
morning. The nomadic women were also expected to bear children, take care of
home and offspring, and prepare the food, including the laborious task of milling
sorghum, tending and milking animals, fetching water and firewood,
constructing and dismantling makeshift huts, and more.

As with many ethnic groups, the women were served food last. This uneven
distribution of food within the family, combined with poverty, has damaging
effects on the nutritional status of women in general and of pregnant and
lactating mothers in particular. These conditions, coupled with strenuous work,
make nomadic women disproportionately vulnerable to illness. Maternal and
infant mortality rates in the region are extremely high (an estimated maternal
mortality rate of 1,000 per 100,000 live births), which is aggravated by the
severely limited accessibility of maternal and child health care, immunization,
family planning, and general health education.

The patriarchal social structure and the low average education level of women
further complicate their access to what few health services may be available.
However, the revolution did make some differences in the emancipation of
women. The female nomads who came to join the Front carried guns and donned
clothes like ours. It was only a short time until a law was passed that at least
30% of each village council must be made up of women.

One of these councilwomen was Fatima, but everybody called her Mussolini.
This Mussolini was only in her early thirties and not much taller than a medium-
sized young girl, but she struck fear in many of the people she encountered. She
was a (p.27) divorcee—owing to her nonconformist will of steel—and so her
lack of husband to complain about her status as a councilwoman, coupled with
fair judgment, made her an excellent candidate for village office.

It was late at night when a dark shape scurried toward us under a desert moon. I
could see that he was a pastoralist from the clothes he wore. He carried nothing
but concern in the deep lines of a weathered face. He was from Brij, Fatima’s
village, and begged us to come quickly to treat his wife. I went.

We arrived at the man’s tent an hour later. The woman had pneumonia and was
critically ill with other complications. Her daughter mopped sweat from her
mother’s forehead with a bright yellow cloth. The woman shivered despite a thin
blanket tucked around her bony shoulders and the perspiration that poured from
her skin. I squatted on the floor of the hut and examined her. She was febrile
and severely dehydrated. She was very ill, so I took the woman’s husband
outside with me.

Nomads and Nationalists in the Eritrean Sahel

Page 10 of 17

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 20 February 2022

“We must take your wife to the clinic,” I told him. “She’s dehydrated. She needs
an intravenous infusion and maybe blood.”

“I can’t take her to the clinic,” he said. He shook his head and shrugged. “I don’t
have anybody to help me and I can’t take her alone.”

“What do you mean you can’t take her? She’s your wife,” I said. “If she doesn’t
go to the hospital, she’ll die.” He was a young man, in his late twenties at most,
and he simply refused. I left the hut and walked over to Fatima and explained
the situation to her.

“You go back to the clinic,” she told me. “Don’t worry. He’ll meet you there.”

I left, sure th

Physiology homework help

Exam Study Guide Topics

Know what each of the 7 health sector issues means, plus:

A specific example

A strategy to address issues related to that Key Sector Issue

Use this understanding to do research for part III of your country papers

Before next slide: what would a demographic change be? Epidemiologic change?

1

Definition Examples Strategies to address concerns
Changes in the population or changes in the patterns of disease. A health system needs to be able to respond to these. Longer life expectancy or immigration, the increase in non-communicable diseases or the emergence of a new disease like HIV or Zika. A health system needs to be able to respond to these issues. If non-communicable disease are on the rise, then need initiatives to address lack of physical activity, cigarette usage, etc. If HIV is on rise, need effective treatment and prevention. If population is aging, need to address NCDs such as CVD, dementia, and if the country can financially support aging population.

1. Demographic & Epidemiologic Change

2

Definition Examples Strategies to address concerns
Quality of governance—is it open/transparent? Clear rules/
regulations? Are rules enforced?
Staff hired because of connections rather than skill. New staff may have to pay off hiring managers. Staff high absenteeism without losing job. Buying products without best prices because of corruption. Staff getting kickbacks.

This happens because of lack of governance—not just individual choice.

Nat’l anticorruption campaigns with strong political will. Reforming supply procurement systems & making transparent. Auditing health system & enforcing penalties.

2. Stewardship and governance

3

Definition Examples Strategies to address concerns
 Issues related to health system staff members (includes having sufficient staff, well-trained staff, distributed throughout country where needed, salaries to keep people, high quality work conditions, not losing top skilled workers to other countries/settings). Shortages of docs, nurses, lab techs, unqualified managers. Deficient skills due to poor training. More staff in cities; more shortages rural areas. Public sector salaries < private sector.

Lack financial incentive to do quality work. Poor working conditions prompt them to leave country.

Countries & their dev’ment partners more support for education, training, plans for retention. Wealthy countries more shared global responsibility so workers won’t leave resource poor areas.

3. Human Resources

4

Human Resources Sector issue example

2003 survey of over 1400 public health centers across India

Surveyors verified the attendance of providers during unannounced visits

nearly 40% of doctors and medical service providers are absent from work on a typical day.

the absence problem is quite widely distributed and not concentrated among a few doctors.

“Doctors posted at remote facilities and at facilities with poor infrastructure and equipment were absent at significantly higher rates, as were those with longer commutes.”

Muralidharan, Karthik, Nazmul Chaudhury, Jeffrey Hammer, Michael Kremer, and Halsey Rogers. 2011. “Is There a Doctor in the House? Medical Worker Absence in India”. (working paper, Harvard University)

5

Definition Examples Strategies to address concerns
Safe, effective, patient-centered, timely, efficient, equitable Not using evidence-based guidelines. Don’t know correct diagnosis or treatment for a disease. Inappropriate use of antibiotics, fluids, feeding, oxygen. [Note: High quality can be achieved in low-resource settings.] Need assessments to identify quality gaps. Better oversight & training. Use clear guidelines & algorithms. Link payments to NGOs with performance.

4. Quality of care

6

7

Definition Examples Strategies to address concerns
How to fund sufficiently, how to find funding to cover more or to keep covering what system is supposed to cover with changing costs (new tech, drugs, aging pop increase costs) New technologies drive up cost of care, how to fund to reduce wait times, govt not funding health system enough to ensure decent care regardless of ability to pay. Shift some $ from another part of economy to health. Shift to most cost effective interventions. Gather data, monitor outcomes. Increase efficiency.

5. Financing of Health System

8

Definition Examples Strategies to address concerns
Financing the system without denying healthcare coverage to poor & without making people go bankrupt. Goal: universal coverage for basic package of health services In India spending $ on health is a primary reason why families fall below poverty line & cause of family selling assets. People use less health care (ie hospital deliveries of babies) when charged. Raising $ for health, improving efficiency, less out-of-pocket. Providing universal health ins. Targeting free basic package of services to those most in need

6. Financial Protection & the Provision of Universal Coverage

More example of solutions: Allocate more proportionately to basic packages to people & places with most need. Subsidize care for poor. govts encourage NGOs to provide services to poor.

Before next slide: what’s access and equity?

9

Definition Examples Strategies to address concerns
Any disparities by sex, age, ethnicity, income, education, location? Lack of coverage in areas where poor, rural & minorities live. Fewer trained people, equipment & drugs in those areas. Services like vaccines more available in urban areas & areas with higher income & educ. Richer people get the more expensive services. Govts need to gather data and use it to look at where inequalities exist. Then target services there. Best if paired with improved water, sanitation, nutrition, hygiene, health behaviors (via increased knowledge)

7. Access and Equity

10

Part III of your country papers: Health System

Organization, financing, coverage – previous lecture.

Key Sector Issues​: ​Analyze ​the ability of your country’s health system to tackle its health issues by researching and describing each of the following issues discussed in class (a few sentences for each issue, or a short paragraph on each, is sufficient):

demographic and epidemiologic changes

health workforce concerns (human resources)

access and equity

11

Physiology homework help

Requirements:

Content Criteria:

1. Read the case study listed below.

2. Refer to the rubric for grading requirements.

3. Utilizing the 
Week 1 Case Study Template (Links to an external site.)
, provide your responses to the case study questions listed below.

4. You must use at least one scholarly reference to provide pathophysiology statements. For this class, use of the textbook for pathophysiology statements is acceptable. You may also use an appropriate evidence-based journal.

5. You must use the Clinical Practice Guideline (CPG) for the management of allergic rhinitis to answer the treatment recommendation questions. The guideline can be found at the following web address: 
https://journals.sagepub.com/doi/10.1177/0194599814561600 (Links to an external site.)
 .You may also use a medication administration reference such as Epocrates to provide medication names.

6. Proper APA format (in-text citations, reference page, spelling, English language, and grammar) must be us

A 35-year-old woman presents to the primary care office with a history of nasal congestion that has worsened over time and recurrent sinus infections. She considered herself healthy until about 12 months ago when she began experiencing rhinorrhea, sneezing, and nasal stuffiness that “seems to never go away”. She noticed that her rhinorrhea greatly improved when she attended her family reunion on a two-week Caribbean cruise but returned after being home a few days. She lives with her husband and 5- year-old child. They have two household pets: a dog that has lived with them for the last 4 years and a cat who joined the family 1 year ago. Upon exam, the NP observed eyelid redness and swelling, conjunctival swelling and erythema, allergic shiners (lower lid venous swelling), Allergic crease (lateral crease on the nose) and inflamed nares.

· Identify the correct hypersensitivity reaction.

· Explain the pathophysiology associated with the chosen hypersensitivity reaction.

· Identify at least three subjective findings from the case.

· Identify at least three objective findings from the case.

Management of the Disease

*Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations.

1. Identify two strongly recommended medication classes for the treatment of the condition and provide an example (drug name) for each.

2. Describe the mechanism of action for each of the medication classes identified above.

3. Identify two treatment options that are NOT recommended (I.e., recommended against).

Physiology homework help

Discussion Board posts should be at minimum 250 words.  You are expected to conduct independent research on the subject and use two scholarly sources in addition to the textbook. Provide in-text citations and list of references to support your post as required. Use APA writing format.

*** ENSURE YOU ANSWER ALL THE QUESTIONS***

Week Four: Discussion One

Must post first.

Patient-centered care. (CLO 3, 5, 6, 7)

A study at Johns Hopkins in 2018 claims that more than 250,000 people in the U.S. die every year from medical errors (Makary & Daniel, 2016) . Medical errors can involve medicines, surgery, diagnosis, equipment, or lab reports. The Agency for Healthcare Research and Quality (AHRQ) has sponsored hundreds of patient safety research and implementation projects to prevent and reduce medical errors. 

A stakeholder is a person or group that has an interest or concern in an organization, or is somehow affected by a course of action by that organization. Review the below presentation and consider the questions that follow:

Stakeholders in Healthcare Delivery – HTML http://d2jw81rkebrcvk.cloudfront.net/assets.navigate/issa/MHA/healthcare_industry/LB4/Core_Lesson/media.html

· How would improving communication and collaboration lead to a safer environment for patients, their families, and healthcare professionals?

· How can patient-centered care and patient activation improve quality of care?

· Describe how patient-centered care is changing and influencing the future of health care.

· Explain why it is important for health care administrators to be aware of the impact of consumer needs, expectations, and actions on health care delivery.

· Provide recommendations for reducing medical errors in a healthcare setting.

References

Makary, M. A., & Daniel, M. (2016). Medical error—the third leading cause of death in the US. Bmj, 353. https://www.oliveviewim.org/wp-content/uploads/2018/10/Makary-2016-3rd-leading-cause-of-death.pdf (SEE ATTACHMENT).

Physiology homework help

Exam Study Guide Topics

Understand the 10 essential services of a healthcare system

Understand the different parts of the WHO’s Health Systems Framework, including the “building blocks” and the relationship to other parts of the diagram.

Know the 3 levels of health care, and be able to identify the level given an example.

Understand the main ways that healthcare systems are organized according to financing and delivery. Given an example, be able to identify whether that is public or private (e.g. know some examples of each)

Understand the common terms used to discuss health systems, including “public,” “private,” “co-payments,” “co-insurance,” “premiums,” etc.

Know the 4 types of health care systems including:

The country known for developing it

How it is financed

Whether there is insurance. If there is insurance, describe how it works.

Impact on citizens: cost of treatment, whether everyone is insured (“Universal coverage”)

If given a description of a health care system, be able to state which of the four types of health care systems it is most like and why.

Understand the components of the US system and how it is related to the 4 “models”

Describe the political and ideological value placed on health that is associated with different types of health systems

1

Bigger questions to keep in mind as you listen and read about health systems in Unit 9

To what extent do different health systems value the “right to health”?

What is the role in various health systems of individuals, as well as the public, private and nongovernmental sectors?

What is the extent to which different actors in the system are engaged in the financing and provision of health services?

How are different health systems organized and managed?

What are the key issues constraining the effectiveness and efficiency of health systems in different settings?

How can those constraints best be addressed?

2

What is a health system?

WHO definition: “All actors, institutions, and resources that undertake health actions – where a health action is one where the primary intent is to improve health.”

Similarly, “a health system in the combination of resources, organization and management that culminate in the delivery of health services to the population”

Resources: drugs, medical technologies, first aid equipment, vaccines, funding, etc.

Institutions: Clinics, hospitals, pharmacies, laboratories, agencies that set standards, fundraising institutions, etc.

Actors: Doctors, nurses, community health workers, lab technicians, pharmaceutical industry workers, health researchers, etc.

Agencies (planning, regulating)

Money

People hwo provide preventative health services

“ “ “ clinical sercies

“ “ “ specilized inputs like education, drug manufacturing, research on medical devices…

From skolnik.

3

The 10 Essential Public Health Services

Monitor health status to identify and solve community health problems

Diagnose and investigate health problems and health hazards in the community

Inform, educate, and empower people about health issues

Mobilize community partnerships to identify and solve health problems

Develop policies and plans that support individual and community health efforts

Enforce laws and regulations that protect health and ensure safety

Link people to needed personal health services and assure the provision of health care when otherwise unavailable

Assure a competent public and personal health care workforce

Evaluate effectiveness, accessibility, and quality of personal and population-based health services

Research for new insights and innovative solutions to health problems

4

5

The three Levels of Care

Primary Care

First point of contact for a patient, and ongoing care over time

Primary care physician – often acts as a gatekeeper to access other levels in cases of non-emergency. Referral (to hospital) only when problems are too uncommon to maintain competence. Coordinates care when people receive services at other levels.

Secondary Care: all of the above, plus…

Specialist physicians

E.g. General hospitals

Tertiary Care: all of the above, plus…

Specialized consultative care, usu. in hospitals, on referral

Wide range of physicians (but they are specialists)

Can address a wide range of health problems

High-level diagnostics, surgeries and treatments

6

Health Care Systems are Complicated!

And yes, lots of people already knew that.

Levels of care:

Primary

Secondary

Tertiary

7

Classifying healthcare systems

Delivery
Public Private
Financing Public National Health Service (NHS) National Health Insurance models
Private None Out-of-Pocket

8

Four Basic Models of Health Care Systems

British System (The Beveridge Model, aka, National Health Service)

German System (The Bismark Model)

Canadian System (The National Health Insurance Model)

Out-of-pocket System

9

Beveridge Model, aka, National Health Service (NHS)

Often called “British System”

There is no insurance in this system!

Comprehensive health services available to everyone, regardless of ability to pay

Coverage is universal; Health care is viewed as a state-supported service

Covers wide range of preventative and therapeutic services, mental health care, physical therapy, some palliative care, dental and eye care

Health care is provided and financed primarily by the government

“Single-payer system” means the government is the single payer

Countries that use the Beveridge model: Great Britain, Spain, New Zealand, Cuba, most of Scandinavia, Hong Kong

10

The Beveridge Model as it works in the UK today

Mostly public financing

75% general taxation

25% payroll tax

Minimal private funding

Copayments for outpatient (non-hospital) prescription drugs, dentistry services

11% of population also buys private voluntary health insurance

To get faster and more convenient care

For elective surgery at private hospitals

11

The Beveridge Model as it works in the UK today

Patients never get a bill from the doctor

Have some copays, but minimal

Out-of-pocket spending was 9% of total health care spending in the UK in 2012 (OECD, 2014a)

Some health care workers are public, some are private

Government pays private doctors set fees for services

All healthcare workers directly bill the government; patients don’t get bills

Single-payer system

Government decides what doctors can do

Government decides what doctors can charge

Tight government control keeps overall costs (e.g. cost per capita) low because government decides

Limits choice on what services people can get

12

Variation on the NHS in Cuba

Cuba: whole system is government-operated

all clinics, hospitals, services staff

13

Key components of the UK/Beveridge system (review)

The country known for developing it?

How it is funded?

If there is insurance, describe how it works

Impact on citizens: cost of treatment, whether everyone is insured?

Which part of the U.S. system is most similar to this?

14

The Bismark Model (German system)

First universal system of health insurance, developed 1880s

Mandatory insurance, provided by “sickness funds”, covers 90% of population; rest have private insurance

Government regulates but does not provide health services directly

Financed by both employers’ tax, and employees through payroll deductions

Countries that use the Bismark Model: Germany, France, Belgium, the Netherlands, Japan, Switzerland and many Latin America countries

15

The Bismark Model in Germany today

Insurance plans — “sickness funds”

Have to cover everyone

Must be not-for-profit (different from US system)

Participation is mandatory (like the “individual mandate” in the US Affordable Care Act)

Employers and employees split the cost of care equally (similar to employer-based insurance for the US)

The self-employed buy private insurance

Disabled and unemployed are also covered through various schemes

16

The Bismark Model in Germany today

240 sickness funds, tightly regulated by government

Multi-payer system, but tightly regulated by government to control costs

Must accept everyone, and must provide certain services mandated by the government

Can only compete by providing additional services

Health care providers and institutions are private

Payment is negotiated between the sickness funds and providers

Patients can choose their providers

17

The National Health Insurance Model: Canada

Universal coverage

Single-payer: National government-run insurance program

No profit

No need to market the plan to sell it to everyone

No financial motive to deny claims

Cheaper and simpler than private for-profit insurance (like US)

Single-payer (the government) (like Beverage)

Providers are private (like Bismark)

Countries with National Health Insurance Model: Canada, South Korea, Taiwan

This is Canada’s system

This system has elements of both Beveridge and Bismarck:

It uses private-sector providers (like Bismark) but payment comes from a government-run insurance program that every citizen pays into (like Beverage).

Canadian system – also an insurance model: government pays the providers directly through insurance,

Since there’s no need for marketing, no financial motive to deny claims and no profit, these universal insurance programs tend to be cheaper and much simpler administratively than American-style for-profit insurance.

The single payer tends to have considerable market power to negotiate for lower prices; Canada’s system, for example, has negotiated such low prices from pharmaceutical companies that Americans have spurned their own drug stores to buy pills north of the border. National Health Insurance plans also control costs by limiting the medical services they will pay for, or by making patients wait to be treated.

18

National Health Insurance Model in Canada today

Funded by taxation at the federal and provincial levels

Both personal and corporate income taxes

And some from sales tax, lottery in some provinces

Keeps costs low by limiting services and long waits for treatment

Pharmaceutical costs are so low that many Americans drive to Canada to buy medications

Although some in Canada still think they are too high

And pharmaceuticals are an out-of-pocket expense

Health care providers are largely public

National Health Insurance Model in Canada today

Covers preventive care, medical care from primary care physicians, hospitals, dental surgery and more

Some provinces require premiums for some services

But, health services cannot be denied due to financial inability to pay

Some people buy supplemental private insurance through their employer for non-covered health services

Dental services, eye care, prescription medicines

Federal system but each province gets a lot of autonomy

Differential care by province

20

The Out-of-pocket Model

The out-of-pocket model is one in which any medical care is paid for entirely by the patient

This may mean seeing a non-traditional healers

Or it may mean paying with money, food, services

Or it may mean being sick and dying young

It most likely means little to no preventative care

Many low and middle income countries have no established health care system

In many places, the rich get medical care, but not the poor

21

Out-of-pocket expenses vs. Out-of-pocket model

Most of the systems described here have some form of ‘out-of-pocket’ spending

British system: Copayments for drugs

Canadian system: Private health insurance to decrease wait times, and uncovered services

That is not the same as an ‘out-of-pocket’ model of health service

22

Is there insurance?

Who runs the insurance system?

Yes

No

Canadian System

German System

Public/Government

Private

companies

Who pays at point of service? (Who gets the doctor’s bill?)

British System

Out of pocket System

The government

The patient

Distinguishing between the models based on insurance

23

Distinguishing the models based on delivery and financing

Delivery
Public Private
Financing Public National Health Service
(UK, Cuba, Spain)
National Health Insurance
(Canada, South Korea, Thailand, New Zealand)
Private None Out-of-Pocket
(most countries until the 19th or 20th c.)

24

Pluralistic Models

Combination of private, public, and not-for-profit sectors playing important roles in health care services

Health care is not considered a human right, but rather a personal good that is commodified

Countries that have ‘pluralistic’ models health systems

India

Nigeria

United States

25

The US system is pluralistic

“Health care in the United States is currently a unique hybrid, multiple-payer system, but with elements of single payer (i.e., Medicare, although beneficiaries also contribute through premiums), publicly subsidized private payers (e.g., employer-sponsored health insurance), socialized medicine (e.g., Department of Veterans Affairs, in which government is both the payer and the employer), and self-pay (i.e., out of pocket).”

Donnelly, Peter D., Paul C. Erwin, Daniel M. Fox, and Colleen Grogan. 2019. “Single-Payer, Multiple-Payer, and State-Based Financing of Health Care: Introduction to the Special Section.” American Journal of Public Health 109 (11): 1482–83. https://doi.org/10.2105/AJPH.2019.305353.

26

Which parts of the US health system are like these health models?

German system – employer-provided insurance

Difference being that in Germany, these are all non-profit insurance organizations, whereas most insurance plans in the US are for profit

Canadian system – Medicare and Medicaid

Government-run insurance plans that pay private doctors for certain sets of treatments

British system – Veteran’s health plans

Government run hospital system, public health providers

Out-of-pocket system – population with no health insurance

They can get care if they can pay for it

27

Health system: 1. Private 2. Pluralistic 3. National Health Insurance 4. National Health Service (NHS) 5. Socialized Health Service
Prototype: Most countries until the 19th or 20th century United States, Peru, Nigeria, India Canada, Germany, France, Belgium, Netherlands, Taiwan, Japan, Costa Rica, Latin American countries United Kingdom, Italy, Sweden Cuba, Soviet Union
Political and ideological values: Health care as an item of personal consumption Health care as primarily a consumer good Health care as an insured, guaranteed service Health care as a state-supported service Health case as a right and a state-provided public service
Position of the physician: Solo entrepreneur Solo entrepreneur and member of practitioner group Private solo or group practice and/or employed by hospitals Private solo or group practice and/or employed by hospitals State employee
Ownership of facilities: Private Private, not-for-profit, and public Not-for-profit and public, some private Mostly public Entirely public
Source of financing: Private out-of-pocket payments Mix of private out-of-pocket and public Primarily public single-payer Public monopsony (only 1 buyer) Public monopsony (only 1 buyer)
Administration and regulation Market Market, some government Government, some market Government Government

Adapted from: Birn, A, Y, Pillay, and T. H. Holtz. 2017.
Textbook of Global Health. Oxford University Press. Page 481.

The spectrum of health systems

28

Part III of your country papers: Health System

Organization: Is it a coordinated system run by the Ministry or Department of Health or is it more fragmented and relies primarily on market forces or NGOs? Is there a linked system of primary care, hospital care, and tertiary care?

Financing: This will vary widely by country, but some guiding questions: Is the system publicly funded, privately funded, supported by foreign donors, or a mix? If it is a mix, which kind of financing is dominant? Is the funding level sufficient to meet the needs of the population? If it has public funding, is it from taxes (if so, what kind of taxes?) or insurance premiums? What percent of healthcare costs are paid by the government (versus individuals)?

Coverage: ​Is there insurance? How does insurance work (who pays for it, what % of people are insured)? What costs are incurred by citizens ​(insurance premiums/cost of care)? Any recent significant changes in the system?

Key sector issues… next lecture.

Describe the overall health system (including organization, financing, coverage and model). After you’ve given an overview, then you’ll analyze the key sector issues. You’ll need to be concise as you will only have about a paragraph or less for each of the key sector issues.

29

Physiology homework help

Swasthya: The Politics of Women’s Health in Rural South India

Page 1 of 22

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 01 March 2022

The Practice of International Health: A Case-
Based Orientation
Daniel Perlman and Ananya Roy

Print publication date: 2009
Print ISBN-13: 9780195310276
Published to Oxford Scholarship Online: September 2009
DOI: 10.1093/acprof:oso/9780195310276.001.0001

Swasthya: The Politics of Women’s Health in
Rural South India
Suneeta Krishnan

DOI:10.1093/acprof:oso/9780195310276.003.07

Abstract and Keywords
This chapter looks at experiences providing health care to rural women in India.
It shares thoughts about the quality of health care offered to women. The
chapter also describes the establishment of the Well Woman Clinics, aimed at
providing empathic reproductive health care, including information, counseling,
and clinical services to women. Community health workers (CHWs) were trained
to take a comprehensive, broadly defined health history and provide pre-
examination counseling to help women assess what kind of clinical consultation
they required and become acquainted with routine examinations.

Keywords:   health services, reproductive health care, women’s health, rural health, public health
practice, health workers

In August 1997, three American students, including two of Indian origin, met at
a newly opened cyber café in Bangalore city, India, to plan a women’s health
program in Vijaygiri,i a rural community 350 kilometers away. Rajiv, whose
brainchild the program was and who had raised funds for it, did not turn up for
the meeting. The others decided to go ahead with their trip to Vijaygiri anyway.
So, at the height of the monsoon season, the trio traveled to Vijaygiri to conduct
a needs assessment for the program. I heard of their plans through a friend. In
search of inspiration for my dissertation research, I decided to tag along. My
father had passed away recently, and the sudden loss had left me drifting. I
needed to find an anchor, a focus.

Swasthya: The Politics of Women’s Health in Rural South India

Page 2 of 22

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 01 March 2022

At around 9 P.M., we boarded a “luxury” government bus that turned out to be
anything but luxurious. Last-minute booking meant that we had the last row.
After a few hours on a relatively straight highway, we started to climb up
through the mountains. In the last row, even the most minor pothole tossed us
high off our seats. And the rain! The rain came pouring down the whole night,
leaking through the cracks around the edges of the windows. The next morning I
stepped off the bus at the Vijaygiri bus stand damp and aching.

The bus stand was a patch of ground big enough to accommodate two buses and
a few auto rickshaws. Coconut, arecanut, and other trees bordered the stand
and houses crowded in on the sides. It was about 5 o’clock in the morning. Faint
strains of the traditional Sanskrit morning chants played on a radio. A few auto
drivers were standing around, yawning and stretching. Now that the rain had
ended, the air was crisp, cold, and damp. Leaves on the trees were fresh with
dew and (p.129) rain. Ah, how peaceful, how idyllic were those first few
moments in Vijaygiri after the hustle and bustle of Bangalore. “Perhaps here I
will find a dissertation topic and peace after the turmoil of my father’s death,” I
thought.

No one was there to meet us, so we approached an auto rickshaw driver and
asked to be taken to the hospital. We drove through what looked like the main
road of the town, up a hill and around a corner. There at the top of the hill was a
sprawling pink building. To the left, by the side of the parking area, was a
badminton court. People slowly moved about with toothburshes, towels, and
flasks. No one seemed to notice us. We wandered in through the main entrance
and reached an inner courtyard with hallways going left and right and stairs
going down. Just as I began to feel a bit frustrated, we saw a tall man, maybe in
his fifties, walking toward us from the corridor on the left. He carried himself
with an air of authority, but at the same time his smile was open, welcoming. He
reminded me a bit of my grandfather. It was Dr. Vasan, the chief medical officer
of the hospital.

Rajiv and the students I was with had worked out the broad goals of the project
with Dr. Vasan. The idea was to extend the mobile clinics that the hospital was
conducting to make outreach more regular and to recruit a group of local
women to engage in health education. The initial mission was to “empower
women with information and other tools to make and act upon health care
decisions.” I was wary of the fact that the project did not have an explicit
ideological or theoretical orientation. Further, there had been no discussion
about roles and responsibilities—of the student group, the hospital, or the health
workers we would recruit. I was apprehensive that the undertaking might turn
out to be a haphazard student project rather than a formal program and about
being saddled with responsibilities that I had not had time to fully comprehend. I
was already a year into my “all but dissertation” status in the doctoral program
in epidemiology at the University of California, Berkeley, and was conscious of

Swasthya: The Politics of Women’s Health in Rural South India

Page 3 of 22

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 01 March 2022

the need to stay focused on completing the dissertation. I was also committed to
a project that would keep me linked to my childhood roots in India—a desire that
had shaped the focus of my undergraduate and graduate studies in the United
States. Thus, quite quickly, I became the group’s point person.

Later that first morning, after we had showered and dressed, we met Dr. Vasan
at the canteen, a low-roofed annex to the main hospital building. As we devoured
the iddlis (steamed rice cakes), chutney, and sweet hot coffee served in 2-inch-
high steel cups, a doctor who looked to be in his early thirties greeted Dr. Vasan
with respect and then turned to us with an excited smile.

“So these are the Americans.”

“This is Jagan,” introduced Dr. Vasan. “He has been running the hospitals’s
nursing program and the community outreach.”

Dr. Jagan seemed excited and enthusiastic about meeting people interested in
his line of work. We began to discuss what our role at the hospital would be, and
once our conversation was under way, Dr. Vasan excused himself to begin
morning rounds and left us to our discussions with Jagan.

(p.130) A few days later, in an airy, spacious office of the hospital, I met with
Dr. Jagan and the honorary secretary of the hospital, an elderly, sprightly man
who had retired from the banking sector. Jagan seemed far more relaxed in the
presence of the secretary than in that of Dr. Vasan. In fact, he was in his
element.

“What we need is mass education,” he announced. “Now is the time to start. I
have 20 girls finishing the nursing course this month.” Dr. Jagan had been
running a 1-year training program for nursing assistants, who were simply
called nurses. If we did not move fast, we would lose the opportunity to recruit a
few of the graduates. Most got hired by nursing homes and clinics in the district
and neighboring districts. Once they got jobs, it would be difficult to recruit
them for our project. And once we hired them, we would need to initiate training
as well.

At first I was reluctant to rush to action, hoping instead to take our time in
developing a solid plan. However, I caved in.

“We’ll interview the candidates tomorrow,” announced Dr. Jagan.

The secretary seconded the proposal. Dr. Jagan recognized the importance of
identifying young women with a commitment to staying back in their home
communities, with an interest in working on women’s health. But I learned from
him that in order to accomplish our goals, we had to work very strategically

Swasthya: The Politics of Women’s Health in Rural South India

Page 4 of 22

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 01 March 2022

In her more recent work, Suneeta
Krishnan has been operating out of urban
clinics in Bangalore, India, interviewing
young women about their marriages,
economic situation, and sex lives. (Photo:
Jason Taylor for Time.)

within the hospital. We had to bring on board the authorities, like the secretary,
and the staff, like the head nurse, by trying to work on terms acceptable to them.

On one of my early trips, I drove back to Bangalore with Dr. Vasan and his wife,
Dr. Sarojini. Dr. Vasan was in a nostalgic mood and eager to confide. We spoke

(p.131) at length about the
hospital during our ride to
Bangalore—about the 10 years
they had spent struggling to
establish the hospital, and about
Dr. Jagan. I learned that Jagan was
a native of the town, trained in
Ayurvedic medicine.
“We sent him to get training in
anesthesia. The main problem
with him is that he doesn’t have
confidence. He doesn’t focus,”
Dr Vasan said.

“You know, for even a little
thing, he will send people for an
x-ray, an electrocardiogram,”
added Dr. Sarojini.

Dr. Vasan continued in a resigned voice, “I manage with him. His main strength
is public relations. He will be good at helping you with the training of these
health workers and talking to the panchayat [village council].ii He’s good at
handling politics. But I will come to the weekly clinics myself.”

In contrast with what Dr. Vasan had told me, Dr. Jagan seemed very confident.
As the project evolved, the student group and the community health workers
(CHWs) relied on him to negotiate with the hospital authorities as well as with
local village authorities like the panchayats and local landlords. He had the
ability to connect with people and to speak in ways that they could identify with.
I felt that ultimately it was Dr. Jagan who understood the project—and in many
ways it was his project: it emerged as an extension of his nursing training
program and his community outreach work. For years, before Dr. Vasan and Dr.
Sarojini had joined the hospital, Jagan would hitch rides with taxis and jeeps
going out to the villages to offer health care and information. He had a strong
commitment to social service, which made him a natural leader for our project.

Our new recruits, the CHWs, participated in a 3-month training program in
community health. During this time, Jagan lobbied with wealthy families and
local panchayats to donate space for the CHWs’ health centers. In January 1998,
we launched health centers in six villages within a 30 kilometer radius of

Swasthya: The Politics of Women’s Health in Rural South India

Page 5 of 22

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 01 March 2022

Vijaygiri. Jagan and Dr. Vasan planned a grand launch—a large multispecialty
camp. Camps are a common strategy used in India to promote health-care
access as well as utilization of particular kinds of health services such as
sterilization or screening. A number of doctors we met at Vijaygiri and
Bangalore who were involved in community health all felt that the most effective
ways of establishing oneself in the community was by providing basic medical
care through camps and outreach clinics. Dr. Vasan and Jagan too felt that this
was crucial.

The day of the launch, Jagan was extremely tense but in charge. He paced up
and down, checklist in hand, overseeing the packing of equipment and materials.
We left the hospital as a convoy of four vehicles. The hospital van left at around
8:45 A.M. with a team of student nurses, laboratory technicians, and equipment.
Jagan followed in his car with the CHWs, his wife Ila, his daughter Ashwini, and
Ashwini’s puppy Amitabh, named after a famous Bollywood actor. I followed in a
jeep with Dr. Vasan and a few other doctors.

The first center, located in hilly estate country, was being launched at the village
farthest away from the hospital. It consisted of two rooms within the village
government office at the foot of a hill. Areca nut trees dripping with black
pepper (p.132) vines and sweet-smelling coffee bushes in bloom grew on the
slopes. Closer to the summit were the neatly cropped tea plantations.

By the time we reached the site at about 10 A.M., at least 50 people had
gathered. The majority were women, some with children. The panchayat
officials, registers and pens in hand, seemed extremely organized, as did several
community volunteers. There must have been a team of about 20 organizers and
a total of about 8 clinical specialists at the camp. It was 10:15, and a festive
atmosphere prevailed. Hindi pop music blared on the speakers. The panchayat
officials decided it was time to begin.

The next thing I knew, the owner of a local tea estate who was sponsoring the
day’s program was announcing my name, and I was led to the stage by one of
the camp volunteers.

With a dry mouth and a racing heart I walked to the microphone. Over 100
people had gathered by then. Dr. Jagan introduced me: “Now, Mrs. Suneeta
Krishnan will say a few words about Swasthya. She is one of the dedicated
students who has come all the way from America to work with us.”

I reminded myself that I was the “laudable American” and could do no wrong.
Braced by this thought, I launched into my speech, in English: “Today’s program
is a true representation of what Swasthya is trying to accomplish: local
communities, the hospital, and the Swasthya team working together to promote
health. We hope this partnership will be a long and successful one.”

Swasthya: The Politics of Women’s Health in Rural South India

Page 6 of 22

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 01 March 2022

Dr. Jagan stepped up to translate and then launched into a few of his own
remarks: “Our goal is to provide not merely treatment but also health education.
Illness prevention is the goal.” Throughout the life of the project, he would
repeatedly emphasize this goal.

Finally, after what seemed to be an eternity, the speeches came to a close. The
panchayat president (head of the village government) kicked off the camp by
requesting all those who wanted a health checkup to register. In minutes, a long
queue of men, women, and children formed at the registration desk in front of
the panchayat office. Three young men, panchayat volunteers, sat at the
registration desk and asked each individual to identify which specialists he or
she wanted to consult. I watched the proceedings for a few minutes. There were
many women in line—dressed in their holiday finest, with flowers in their hair
and colorful glass bangles on their arms. Some had babies on their hips. A few
were chatting and joking; others looked tense.

“Do you live here—in this village? It looks like the entire village is here!” I asked
a group of women in broken Kannada, the local language, peppered with Tamil
and Malayalam, the two languages that I spoke growing up in Kerala, another
South Indian state.

“No, we are from the tea estates up over the hill behind you. We had to walk
nearly 8 kilometers to get here,” they replied. Behind me was a steep hill,
crowded with tall, lanky silver oak trees whose leaves glistened like silver in the
sun. The district had many large estates tucked away at the tops of remote hills.
Some provided (p.133) basic primary health care, but in general accessing
care was a considerable challenge, given the terrain and the distances involved.

I was with another Indian-American student, Preeti, who was taking about 6
months off before starting medical school in the United States. For us, this first
camp was an opportunity to begin understanding the range of health problems
that women had, how they talked about them, what they did, and how local
clinicians responded. We decided to split up, observe, and take notes.

I continued to stand by the registration desk to observe the requests being
made. Once the women realized that I could speak a little Kannada, they started
to talk.

“My two children and I walked 10 kilometers across the paddy fields over there,”
a woman told me, pointing to the valley down below the panchayat office. Green
fields beginning to turn a golden brown, approaching the winter harvest,
extended for several kilometers ahead. Near the horizon I could make out a
settlement. At the camp, we learned how important the local terrain was in
shaping women’s access to care. This region is heavily forested and
mountainous. Many villages are tucked into the hillsides and surrounded by
dense vegetation. Because of heavy rainfall, there is extensive paddy cultivation

Swasthya: The Politics of Women’s Health in Rural South India

Page 7 of 22

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 01 March 2022

in the valleys where “villages,” consisting often of just a handful of homes, are
separated by kilometers of fields. Distance and lack of transportation were
therefore important barriers to health-care access.

“We even missed a day’s pay to come to the camp! Management is like that—
they won’t even give us a day off if we are sick,” said one young woman.

“Sixty kilos we pluck. Is it any wonder that we have back pain and white
discharge?!” questioned another.

Many of the large estates are mandated by law to provide basic amenities such
as health care and primary education. However, most of these clinics are run by
male doctors. Doctors and women are uncomfortable with physical exams;
therefore, if a woman does seek care for a gynecological problem (which she
may not), treatment is usually based only on reported symptoms. Without the
estate doctor’s permission, women would incur leave without pay if they needed
a day off to seek gynecological care from a woman doctor, who might be
anywhere from 10 to 30 kilometers away.

One woman explained, “When we to go to the town to see a lady doctor, we have
to spend so much—5 rupees bus charge and another 50 rupees to the doctor.
And then the medicines.”

Even when health care was accessible, as in the case of our camp, the culture of
silence around women’s gynecological health was so pervasive that women
would not reveal their problems. The fact that we were requiring everyone to
publicly state which specialist they wanted to see was clearly not conducive to
making women comfortable about indicating gynecological concerns. Further,
we had young men sitting at the registration desk noting down this information.
This did not strike me immediately. But as I stood there for 5, 10, 15 minutes and
found that so (p.134) few of the women were stating gynecological problems
and seeking consultations with the gynecologist, I began to become suspicious.

My uneasiness was confirmed when I struck up a conversation with a tall, thin
woman who looked to be in her thirties. She seemed tense and apprehensive,
wringing the edge of her sari, scanning the crowd. I approached her with a smile
and welcomed her to the inauguration of our new health center.

Bharati was her name. I described Swasthya’s services and focus on women and
I asked her what concerns brought her to the camp.

“Headaches,” she said.

“Have you been having any other problems?” I asked as we waited for her turn
to register.

Swasthya: The Politics of Women’s Health in Rural South India

Page 8 of 22

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 01 March 2022

“No,” she said uncertainly. Given her hesitation, I engaged her in some lighter
conversation. “So, how many children do you have?”

“Three—two girls and a boy.”

“Have you brought them also for a checkup, or did you come on your own?”

“I came on my own.”

“So tell me, how is your health? What kinds of problems do you have?”

She moved closer to me, and while keeping her eyes downcast, confided, “I have
been bleeding a lot, more than what is my usual, and throughout the month.”

I asked how long it had been happening.

“It’s been more than half a year now. But the estate doctor said not to worry, he
didn’t even need to look at me. He said that it happens to women at my time of
life and that it would stop soon. I am waiting, and yet I feel so weak. Every day is
more difficult.”

At 35, Bharati seemed young for menopause. I felt that her symptoms merited an
examination, if not some extended treatment, and I was angry the estate doctor
had not even examined her. I was sure she would benefit from an exam from the
female gynecologist at our camp.

“Oh, there is really no need,” she said, “I am sure I will be feeling better soon.”

We had been speaking with a friendly rapport, but I reverted to playing the
health professional role, and after a few more words of encouragement, Bharati
nervously agreed to an exam. I completed her registration and then
accompanied her to the line in front of the gynecologist’s room. I returned to the
main registration queue to continue talking to others.

I saw Jagan nearby: “You have to tell the men at the registration desk to ask all
the women if they want to see a ‘lady’ doctor,” I said anxiously. “The women are
too shy to ask and they’re going to miss out on an opportunity to see the
gynecologist!”

I watched understanding flash across Jagan’s face. Immediately, he headed to
the registration desk to make our request. This approach worked much better.
The doctors’ consultations went on all day.

A typical exam took place like this: The doctor is sitting behind a wooden desk.
The nurse is standing, attentive, by her elbow. The patient enters and stands,
(p.135) waiting to be acknowledged. She moves to sit on a stool by the side of
the desk when the doctor motions her to do so. “So what is the problem?” the
doctor asks, without lifting her eyes from the case sheet on the desk. The patient

Swasthya: The Politics of Women’s Health in Rural South India

Page 9 of 22

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 01 March 2022

describes her symptoms and the doctor orders her to the examination table,
chiding her if she does not cooperate by getting into the lithotomy position to
facilitate a pelvic exam. Occasionally, if the patient resists out of fear, her legs
are pried apart.

Later, we noticed the marked difference when doctors treated women whom
they perceived to be their social “equals,” that is women of an upper caste.
Upper-caste women were welcomed into the consultation room with a smile. Eye
contact would be made and explanations given. The women would be put at ease
before the examinations began.

The most common problems that women at the camp reported were white
discharge, excessive bleeding during menstruation, and missed periods. The
doctors examined the women who complained of white discharge (some with a
speculum and some without), but most of the time they could not find anything
wrong and would either prescribe ayurvedic medications or order a blood test.
The doctors did not offer much advice to the patients. Mostly, they simply
prescribed medications.

The experience of Lakshmi, a thin, diminutive 28-year-old woman who worked
on the tea estate, was illustrative of the lack of dialogue during medical
consultations. She came to the gynecologist because she had still not started
menstruating. Dr. Sarojini took her into an inner room for an examination.
Shortly after, she returned to tell us that Lakshmi had poorly developed female
sexual organs (immature breasts and poorly developed genitals), probably due to
reduced production of female hormones. Dr. Sarojini told us that this problem
should have been addressed when Lakshmi was much younger and that it was
probably too late to do anything about it. While she explained all this to us in
English, Lakshmi was standing patiently next to the desk, waiting for something
to be conveyed to her in Kannada.

Dr. Sarojini asked her to come to the hospital at Vijaygiri on a day that doctors
from the nearby teaching hospital visited for special consultations. Not
surprising but telling was the fact that during the discussion with Lakshmi, Dr.
Sarojini provided no information about her health problem or prospects for
treatment.

About an hour later, I saw Bharati standing in a corner of the compound. The
kohl she was wearing around her eyes was smudged down her cheeks. She was
distraught and could barely speak.

“The doctor just said that I had to come to the hospital this week to have my
uterus removed!”

“But didn’t she tell you why?” I asked.

Swasthya: The Politics of Women’s Health in Rural South India

Page 10 of 22

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press,
2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.
Subscriber: University of Colorado at Boulder; date: 01 March 2022

“No, she examined me and just said to come to the hospital to get my uterus
removed.” Fresh tears poured forth. “It’s going to cost so much money. And I’m
sure the doctor won’t give me leave!”

I was confused. I had thought that Bharati was upset about having to undergo a
surgery. “What do you mean—the doctor won’t give you leave?”

(p.136) Bharati explained that she needed to get a referral for the surgery
from the estate doctor, otherwise she would not get sick leave or reimbursement
for her expenses. I told her that I would go with her to talk to the estate doctor,
who was also at the camp, and convince him to give her a referral to the
hospital.

The doctor, a short, bespectacled man, was not someone I would see as an
intimidating person. However, he clearly wielded great power over Bharati; she
was even quieter in front of him, almost fearful. Later, while recounting the
incident to Jagan, he explained that the estate doctors are quite powerful but
also find themselves in the crossfire between estate workers and the
management. Estate management wants the doctors to cut down costs and limit
referrals and expensive procedures, but workers look to the doctors to help keep
them in good health. The success of his job depends on his ability to establish
good rapport with the workers and their families so that they follow his advice.
This estate doctor seemed open to listening, and after I explained the situation
to him, he agreed to give Bharati the referral letter she needed in order to get
the estate’s health insurance coverage for her surgery.

Bharati thanked me profusely for talking to the estate doctor and started to cry. I
went to ask the gynecologist what was wrong with Bharati. She only had a
moment between other examinations to inform me that Bharati had uterine
fibroids and that a hysterectomy had therefore been recommended.

I returned to where Bharati was waiting and explained what a fibroid is and how
it could be treated. Bharati told me that she had been experiencing bleeding for
quite some time but had not been told by any of the doctors she had consulted
why it was happening. The estate doctor, who had not examined her, had j

Physiology homework help

Medical error—the third leading cause of death in the
US
Medical error is not included on death certificates or in rankings of cause of death. Martin Makary
and Michael Daniel assess its contribution to mortality and call for better reporting

Martin A Makary professor, Michael Daniel research fellow

Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA

The annual list of the most common causes of death in the
United States, compiled by the Centers for Disease Control and
Prevention (CDC), informs public awareness and national
research priorities each year. The list is created using death
certificates filled out by physicians, funeral directors, medical
examiners, and coroners. However, a major limitation of the
death certificate is that it relies on assigning an International
Classification of Disease (ICD) code to the cause of death.1 As
a result, causes of death not associated with an ICD code, such
as human and system factors, are not captured. The science of
safety has matured to describe how communication breakdowns,
diagnostic errors, poor judgment, and inadequate skill can
directly result in patient harm and death. We analyzed the
scientific literature on medical error to identify its contribution
to US deaths in relation to causes listed by the CDC.2

Death from medical care itself
Medical error has been defined as an unintended act (either of
omission or commission) or one that does not achieve its
intended outcome,3 the failure of a planned action to be
completed as intended (an error of execution), the use of a wrong
plan to achieve an aim (an error of planning),4 or a deviation
from the process of care that may or may not cause harm to the
patient.5 Patient harm from medical error can occur at the
individual or system level. The taxonomy of errors is expanding
to better categorize preventable factors and events.6 We focus
on preventable lethal events to highlight the scale of potential
for improvement.
The role of error can be complex. While many errors are
non-consequential, an error can end the life of someone with a
long life expectancy or accelerate an imminent death. The case
in the box shows how error can contribute to death. Moving
away from a requirement that only reasons for death with an
ICD code can be used on death certificates could better inform
healthcare research and awareness priorities.

How big is the problem?
The most commonly cited estimate of annual deaths from
medical error in the US—a 1999 Institute of Medicine (IOM)
report7—is limited and outdated. The report describes an
incidence of 44 000-98 000 deaths annually.7 This conclusion
was not based on primary research conducted by the institute
but on the 1984 Harvard Medical Practice Study and the 1992
Utah and Colorado Study.8 9 But as early as 1993, Leape, a chief
investigator in the 1984 Harvard study, published an article
arguing that the study’s estimate was too low, contending that
78% rather than 51% of the 180 000 iatrogenic deaths were
preventable (some argue that all iatrogenic deaths are
preventable).10 This higher incidence (about 140 400 deaths due
to error) has been supported by subsequent studies which suggest
that the 1999 IOM report underestimates the magnitude of the
problem. A 2004 report of inpatient deaths associated with the
Agency for Healthcare Quality and Research Patient Safety
Indicators in the Medicare population estimated that 575 000
deaths were caused by medical error between 2000 and 2002,
which is about 195 000 deaths a year (table 1⇓).11 Similarly, the
US Department of Health and Human Services Office of the
Inspector General examining the health records of hospital
inpatients in 2008, reported 180 000 deaths due to medical error
a year among Medicare beneficiaries alone.12 Using similar
methods, Classen et al described a rate of 1.13%.13 If this rate
is applied to all registered US hospital admissions in 201315 it
translates to over 400 000 deaths a year, more than four times
the IOM estimate.
Similarly, Landrigan et al reported that 0.6% of hospital
admissions in a group of North Carolina hospitals over six years
(2002-07) resulted in lethal adverse events and conservatively
estimated that 63% were due to medical errors.14 Extrapolated
nationally, this would translate into 134 581 inpatient deaths a
year from poor inpatient care. Of note, none of the studies
captured deaths outside inpatient care—those resulting from
errors in care at home or in nursing homes and in outpatient
care such as ambulatory surgery centers.

Correspondence to: M A Makary mmakary1@jhmi.edu

For personal use only: See rights and reprints http://www.bmj.com/permissions Subscribe: http://www.bmj.com/subscribe

BMJ 2016;353:i2139 doi: 10.1136/bmj.i2139 (Published 3 May 2016) Page 1 of 5

Analysis

ANALYSIS

Case history: role of medical error in patient death

A young woman recovered well after a successful transplant operation. However, she was readmitted for non-specific complaints that were
evaluated with extensive tests, some of which were unnecessary, including a pericardiocentesis. She was discharged but came back to the
hospital days later with intra-abdominal hemorrhage and cardiopulmonary arrest. An autopsy revealed that the needle inserted during the
pericardiocentesis grazed the liver causing a pseudoaneurysm that resulted in subsequent rupture and death. The death certificate listed
the cause of death as cardiovascular.

A literature review by James estimated preventable adverse
events using a weighted analysis and described an incidence
range of 210 000-400 000 deaths a year associated with medical
errors among hospital patients.16 We calculated a mean rate of
death from medical error of 251 454 a year using the studies
reported since the 1999 IOM report and extrapolating to the
total number of US hospital admissions in 2013. We believe
this understates the true incidence of death due to medical error
because the studies cited rely on errors extractable in
documented health records and include only inpatient deaths.
Although the assumptions made in extrapolating study data to
the broader US population may limit the accuracy of our figure,
the absence of national data highlights the need for systematic
measurement of the problem. Comparing our estimate to CDC
rankings suggests that medical error is the third most common
cause of death in the US (fig 1⇓).2

Better data
Human error is inevitable. Although we cannot eliminate human
error, we can better measure the problem to design safer systems
mitigating its frequency, visibility, and consequences. Strategies
to reduce death from medical care should include three steps:
making errors more visible when they occur so their effects can
be intercepted; having remedies at hand to rescue patients 17;
and making errors less frequent by following principles that
take human limitations into account (fig 2⇓). This multitier
approach necessitates guidance from reliable data.
Currently, deaths caused by errors are unmeasured and
discussions about prevention occur in limited and confidential
forums, such as a hospital’s internal root cause analysis
committee or a department’s morbidity and mortality conference.
These forums review only a fraction of detected adverse events
and the lessons learnt are not disseminated beyond the institution
or department.
There are several possible strategies to estimate accurate national
statistics for death due to medical error. Instead of simply
requiring cause of death, death certificates could contain an
extra field asking whether a preventable complication stemming
from the patient’s medical care contributed to the death. An
early experience asking physicians to comment on the potential
preventability of inpatient deaths immediately after they
occurred resulted in an 89% response rate.18 Another strategy
would be for hospitals to carry out a rapid and efficient
independent investigation into deaths to determine the potential
contribution of error. A root cause analysis approach would
enable local learning while using medicolegal protections to
maintain anonymity. Standardized data collection and reporting
processes are needed to build up an accurate national picture of
the problem. Measuring the consequences of medical care on
patient outcomes is an important prerequisite to creating a
culture of learning from our mistakes, thereby advancing the
science of safety and moving us closer towards the Institute of
Medicine’s goal of creating learning health systems.19

Health priorities
We have estimated that medical error is the third biggest cause
of death in the US and therefore requires greater attention.
Medical error leading to patient death is under-recognized in
many other countries, including the UK and Canada.20 21
According to WHO, 117 countries code their mortality statistics
using the ICD system as the primary indicator of health status.22
The ICD-10 coding system has limited ability to capture most
types of medical error. At best, there are only a few codes where
the role of error can be inferred, such as the code for
anticoagulation causing adverse effects and the code for
overdose events. When a medical error results in death, both
the physiological cause of the death and the related problem
with delivery of care should be captured.
To achieve more reliable healthcare systems, the science of
improving safety should benefit from sharing data nationally
and internationally, in the same way as clinicians share research
and innovation about coronary artery disease, melanoma, and
influenza. Sound scientific methods, beginning with an
assessment of the problem, are critical to approaching any health
threat to patients. The problem of medical error should not be
exempt from this scientific approach. More appropriate
recognition of the role of medical error in patient death could
heighten awareness and guide both collaborations and capital
investments in research and prevention.

Contributors and sources: MM is the developer of the operating room
checklist, the precursor to the WHO surgery checklist. He is a surgical
oncologist at Johns Hopkins and author of Unaccountable, a book about
transparency in healthcare. MD is the Rodda patient safety research
fellow at Johns Hopkins and is focused on health services research.
This article arose from discussions about the paucity of funding available
to support quality and safety research relative to other causes of death.
Competing interests: We have read and understood BMJ policy on
declaration of interests and declare that we have no competing interests.
Provenance and peer review: Not commissioned; externally peer
reviewed.

1 Moriyama IM, Loy RM, Robb-Smith AHT, et al. History of the statistical classification of
diseases and causes of death. National Center for Health Statistics, 2011.

2 Deaths: final data for 2013. National vital statistics report. http://www.cdc.gov/nchs/fastats/
leading-causes-of-death.htm.

3 Leape LL. Error in medicine. JAMA 1994;272:1851-7. doi:10.1001/jama.1994.
03520230061039 pmid:7503827.

4 Reason J. Human error. Cambridge University Press, 1990. doi:10.1017/
CBO9781139062367.

5 Reason JT. Understanding adverse events: the human factor. In: Vincent C, ed. Clinical
risk management: enhancing patient safety. BMJ, 2001:9-30.

6 Grober ED, Bohnen JM. Defining medical error. Can J Surg 2005;48:39-44.pmid:15757035.
7 Kohn LT, Corrigan JM, Donaldson MS. To err is human: building a safer health system.

National Academies Press, 1999.
8 Brennan TA, Leape LL, Laird NM, et al. Incidence of adverse events and negligence in

hospitalized patients. Results of the Harvard Medical Practice Study I. N Engl J Med
1991;324:370-6. doi:10.1056/NEJM199102073240604 pmid:1987460.

9 Thomas EJ, Studdert DM, Newhouse JP, et al. Costs of medical injuries in Utah and
Colorado. Inquiry 1999;36:255-64.pmid:10570659.

10 Leape LL, Lawthers AG, Brennan TA, Johnson WG. Preventing medical injury. Qual Rev
Bull 1993;19:144-9.pmid:8332330.

11 HealthGrades quality study: patient safety in American hospitals. 2004. http://www.
providersedge.com/ehdocs/ehr_articles/Patient_Safety_in_American_Hospitals-2004.pdf.

12 Department of Health and Human Services. Adverse events in hospitals: national incidence
among Medicare beneficiaries. 2010. http://oig.hhs.gov/oei/reports/oei-06-09-00090.pdf.

13 Classen D, Resar R, Griffin F, et al. Global “trigger tool” shows that adverse events in
hospitals may be ten times greater than previously measured. Health Aff 2011;30:581-9doi:
10.1377/hlthaff.2011.0190.

For personal use only: See rights and reprints http://www.bmj.com/permissions Subscribe: http://www.bmj.com/subscribe

BMJ 2016;353:i2139 doi: 10.1136/bmj.i2139 (Published 3 May 2016) Page 2 of 5

ANALYSIS

Summary points

Death certificates in the US, used to compile national statistics, have no facility for acknowledging medical error
If medical error was a disease, it would rank as the third leading cause of death in the US
The system for measuring national vital statistics should be revised to facilitate better understanding of deaths due to medical care

14 Landrigan CP, Parry GJ, Bones CB, Hackbarth AD, Goldmann DA, Sharek PJ. Temporal
trends in rates of patient harm resulting from medical care. N Engl J Med
2010;363:2124-34. doi:10.1056/NEJMsa1004404 pmid:21105794.

15 American Hospital Association. Fast facts on US hospitals. 2015.http://www.aha.org/
research/rc/stat-studies/fast-facts.shtml.

16 James JTA. A new, evidence-based estimate of patient harms associated with hospital
care. J Patient Saf 2013;9:122-8. doi:10.1097/PTS.0b013e3182948a69 pmid:23860193.

17 Ghaferi AA, Birkmeyer JD, Dimick JB. Complications, failure to rescue, and mortality with
major inpatient surgery in Medicare patients. Ann Surg 2009;250:1029-34. doi:10.1097/
SLA.0b013e3181bef697 pmid:19953723.

18 Provenzano A, Rohan S, Trevejo E, Burdick E, Lipsitz S, Kachalia A. Evaluating inpatient
mortality: a new electronic review process that gathers information from front-line providers.
BMJ Qual Saf 2015;24:31-7. doi:10.1136/bmjqs-2014-003120 pmid:25332203.

19 Institute of Medicine of the National Academies. Continuous improvement and innovation
in health and health care. Round table on value and science-driven health care. National
Academies Press, 2011.

20 Office for National Statistics’ Death Certification Advisory Group. Guidance for doctors
completing medical certificates of cause of death in England and Wales. 2010.

21 Statistics Canada. Canadian vital statistics, death database and population estimates.
http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/hlth36a-eng.htm.

22 World Health Organization. International classification of diseases.http://www.who.int/
classifications/icd/en/.

Published by the BMJ Publishing Group Limited. For permission to use (where not already
granted under a licence) please go to http://group.bmj.com/group/rights-licensing/
permissions

For personal use only: See rights and reprints http://www.bmj.com/permissions Subscribe: http://www.bmj.com/subscribe

BMJ 2016;353:i2139 doi: 10.1136/bmj.i2139 (Published 3 May 2016) Page 3 of 5

ANALYSIS

Table

Table 1| Studies on US death rates from medical error since the 1999 IOM report and point estimate from pooled results

Extrapolation
to 2013 US
admissions†

% of admissions
with a

preventable

No of deaths
due to

preventable
adverse event

% of events
deemed

preventable

Lethal
adverse
event rate

(%)

Adverse
event rate

(%)

Patient
admissions

Source of
information

Dates
covered

Study

lethal adverse
event

251 4540.71389 576NR0.7*3.137 000 000Medicare patients2000-02Health Grades11

219 5790.6212441.413.5838Medicare patients2008Office of
Inspector
General12

400 2011.1391001.133.27953 tertiary care
hospitals

2004Classen et al13

134 5810.3814630.618.1234110 hospitals in
North Carolina

2002-07Landrigan et al14

251 454‡0.71——————2000-08Point estimate
from all data

NR=Not reported.
*All were considered preventable.
†Total number of US hospital admissions in 2013 was 35 416 020.10

‡Total number of people who died from a preventable lethal adverse event calculated as a point estimate of the death rate among hospitalized patients reported
in the literature extrapolated to the reported number of patients hospitalized in 2013.

For personal use only: See rights and reprints http://www.bmj.com/permissions Subscribe: http://www.bmj.com/subscribe

BMJ 2016;353:i2139 doi: 10.1136/bmj.i2139 (Published 3 May 2016) Page 4 of 5

ANALYSIS

Figures

Fig 1 Most common causes of death in the United States, 20132

Fig 2 Model for reducing patient harm from individual and system errors in healthcare

For personal use only: See rights and reprints http://www.bmj.com/permissions Subscribe: http://www.bmj.com/subscribe

BMJ 2016;353:i2139 doi: 10.1136/bmj.i2139 (Published 3 May 2016) Page 5 of 5

ANALYSIS

Physiology homework help

Research Paper Topic:

The Change Process

The topic chosen for the research paper is the change process within the workplace (examples of changes would be management, employee relocation, and etc.). This is a topic briefly discussed in Human Resource Management in Public Service textbook. The topic is deserving of an analysis because it is critical for long- and short-term success as well as the health of the organization. Also, during this process skills are developed which can help the next project run smoothly and efficiently. This process can be considered in overall management of an organization. The research topics discussed will be: Importance and effectiveness of the change process, steps in the change process, and methods to prepare the employees and organization for change. In addition, discussed will also be ways to bring employees into the change process the are some services and methods that can benefit or support employees through the change process in the workplace.

Physiology homework help

                                                    RESEARCH PAPER REQUIREMENT

The purpose of the research paper requirement is to give the student experience in the collection, synthesis, and analysis of qualitative data. Every student is expected to be the sole author of original, unpublished work, which has not fulfilled requirements of any other courses. The paper is to be of professional quality. The paper should be grammatically correct, use the APA citation style, and address the research question selected by the student clearly and succinctly. 

The instructor must approve your topic. Students must READ AND FOLLOW the guidelines listed below. There is a high correlation between adherence to the guidelines and good grades on research papers. (The topic is in the second attachment).

General Guidelines
1. Topic selection: Develop a preliminary title and briefly describe (no more than 1 page) the topic you want to investigate. Also discuss your motivation for selecting the topic. A good topic and a well-crafted statement of the research question is the basis for a quality paper. This step is perhaps the most difficult part of the research paper. Requirement: The instructor must approve all topics. To meet this requirement students will provide to the instructor a typed description of their topic (a single page should be adequate).  Deadline: fourth class session. 

2. Introduction: This is a narrative of about 1 to 1 1/2 pages in length. It should explain the topic under investigation and why it deserves analysis. Place your topic within the general context of public administration. Then move to the more specific issues of interest to you. This section also includes an explicit statement of your research question. A research question is stated in such a way that there is more than one answer. A question involving the relationship between two variables takes the form: What influence does (your independent 
variable-the causal agent) have on (your dependent variable-what gets acted upon)?  For example, “What impact does personnel management have on organizational performance?”  In contrast a descriptive research question involves the how, what, where, why or when of a particular phenomenon. A descriptive research question takes the form:  How do public organizations appraise employee performance?

Final Paper: The required length of the paper is 8 – 10 pages, excluding title page and references. The paper must be written in Standard English, type written or printed from a computer printer, and double-spaced using 1-inch margins. Prepare your paper using Times New Romans 12-pitch font. Your paper should have a cover page that contains the following information: Title of Proposal, Course Name and Number, Student Name, and Date of Submission.  
– The paper must be written in narrative form. 
– Use appropriate major and minor headings to divide the major sections of the paper. 
– All sources used in the paper must be cited whether you use direct quotes or summaries. The paper must follow the conventions of the APA Publication Manual.  The paper must be submitted into Turnitin by the deadline date of March 4th.  Individual meetings will be held on the Team’s App following submission of your paper if your Turnitin originality report far exceeds 20%.   Individual students will be notified of the need to meet. 

                                              Format
Introduction: The purpose of this section is to inform your audience on important aspects of the question you propose to investigate. What is the context of the question and how does it relate to the subject of organization theory? Your narrative should move from a general idea to a well-defined research question. 

Literature Review: This section includes a discussion of each source (A MINIMUM OF 10) that you select to use to support your paper. The discussions should focus on the relevance of the source to your research question and the evidence it provides. The instructor values the use of scholarly books and journal articles. Using other sources (newspapers, magazines, web sites) will hurt the substance of your paper. Care in selection and written presentation of sources is essential to drawing supportable conclusions about your research question. 

Conclusions: in this section you will briefly summarize, in an integrated form, what you have learned from the entire literature review. The challenge is to blend the sources identified in the literature review into a coherent discussion of how the evidence relates to the research question. You want to present the material in a logical and understandable manner. One way to approach this task is to identify themes from the Literature Review and then build your summary/conclusions around these themes. The themes you select must extend logically from the material you have collected. Themes that are not supported by your literature review hurt the substance of your paper. The question you are trying to answer is the following: What does it (all your reviews) all mean as relates to your research question?

Physiology homework help

EXAM INSTRUCTIONS 

Answer both case/scenarios with recommendations that thoroughly address all issues presented. Your recommendations should be comprehensive in nature and should include concepts, case law and appropriate legislation from course work completed this term. Each recommendation should be approximately 600 words in length.

In this exam, you are writing recommendations that a personnel manager would send to a legal unit for review. This exam does not require you to use the format as found on your capstone exam. Accordingly, you will not be required to write a summary, identify key players, or suggest three alternatives, etc., as required on your future capstone experience.

In this exam, you will prepare two final recommendations while providing a full justification for each using information from your textbook with a discussion of whatever supporting material you use. Do not cut and paste information directly from the textbook. Your narrative should be in your own words using specific terms and ideas with explanations. The more details the better the grade. Remember to define, discuss and write clearly clarifying cases, concepts and other data from the Berman textbook supporting your points. There are several areas each of the cases address that you must clearly address. Your textbook should be specifically stated in your answers as to where the information came from (feel free to use the name Berman for time considerations).

Draft Ms. Snapp’s recommendation for each case/scenario comprehensively using all information you have learned that is applicable to each situation. In other words, show how much you have learned from this course.

You will answer each case/scenario with a justified response from the perspective of the personnel director. Realize that the format being required here is not like the case analysis used in the capstone exam. Accordingly, you will NOT summarize the case, cite key players or complete an analysis of the alternatives. In the format being used here, you will only prepare the response of the personnel director as to her recommended resolution of the multiple issues posed within each case. You will have a fully written recommendation for each scenario and justifications that thoroughly addresses each area discussed (for example, employee rights, union rights, grievance procedures, First Amendment free speech rights, Hatch Act provisions, Freedom of Association issues, sexual harassment issues, etc.) 
Be sure there is a solid recommendation and make sure each area is fully supported. Where you use your textbook as a source, write “Berman” and give appropriate credit to the authors (for example, you would say… “According to Berman, strikes are illegal in the public sector and therefore…). This will save time.

Each case/scenario response should be approximately 600 words or more. You must work on your own and all exam responses are subject to turnitin. Plagiarized materials will result in zero credit for submitted responses. Again make sure you label your responses Case One and Case Two. You have 2 hours to complete the exam. You need to keep your own time in case your internet disconnects. Once you have entered the exam the clock has begun.

Physiology homework help

Week Three: Signature Assignment

Top of Form

Instructions

Signature Assignment (CLO 4, 5, 7, 8)

“To a large extent, factors such as where we live, the state of our environment, genetics, our income and education level, and our relationships with friends and family all have considerable impacts on health, whereas the more commonly considered factors such as access and use of healthcare services often have less of an impact” (World Health Organization, 2015).

Reflect on the statement above both from individual and public health views. Do you agree? Why or why not? Considering the history, philosophy and values in public health, how does this influence your approach to improving health of the population? Building on the learning resources and your own research, what recommendations would you have for improving equality and equity in healthcare?

Please write a 4-5 page paper (excluding cover page, abstract, and references) and provide at least three (3) scholarly references to support your assessment and include your text book as reference. Apply APA format for all your formatting, citations, and references, unless otherwise indicated.

All papers should be double spaced, and follow APA format. Each paper must have:

· Title page;

· Abstract;

· Use of Level I and II headings (if applicable);

· In-text citations;

· References page

Please use the sample APA paper template (with instructions) (provided below) for all paper assignments:


APA paper template- PDF format


APA paper template – Word Document
(see attachment)

Bottom of Form

Physiology homework help

This was an actual case and the arbitrator ruled in the company’s favor as indicated below.   Note that, although an arbitration proceeding is quasi-judicial in nature, the arbitrator has a lot of discretionary authority in making decisions.  When reading the arbitrator’s decision, ask yourself, would you want the grievant to inspect a gas leak at your home?    

In reviewing the totality of the situation, the arbitrator believed discharge was appropriate in this case.  Management was correct in using its “Management Rights” clause to dismiss the grievant.  His negligence could have caused harm to customers and legal problems galore for the company.   As you prepare for the final exam, remember the “practical” approach used in this scenario.

 

EXERCISE: LABOR EXERCISE

OBJECTIVES: 

1. To familiarize students with the arbitration process.

2. To give students practice in presenting and defending a case before others.

3. To examine issues associated with interpretation of the conditions of a contract and the application of just cause in termination.       

                                                                              ARBITRATOR’S DECISION

 

The arbitrator decided that there was just cause for the company to discharge grievant.  The arbitrator, therefore, denied the grievance and ordered that the grievance be dismissed.  The arbitrator had two questions to answer:  (1) Was this a case of poor job performance or negligence of duty?  and (2) Was the discharge penalty appropriate?  In addressing the first question, the arbitrator noted that poor performance is usually associated with a lack of skills or intelligence.  The grievant had been an employee of the company for nearly four years and had nearly five years of experience as a service technician.  The grievant did not lack the requisite skills or innate ability to do the job in the opinion of the arbitrator.  The arbitrator also noted the serious nature of the situation that the grievant left the customer in as a result of not following prescribed procedures.  With respect to the appropriate nature of the penalty, the arbitrator noted that no extenuating or mitigating circumstances were brought to his attention which might justify imposition of a lesser penalty. The arbitrator also noted the grievant’s less than exemplary work record and that throughout his testimony, grievant’s penchant for placing blame on others without taking responsibility for his own errors.  The grievance was denied and the termination stands. 


Physiology homework help

Running head: ABBREVIATED TITLE HERE IN ALL CAPS (Note: include the words 1 Running head: on the first page only as shown.)

INSERT ABBREVIATED TITLE HERE IN ALL CAPS

Insert the Title of Your Paper Here on the Upper Half of Title Page

Insert Your Name Here

National University

Insert due date of paper here

Abstract

The abstract provides a brief, comprehensive summary of the paper. Abstracts should not exceed 120 words, unless otherwise stated, and should note the major ideas of the paper. The abstract appears on a page by itself, (page 2), with title Abstract, as shown above, centered on the first line of the page and is not bolded. Unlike all other paragraphs in the research paper, it is not indented. The Abstract should be one long paragraph with no indentations.

Insert the Title of Your Paper Here Again (centered, exactly as on title page, bolded)

These instructions are based on APA 7th ed. Begin the first paragraph of the body of your paper here (indented). Introduce your reader to your topic and why you are writing about it. The introduction does not need the heading Introduction to label it due to its location in the paper. When writing a research paper, you should strive to write in the third person. Avoid using words like I, or this researcher will. Relative to formatting, APA dictates that there are now two spaces after punctuation marks at the end of sentences. All text in your paper from beginning to end, including the References page, should be double-spaced. Set your margins to one inch all around.

Beginning on your title page, double click in the header to place an abbreviated title of your paper in all capital letters. This is called the Running head and should be flush left with the margin. Then using the page insert function, insert your page numbers starting page 1 on the title page, located at the upper right margin. Your page numbers will automatically fall in proper order.

Insert a New Major Heading Here (bolded)

This is where you will continue the body of your paper, citing some background or history on the subject you have chosen for your paper. Titles that are centered and bolded are called Level I Headings. You will most likely need to use subheadings like the one below, to indicate that you are changing the focus of your discussion. It is not APA compliant to underline headings, or any other text for that matter, so do not underline any text anywhere. Also, do not use any colors anywhere in your paper, just plain black and white. Some templates use colors and blocks around page numbers. This is not APA compliant.

Level Two Heading (subheading)

As above, subheadings are left justified (not indented) and they need to be in upper and lower case letters and bolded. Do not underline headings. Each main word is capitalized. Throughout your entire paper use 12-point font, either Times New Roman or Arial only (although others might be easy to read or look pretty, nothing else is acceptable). Make sure your entire paper is left justified (align text left), not center justified (center text). Center justified text stretches text out evenly across the page, but is not APA compliant.

In Text Citations

In-text citations are required in your paper and must be APA compliant relative to formatting. If you are not familiar with how to format in-text citations, refer to your APA Publication Manual to appropriately cite references in your text. Do not use URL’s as in-text citations. URL’s should only be used in your References page to indicate where you retrieved information.

Conclusion

Conclude your paper by briefly summarizing what you have already said throughout your paper. This is where it would be appropriate to cite your opinions or to talk about what you learned about the topic you have researched and written about. The References page should be on a page by itself. What that means, is regardless of where your Conclusion ends, always start your References page on a new page, and type the word References, centered, not bolded, on the very first line. Do not use the words Resources, Reference (singular), Works Cited, etc. Use References.

References

American Psychological Association. (2009). Publication manual of the American Psychological Association (6th ed.). Washington, DC: Author.

Cohen, L., Chávez, V., & Chehimi, S. (2007). Prevention is primary: Strategies for community well-being. San Francisco: Jossey-Bass.

Schneiderman, N., Speers, M. A., Silva, J. M., Tomes, H., & Gentry, J. H. (Eds.). (2001). Integrating behavioral and social sciences with public health. Washington, DC: American Psychological Association.

NOTE: Your reference page is always last and begins on a new separate page like this. The title is just as you see it above. The following applies:

· All references are double spaced like the rest of your paper with the first line flush left with the margin and all lines after the first line (of each individual reference) is indented as above. This is also referred to as a hanging indent.

· There are specific components for each of the various types of references used, (books, journals, magazines, websites, etc.) depending on the type of reference you are listing. Check the APA Publication Manual to make sure you include all the appropriate components for your references. Review the proper use of italics as demonstrated on the examples above.

· All references must be alphabetized A to Z, regardless of type of reference. See your APA Publication Manual for examples.

· If you cite a reference in the body of the text of your paper, the reference must be listed on this page and vice versa. If you have a reference listed here, make sure you have cited it in your paper somewhere.

Physiology homework help

3

The New Reality
Diversity and Complexity 1

n her work at a community mental health center, a recently
graduated, young European American woman named Sarah1
received a referral from the Office of Children’s Services (OCS)
for a severely abused, biracial 4-year-old named Maya. Follow-
ing removal from her biological parents, Maya was brought to
the initial appointment by her new foster mom, Carmen, an
assertive, self-described Latina/African American Jehovah’s
Witness. Carmen agreed to meet with Sarah because OCS
required it. During sessions that alternated between individ-
ual and family meetings, Carmen interacted defensively with
Sarah but was warm and caring with Maya.

After 6 weeks, Maya appeared very comfortable with her
foster mom, and many of her posttraumatic stress disorder
symptoms had improved. However, in a subsequent meeting
alone with Sarah, Maya asked her if she believed in Jesus.
Sarah said that she wasn’t a Christian but that she believed in

I

1All cases are composites with pseudonyms and do not represent a
specific individual.

http://dx.doi.org/10.1037/14801-001
Addressing Cultural Complexities in Practice: Assessment, Diagnosis, and Therapy,
Third Edition, by P. A. Hays
Copyright © 2016 by the American Psychological Association. All rights
reserved.

Co
py

ri
gh

t
Am

er
ic

an
P
sy

ch
ol
og
ic
al
A
ss
oc
ia
ti
on
.
No
t
fo
r
fu

rt
he

r
di

st
ri

bu
ti

on
.

4 B E C O M i n g A C u L t u r A L L y r E S P O n S i v E t H E r A P i S t

god—a response that clearly distressed Maya, who brought up the topic
again in their next individual session, adding that she was afraid Sarah
would die and go to the “bad place.” Sarah began to worry that Carmen
might be sharing religious beliefs that were reactivating Maya’s fears.
She also wondered whether Carmen knew that Sarah was gay and, if
so, whether this might be a factor, along with their cultural, age, and
religious differences, in Carmen’s defensiveness toward her. Considering
Carmen’s disinterest in Sarah’s help, Maya’s overall improvement while
in Carmen’s care, and the severe shortage of caring foster homes, Sarah
was unsure whether she should address her concerns with Carmen,
with OCS, or with both or neither.

When i began teaching a multicultural counseling class at Antioch
university in Seattle in 1989, the field of multicultural counseling was
just beginning, and like most new fields, its focus was relatively narrow.
relevant textbooks focused primarily on the ethnicity and race of the
client, with little attention to the therapist’s identity or to the interaction
of ethnicity and race with the client’s (or therapist’s) religion, class, age,
disability, gender, sexual orientation, or nationality. there were some
population-specific fields regarding women, older adults, and people
who identified as gay or as having a disability, but the available books
and articles in these fields also conceptualized identity in unidimen-
sional terms. Feminist therapy initially focused on women (presumably
White, Christian or secular, nondisabled, and middle class); the lesbian,
gay, and bisexual literature on lesbian, gay, and bisexual people (pre-
sumably White, Christian or secular, nondisabled, and middle class);
geropsychology on older men (presumably White, Christian or secular,
nondisabled, and middle class); and so on. A field known as transcultural
psychiatry overlapped with one called cross-cultural psychology, both of
which focused on work with populations outside north America and
Europe but were conducted primarily by European and u.S. (White)
researchers.

Since 1989, the world’s awareness of and approach to diversity have
changed significantly. increasing numbers of people have been displaced
both within and across national borders because of war, poverty, and
violence. Environmental degradation and extreme climate changes have
magnified the impact of natural disasters on human communities. With
economic globalization and technology accelerating the pace of change,
social connections have increased dramatically across borders, with a wide
range of effects including a growing number of people who marry across
cultural groups and who identify as multiracial and multicultural and
changing attitudes toward minority groups such as lesbian, gay, and trans-
gender people and people who have disabilities. And around the world,
as indigenous people become increasingly empowered and unified, the
value of indigenous traditions is being increasingly acknowledged.

Co
py

ri
gh

t
Am

er
ic

an
P
sy

ch
ol
og
ic
al
A
ss
oc
ia
ti
on
.
No
t
fo
r
fu

rt
he

r
di

st
ri

bu
ti

on
.

5The New Reality

in the face of such changes, therapists are now expected to work effec-
tively with people of diverse ages, ethnic cultures, religions, disabilities,
gender identities, sexual orientations, nationalities, and classes. At the
same time, the effects of violence, abuse, trauma, chemical dependency,
disability, chronic physical and mental illness—that is, poverty-correlated
problems—are now commonly encountered in clinical practice, even in
many wealthier countries. Counselors and clinicians are expected to “fix”
the mental health problems stemming from these persistent social causes
even as economic pressures have resulted in higher caseloads, less super-
vision, and fewer mental health resources. Cases as complex as Maya’s
are now commonplace.

recognizing the need for clear guidance on what works, an American
Psychological Association (APA) task force took on the project of deter-
mining what constitutes practical, research-based, and highly relevant
psychotherapy practice. the result was their definition of evidence-based
practice in psychology (EBPP) as “the integration of the best available
research with clinical expertise in the context of patient characteristics,
culture, and preferences” (APA Presidential task Force on EBPP, 2006).
this definition does not prioritize any one theoretical orientation but
rather tends to support a more integrative approach. in addition, by
emphasizing “best available research,” the definition acknowledges the
reality that for many minority groups, controlled studies of psychotherapy
effectiveness do not exist. the definition also gives equal weight to clini-
cal expertise, with an emphasis on using one’s expertise to adapt therapy
to the particular individual and their cultural context.

Developing Multicultural
Competence

At a national psychology conference in the united States several years
ago, i started a conversation with a young European American psy-
chologist who had recently joined the faculty of a prestigious univer-
sity. in response to my questions about the diversity of the psychology
department, she told me that it consisted of 36 full-time members, one
of whom was a person of color. She stressed that they’d made signifi-
cant progress in the hiring of women, but all of the women were White
except the one person of color, and none were tenured. i asked her opin-
ion about why this was the case, and she replied, “Well, i think the core
faculty put their priority on developing a high-quality research program
rather than on hiring for diversity.”

this psychologist’s statement reflects the commonly held belief that
quality and diversity involve competing agendas. However, i would argue,

Co
py

ri
gh

t
Am

er
ic

an
P
sy

ch
ol
og
ic
al
A
ss
oc
ia
ti
on
.
No
t
fo
r
fu

rt
he

r
di

st
ri

bu
ti

on
.

6 B E C O M i n g A C u L t u r A L L y r E S P O n S i v E t H E r A P i S t

as many others have, that the exact opposite is true. A high-quality pro-
gram by definition includes faculty of diverse perspectives who bring ideas
that move a department beyond those of the mainstream. it consists of
diverse teachers and supervisors who serve as role models for a culturally
diverse student body and clinical faculty who have firsthand knowledge
of the cultures of the clients being seen by their students. it includes fac-
ulty who speak more than one language, read the psychological literature
of more than one culture, and are connected to minority groups whom
they consider and consult in their development of research projects.

given the relatively monocultural origins of the field, this is a tall
order. However, significant strides have been made. throughout the fields
of psychology, counseling, mental health, and social work, professional
organizations have made a clear commitment to increasing the multi-
cultural competence of their members; in north America, this effort has
included the APA (2000a, 2000b), the American Counseling Association
(roysircar, Arredondo, Fuertes, Ponterotto, & toporek, 2003), and the
national Association of Social Workers (2007). As researchers, teachers,
supervisors, and practitioners in these professions become more diverse,
they are experiencing and demonstrating the advantages of a diverse
learning environment. And the idea that diversity can be addressed in
one multicultural counseling course has been replaced by the view that
cross-cultural information, experiences, and questions must be integrated
throughout the training curriculum, including practica and internships
(Magyar-Moe et al., 2005).

Addressing Both Diversity
and Complexity

When i teach multicultural awareness workshops, i start by asking partici-
pants to do the following: “take a minute to share with a partner every-
thing you feel comfortable sharing about yourself that explains who you
are and your identity, including past and current cultural influences on
you.” if you’re reading this by yourself, try doing this in the box before
reading further.

List all of the cultural influences you can think of that explain
or describe your identity:

_____________________ ____________________
_____________________ ____________________
_____________________ ____________________
_____________________ ____________________

Co
py

ri
gh

t
Am

er
ic

an
P
sy

ch
ol
og
ic
al
A
ss
oc
ia
ti
on
.
No
t
fo
r
fu

rt
he

r
di

st
ri

bu
ti

on
.

7The New Reality

Once people have finished sharing, i ask how many mentioned
ethnicity or race in their self-description; depending on the makeup of
the group, a varying number of people raise their hand. i then ask how
many mentioned religion, and a different number raise their hand. i
also ask about age and generational influences, disability, sexual orien-
tation, social class, nationality, language, and gender. then i ask if any-
one thought of influences i did not mention, and participants often add
being from a particular geographic region, growing up in the military,
working in the business world, and others.

this exercise illustrates how, when we think of culture, so many
different influences come into play. All of these influences shape who
we are, but as i found when i began teaching, the dilemma is how,
whom, and what to focus on. For the purposes of psychological prac-
tice, i have chosen to focus on the influences and related minority
groups that the major helping professions target for special attention
because these influences and groups have been neglected in the field
and dominant culture. these influences can be organized in an easy-to-
remember acronym that spells the word ADDrESSing (see table 1.1).

As you read through the list of ADDrESSing influences and domi-
nant and minority groups, you will recognize that for many of the influ-
ences, the groups listed as minority groups are minorities only in the
united States (e.g., people of Asian heritage are not a minority in China
or, for that matter, in the world). So think of this list as only an exam-
ple: if you are practicing in a different region or country, the dominant
and minority groups will be specific to that particular context.

ADDRESSING Influences

A stands for Age and generational influences and includes not just chrono-
logical age, but also generational roles that are important in a person’s
culture. For example, the role of eldest son in many cultures carries
specific responsibilities, just as being a parent, grandparent, or auntie
brings with it culturally based meanings and purpose.

Age and generational influences also include experiences specific to
age cohorts, particularly experiences that occurred during the cohort’s
childhood and early adulthood (i.e., the formative years). For example,
for many elders, the great Depression, World War ii, and racial segrega-
tion were generation-related influences that profoundly affected their
lives. For baby boomers, important early influences were post-World
War ii economic prosperity, the civil rights movement, the women’s
movement, vietnam War protests, and the widespread use of drugs. For
people in their 20s, economic pressures, college debt, technology and
social media, and environmental degradation are common influences—

Co
py

ri
gh

t
Am

er
ic

an
P
sy

ch
ol
og
ic
al
A
ss
oc
ia
ti
on
.
No
t
fo
r
fu

rt
he

r
di

st
ri

bu
ti

on
.

8 B e c o m i n g a c u l t u r a l l y r e s p o n s i v e t h e r a p i s t

all of these also affect older people, but people in their 20s have never
lived without them.

obviously, age and generational influences vary across ethnic and
other cultural groups, just as dominant and minority groups vary in dif-
ferent countries and contexts. in north america, the minority groups
associated with age and generational influences are children and older
adults, because elders and children do not have the same privileges
that young and middle-aged adults have. however, in some countries,
elder status carries a great deal of privilege and power. i will provide
examples of contextual specifics of these definitions in chapter 2.

the next letters, DD, stand for Developmental or other Disability. the
broad category of disability includes disability that may occur at any

T A B L E 1 . 1

ADDRESSING Cultural Influences

Cultural influence Dominant group Nondominant or minority group

Age and generational
influences

Young and middle-aged
adults

Children, older adults

Developmental or other
Disabilitya

Nondisabled people People with cognitive, intellectual,
sensory, physical, and psychiatric
disabilities

Religion and spiritual
orientation

Christian and secular Muslims, Jews, Hindus, Buddhists,
and other religions

Ethnic and racial identity European Americans Asian, South Asian, Latino, Pacific
Islander, African, Arab, African
American, Middle Eastern, and
multiracial people

Socioeconomic status Upper and middle class People of lower status by occupa-
tion, education, income, or inner
city or rural habitat

Sexual orientation Heterosexuals People who identify as gay, lesbian,
or bisexual

Indigenous heritage European Americans American Indians, Inuit, Alaska
Natives, Métis, Native Hawaiians,
New Zealand Ma

_
ori, Aboriginal

Australians
National origin U.S.-born Americans Immigrants, refugees, and inter-

national students
Gender Men Women and people who identify

as transgender

Note. Adapted from Addressing Cultural Complexities in Practice, Second Edition: Assessment, Diagnosis, and
Therapy (p. 18), by P. A. Hays, 2008, Washington, DC: American Psychological Association. Copyright 2008 by the
American Psychological Association.
aWith the increased use of the term intellectual disability, the term developmental disability is being used less often,
particularly within the Disability community; however, it is included in the Diagnostic and Statistical Manual of Mental
Disorders, Fifth Edition (DSM–5) and the International Classification of Diseases, Tenth Edition, Clinical Modification
(ICD–10–CM; see Chapter 4).

Co
py

ri
gh

t
Am

er
ic

an
P
sy

ch
ol
og
ic
al
A
ss
oc
ia
ti
on
.
No
t
fo
r
fu

rt
he

r
di

st
ri

bu
ti

on
.

9The New Reality

time during a person’s lifetime, for example, as a result of illness, acci-
dent, or stroke. Developmental disabilities are specifically those that affect
a person’s development from birth or childhood, such as fetal alcohol
spectrum disorder or Down syndrome. (note that the term intellectual
disability has replaced the pejorative term mental retardation; more on this
in Chapter 4.) related minority groups include people who have cogni-
tive, intellectual, sensory, physical, and psychiatric disabilities.

Some individuals with disabilities identify as members of a Disability
culture (signified by a capital D). However, many individuals who have
disabilities do not consider themselves members of a culture, particu-
larly people who acquire a disability later in life (e.g., an older woman
whose cognitive functioning is impaired following a stroke). Similarly,
many people who identify as members of Deaf culture do not identify as
disabled because they have no impairments when in the Deaf culture; it
is the hearing world’s inability to sign that is the problem.

the distinction between people who grow up with a disability and
those whose disability is acquired later in life has important implications
for therapeutic work. Many people who grow up with a disability learn
coping skills that enable them to function well in the dominant non-
disabled world; when these individuals come to counseling, it is often
for a problem that is unrelated to the disability. in contrast, individuals
who become impaired later in life (e.g., following an accident or physical
illness) often come to therapy for help with learning how to cope and
live with the disability.

the next letter, R, stands for Religion and spiritual orientation. in north
America, the largest religious minority groups are Muslim, Jewish, Hindu,
and Buddhist, and there are many smaller groups (e.g., Baha’i, Shinto,
Confucian, Zoroastrian). Although some members of particular Christian
religions (e.g., Mormon, Seventh-Day Adventist, Jehovah’s Witness, and
fundamentalist Christian) think of themselves as minority groups, they
are still Christian groups and as such have privileges that non-Christian
groups do not have. Similarly, some individuals with atheistic beliefs con-
sider themselves part of a minority group; however, atheists still benefit
from privileges related to the dominant secular culture.

E stands for Ethnic and racial identity. in the united States, the largest
groupings of ethnic and racial minority cultures are Asian, South Asian,
Pacific islander, Latino, and African American. Also included are people
who identify as biracial or multiracial and people of Middle Eastern her-
itage who are experiencing racism and other oppressive attitudes and
behaviors from the dominant culture. Within each of these large cul-
tural groupings, there are many specific groups. For example, South Asian
includes people whose heritage originates in Pakistan, india, Bangladesh,
Afghanistan, nepal, Sri Lanka, Bhutan, and the Maldives (and, depend-
ing on the definition, some additional countries such as tibet). Here
again, the definition of these cultures as minority groups is specific to

Co
py

ri
gh

t
Am

er
ic

an
P
sy

ch
ol
og
ic
al
A
ss
oc
ia
ti
on
.
No
t
fo
r
fu

rt
he

r
di

st
ri

bu
ti

on
.

10 B E C O M i n g A C u L t u r A L L y r E S P O n S i v E t H E r A P i S t

the united States; what constitutes a minority group depends on the
country and its dominant culture.

S stands for Socioeconomic status, which is usually defined by educa-
tion, occupation, and income. related minority groups include people
who have lower status because of limited formal education and the
occupations and lower income that usually go along with less educa-
tion. the focus is on people who are living in poverty, often in rural and
inner-city areas.

the second S stands for Sexual orientation, and the related minority
groups include people who identify as lesbian, gay, and bisexual. in the
united States, sexual minority groups often use an acronym that includes
additional groups, such as LgBtQiA (lesbian, gay, bisexual, transgender,
queer, intersex, ally or asexual), but because some of these groups are
related more to gender, i group them under the influence of gender iden-
tity (see discussion of G that follows).

the I stands for Indigenous heritage, and related minority groups
are people of indigenous, Aboriginal, and native heritage. these terms
are similar in meaning but are used differently in different countries
and contexts (more on this in Chapter 4 on finding the right words).
Within the cultural grouping of indigenous people, there are many
smaller and specific cultures. For example, i work with members of the
Kenaitze tribe, which is the local indigenous culture where i live in
Alaska. Members of the Kenaitze tribe belong to the larger culture of
Dena’ina people, who belong to the larger Athabascan culture, which
is one of many Alaska native cultures. the ADDrESSing acronym lists
indigenous heritage as a separate influence from ethnic and racial iden-
tity because many indigenous people identify as part of a worldwide
culture of indigenous people who have concerns and issues separate
from those of ethnic and racial minority groups (e.g., land, water, and
fishing rights related to subsistence and cultural traditions) and who, in
some cases, constitute sovereign nations.

the N stands for National origin, and related minority groups includ-
ing immigrants, refugees, and international students. Language is often
a strong cultural influence related to national origin, but it may also
be related to the ADDrESSing domains of ethnic and racial identity,
indigenous heritage, and disability (e.g., sign language).

Finally, G stands for Gender identity, and minority groups include
women and people of transgender, transsexual, intersex, gender ques-
tioning, androgyne, and other gender-nonconforming identities. i’ll talk
more about the complexities of gender identity in Chapter 4 on language
and terminology.

As mentioned earlier, the ADDrESSing acronym summarizes nine
key cultural influences that shape the beliefs and behaviors of domi-
nant and minority group members. it calls attention to the overlapping,

Co
py

ri
gh

t
Am

er
ic

an
P
sy

ch
ol
og
ic
al
A
ss
oc
ia
ti
on
.
No
t
fo
r
fu

rt
he

r
di

st
ri

bu
ti

on
.

11The New Reality

multidimensional nature of identity (also referred to as intersectionality;
Ecklund, 2012). the acronym serves as a reminder of minority groups
related to each of the nine influences, and it can be used to highlight
the within-culture diversity of any given culture (whether minority or
dominant). in addition, the ADDrESSing acronym is the foundation
for what i call the ADDrESSing framework.

The ADDRESSING
Framework

the ADDrESSing framework is a practitioner-oriented approach to ther-
apy that conceptualizes multicultural work in two broad categories. the
first category of personal work involves introspection, self-exploration,
and understanding of cultural influences on one’s own belief system and
worldview. the second category of interpersonal work focuses on learning
from and about other cultures, which usually involves interaction with
people. the importance of both the personal and interpersonal aspects
of learning has been emphasized throughout the multicultural literature
(Arredondo & Perez, 2006).

PErSOnAL WOrK

the ADDrESSing approach begins with an emphasis on understanding
the effects of diverse cultural influences on your own beliefs, thinking,
behavior, and worldview. these effects stem from age-related genera-
tional experiences, experience or inexperience with disability, religious
or spiritual upbringing, ethnic and racial identity, and so on (i.e., the
ADDrESSing influences). in particular, recognizing the areas in which
you are a member of a dominant group can help you become more
aware of the ways in which such identities limit your knowledge and
experience regarding minority members who differ from you.

For example, as a result of her membership in a sexual minority
group, a middle-class European American lesbian therapist may hold
an exceptional awareness of the sexist and heterosexist biases against
lesbian, gay, bisexual, and transgender clients and the challenges these
clients face. However, this awareness and expertise do not automatically
translate into greater awareness of the issues faced by people of color,
people who have disabilities, or people living in poverty.

the privileges this therapist holds in relation to her ethnicity, edu-
cation, mental and physical abilities, and professional status are likely
to separate her from people who do not hold such privileges. And if

Co
py

ri
gh

t
Am

er
ic

an
P
sy

ch
ol
og
ic
al
A
ss
oc
ia
ti
on
.
No
t
fo
r
fu

rt
he

r
di

st
ri

bu
ti

on
.

12 B E C O M i n g A C u L t u r A L L y r E S P O n S i v E t H E r A P i S t

her friends and family are similar with regard to ethnicity, religion, and
social class, she will not have easy access to information that would help
her understand, for example, a client of African American Muslim heri-
tage. in contrast, an African American Muslim therapist working with
the same client would be more likely to know relevant cultural infor-
mation or would have easier access to it. Because of the way privilege
separates dominant-culture members from knowledge about minor-
ity groups, this European American therapist would need to put extra
effort into finding and learning the knowledge and skills to understand
this client and work effectively with him.

intErPErSOnAL WOrK

Although we human beings like to think of ourselves as complex, we
often regard others as one dimensional, relying on their visible charac-
teristics as the explanation for everything they say, believe, and do. the
more we recognize the complexity of human experience and identity,
the more able we are to understand and build a positive therapeutic
alliance. And by calling attention to multiple identities and contexts,
the ADDrESSing framework helps therapists avoid inaccurate gen-
eralizations on the basis of characteristics such as the person’s physical
appearance, name, or language.

For example, by using the ADDrESSing acronym as a reminder of
influences that may not be immediately apparent, a therapist attempting
to understand an older man of East indian heritage could begin to think
about a more relevant and broader range of questions and hypotheses,
such as the following:

❚❚ What are the issues related to Age and generational influences on this
man, given his status as a second-generation immigrant?

❚❚ Might he have a Developmental or other Disability that is not appar-
ent, for example, a learning disability, difficulty hearing, or chronic
back pain? Could he have had experience with a temporary dis-
ability in the past, or might he be a caregiver for a child or parent
with a disability?

❚❚ Does he have an identity related to his Religion or spirituality? Was
he brought up in a particular religion? (Hindu, or possibly Muslim
or Sikh, would be reasonable hypotheses, but at this point, one
is simply hypothesizing.) is he a member of a religious minority
that was forcibly ejected from his country of birth or his parents’
residence? (Many indian people immigrated to African countries
but then were forced to leave because of political changes and
racism in the host country.)

❚❚ Does he identify himself as having an Ethnic or racial identity? is
he often mistaken for another identity (e.g., Pakistani or Arab)?
How does his physical appearance (e.g., skin color) relate to his

Co
py

ri
gh

t
Am

er
ic

an
P
sy

ch
ol
og
ic
al
A
ss
oc
ia
ti
on
.
No
t
fo
r
fu

rt
he

r
di

st
ri

bu
ti

on
.

13The New Reality

ethnic or racial identity and experiences within his own ethnic
group and in the dominant culture? (For examples, see inman,
tummala-narra, Kaduvettoor-Davidson, Alvarez, & yeh, 2015).

❚❚ What was his Socioeconomic status (SES) growing up, and what is
it now—within his own ethnic community, and in relation to
the dominant culture? How might his within-culture status be
affected by factors not commonly associated with SES in the dom-
inant culture—for example, his family name, geographic origins,
or marital status?

❚❚ What is his Sexual orientation, not assuming heterosexuality sim-
ply because he is or has been married? How would he perceive a
question about his sexual orientation?

❚❚ Might Indigenous heritage be part of his ethnic identity, for exam-
ple, related to his premigration geographic, family, or community
origin?

❚❚ What is his National origin? Was he born in his country of resi-
dence? What is his national identity (e.g., indian, the nation of
his residence, both, or neither)? What is his primary language—
Hindi, English, Bengali, or some other language?

❚❚ Finally, considering his cultural heritage and identity as a whole,
what important influences related to Gender has he experienced—
for example, gender roles, expectations, and accepted types of
relationships in his culture?

the ADDrESSing acronym does not provide the answers to these
questions; rather, it is a tool for developing hypotheses and questions.
in some cases, it may be appropriate to ask a question directly. However,
in many cases such questions will be perceived as irrelevant or offen-
sive, with a resulting diminishment of the therapist’s credibility. the
way i use the acronym is to facilitate my consideration of questions and
hypotheses that i might otherwise overlook. Once i know how a client
identifies, i can then seek out the culture-specific information that will
help me better understand the client.

regarding this point about gathering cultural information, i have
heard some therapists say that it is best to let the client educate you
about their culture, but i think this point needs clarification. As a
therapist, i believe it is my responsibility to learn as much as i can
about the broad cultural influences related to the client’s identity. this
broad cultural information can then help me understand the client’s
individual experience within that culture. the broader cultural infor-
mation serves as a sort of template that helps me generate hypoth-
eses and questions that are closer to the client’s reality, increasing
my efficiency and decreasing the likelihood of offensive questions. i
will talk more about the use of the ADDrESSing acronym to facili-
tate hypothesis generation and culturally responsive assessment in
Chapters 5 and 7.

Co
py

ri
gh

t
Am

er
ic

an
P
sy

ch
ol
og
ic
al
A
ss
oc
ia
ti
on
.
No
t
fo
r
fu

rt
he

r
di

st
ri

bu
ti

on
.

14 B E C O M i n g A C u L t u r A L L y r E S P O n S i v E t H E r A P i

Physiology homework help

Discussion – Week 2

Top of Form

Discussion: Power, Privilege, and Social Work

In many societies, power and privilege are based on one’s membership in a dominant or non-dominant group. It is not a matter, though, of either having privilege or not. The dominant group varies based on the dimension of diversity. For example, you could experience privilege as Caucasian but oppression and “otherness” as a gay person.

Social workers often work with clients who are perceived as “others.” “Otherness” often leads to marginalization and barriers promoted by society and social institutions. As you begin your work with clients, consider not only the individual (micro) concerns brought to the session but also the environmental or macro factors that may have either created or perpetuated the concern. You can empower your clients by helping them identify and define the oppression they have experienced throughout their lifetime.

For this Discussion, you use the ADDRESSING-GSA framework to explore your own diverse identities and your membership in dominant or non-dominant groups. You then examine how these identities might influence your relationship with clients.

To Prepare:

· Review the Learning Resources on power, privilege, and oppression. Focus on the Hays chapter, which describes the original ADDRESSING framework.

· Complete the ADDRESSING-GSA Self-Assessment in the Learning Resources.

By Day 03/ 09/2022

Post a reflection on the ADDRESSING-GSA Self-Assessment and apply what you learned to social work practice. Copy included of my addressing GSA Self-Assessment included. Specifically, answer the following questions:

· What insights did you gain from the activity in terms of your identities and aspects of power and privilege?

· In what ways do you envision your diverse identities and associated power, privilege, or oppression influencing the social worker–client relationship? Provide an example.

Bottom of Form

Required Readings

Sue, D. W., Rasheed, M. N., & Rasheed, J. M. (2016). Multicultural social work practice: A competency-based approach to diversity and social justice (2nd ed.). Jossey-Bass.

· Chapter 4: Understanding the Sociopolitical Implications of Oppression and Power in Social Work Practice (pp. 89–115)

· Chapter 5: Microaggressions in Social Work Practice (pp. 117–148)

Harvard University Project Implicit. (2011). Project implicit social attitudes. https://implicit.harvard.edu/implicit/selectatest.html

Hays, P. A. (2016b). The new reality: Diversity and complexity. In Addressing cultural complexities in practice: Assessment, diagnosis, and therapy (3rd ed., pp. 3–14). Washington, DC: American Psychological Association. doi:10.1037/14801-001

Required Media

Center for Prevention MN. (2021, February 21). What is implicit bias? [Video]. YouTube.

Note: The approximate length of this media piece is 1 minute.

Graduate School of Social Work—DU. (2018, March 26). Power privilege and oppression [Video]. YouTube. https://www.youtube.com/watch?v=LTDikx-maoM

Note: The approximate length of this media piece is 7 minutes. 

Walden University. (n.d.). ADDRESSING-GSA self-assessment [Interactive media]. https://cdn-media.waldenu.edu/2dett4d/Walden/SOCW/6051/AD/index.html

Follow Rubric

Initial Posting: Content

14.85 (49.5%) – 16.5 (55%)

Initial posting thoroughly responds to all parts of the Discussion prompt. Posting demonstrates excellent understanding of the material presented in the Learning Resources, as well as ability to apply the material. Posting demonstrates exemplary critical thinking and reflection, as well as analysis of the weekly Learning Resources. Specific and relevant examples and evidence from at least two of the Learning Resources and other scholarly sources are used to substantiate the argument or viewpoint.

Follow-Up Response Postings: Content

6.75 (22.5%) – 7.5 (25%)

Student thoroughly addresses all parts of the response prompt. Student responds to at least two colleagues in a meaningful, respectful manner that promotes further inquiry and extends the conversation. Response presents original ideas not already discussed, asks stimulating questions, and further supports with evidence from assigned readings. Post is substantive in both length (75–100 words) and depth of ideas presented.

Readability of Postings

5.4 (18%) – 6 (20%)

Initial and response posts are clear and coherent. Few if any (less than 2) writing errors are made. Student writes with exemplary grammar, sentence structure, and punctuation to convey their message.

Physiology homework help

HRMT 44004D – Leadership Development                                                                   

Online Discussion Assignment #3: Leading through Strengths  (Letter Exchange)                                                                   

Graphical user interface, website  Description automatically generated

Graphic Image Source: StrengthsFinder

“When we’re able to put most of our energy into developing our natural       
talents, extra ordinary room for growth exists”   (p.9)   

 

Background: This Online Discussion Assignment is intended to support you as you further explore your understanding of Leadership and how various theories may inform your own individual Leadership Identity.  The discussion will help to inform:

1.Your understanding of Leadership Theory

2. Your Leadership Development Plan, and

3. Your Digital Leadership Story, and

4. Your Leadership Creative Learning ePortfolio.

During the first few weeks of class, we took some time to begin the exploration of our notions of leadership, were introduced to the process of critical thinking, and using our views and the process of critical thinking analyzed the dominant theories of leadership.

Instructions

Discussion #3 will be a letter exchange with your designated writing partners in a private discussion board group. This letter exchange is a personal or reflexive interpretation of contents, “aha moments,” questions, next steps, etc. 

The purpose of this Online Discussion is to provide a space for each of you to reflect upon and begin to analyze the Signature Themes Report. When you discover your greatest talents, you discover your greatest opportunity for strength. One way to identify your talents is for you to pay attention to the moments of greatness.  

1. Upload Your Signature Theme report to the StrengthsFinder Assessment dropbox as a part of completing the assignment. Discussions that do not have a report will receive a grade of zero. i.e. No report=0

2.  In your letter exchange reflect on and answer the following: 

a. What Domain or Domains did your themes fall? [Executing, Influencing, Relationship Building or Strategic Thinking]

b. What are your top five Signature Themes (explain)? How might you apply your top 5 themes (strengths) into your emerging leadership identity?

c.  What is your favorite talent theme from their Signature Theme report? How might you leverage this theme (strengths), and your understanding of it, in a leadership context?

d. What is one word or phrase from that theme definition that best describes you?

e. Does anything in the report surprise you? 

f. What is your first reaction to these themes (strengths)? What do they mean to you at this point?

g.  Explore the “shadow” side, or “blind spot” of one (1) of your top 5 themes (strengths) as they relate to leadership. i)Has there been a time when the application of your strength was misunderstood/misinterpreted? ii) If so, what happened? iii) How did you feel? iv) How did others respond? v)What might you need to be mindful of as you seek to develop and leverage your strengths in a leadership context in the future?

Note: Assignment Questions adapted from “StrengthsFinder – Strengths Insight and Action Planning Guide”

Assignment Details and Outline

· Use relevant leadership theories discussed in class to support your answers.

· Use of APA 7th formatting is required for any sources you include. Please refer to the file below for the format using the APA 7th guide as an example. To cite the StrengthsFinder Assessment see:   
Citation for test scales and inventories

· The use of personal pronouns is acceptable.

· Allow adequate time to reply if a reply to your colleagues post.

· This one posting should be between 300-500 words and is conversational in tone.

· Address your writing partners in their posting.

· Participants are not required to post replies to their writing partners in the Discussion thread (SLATE Discussion Board).

Assessment for Online Discussion #3

Your participation in Online Discussion 3 will be assessed in the following manner:

1. Your critical analysis of your StrengthsFinder report.

2. The level, and quality, of your participation during the Online Discussion. At a minimum, you are to respond to, and engage in dialogue, with two of your peers.

3. Your online etiquette demonstrated by the way in which you engage with your peers, the way in which you ask questions, and/or clarify statements.

Online Discussion Rubric

 

Assessment Criteria

Unsatisfactory = 0

Novice = 1

Progressing = 2

Proficient = 3

Score (Max 3)

Critical Analysis of your emerging definition of Leadership

Discussion posting shows little or no evidence that an analysis of the leadership theories explored and/or one’s emerging definition of leadership.  No links included to readings or emerging understanding of leadership. Posting is vague and does not include supporting materials, links to concepts from readings, in-class discussions, outside resources, or specific real-life application

Discussion posting repeats and summarizes the necessary information found in the readings. Few links to concepts from readings, in-class discussions, outside resources, or specific real-life applications are provided. Minimal analysis of findings as it relates to leadership contexts indicating a limited emerging understanding of leadership. 

Discussion posting displays an understanding of the leadership theories evidenced by an analysis of the findings related to one’s own experiences with leadership in different contexts. Links made to concepts from readings, in-class discussions, outside resources, or specific real-life applications. Displays correct use of terminology. Posting explores connections between and among theories and experiences

 

Discussion posting displays an excellent understanding of the leadership theories explored and their respective links to the emerging understanding of self as leader and leadership definition.  The correct terminology is used. Posting integrates readings, in-class discussion, and real-life application. Discussion utilizes well-sourced resources to support assertions made. 

 

APA References/Citation

No Sources Cited

APA formatting may not be used, or it contains many errors.

Some Sources Cited

APA formatting is used but contains many errors.

Most Sources Cited.

APA formatting is used but may contain minor errors.

All sources cited.

 

APA formatting is correct and error-free.

 

Participation in the Learning Community

Discussion posting does not contribute to the ongoing conversation. Limited to no responses/questions posed/posted to peers. Questions that are posted do not generate deeper thinking of others. No evidence of critical thought in replies to questions.

Discussion posting sometimes contributes to the ongoing conversation, as evidenced by affirming statements or references to readings or asking relevant, probing questions. Some responses/questions posed/posted to peers. Questions generate some additional thinking; however, probes to hidden assumptions not evident. 

Discussion posting contributes to ongoing conversation evidenced by affirming statements or references to readings, asking relevant, probing questions. Assumptions are questioned/clarified by proposing alternative point of view

Discussion posting actively stimulates and sustains further discussion and deep thinking by building on peer’s postings or responses, including, but not limited to, building a focused argument around an issue, asking a new related question, challenging assumptions by providing an alternative point of view.

 

Etiquette in Dialogue and Quality of Writing

Posts on the discussion board show disrespect for the viewpoints of others. Posts contain numerous grammatical, spelling, and punctuation errors. Personal and authentic voice not present

No sources are cited

Some posts on the discussion board show respect and interest in the viewpoints of others. Posts include some grammatical, spelling, or punctuation errors. Emerging authentic voice evident. Some sources not cited

Posts on the discussion board show respect and interest in the viewpoints of others. Posts are mostly free of grammatical, spelling or punctuation errors. The language used demonstrates an authentic voice. Most sources cited.

Posts on the discussion board show respect and sensitivity to peers’ opinions and ideas. Engages with a sense of curiosity rather than a space of “knowing.” Posts are free of grammatical, spelling, or punctuation errors. All sources cited

 

Discussion Engagement 

Did not respond to peer’s postings.

Responded in a meaningful conversation with one (1) classmates’ post.

The engagement was somewhat active; some questions/responses posted to peers.

Responded in a meaningful conversation with at least two (2) classmates’ posts. The engagement was somewhat active; some questions/responses posted to peers.

Responded in a meaningful conversation with at least two (2) classmates’ posts. Active engagement with questions/responses posted to peers.

 

Total Score

 

 

 

 

 Out of 15

Physiology homework help

www.va luescentre .com

Personal Values Assessment
Aya

Prepared by Barrett Values Centre
Date: February 16, 2022

Barrett Values Centre’s vision is to create a values driven society. This free assessment will help you become
more aware of your own values and how these values influence your decisions and actions.

www.valuescentre.com BARRETT VALUES CENTRE and SEVEN LEVELS OF CONSCIOUSNESS are registered trademarks of Barrett Values Centre, LLC. 2

Personal Values and Awareness

Our values reflect what is important to us. They are a shorthand way of describing our individual motivations. Together with our beliefs, they are the causal factors that drive our decision-
making.

Barrett Seven Levels of Consciousness Model

Service
Selfless service

Making a Difference
Making a positive difference in the world

Internal Cohesion
Finding meaning in existence

Transformation
Letting go of fears.
The courage to develop and grow

Self Esteem
Feeling a sense of self-worth
Fear: I am not enough

Relationship
Feeling protected and loved
Fear: I am not loved enough

Survival
Satisfying our physical and survival needs
Fear: I do not have enough

Values can be positive or fear-based (limiting). For example, honesty, trust and
accountability are positive values, whereas blame, revenge and manipulation are
potentially limiting, or fear-based, values.

Personal mastery involves overcoming or eliminating our fear-based beliefs. When our
beliefs or behaviours are out of alignment with what is really important to us – our values,
we lack authenticity.

Every human being on the planet grows and develops within seven well defined areas.
These areas are defined in the Barrett Seven Levels of Consciousness Model. Each area
focuses on a particular need that is common to all people. The level of growth and
development of an individual depends on their ability to satisfy these needs.

At different times you may find that you focus more on some levels and less on others, in
response to changing life conditions. It is important to understand that in terms of the
seven areas higher is not better; for example it will be difficult for you to focus on helping
others if you are having health and money problems.

The seven areas in the development and growth of personal awareness are summarised
in this diagram and are described in more detail on page 3.

www.valuescentre.com BARRETT VALUES CENTRE and SEVEN LEVELS OF CONSCIOUSNESS are registered trademarks of Barrett Values Centre, LLC. 3

Personal Values and Awareness

Common Good

Transformation

Self Interest

Self Interest
The first three areas of awareness – Survival, Relationship and Self-Esteem, focus on our
personal self-interest – satisfying our need for security and safety, our need for love and
belonging, and our need to feel good about ourselves through the development of a sense
of pride in who we are. We feel no sense of lasting satisfaction from being able to meet
these needs, but we feel a sense of anxiety if these needs are not met.

Transformation
The focus of the fourth area of awareness, Transformation, is on letting go of fears.
During this stage in our development, we establish a sense of our own personal authority,
and our own voice. Within the area of Transformation, we choose to live by the values and
beliefs that resonate deeply with who we are.

Common Good
The upper three areas of awareness – Internal Cohesion, Making a Difference and Service
– focus on our need to find meaning and purpose in our lives. We express that meaning by
striving to make our world a better place and by leading a life of selfless service. When
these needs are fulfilled they engender deeper levels of motivation and commitment.
Within these areas, we learn how to develop an inner compass that guides us into making
life affirming decisions.

Personal Mastery
Individuals who focus exclusively on the personal self-interest areas may be influenced
by the fears they hold about satisfying their individual needs. They look for approval or
reassurance from others.

Individuals who focus exclusively on the satisfaction of the upper common good needs
may lack the skills necessary to remain grounded. They can be ineffectual and
impractical when it comes to taking care of their basic needs.The most successful
individuals are those who balance all of the areas. They are trusting of others, are able
to manage complexity, and can respond or adapt to all situations.

In reality people do not operate from any one single area of awareness. They tend to be
clustered around three or four areas. Individuals are usually focused at areas 1 through
5, typically with a specific emphasis on Internal Cohesion, the fifth area, in which we
seek meaning in our lives.

Your Results
On the next page we will show you how the values you chose map against these seven
areas. Positive values will be identified with a blue dot and potentially limiting or fear
based values will be shown as a white dot.

www.valuescentre.com BARRETT VALUES CENTRE and SEVEN LEVELS OF CONSCIOUSNESS are registered trademarks of Barrett Values Centre, LLC. 4

Aya – Results

7: Selfless service

6: Making a positive difference in the world

5: Finding meaning in existence

4: Letting go of fears.
The courage to develop and grow

3: Feeling a sense of self-worth

2: Feeling protected and loved

1: Satisfying our physical and survival needs

Positive: Potentially Limiting (L):

Area

ambition 3

being liked (L) 2

caring 2

conflict resolution 2

control (L) 1

creativity 5

enthusiasm/ positive attitude 5

humour/ fun 5

listening 2

trust 5

From the values you selected it is clear that:

· You are a person for whom meaning is important. You have a strong set of moral standards which are
important in how you treat others and how you wish to be treated.

· Having close relationships and connections with others is important to you. You need to feel a sense of
love and belonging. If these needs are threatened or not met you will experience anxiety about not
being accepted or not being loved enough.

Your values show:

· Living with a passionate and an upbeat, fun-loving approach are important to you.
· You have high aspirations and seek to improve your circumstances.
· You are protective and considerate of others.
· Utilising your skills and experience to mediate with others allows you to solve issues that arise.
· You are able to think imaginatively and use your skills to produce new ideas.
· You make a conscious effort to hear and consider the opinions of others.
· Building confidence in others and wanting others to feel they can rely on you are key factors in your

interactions.

The type of values you selected indicates that the connections you build with others are most important to
you.

Understanding our values helps us better understand ourselves and why we may act or react in the way that
we do. For example, if someone undermines one of your values it can result in feelings of hurt; you would be
likely to feel upset if your value of “caring” was not being honoured by someone else. Similarly, if you make a
decision which goes against one of your values this may lead you to feel uneasy or unsettled about the
decision, because you are not being true to yourself.

You have selected two values which might be classed as potentially limiting or fear based:

· Being liked: Feeling a need to be liked by others can lead to situations where you compromise your
values to please someone else. It may result in a lack of openness and honesty with others.
· Control: A desire for control may illustrate an underlying fear or lack of trust. It can also indicate a need
for power over others and can inhibit relationships.

To what extent do you think that this affects the decisions you make and how others see you?

www.valuescentre.com BARRETT VALUES CENTRE and SEVEN LEVELS OF CONSCIOUSNESS are registered trademarks of Barrett Values Centre, LLC. 5

Self-Development

Self-Reflection
Now that you have seen your own results take time to reflect upon these and to think
about what role these values play in your life. Look also to see if there are any areas in
the values chart that have no focus. This can signify either an area that is already
covered, a gap in your awareness, or an area for future development. If you have empty
areas what do you think this means for you? (See Exercise 2 below to support you with
areas you may want to develop.)

The successful mastery of each area of awareness involves two steps: first, becoming
aware of the emergent need, and second developing the skills that are necessary to
satisfy that need.

Learning how to manage our needs is a life-long process. Even when we have learned
how to become the author of our own lives, we will find situations arising where we
discover that we still have fear-based beliefs that keep us anchored in the lower areas of
awareness -situations that frustrate us or cause us to feel anxious and bring up our
fears. It is vitally important, therefore, to develop a deep understanding of yourself and to
learn the skills and techniques that allow you to manage your life and so that you can
find personal fulfilment.

Next Steps
Now that you have seen your results you may find it useful to discuss the results with
your partner, family and friends. It may also be valuable to ask them to complete an
assessment for themselves. This will enable you to share results, which will help you to
understand your relationships better and lead to a deeper understanding of each other’s
needs.

There are also other ways to better understand your values, for example, reading about
self-development, meditation, coaching, asking for feedback and personal reflection.

Working with your values is a life-long process; developing a deep understanding of
yourself, and learning skills and techniques to help you grow, can help you to find
personal fulfilment.

The exercises on the following pages are included to help you start to gain a greater
awareness of your values. The first exercise looks at those values which are most
important to you and helps you see how these values influence your life.

The second exercise is to help you think about where you might want to develop or grow,
and to help you start to become mindful of what you might do in this regard.

www.valuescentre.com BARRETT VALUES CENTRE and SEVEN LEVELS OF CONSCIOUSNESS are registered trademarks of Barrett Values Centre, LLC. 6

Self-Development: Exercise 1

In this exercise you are asked to choose your top three values from the ten you originally chose above and to start to examine why these are so important to you. Completing this will
help you think more about how these values influence your actions and understand why you may respond in a certain way if someone acts in a manner that goes against one of these
values.

From the 10 values chosen above, think
about the three that are most important to
you? Write them in the spaces below.

Why do you believe that this value is
important to you?

Recall a moment in your life when you
really lived this value. What behaviours did
you exhibit that support this value?

How might you react if this value was not
being honoured by others? Describe your
feelings, thoughts and actions.

1.

2.

3.

www.valuescentre.com BARRETT VALUES CENTRE and SEVEN LEVELS OF CONSCIOUSNESS are registered trademarks of Barrett Values Centre, LLC. 7

Self-Development: Exercise 2

In this second exercise you are asked to think about areas to strengthen or develop, or values you would like to demonstrate more fully in your life. Completing this will allow you to
start to build an action plan to support your self-development.

From your selected values or the values
listed below, choose up to three that you
would like to live more fully.

What behaviours or actions do you already
demonstrate which support this intention?

What could you stop doing to better
support this value?

What could you start doing to help you
demonstrate this value more fully?

1.

2.

3.

accountability
achievement
adaptability
ambition
balance (home/work)
being the best
caring
clarity
coaching/ mentoring
commitment
community involvement

compassion
competence
conflict resolution
continuous learning
courage
creativity
dialogue
ease with uncertainty
efficiency
enthusiasm/ positive attitude
entrepreneurial

environmental awareness
ethics
excellence
fairness
family
financial stability
forgiveness
friendship
future generations
generosity
health

humility
humour/ fun
independence
initiative
integrity
job security
leadership
listening
making a difference
openness
patience

perseverance
personal fulfilment
personal growth
professional growth
recognition
reliability
respect
risk-taking
safety
self-discipline
teamwork

trust
vision
wealth
well-being (physical/
emotional/ mental/ spiritual)
wisdom

www.valuescentre.com BARRETT VALUES CENTRE and SEVEN LEVELS OF CONSCIOUSNESS are registered trademarks of Barrett Values Centre, LLC. 8

Next Steps

If you are interested to learn more about values here are some suggested areas to explore.

Further Resources

The Importance of Values

The Six Modes of Decision-making

Fundamentals of Cultural Transformation

Learn how you can use the measurement of values to improve organisations and leaders:

Home

Physiology homework help

1. What were the dependent variables examined in the study, specifying the dimension of behavior the authors used?

2. List the operational definitions of any target behavior(s).

3. Were any reliability measures gathered? If so, for which behaviors? For how much of the data was reliability collected? What were the ranges?

4. What type of experimental design was used?

5. In your own words, provide a description of all the experimental procedures used in the study.

6. For how many days/weeks/months did the study last? How long were the baseline and treatment phases?

7. In your own words, summarize the changes in trend, level and variability for one of the participants.

8. Did the authors collect any follow-up or maintenance data? If so, did the results maintain over time? How do you know?

9. List any of study’s limitations.

10. Was this a socially valid procedure? Why or why not? (Consider habilitation and how the individual’s life was improved)

Physiology homework help


CASE STUDY FOR INSTRUCTIONS DOCUMENT

The two cases/scenarios are listed below. This exam must be submitted no later than Wednesday as indicated on your syllabus. You have 4 hours From the moment you open the exam. If you encounter any problems, send me an email. Make sure you label each case: Case One Recommendation with justifications; Case Two Recommendations and justification. 

Background Scenario:

Ms. Anita Snapp is a new personnel administrator at the Oakland Federal Health Department. The previous personnel administrator, Mr. Bill Board, made several poor decisions in the past and was dismissed. Ms. Anita Snapp has been hired to take Mr. Board’s place to review personnel concerns and respond to them with justifications for her recommendations. However, Ms. Snapp has to forward her decisions to the legal department to ensure that her recommendations meet legal requirements and to have someone double-check her work.

Ms. Snapp knows that in order to look professional in the eyes of the legal team, she must base all of her responses on appropriate legislation, previous cases and sources (your textbook) that serve as precedents for her decisions. She wants to be accurate in her responses and very thorough. The past administrator demonstrated that he had limited personnel knowledge and several of his justifications were overturned. Many of his decision were resolved with penalties to the agency because he had never consulted with the legal staff prior to taking action. Anita Snapp does not intend to make the same mistakes. A thorough review and justification of cases, along with solid support from past case decisions, legislation and other sources (NK), will demonstrate Ms. Anita Snapp’s knowledge and abilities to her superiors and the legal team.

CASE ONE

Summary: Ms. Ida Claire alleges that she has had an issue with her Supervisor, Mr. Amos Manley, not liking her party affiliation ever since she was moved into his division. Ms. Claire claims that Mr. Manley had stated this fact to her and she says she has witnesses to support her statements. In addition, Ms. Ida Claire also asserted that she should be able to talk with her coworkers about her political beliefs and about the candidate she is supporting inside or outside of the office. As indication of the problems cited here, recently Mr. Manley asked Ms. Claire to pull a Republican poster off of her desk as well as her support sticker for one of the local candidates. He also asked her to stop discussing her political beliefs with co-workers in the office.

Because of the problems she had with Supervisor Manley, Ida Claire has gone to the newspapers to express her belief that Mr. Manley is treating her badly because of her political affiliations and that he is harassing her for this because she is a woman. She gave no indication that anyone else was treated this way and gave the impression that she was the only one being singled out by Mr. Manley. She even hinted in the newspaper article that he should be removed for incompetency in his supervisory position.

Because of her actions, Mr. Manley submitted a request to the personnel administrator, Ms. Anita Snapp, that Ms. Claire be fired. After learning of Mr. Manley’s actions, Ms. Claire asserted that Mr. Manley’s action are all because she has claimed sexual harassment by him as well as her party affiliation rights being violated. She further claimed that his actions are based on her going to the newspapers in violation of her freedom of speech rights.

Action Request: What does Ms. Anita Snapp decide? To begin, Ms. Snapp realizes that there are several laws she must address in reviewing this case and dealing with Ms. Claire and her supervisor. She must not only discuss the cases and other legislation that apply to the claims, but discuss the employee rights and provide a recommendation for the legal unit as to how she must proceed. Ms. Snapp is fully prepared to write details and support for this information using a textbook she used in a course entitled Public Human Resource Management. She intends to cite this textbook to support and explain her decisions and recommendations. 

CASE TWO

Summary: Ms. Anita Snapp has one other case that she needs to decide quickly before it becomes a much larger issue and possibly a labor union battle. Mr. Joe King was hired to be an X-Ray technician to include running the MRI equipment. He had previous training in the position as well as recommendations from his previous jobs. However, all other x-ray technicians have complained that Mr. King was dangerous to work with because of his incompetence with the technology and his failure to follow safety procedures. Accordingly, his supervisor, Lance Boyle, sent Mr. Joe King to a three week, $5,000 training program with the agency covering all boarding, travel and food expenses. He returned from the training program, but still displayed poor procedures in completing his work. Other technicians that had undergone the same program came back and performed in a competent manner. Supervisor Boyle sent Mr. King a second time through the training with the agency paying all fees.

Upon his return from a second training program, Mr. Joe King, injured a patient in the MRI because he did not follow a safety procedure of ensuring all metallic objects were cleared from the room prior to starting the MRI. A cigarette lighter that he left next to the machine became a projectile that flew into the activated MRI and hit the patient’s face leaving a deep gash and narrowly missed the patient’s eye. This is a safety protocol that is taught over and over again to all MRI technicians ever since the death of a 6 year old that was hit in the head by a flying metal oxygen container while in an MRI.

Mr. Lance Boyle wants to fire Joe King due to incompetence. At a planned meeting to discuss Joe King’s pending dismissal, the union representative, Mr. Lou Pole, requested to sit in on the meeting as Mr. King’s union representative.

At one point in the meeting the union representative leaped to his feet exclaiming that Mr. King was being discriminated against because he is Asian and that there were few Asians considered in the hiring process and nor did Oakland Federal Health meet the Affirmative Action requirements in the union contract. Thus, Union Representative Lou Pole stated that the Oakland Federal Health Department could not fire Mr. King. Supervisor Boyle responded that affirmative action selection are considerations only under the contract, but are not mandatory for hiring and firing. He pulled out his collective bargaining agreement to prove the point. Union representative Lou Pole had no further response on this point and then said that the firing of Mr. Joe King could become grounds for a strike of many of the Oakland Federal public health employees. At that point, Supervisor Boyle halted the meeting to confer with the agency’s personnel administrator, Ms. Anita Snapp.

Action requested: Mr. Boyle has elevated the decision to Ms. Snapp and requested her assistance in helping him assess his next step in firing Mr. Joe King. Ms. Snapp realizes she must look at the legality of any strike and be clear on what she can or cannot do in dismissing Mr. King. She must also assess the claim of discrimination as being an issue in this case as well as claims by Mr. Lance Boyle that not only is Mr. King incompetent, his continued employment poses a danger to patients. She also knows that her decisions and justifications will be reviewed by the legal unit before any actions are taken. Ms. Anita Knap has her work cut out for her in this situation and realizes she must provide a strong and convincing recommendation to the legal unit. She must address the issue of the legality of strike threats, claims of discrimination and claims by Supervisor Boyle that Mr. Kings poses a threat to his co-workers and the hospital’s patients.

Physiology homework help

Module 4.1 States of Consciousness

Module 4.2 Sleeping and Dreaming

Module 4.3 Altering Consciousness Through Meditation and Hypnosis

Module 4.4 Altering Consciousness Through Drugs

Consciousness deals with our awareness of ourselves and the world around us.

4.1

4.2

4.4

4.3

Module 4.1

States of Consciousness

William James: Described consciousness as a stream of thoughts

Today’s view: Consciousness is a state of awareness of ourselves and of our world.

4.1

4.2

4.4

4.3

Focused awareness

Drifting consciousness (e.g., daydreaming)

Divided consciousness

Altered states of consciousness

States of unconsciousness during sleep
and dreaming

States or levels of consciousness vary through the course of day from brief states of full absorption, called focused awareness, to states of distracted consciousness, divided consciousness, altered states of consciousness associated with practice of meditation and hypnosis and use of psychoactive drugs, and states of unconsciousness during sleep and dreaming.

4.1

4.2

4.4

4.3

Source: Adapted from 2003 Nerves of Steel survey, commissioned by the Steel Alliance and the Canada Safety Council, retrieved from
www.safety-council.org/info/traffic/distract.html

© mtsyri/Shutterstock.com

© Galina Barskaya/Shutterstock.com

Behaviors Yourself (%) Another
Driver (%)
Drinking beverages
(e.g., coffee, soft drinks)
65 74
Eating 53 66
Using a cell phone 35 79
Arguing with passengers 27 41
Disciplining children 18 33
Reading 8 26
Putting on makeup, shaving, or combing hair 8 43
Using PDAs, laptops, or other high-tech devices 5 21

Risks of divided consciousness, especially distracted driving.

Driving while on the phone is about as dangerous as driving with a blood alcohol concentration at the legal limit.

Here we see some of the other foolish things that people do when they are driving, all of which reduce their focus on driving in a safe manner.

4.1

4.2

4.4

4.3

Module 4.2

Sleeping and Dreaming

Why do we sleep?

Several functions of sleep have been proposed:

Protective function

Energy conservation

Restore bodily processes

Consolidate newly learned information into lasting memories

May bolster immune system

4.1

4.2

4.4

4.3

© Cengage Learning

12

3

9

6

Humans and other animals operate on a 24-hour biological cycle, called a circadian rhythm. These daily cycles are particularly important in the regulation of sleep.

Many bodily processes fluctuate in a daily pattern. Sleep-wake cycle is close to 24 hours in length. Regulated by the suprachiasmatic nucleus in the hypothalamus Jet lag is associated with a disruption of the sleep-wake cycle.

4.1

4.2

4.4

4.3

Exposure to light apparently affects the activity of a small structure in the hypothalamus called the suprachiasmatic nucleus, which sends signals to the nearby pineal gland, whose secretion of the hormone melatonin plays a key role in adjusting biological clocks.

This video shows a few possible treatments that can be used for jet lag, with varying efficacy. 

How does jet lag affect you?

4.1

4.2

4.4

4.3

Visiting Team
Flies East
Wins 37% of Games

Visiting Team
Flies West
Wins 44% of Games

Getting out of sync with your circadian rhythms causes a reduction in the quality of sleep, as well as jet lag.

The speed of readjustment to the biological block depends on the direction traveled – traveling westward is generally easier than traveling eastward.

Jet lag has a significant enough impact that it affects the performance of sports teams, as you can see here.

4.1

4.2

4.4

4.3

Amplitude

Frequency

Measuring variations of consciousness has historically relied on the electroencephalograph, or EEG.

The EEG records activity in the cortex with a series of brain-wave tracings that vary in amplitude and frequency.

Different EEG patterns are associated with different states of consciousness.

4.1

4.2

4.4

4.3

Stage 1 Sleep
Small, irregular brain waves

Stage 2 Sleep

Sleep Spindles and Mixed EEG Activity

Slow-wave Sleep (Stage 3 and Stage 4 Sleep)

Progressively More Delta Waves (Stage 4 Shown)

Small, irregular brain waves

Sleep Spindle

Stage 1 is a brief stage of light sleep characterized by small, irregular brain waves.

[Click to continue]

During stage 2, brief bursts of higher-frequency brain waves, called sleep spindles, appear against a background of mixed EEG activity.

[Click to continue]

Gradually, your brain waves become higher in amplitude and slower in frequency. As you move into stages 3 and 4, which are called slow-wave sleep, delta waves become prominent

4.1

4.2

4.4

4.3

© Cengage Learning

Beta waves are correlated with alertness and problem solving. Alpha waves are associated with resting and relaxation. Delta waves, which are slow rhythmic brain wave patterns, are associated with deep sleep.

4.1

4.2

4.4

4.3

1

2

3

4

1

3

2

4

5

6

7

Waking

REM sleep

Hours of sleep

Sleep stages

After about a half-hour in these deep stages of sleep, the cycle reverses itself, and you gradually move upward through lighter stages of sleep.

When you reach what should be stage 1 once again, you usually go into the fifth stage of sleep, which is called REM sleep.

.

4.1

4.2

4.4

4.3

Awake
Low Amplitude, High Frequency Beta Waves

REM Sleep
Low Amplitude, High Frequency Beta Waves

1 Second

50 µv

EEG activity during REM sleep is dominated by high-frequency beta waves that resemble those observed when people are awake and alert.

REM sleep is the stage of sleep during which most dreaming occurs.

4.1

4.2

4.4

4.3

Wakefulness

Stage 1

Stage 2

Stage 3

Stage 4

REM

REM

During the course of a night, people usually repeat the sleep cycle about four times.

As the night wears on, the cycle gradually changes. The first REM period is relatively short. Subsequent REM periods are longer, peaking at around 40 to 60 minutes. Additionally, non-REM intervals tend to get shorter, and descents into non-REM stages usually become shallower.

4.1

4.2

4.4

4.3

4.1

4.2

4.4

4.3

Time

Wakefulness

Stage1

Stage 2

Stage 3

Stage 4

REM

Dreams

Dreams typically occur during REM sleep and often have vivid imagery, a story-like quality, and are sometimes bizarre, but seem real to the dreamer.

People may also dream in non-REM sleep, although the dreams tend to be briefer, less frequent, less story-like and lacking in vivid imagery.

4.1

4.2

4.4

4.3

© Cengage Learning

According to the activation-synthesis hypothesis, the cerebral cortex tries to make sense of random electrical discharges from the brainstem during sleep, piecing together story-like dreams based on memories and emotional associations.

4.1

4.2

4.4

4.3

© Wadsworth, Cengage Learning, SuperStock 2008 Artists Rights Society (ARS), New York/ADAC, Paris

The question of what dreams mean continues to be debated. Research shows that the content of dreams is usually familiar. Common themes in dreams include things like falling, being pursued, trying repeatedly to do something, school, sex, being late, eating, being frightened, etc.

Freud believed that dreams represent the deepest wishes, urges, and desires of our unconscious. He believed that wish fulfillment was the major impetus behind the dreams that we have.

Manifest content – The events that actually occur in your dream.

Latent content – The true, underlying meaning of a dream, disguised by symbols.

4.1

4.2

4.4

4.3

Have you ever been aware that you were dreaming?

Do you ever have the ability to control the content and direction of your dreams?

Lucid dreams involve being aware that one is in a dream state and, less frequently, being able to control the dream that is occurring.

4.1

4.2

4.4

4.3

How Long We Sleep

When Americans

Go to Bed

Source: CDC, National Health Interview Survey, 2008

Source: Adapted from “Sleepless in America,” a survey conducted by the ACNielsen Company, April 2005

Research suggests that the effects of sleep deprivation are impaired attention, reaction time, cognitive speed and accuracy, motor coordination, and decision making.

Drowsiness factors into about 20% of all traffic incidents, as well as contributing to accidents in the workplace.

Sleep deprivation is also linked to health problems, including obesity, diabetes, hypertension, and coronary disease.

Both total amount and type of sleep affects functioning

4.1

4.2

4.4

4.3

This news clip shows examines research linking lack of sleep and childhood obesity.

4.1

4.2

4.4

4.3

Sleep disorders are quite varied. The most common, however, is insomnia.

Insomnia occurs in 3 different patterns…trouble falling asleep, trouble remaining asleep, and persistent early morning awakening.

Other sleep disorders include narcolepsy, a disorder involving the sudden and irresistible onset of sleep, and sleep apnea, a frequent, reflexive gasping for air that disrupts sleep.

Nightmare disorder involves frequent, disturbing nightmares that interfere markedly with normal sleep, and sleep-terror disorder involves panic-laden “night terrors” that seem to be unrelated to dream content.

Sleepwalking, when persistent and chronic, may be more than a passing phase and may indicate a sleep-wake disorder.

4.1

4.2

4.4

4.3

Module 4.3

Altering Consciousness Through Meditation and Hypnosis

4.1

4.2

4.4

4.3

Transcendental Meditation

Mindfulness Meditation

Kim Eriksen/Flirt/Corbis

Meditation is an ancient discipline which has recently become an area of growing interest.

Involves the focusing on attention and inducing a relaxed, contemplative state.

Transcendental meditation – focusing attention by the repetition of a mantra

Mindfulness meditation – focus on unfolding experiences on a moment-to-moment basis without judgment (e.g, “Am I doing this right?”) bearing on their experiences

Health benefits of meditation include: combating the effects of stress, lowering blood pressure, and relieving chronic pain, insomnia, anxiety, and depression.

Cognitive benefits include improved memory and emotional processing.

4.1

4.2

4.4

4.3

B. BOISSONNET/BSIP/Alamy

Hypnosis involves a systematic procedure involving a narrowing or focusing of attention that typically produces a heightened state of suggestibility and states of deep relaxation.

There are varied techniques for inducing hypnosis.

Distortions of reality (auditory or visual hallucinations, or negative hallucinations—not perceiving an object that is there, like a chair)

Posthypnotic amnesia (“You will remember nothing that occurred during your hypnotized state”)

Hypnotic phenomena include:

Hypnotic age regression

Hypnotic analgesia (anesthesia, as used during dental or medical procedures)

Distortions of reality (auditory or visual hallucinations, or negative hallucinations—not perceiving an object that is there, like a chair) Posthypnotic amnesia (“You will remember nothing that occurred during your hypnotized state”)

Posthypnotic suggestion (“After you awake, you will feel itchy all over when you hear the word watermelon.”).

4.1

4.2

4.4

4.3

Role-playing model

Trance state

Hilgard’s neodissociation theory

Dissociated consciousness

The Hidden Observer

There is no consensual agreement about what hypnosis “is” or even how to define it. The most prominent theories of hypnosis include the belief that it involves a trance-like state of consciousness, role-playing theory which focuses on the social interaction between the hypnotist and the subject, and Hilgard’s neodissociation theory or splitting of consciousness.

4.1

4.2

4.4

4.3

Well-developed fantasy life

Vivid sense of imagination

Tendency to be forgetful

Positive attitude toward hypnosis

People vary in their hypnotizablity.

4.1

4.2

4.4

4.3

Module 4.4

Altering Consciousness Through Drugs

4.1

4.2

4.4

4.3

Chemical substances that act on the brain to affect emotional or mental states

Used for a variety of reasons:

Change level of alertness

Alter one’s mental state

Blunt awareness of the stresses
and strains of daily life

Seek inner truths

Psychoactive drugs modify mental, emotional, or behavioral functioning. They are divided into three general classes: depressants, stimulants, and hallucinogens.

4.1

4.2

4.4

4.3

When does drug use cross the line to drug abuse?

What is drug dependence?

What is psychological dependence?

Drug Abuse and Dependence

Substance abuse involves maladaptive use of a drug associated with harmful consequences

Drug dependence involves impaired control over the use of the drug, typically associated with physiological or chemical dependences, as marked by a withdrawal syndrome and/or tolerance.

Psychological dependence is characterized by compulsive use of a substance to meet a psychological need (cope with stress, treat anxiety or depression).

4.1

4.2

4.4

4.3

Depressants – drugs that reduce central nervous system activity. Include alcohol, barbiturates and tranquilizers, and opioids.

Alcohol is the most widely used psychoactive drug.

Alcohol is classified as a depressant drug, although may incorrectly believe it to be a stimulant. When people drink heavily, the effect is a relaxed euphoria that temporarily boosts self-esteem and decreases inhibitions.

4.1

4.2

4.4

4.3

Progressive Effects of Blood Alcohol Levels

Source: Adapted from Teacher’s Guide: Information about Alcohol, National Institutes of Health, National Institute on Alcohol

Abuse and Alcoholism, 2003. Retrieved from http://science.education.nih.gov/supplements/nih3/alcohol/guide/info-alcohol.htm

Physical and Psychological Effects of Alcohol

Blood Alcohol Concentration (%) Effects/Risks
0.01–0.05 Relaxation, sense of well-being, loss of inhibition, impaired alertness
and judgment
0.06–0.10 Pleasure, numbness of feelings, nausea, sleepiness, emotional arousal,
and impaired coordination (especially for fine motor skills)
0.11–0.20 Mood swings, anger, sadness, mania, impaired reasoning and depth
perception, and inappropriate social behavior (obnoxiousness)
0.21–0.30 Aggression, reduced sensations, depression, stupor, slurred speech,
lack of balance, and loss of temperature regulation
0.031–0.40 Unconsciousness, coma, possible death, loss of bladder control, and
difficulty breathing
0.41 and greater Slowed heart rate, death

Alcohol overdose can have fatal consequences. Here we see the general effects of different concentrations of alcohol in the blood.

Dependence on alcohol, both physically and psychologically, affects millions of Americans. Alcohol dependence is commonly called alcoholism.

4.1

4.2

4.4

4.3

Brain Wernicke’s syndrome,
an acute condition characterized
by mental confusion and ocular abnormalities; Korsakoff’s syndrome, a psychotic condition characterized by impairment of memory and learning, apathy, and degeneration
of the white brain matter

Eyes Tobacco-alcohol blindness; Wernicke’s ophthalmoplegia,
a reversible paralysis of the muscles of the eye

Pharynx Cancer of the pharynx

Esophagus Esophageal varices,
an irreversible condition in which
the person can die by drowning in his own blood when the varices open

Lungs Lowered resistance
thought to lead to greater incidence of tuberculosis, pneumonia,
and emphysema

Spleen Hypersplenism

Heart Alcoholic cardiomyopathy,
a heart condition

Liver Acute enlargement of liver, which is reversible, as well as irreversible alcoholic’s liver (cirrhosis)

Stomach Gastritis and ulcers

Pancreas Acute and
chronic pancreatitis

Rectum Hemorrhoids

Testes Atrophy of the testes

Nerves Polyneuritis, a condition characterized by loss of sensation

Muscles Alcoholic myopathy,
a condition resulting in painful
muscle contractions

Blood and Bone Marrow Coagulation defects and anemia

Brain Wernicke’s syndrome, an acute condition characterized by mental confusion
and ocular abnormalities; Korsakoff’s syndrome, a psychotic condition characterized by impairment of memory and learning, apathy, and degeneration of the white brain matter

Eyes Tobacco-alcohol blindness; Wernicke’s ophthalmoplegia, a reversible paralysis
of the muscles of the eye

Pharynx Cancer of the pharynx

Esophagus Esophageal varices, an irreversible condition in which the person can die
by drowning in his own blood when the varices open

Lungs Lowered resistance thought to lead to greater incidence of tuberculosis, pneumonia, and emphysema

Spleen Hypersplenism

Heart Alcoholic cardiomyopathy, a heart condition

Liver Acute enlargement of liver, which is reversible, as well as irreversible alcoholic’s liver (cirrhosis)

Stomach Gastritis and ulcers

Pancreas Acute and chronic pancreatitis

Rectum Hemorrhoids

Testes Atrophy of the testes

Nerves Polyneuritis, a condition characterized by loss of sensation

Muscles Alcoholic myopathy, a condition resulting in painful muscle contractions

Blood and Bone Marrow Coagulation defects and anemia

© Cengage Learning

Alcoholism is associated with a diverse array of physiological maladies, such as liver disease, malnutrition, brain damage, neurological disorders, heart disease, stroke, hypertension, ulcers, cancer, and birth defects.

4.1

4.2

4.4

4.3

This clip involves a person discussing his experience of suffering from alcoholism.

4.1

4.2

4.4

4.3

Alcohol Use Among
College Students

Alcohol on Campus:
The Annual Toll

Source: Johnston, O’Malley, & Bachman, 2001

Source: Hingson et al., 2002; Sink, 2004; Yaccino, 2012. Note: These figures represent the estimated annual numbers of alcohol-related physical assaults, injuries, sexual assaults, and deaths among U.S. college students ages 18 to 24

86.6 Percentage who have used alcohol in their lifetime
83.2 Percentage who have used alcohol within the past year
67.4 Percentage who have used alcohol within the past 30 days
3.6 Percentage who have used alcohol daily within the past 30 days
39.3 Percentage who have had five or more drinks in a row during the last 2 weeks
600,000 physical assaults
500,000 injuries
70,000 sexual assaults
1,800 deaths due to overdose and accidents

College campuses are often described as “alcohol-soaked,” and while that may be a slight overstatement the fact remains that drinking is a major problem at colleges.

Binge drinking and drinking games pose significant health risks, particularly to those who are not accustomed to such alcohol consumption.

It is important not only to monitor your own behaviors and protect yourself, but to also know the signs of dangerous alcohol overdoes and how to respond appropriately if someone has drunk excessively.

4.1

4.2

4.4

4.3

Barbiturates are calming or sedating drugs that have legitimate medicinal use, but can be abused ot lead to dependence. Some examples include amobarbital, pentobarbital, phenobarbital, and secobarbital.

Tranquilizers are most commonly prescribed to treat anxiety and insomnia. They can be very dangerous in high doses, and should never be combined with alcohol. One category of tranquilizers, benzodiazepines, includes Valium, Xanax, and Halcion.

4.1

4.2

4.4

4.3

Barbiturates and

Tranquilizers

Yes

Risk of physiological
Dependence

Yes

Risk of Psychological
Dependence

High

Fatal Overdose
Potential

Drugs

Sedatives also have high rates of dependence and fatal overdose potential. They also increase the risk of accidental injuries because they severely impair motor coordination and are especially dangerous when mixed with other drugs, such as alcohol.

4.1

4.2

4.4

4.3

Opioids

Opioids are narcotics, including heroin, morphine, codeine, and Demerol, are addictive drugs that have pain-relieving and sleep-inducing properties. They also produce an overwhelming sense of euphoria – a “who cares” quality. Heroin, morphine, opium, and codeine are derived from the poppy plants. Synthetic opiates, such as OxyContin and Vicodin, are synthesized in the laboratory to have opiate-like effects.

4.1

4.2

4.4

4.3

Opioids
(Narcotics)

Yes

Risk of Physiological
Dependence

Yes

Risk of Psychological
Dependence

Yes

Fatal Overdose
Potential

Drugs

Narcotics have high rates of physical and psychological dependence, as well as a high risk for fatal overdose.

Other risks include infectious diseases (through sharing of needles), accidents, and immune suppression.

4.1

4.2

4.4

4.3

Caffeine

Nicotine

Amphetamines

Cocaine

MDMA (“Ecstasy”)

Examples of Stimulants

Stimulants include mild drugs such as caffeine and nicotine, as well as much stronger drugs such as cocaine and amphetamines. Cocaine and amphetamines have similar effects, except the effects of amphetamines last longer. The euphoria created by these drugs is very different from the “who cares,” very relaxed state of narcotics. It is more like an “I can conquer the world,” or very alert state of being.

4.1

4.2

4.4

4.3

Amphetamines are synthetic stimulants that are synthesized in a laboratory.

They boost neurotransmitters in the brain, especially dopamine, to achieve their effects.

Health risks of the abuse of amphetamines include restlessness, loss of appetite, tremors, and heart irregularities that can lead to a coma or death.

Amphetamine psychosis is marked by delusions and hallucinations and can resemble an episode of schizophrenia.

4.1

4.2

4.4

4.3

1. Neurotransmitters, such as dopamine, are stored
in synaptic vesicles in the sending neuron and released into the synaptic gap. Normally, excess molecules of neurotransmitters not taken up by receptor sites are absorbed by the sending neuron in a recycling process called reuptake.

2. Cocaine (orange circles in diagram) blocks the reuptake of dopamine by the sending neuron.

3. The accumulation of dopamine in the synapse overstimulates neurons in key reward pathways
in the brain, producing a pleasurable “high.”
Over time, the brain becomes less capable of producing feelings of pleasure on its own, leading users to “crash” if they stop using the drug.

Sending neuron

Synaptic vesicle

Neurotransmitters

Synaptic gap

Receptor site

Receiving neuron

Source: National Institute on Drug Abuse, U.S. Department of Health and Human Services,
National Institutes of Health, 2004

Cocaine interferes with the reuptake of dopamine by the transmitting neuron. As a result, more dopamine remains available to bind at receptor sites on postsynaptic neurons, causing greater levels of excitation and stimulation of reward pathways in the brain, producing states of pleasure or euphoria.

4.1

4.2

4.4

4.3

The major preventable cause of death

450,000 deaths annually in the U.S.

Accounts for one in five deaths in the U.S.

Decreases average lifespan by 10 years

Responsible for nearly 1 of 3 cancer deaths in the U.S.

Major contributor to serious health problems

Smoking is the leading preventable cause of death in the U.S. and worldwide.

4.1

4.2

4.4

4.3

Stimulants

Yes

Yes

Risk of Psychological
Dependence

High for
amphetamine and
cocaine overdose

Fatal Overdose
Potential

Drugs

Risk of Physiological
Dependence

Stimulants have moderate to high levels of physical and psychological dependence, as well as risk of fatal overdose.

Other risks include sleep problems, malnutrition, nasal damage (from snorting), hypertension, and respiratory diseases, cardiovascular disease and other diseases (from smoking).

4.1

4.2

4.4

4.3

LSD

Mescaline, Psilocybin, and PCP

Marijuana

© Ann Marie Rousseau/The Image Works

Hallucinogens induce sensory distortions and hallucinations that vary in intensity from relatively mild (marijuana) to extreme (LSD).

4.1

4.2

4.4

4.3

Cannabis is the hemp plant from which marijuana, hashish, and THC (delta-9-tetrahydrocannabinol) are derived. THC, the active chemical ingredient, causes a mild, relaxed euphoria and enhanced sensory awareness. The most potent form is hashish (“hash”) which is derived from the resin of the plant.

More than 40% of American report having used it at least once, with 10% being active current users.

4.1

4.2

4.4

4.3

Marijuana

Unclear

Risk of Physical
Dependence

Yes

Risk of Psychological
Dependence

Low

Fatal Overdose
potential

Drugs

It is unclear what the risk is of physiological dependence on marijuana, however there is potential of psychological dependence.

Other risks associated with marijuana use include accidents, lung cancer, respiratory disease, pulmonary disease, and paranoia.

4.1

4.2

4.4

4.3

Sociocultural influences

Cultural norms, role of unemployment
and alienation from mainstream culture

Biological influences

Genetic factors

Role of neurotransmitters

Psychological in

Physiology homework help

REPORT

LEADERSHIP

Copyright © 2012 Multi-Health Systems Inc. All rights reserved.

AYA MAHMOOD YOUNUS

Your EQ-i Results
Sheridan College HRMT44004D

February 17, 2022

Copyright © 2012 Multi-Health Systems Inc. All rights reserved.

Low Range Mid Range High Range

Introduction
Understanding Your Report

Welcome to a new way of examining your emotional intelligence (EI) skills! You will find this report has many
unique features linking EI and leadership development. These features provide you with a snapshot of how your EI
compares to that of other leaders and insight into your leadership strengths and potential areas for development.
This report examines your results on the EQ-i 2.0 through four key dimensions of leadership:

These leadership dimensions were identified from research conducted on 220 leaders who took the same assessment
you did (the EQ-i 2.0) and who also responded to a leadership assessment measuring performance across these
four areas of leadership. These leaders held positions of mid-level management through to C-suite leadership roles
and were from a variety of industries (e.g., healthcare, technology, financial services, and construction) across North
America. The majority of leaders were working in large organizations (over 400 employees).

As a group, the leaders had significantly higher EI than the general population. In fact, the average Total EI score for
leaders was 14 points higher than that of the general population.

While this leadership sample is a valuable comparison group, it also helped organize the EQ-i 2.0 subscales (page 4)
according to the four leadership dimensions to which they were most strongly connected. Particular subscales were
associated with stronger performance in these four leadership areas (page 6).

Emotional Intelligence and Leadership
How is EI linked to leadership? In addition to the research supporting this report, fifteen years of research has
shown that leaders tend to score higher in EI than the general population. Also, many professionals find it easier
to focus on improving a few specific skills that underlie broader leadership competencies, making the EQ-i 2.0
subscales the perfect building blocks to reaching your leadership potential.

Getting the Most out of Your Report
Keep the following tips in mind as you work through your Leadership Report:

1. No one knows your role like you do. Although this report offers insight into how your EQ-i 2.0 results can
help strengthen your leadership skills, the value of the report is enhanced by framing it within your own
individual context. Integrate your wealth of knowledge about your organization, its culture, and the specifics
of your leadership with the information in this report to derive the most value from it.

2. Take notes as you read the report. Choose strategies for development that you wish to try in your role.

3. All EQ-i 2.0 subscales are related to leadership behaviors, but selecting the right areas to focus on is key
to development. Work with your coach or administrator to determine which subscales will help drive the
leadership results you are looking for. You can treat subscales as building blocks that strengthen broader
leadership skills like mentoring, communication, or conflict resolution.

Leadership Bar
The gold bar positioned on the top of your graph
is the Leadership Bar. This bar represents the range
of scores of the top leaders (those whose EQ-i 2.0
scores were in the top 50% of the leader sample).
Using this bar you can compare your results on the
EQ-i 2.0 to those exceptional leaders who demonstrate
high EI. If your score falls near the bottom of the leadership
bar, then your EI skills need further development in order to be on par with top leaders. If your score falls near the
top of the leadership bar, then your EI skills are as strong as those of top leaders.

Authenticity Coaching Insight Innovation

An authentic leader
serves as a role model
for moral and fair
behavior. A transparent
approach commands
esteem and confidence
from employees.

A leader who coaches
effectively is seen as a
mentor who supports
employee growth.
Employees are nurtured
towards achieving
their highest levels of
performance.

A leader provides
insight by sharing a
purpose and hopeful
vision for colleagues to
follow. Employees are
compelled and inspired
to exceed goals.

An innovative leader
focuses on taking risks,
spurring colleagues’
ingenuity and
autonomous thought.
Knowledge is valued and
challenges are viewed as
learning opportunities.

Name: AYA MAHMOOD YOUNUS

2222 54321-2.054321-2.054321-2.054321-2.0

Copyright © 2012 Multi-Health Systems Inc. All rights reserved.

Highest 3 Subscales

Lowest 3 Subscales

Total EI

Executive Summary

Compared to your other scores, these three subscales might be areas you could further leverage. The corresponding
subscale pages may provide insight.

Compared to your other scores, these three subscales might be areas you could develop. The corresponding subscale
pages will provide you with Strategies for Action.

Name: AYA MAHMOOD YOUNUS

70

70

70

90

90

90

100

100

100

110

110

110

130

130

130

Low Range

Low Range

Low Range

Mid Range

Mid Range

Mid Range

High Range

High Range

High Range

Reality Testing (130)

You likely employ a very realistic and grounded leadership style, turning
to data and facts for making decisions and setting directions for your
team. Be careful not to be too realistic that creativity is stifled. Your
result on this subscale is not only above average but it also falls within
the leadership bar.

Emotional Self-Awareness (126)
You have a strong awareness of the full spectrum of emotions and their
triggers. This allows you to carefully sift through emotions and handle
high-pressure situations well. Your result on this subscale is not only
above average but it also falls within the leadership bar.

Empathy (124)
Empathy is likely a very natural and inherent skill for you, which you use
to show compassion and respect for the people you lead. Your result on
this subscale is not only above average but it also falls within the
leadership bar.

Emotional Expression (58)
In general, you tend not to share your emotions. Becoming more
expressive will allow you to be a more inspirational leader who is able to
share a compelling vision. Your result on this subscale falls below the
leadership bar.

Independence (70)
You are likely more reliant than you should be on your team’s
reassurance and approval of your decisions. Improvement in this area
will benefit you when objective and difficult decisions need to be made.
Your result on this subscale falls below the leadership bar.

Flexibility (71)
You tend to stick to tried and true methods, both in your leadership
approach and the directions you set for your team. They are likely
lacking the inspiration they need from you for innovation and progress.
Your result on this subscale falls below the leadership bar.

94

3333 54321-2.054321-2.054321-2.054321-2.0

Copyright © 2012 Multi-Health Systems Inc. All rights reserved.

SELF-PERCEPTION

Self-Regard is respecting oneself while understanding and
accepting one’s strengths and weaknesses. Self-Regard is often
associated with feelings of inner strength and self-confidence.
Self-Actualization is the willingness to persistently try to
improve oneself and engage in the pursuit of personally relevant
and meaningful objectives that lead to a rich and enjoyable life.
Emotional Self-Awareness includes recognizing and
understanding one’s own emotions. This includes the ability to
differentiate between subtleties in one’s own emotions while
understanding the cause of these emotions and the impact they
have on one’s own thoughts and actions and those of others.

SELF-EXPRESSION

Emotional Expression
is openly expressing
one’s feelings verbally
and non-verbally.
Assertiveness
involves communicating
feelings, beliefs and thoughts
openly, and defending
personal rights and values
in a socially acceptable,
non-offensive, and
non-destructive manner.
Independence is the ability
to be self directed and free
from emotional dependency
on others. Decision-making,
planning, and daily tasks are
completed autonomously.

P
E

R
F

O
R

M
A

N
C

E

EM
OT

ION
AL & S

OCIAL FUNCTIONING

P
E

R
F

O
R

M
A

N
C

E

EMOTION AL & SOCIAL FUN
C TI

ON
IN

G

W
E

L
L

– B
E
IN

G

W

ELL -B
E

IN
G

W
E

L
L -B

E
IN

G

W
E
LL

– B
E

IN
G

Emotional
Intelligence

M
A
N
A
GE

M
EN

T

ST
R
ES
S

SELF-EX
PR

ES
S
IO
N

SELF-P
ERCEPTION

M
AKING

DECISION

INTER
PER

SO

NA
L

O
p

ti
m

is
m

S
tr

es
s

To
le

ra
nc

e

Fl
ex

ib
ili

ty

M
A
N
A
GE

M
EN

T

ST
R
ES
S

Proble m

Solving

Reality Testing

Im
pulse ControlMAKING

DECISION

Inte
rpe

rs

on
al

Rela
tio

ns

hi
ps

Em
pa

th

y

Socia
l Re

sp
on

si
bi

lit
y

INTER
PER

SO

NA
L

Independen
ce

Assertiven
ess

Em
otional Exp

ression
SELF-EX

PR
ES

S
IO
N

Sel
f-Awareness
Emotional

Self-
Actualization

Self-Regard

SELF-P
ERCEPTION

Copyright © 2011 Multi-Health Systems Inc. All rights reserved.
Based on the original BarOn EQ-i authored by Reuven Bar-On, copyright 1997.

STRESS MANAGEMENT

Flexibility is adapting
emotions, thoughts and
behaviors to unfamiliar,
unpredictable, and dynamic
circumstances or ideas.
Stress Tolerance
involves coping with
stressful or difficult
situations and believing
that one can manage or
influence situations in a
positive manner.
Optimism is an indicator
of one’s positive attitude
and outlook on life. It involves
remaining hopeful and resilient,
despite occasional setbacks.

DECISION MAKING

Problem Solving is the ability to find
solutions to problems in situations where
emotions are involved. Problem solving
includes the ability to understand
how emotions impact decision making.
Reality Testing is the capacity to
remain objective by seeing things as
they really are. This capacity involves
recognizing when emotions or personal
bias can cause one to be less objective.
Impulse Control is the ability to resist
or delay an impulse, drive or temptation
to act and involves avoiding rash
behaviors and decision making.

INTERPERSONAL

Interpersonal Relationships refers
to the skill of developing and maintaining
mutually satisfying relationships that are
characterized by trust and compassion.
Empathy is recognizing, understanding,
and appreciating how other people
feel. Empathy involves being able to
articulate your understanding of another’s
perspective and behaving in a way that
respects others’ feelings.
Social Responsibility is willingly
contributing to society, to one’s social
groups, and generally to the welfare of
others. Social Responsibility involves
acting responsibly, having social
consciousness, and showing concern
for the greater community.

EQ-i 2.0 Model of Emotional Intelligence

Name: AYA MAHMOOD YOUNUS

4444 54321-2.054321-2.054321-2.054321-2.0

Copyright © 2012 Multi-Health Systems Inc. All rights reserved.

Self-Perception Composite

Self-Regard
Respecting oneself; Confidence

Self-Actualization
Pursuit of meaning; Self-improvement

Emotional Self-Awareness
Understanding own emotions

Self-Expression Composite

Emotional Expression
Constructive expression of emotions

Assertiveness
Communicating feelings, beliefs; Non-offensive

Independence
Self-directed; Free from emotional dependency

Stress Management Composite

Flexibility
Adapting emotions, thoughts and behaviors

Stress Tolerance
Coping with stressful situations

Optimism
Positive attitude and outlook on life

Interpersonal Composite

Interpersonal Relationships
Mutually satisfying relationships

Empathy
Understanding, appreciating how others feel

Social Responsibility
Social conciousness; Helpful

Decision Making Composite

Problem Solving
Find solutions when emotions are involved

Reality Testing
Objective; See things as they really are

Impulse Control
Resist or delay impulse to act

Overview
Total EI

Name: AYA MAHMOOD YOUNUS

70

70

70

90

90

90

100

100

100

110

110

110

130

130

130

Low Range

Low Range

Mid Range

Mid Range

High Range

High Range

94

116

123

96

126

59

58

86

70

107

94

124

96

107

86

130

103

86

71

97

98

5555 54321-2.054321-2.054321-2.054321-2.0

Copyright © 2012 Multi-Health Systems Inc. All rights reserved.

The EQ-i 2.0 subscales are strongly related to leadership competencies that in turn may be associated with productivity,
decreased employee turnover, and increased efficiency. A leader who embodies the competencies below is more likely to
increase work satisfaction, create trust, and foster organizational commitment and loyalty.

This page provides you with a leadership lens through which to view your EQ-i 2.0 results. There are four general
competencies required of most leaders: authenticity, coaching, insight and innovation. The top six EQ-i 2.0 subscales (based
on theory and research) that are associated with each competency are displayed below. High scores on the associated
subscales help ensure optimal functioning in the competency area. Alternatively, if you score lower on a few subscales
for a particular leadership competency, you can quickly see that this might be an area of challenge for you in your current
leadership role. Focusing development efforts in these areas are likely to yield the greatest return in your growth as a leader.

Authenticity
An authentic leader serves as a role model
for moral and fair behavior. A transparent
approach commands esteem and confidence
from employees.

Self-Actualization

Reality Testing

Self-Regard

Emotional Self-Awareness

Social Responsibility

Independence

Insight
A leader provides insight by sharing a purpose and
hopeful vision for colleagues to follow. Employees are
compelled and inspired to exceed goals.

Self-Actualization

Optimism

Self-Regard

Social Responsibility

Interpersonal Relationships

Emotional Expression

Coaching
A leader who coaches effectively is seen as a
mentor who supports employee growth. Employees
are nurtured towards achieving their highest levels
of performance.

Self-Actualization

Empathy

Reality Testing

Interpersonal Relationships

Assertiveness

Emotional Self-Awareness

Innovation
An innovative leader focuses on taking risks,
spurring colleagues’ ingenuity and autonomous
thought. Knowledge is valued and challenges are
viewed as learning opportunities.

Self-Actualization

Independence

Problem Solving

Assertiveness

Flexibility

Optimism

Impulse Control

Stress Tolerance

Problem Solving

Independence

Leadership Potential

Leadership Derailers Omitted
Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Omitted

Name: AYA MAHMOOD YOUNUS

123

123

96 96

96 96

126

126

58

86

86

70

70

70

94

94

124

96

96

86

86

130

130

103

71

97

98

98

AYA MAHMOOD, you may be at a higher risk of derailmenthigher risk of derailmenthigher risk of derailmenthigher risk of derailment as you received a
lower result in Independence and Problem Solving and a moderate result in
Stress Tolerance. Lower scores on any of the four subscales are associated
with adopting a more passive or avoidant leadership style. Your team may see
you as being ineffective in certain situations and may not be fully satisfied
under your leadership. You would benefit from strengthening any lower
scoring subscales and be especially cognizant of any scores below 90.

6666 54321-2.054321-2.054321-2.054321-2.0

Copyright © 2012 Multi-Health Systems Inc. All rights reserved.

What Your Score Means

Self-Regard
Respecting oneself; confidence

Balancing Your EI

Leadership Impact Strategies for Action

Name: AYA MAHMOOD YOUNUS

70 90 100 110 130

Low Range Mid Range High Range

123

Leaders with self-regard respect themselves and accept both personal strengths and limitations while remaining satisfied and self-
secure. AYA MAHMOOD, your result suggests that your self-regard is stronger than most people’s. You are likely seen as a self-
confident leader who understands both personal strengths and weaknesses. It is important to ground your self-assuredness by using
your reality testing skills and by continually seeking feedback. You may:

■ Exercise your considerable influence on key, strategic decisions.
■ Demonstrate courage to stick by your convictions even in the face of dissenting viewpoints.
■ Use a leadership approach that leverages your strengths and delegates tasks in your weaker areas.
■ Want to ensure that your perception of your strengths is supported by objective evidence, otherwise you run the risk of being seen

as overconfident in your abilities.

You scored well above average on Self-Regard and fall within the leadership bar.

Leadership Implications.Leadership Implications.Leadership Implications.Leadership Implications. Your result may mean that you are
driven to surpass organizational targets, create an atmosphere of
excellence and demonstrate a strong sense of confidence in your
leadership capabilities. The challenge is that you could lose touch
with a realistic appraisal of your capabilities. It is important to
draw on reality testing behaviors and feedback from your team to
maintain a healthy self-perception.

Organizational Implications.Organizational Implications.Organizational Implications.Organizational Implications. Your ability to understand and accept
your strengths and weaknesses is likely perceived as a genuine
approach to leadership. Your higher confidence can probably be
seen across department lines, as you feel assured that you can
help out in a variety of capacities. You likely serve as a role
model, and your higher expectations of yourself and your
employees may lead to better quality decisions and greater
productivity. Use external validation to avoid any attempts at self-
aggrandizement and to maintain a realistic appraisal of your
talents.

Be Mindful of Your Weaknesses.Be Mindful of Your Weaknesses.Be Mindful of Your Weaknesses.Be Mindful of Your Weaknesses. Awareness of your shortcomings
helps to circumvent an inflated self-concept and temper this
exaggerated self-image.

■ Nobody’s perfect; our flaws make us human. The key is to be
cognizant of your limitations and ensure that they do not
impinge on organizational performance.

■ Develop strategies to improve your limitations. For example, if
you are impatient and anxious when deadlines are not met in
a timely fashion, you may want to refocus and practice
relaxation techniques (e.g., deep breathing).

■ You are only limited by the power of your imagination.
Awareness leads to action and meaningful change. Be
mindful that change does not occur overnight, but with
persistence, transformation is possible.

Modesty is the Best Policy.Modesty is the Best Policy.Modesty is the Best Policy.Modesty is the Best Policy. While it is important to feel good
about your strengths, do not overinflate them.

■ Watch that you don’t fall prey to arrogance; demonstrate
humility and be humble in your approach. Successful leaders
know their worth, but they remain grounded by seeking
feedback from their team as well as from other leaders.

■ Colleagues respect a leader who is visionary and exudes
charisma, but who is also approachable, genuine and can
relate to others. Your modest approach will help you win the
esteem and admiration of your employees.

This section compares Self-Regard with Self-Actualization, Problem Solving, and Reality Testing. The subscale that differs the most
from Self-Regard is Problem Solving. Improving the interplay between these subscales is likely to significantly impact your overall
emotional intelligence.

Self-Regard Problem Solving(86)

Your Self-Regard is higher than your Problem Solving. These components work effectively together when self-confidence promotes the
feeling that you can and will succeed. Therefore, cultivate a feeling of resilience and perseverance to commit to finding required
solutions.

7777 54321-2.054321-2.054321-2.054321-2.0

Copyright © 2012 Multi-Health Systems Inc. All rights reserved.

What Your Score Means

Self-Actualization
Pursuit of meaning; Self-improvement

Leadership Impact Strategies for Action

Balancing Your EI

Name: AYA MAHMOOD YOUNUS

70 90 100 110 130

Low Range Mid Range High Range

96

Self-actualization is strongly related to overall work success and performance. It can be summed up in three words: pursuit of meaning.
While this sounds quite philosophical, as a leader, it means finding purpose and enjoyment in your role and performing to your fullest
potential. AYA MAHMOOD, your result suggests that you operate with a slightly lower sense of accomplishment and resolve than most
leaders. Although you may believe that you can achieve more, your result may mean that:

■ You would benefit from being more actively involved in business objectives.
■ You try to achieve the goals you establish, although you might benefit from setting more challenging ‘stretch goals.’
■ For the most part, you believe you are fulfilling your potential.
■ Occasionally, you help others reach their fullest potential, but you would benefit from making a more concerted effort in their

development.

You scored below the leadership bar on Self-Actualization and could benefit from strengthening skills in this area.

Leadership Implications.Leadership Implications.Leadership Implications.Leadership Implications. You are likely leading people with a
moderate sense of mastery and accomplishment. You usually
motivate your employees to achieve their potential, and you ignite
their ingenuity and resolve to achieve personal and professional
goals. You may benefit from striving even harder to be the best
you can be so that your work and personal life are as meaningful
as possible.

Organizational Implications.Organizational Implications.Organizational Implications.Organizational Implications. You are perceived as a person who is
striving to learn, developing new skills and willing to grow in order
to fully optimize your talents. If strengthened, this quest could
permeate the entire organization, as employees may emulate your
approach. This drive for self-fulfillment may stimulate higher
productivity and greater employee satisfaction. Continue to work
on achieving the zenith of your potential so that employees may
learn from this style.

One Small Step.One Small Step.One Small Step.One Small Step. Transcribing your objectives is a great strategy
to solidify your action plan as you work toward greater self-
actualization.

■ By writing your action plan on paper or sharing it with a
colleague, you solidify your goals. Choose one small strategy
for making your life more enriching and share this with a
colleague or place it in your calendar. Or, is there a way you
can get your whole team involved in adding more meaning to
the workday? Research clearly demonstrates that the
likelihood of successful goal attainment increases by the mere
fact of simply writing down your goals.

Capitalize on Strengths.Capitalize on Strengths.Capitalize on Strengths.Capitalize on Strengths. You are already aware of your passions,
though at times you may not realize it.

■ List tasks in which you excel (e.g., chairing meetings,
producing comprehensive financial reports), and try to
incorporate these activities throughout the workday. If you
feel unsure of your areas of strength, pinpoint pursuits in
which you receive many compliments, or ask your colleagues
for feedback. These activities will reinvigorate your zeal for
work and improve your productivity.

This section compares Self-Actualization with Self-Regard, Optimism, and Reality Testing. The subscale that differs the most from Self-
Actualization is Reality Testing. Improving the interplay between these subscales is likely to significantly impact your overall emotional
intelligence.

Self-Actualization(96) Reality Testing(130)

Your Self-Actualization is lower than your Reality Testing. These components can be balanced by setting realistic plans to accomplish
meaningful experiences that are internally satisfying and not just objectively required. The challenge is to set goals that are attainable
and realistic, but also intrinsically valuable.

8888 54321-2.054321-2.054321-2.054321-2.0

Copyright © 2012 Multi-Health Systems Inc. All rights reserved.

What Your Score Means

Emotional Self-Awareness
Understanding own emotions

Leadership Impact Strategies for Action

Balancing Your EI

Name: AYA MAHMOOD YOUNUS

70 90 100 110 130

Low Range Mid Range High Range

126

If you have a solid understanding of what brings about your emotions, it is much easier to regulate your behavior and control the
impact your emotions have on employees in the organization. AYA MAHMOOD, your result indicates that more than most people, you
are conscious of your emotions and the impact they have on performance. You likely lead with composure and a full understanding of
your impact on others. It is likely that you:

■ Can choose a course of action based on a “gut feeling” in time-constrained situations.
■ Generate respect, admiration, and honesty from employees because you are viewed as highly self-aware.
■ Generally take time to contemplate instead of acting rashly, thereby considering your emotional response and those of others.
■ May overanalyze your emotions and those of your employees, which can impede decision-making and action in the organization.

You scored well above average on Emotional Self-Awareness and fall within the leadership bar.

Leadership Implications.Leadership Implications.Leadership Implications.Leadership Implications. As a leader, you have a thorough grasp
of your emotional triggers and reactions. This in-depth
understanding helps fuel a streamlined decision-making process
as you incorporate your emotions into your role as a leader.
Knowing your emotional triggers and reactions, you are able to
utilize this emotional knowledge to effectively navigate through
challenging or difficult situations.

Organizational Implications.Organizational Implications.Organizational Implications.Organizational Implications. Your capacity to grasp subtle
emotional nuances helps you take calculated risks that help the
organization meet its strategic goals. This comfort with, and
knowledge of, your emotional triggers and reactions allows you to
lead with authenticity and a candid approach to help you gain
credibility and buy-in with employees. You are able to manage
tense and perhaps overwhelming situations with ease, and you
are able to use and recognize your full spectrum of emotions.

Be a Role Model.Be a Role Model.Be a Role Model.Be a Role Model. Through the steadfast control of your emotions,
you can be innovative, successfully take risks, and gain the trust
of your employees.

■ The most prominent leaders have an aptitude for remaining
composed in competitive situations and under mounting
pressure and duress. Your ability to be aware of your
emotions helps you to serve as a model of composure and
ensures that employees feel secure and content to overcome
any potential challenge.

■ Give seminars/workshops or hire an expert to teach
employees about understanding emotions and the impact of
their emotions on others.

Weigh the Evidence.Weigh the Evidence.Weigh the Evidence.Weigh the Evidence. As you are highly adept at understanding
your emotions, you may have a tendency to be overly reliant on
your emotional barometer to make decisions. Be mindful to
incorporate objective evidence.

■ Intuition can only carry you so far. While a deal may feel right,
data may not support the intended strategy. Be sure to seek
counsel from colleagues, involve members of your team and
emphasize facts to support your proposed course of action.

This section compares Emotional Self-Awareness with Reality Testing, Emotional Expression, and Stress Tolerance. The subscale that
differs the most from Emotional Self-Awareness is Emotional Expression. Improving the interplay between these subscales is likely to
significantly impact your overall emotional intelligence.

Emotional Self-Awareness(126) Emotional Expression(58)

Your Emotional Self-Awareness is higher than your Emotional Expression. You may expect others to be aware of how you are feeling,
so make sure you are clearly communicating your feelings to them. Remember, expression is the way you showcase your emotional
knowledge and it will have greater impact if it works in parallel with your awareness.

9999 54321-2.054321-2.054321-2.054321-2.0

Copyright © 2012 Multi-Health Systems Inc. All rights reserved.

What Your Score Means

Emotional Expression
Constructive expression of emotions

Leadership Impact Strategies for Action

Balancing Your EI

Name: AYA MAHMOOD YOUNUS

70 90 100 110 130

Low Range Mid Range High Range

58

Think of Emotional Expression as the action part of the emotional experience. Leaders who effectively express their emotions use
words and physical expressions to convey their feelings in a way that is not hurtful to others. AYA MAHMOOD, your result indicates
you may have difficulty bringing emotions to the surface and sharing your true feelings and opinions with others. Consider the
following, which may be characteristic of you

Physiology homework help

Name: ____________________ Cohort ____ Date: __________ PT 116 – Pathophysiology

Guided Reading – Ch 8 Immune Response, Hypersensitivity, and Autoimmune Disorders

1. What is the immune system?

2. What are the 2 steps in the immune response?

3. Table 8-2: List and give 1 example of the forms of acquired immunity.

4. What organs comprise the components of the immune system?

5. What are monocytes? Who are the “big guys” that develop from monocytes?

6. What is a lymphocyte?

7. What is a T cell?

8. What is a B cell?

9. What organs are currently being transplanted?

10. What is an allograft? What is it’s other name?

11. What is immunosuppression?

12. What is an autoimmune disorder?

13. What are autoantibodies?

14. Table 8-5: we will be looking at these throughout the term. Start getting familiar with/learning them. Nothing further for this chapter.

15. Table 8-6: again, we will be looking at these throughout the term and the program. This chart looks at factors for your future treatment sessions involving these patients.

16. What is SLE? What is its pathophysiology?

17. What is scleroderma?

18. What is rheumatoid arthritis (RA).

19. What are prophylactic antimicrobial drugs?

20. What is AIDS? What is it caused by? What does it destroy?

21. HIV:

a. What does HIV positive mean?

b. If a person has HIV, does it mean they have AIDS?

c. Describe each of the phases:

i. asymptomatic stage

ii. early symptomatic stage

iii. HIV advanced disease

d. How/from what do these patients end up dying?

e. How can the chance of transmission of HIV and AIDS be reduced?

f. What is the role of the PTA when working with these patients?

22. What is a hypersensitivity reaction?

23. What are the types of hypersensitivity reactions? Briefly describe each, and give 1 example of each.

24. Define Anaphylaxis/anaphylaxis shock.

a. What areas can be affected? How?

b. How is it treated?


Ch 25 p.542 – Rubber Latex Allergy

1. Why is it a problem?

2. What are the possible 3 types of reactions?

3. It is the leading cause of what in the work place?

4. Why is it a problem is someone show an initial reaction to latex?

Physiology homework help

Example A

To cite a test, scale, or inventory, provide a citation for its supporting literature such as:

One Author

Author Last Name, Initials. (year). Title of the test. Test database name. URL

Two Authors

Author A Last Name, Initials. & Author B Last Name, Initials. (year). Title of the test. Test database name. URL

Parenthetical citation: (Tellegen & Ben-Porath, 2011)

Narrative citation: Tellegen & Ben-Porath (2011)

Reference Citation

Tellegen, A., & Ben-Porath, Y. S. (2011). Minnesota Multiphasic Personality Inventory–2 Restructured Form (MMPI-2-RF): Technical Manual. Pearson.

Example B

Cite the test, scale, or inventory itself only if a manual or other supporting literature is not available to cite; if a manual is available for a test, cite the manual, not the test.

Parenthetical citation: (Project Implicit, n.d.)

Narrative citation: Project Implicit (n.d.)

Reference Citation

Project Implicit. (n.d.). Gender-Science IAT. https://implicit.harvard.edu/implicit/takeatest.html

————————————————————————————————————————————-Note: Use this citation for the EQi report

Intext: (EQ-i 2.0 leadership report, 2021) 

References

EQ-i 2.0 leadership report. (2021). Multi-Health Systems Inc. https://mhs.com/

Adapted from APA 7th Edition, Pg. 340, Tests, Scales, and Inventories

Physiology homework help

Reply to each discussion post 1-2 paragraphs. Your responses to peers need to be substantive, with constructive suggestions, critique, or insights. You are expected to use in-text citations and list of references to support your posts.

Latoya Withers (students name)

    The Affordable Care Act, also known as ACA or “Obama Care”, was enacted in March 2010. There were three primary goals when ACA was put in place; To make affordable health insurance available for all Americans, to expand the Medicaid programs, and to support innovative medical care delivery(Healthcare.gov).  The Affordable Care Act became a health Law, which means that our government thought healthcare was necessary.  It was necessary for health insurance to be affordable and to provide quality treatment. 

    Initially Americans seemed excited to be able to have health insurance that they could afford and not have it attached to an employer. The advertisement of low cost was appealing. Some Americans even thought that this was free healthcare. While working as an Eligibility worker for my state Department of Human Resources(DHR), we provided food and financial help to low income households. Through daily interviews with clients, I learned that health insurance through the ACA Market place , was not so affordable for alot of families , and there were still alot of Americans dropping the insurance, and some still could afford to sign up for it. Average monthly premiums for and individual ranged from $200=$450. With minimum wage being around $8.00/hr in my state, that makes premiums not so affordable. also in the beginning , many clients stated that getting in touch with someone to sign up for insurance was difficult because of long phone hold times or no computer and internet access. While I do feel and agree that health insurance is very necessary, there are some needed improvements to the system, so that Americains can access and retain the health insurance. Education Americans on cost, coverage, and benefits will give a better understand of why health insurance is vital to living a healthy life. Without health insurance coverage, a serious accident or health issue can go without proper treatment and can rack up expensive medical bills.  Health coverage is needed even for routine checkups , which help inform us of whats going on in our bodies , helping to make better health choices and creating a better way of living.

1995-2022 American Medical Association

Healthcare.gov.

Health Consequences of Uninsurance among Adults in the United States

Randolph Nyann (students name)

 The national health insurance idea first came about when the American Association for Labor Legistration in 1915 tried to introduce a medical bill to some state legislature, according to Ramachandran (2010). Even though the Affordable Care Act of 2010 does not solve all heath inequality problems, it has been very important and reduced socioeconomic disparities in healthcare access (Griffith, 2017). Making healthcare affordable and accessible increased the number of Americans with coverage, supported research, funded community-based public health and prevetionn programs (eg. free mammogram screening etc.). The ACA begann reducing disparities, enhanced access to preventive care, lowered the nation’s health spending/cost and improved health outcomes.

 The main aim of the  Affordable Care Act (ACA) as the nation’s health reform enacted in 2010 was to reform both private and public health insurance system. The ACA provision, improved healthcare access for Americans in  low-income household, people who were not college graduates, and the unemployed. In expansion states (provision in ACA called for expansion of Medicaid eligibility to cover more low-income Americans) the gap in insurance coverage between poor resident household ($25,000) and high income household ($75,000) fell by 46 percent between 2013 and 2015, while in nonexpansion states, coverage gap fell by 23 percent.

Some U.S. residents are without healthcare coverage beause of cost, incomplete insurance uptake such as unawareness of coverage options, complicated enrollment process, political attitude towards ACA and perceived low value of existing plans. Many people don’t have access to coverage through a job, and poor adults in states that did not expand medicaid remain ineligible for financial assistance for coverage. Undocumented immigrant are also residents who are not eligible for medicaid or marketplace coverage. 

People without insurance have worse access to care. Studies indicate that uninsured are less likely than insured to receive care preventive care and services for major health or chronic conditions and face exhorbitant medical bills when they seek care (KFF, 2019) and have higher mortality rates. On the national level, health related productivity affect and reduce U.S. economic output.

Possible approaches to address and improve health inequities and population health may include extending medicare programme to uninsured adults aged 55 to 64 and eliminate two years wait before disabled people are qualified. Require all businesse to provide health benefits to all employees. States should revise the children’s health insurance programme to innclude adults on income 1.5 times the federal poverty line and children up to 3 times the treshold (Davis, 2007).

References

Griffith, K., Evans, L., &Bor, J. (2017). The Affordable Care Act reduced socioeconomic disparities in healthcare access. Health Affairs, 36(8), 1503-1510.-PDF Document.

Kaiser Family Foundation (2019). Status of state action on   Medicaid decision Retrieved from 
http://www.kff.org/health-reform/state-indicator/state-activity-around-expandinng-medicaid-under-the-affordable-care-act//GoogleSholar.

Davis, K (2007). Uninsured in America: problems and possible solutions. BJM (clinnical research ed.), 334(7589): 346-348. 
http://doi.org/10.1136/bmj.39091.493588E
.

Physiology homework help

Reply to each discussion post. Your responses to peers need to be substantive, with constructive suggestions, critique, or insights. You are expected to use in-text citations and list of references to support your posts.

Week One: Discussion

 

Tiffani Gottschalk (students name)

The U.S healthcare system can be seen as unique and complex compared to healthcare systems in other countries. The U.S healthcare system is comprised of many different components; education, research, suppliers, insurers, providers, payers and government (Shi & Singh, 2019). With almost all other developed countries having universal healthcare coverage for their citizens, the U.S healthcare system does not offer access to its citizens through a national health insurance program. The U.S healthcare system is financed through a mix of public and private healthcare insurances. According to the U.S Census Bureau, in 2020, American citizens were able to gain access to healthcare through employer-based healthcare insurance, private health insurance, direct purchase coverage, and government healthcare programs such as Medicaid, Medicare, Tricare, and Department of Veterans Affairs (Keisler-Starkey & Bunch, 2021). Since the U.S does not have a universal healthcare program that citizens can partake in, subsystems have developed within the U.S healthcare marketplace. These subsystems provide healthcare to certain populations based on qualifying criteria. The U.S healthcare system is considered to have “market justice,” rather than “social justice.”

In 1984, Canada passed the Canada Health Act to ensure universal healthcare coverage for all of its citizens. Canada has a publicly funded national healthcare system where funds are provided through individual and corporate income taxes. Canada’s government healthcare entity offers basic healthcare coverage to its citizens without any out-of-pocket fees. Canada’s national healthcare system is considered to have “social justice”. Comparing the U.S healthcare system and Canada’s healthcare system we can firmly state that:

•    The U.S views healthcare as an economic good, while Canada views healthcare as a social resource.

•    The U.S healthcare system is comprised of free market conditions, whereas Canada has full government involvement in health care delivery.

•    U.S citizens are unable to access healthcare if they are unable to pay, Canadians are able to access healthcare regardless of their ability to pay.

•    Healthcare coverage in the U.S is seen as a reward for ability to access, whereas Canada views healthcare as a basic right.

According to the “National Bureau of Economic Research”, Canada spends far less of it’s gross domestic product on healthcare spending than the U.S, has a lower infant-mortality rate, and higher life expectancy (Comparing the U.S, 2007). 

References

Keisler-Starkey, K., Bunch, L. (2020). Health Insurance Coverage in the United States: 2020. US Census Bureau. Retrieved from 
https://www.census.gov/library/publications/2021/demo/p60-274.html

Shi, L. and Singh, D.A. (2019). Delivering Health Care in America: A Systems Approach. 7th Edition. Sudbury, MA: Jones and Bartlett Publishers.

Comparing the U.S. and Canadian Health Care Systems. (2007). National Bureau of Economic Research. Retrieved from 
https://www.nber.org/bah/fall07/comparing-us-and-canadian-health-care-systems

Discussion week one

 

Rasita Lau (students name)


Previous 



Next 

This page automatically marks posts as read as you scroll.


Adjust automatic marking as read setting

The healthcare system in the U.S.  is very complex because the system still does not function entirely correctly. The healthcare system is mixed between government and private insurance companies responsible for paying expenses.  The U.S. has  medical insurance company and Medicaid (paid by the government) that will pay the difference if another coverage does not cover it. People working in a company will benefit from paying for medical insurance. But a person who is low income or elderly, over the age of 65 and up, will be covered by federal insurance.   The website ISPO (2022) states that:

The US healthcare system does not provide universal coverage. It can be defined as a hybrid system, where publicly financed government Medicare and Medicaid (discussed 
here
) health coverage coexists with privately funded (private health insurance plans) market coverage. Out-of-pocket payments and market provision of range predominate as a means of financing and providing healthcare.2 As of 2019, around 50% of citizens received private insurance coverage through their employer (group insurance), 6% received private insurance through health insurance marketplaces (nongroup insurance) (discussed 
here
), 20% of citizens relied on Medicaid, 14% on Medicare, and 1% on other public forms of insurance (e.g., Veterans Health Administration [VHA] and Military Health Service [MHS]), leaving 9% of Americans uninsured  (para. 2).

However, countries in Europe, such as the U.K., France, Italy, or other European countries, have a healthcare system works differently from the U.S.   The World Health Organization (WHO)  state that  healthcare  should be accessible for everyone at low cost  and individuals will not have to pay more  out of pocket “this means that everyone has equal access to quality healthcare that improves the health of patients and that seeking such care would not cause financial harm to those receiving it” (Rook, 2018, para.2).

Most people in Europe will get free healthcare at the first point of care. They may pay a little bit out of pocket when they get a prescription drug. Those benefits are from tax deductions from each paycheck.  Rook (2018) continues that,

One of the significant similarities across healthcare systems in Europe is that all citizens are included. Even in partially privatized systems, an individual mandate is in place (and strictly enforced) to ensure that healthy people are in the system to help offset the costs of sick people. Another commonality is that healthcare in Europe (regardless of method) is primarily funded by tax dollars collected from employers and the public (para.5).  

So, the U.K. or France people do not have to purchase health insurance, but they can see a doctor for free when they get sick.    This is similar to a benefit for low-income people in America.   The funds in the United States are from the government, and state capitals will cover medical expenses for that person. For people who have health insurance through a company, the organization has purchased a group health insurance that will pay for medical costs, employees responsible for co-pay, or some percentage of their treatments.

To compare between the U.S. and other countries in Europe, America has a higher number of maternal deaths: “Although most are preventable, maternal deaths have been increasing in the United States since 2000

That shows that pregnancy deaths in the U.S. are higher than in other countries in Europe such as France, Italy, the U.K., etc.  The Commonwealth Fund by Tiainen (2018) compares between developing countries;

Women in the U.S. are the most likely to die from complications related to pregnancy or childbirth.  In 2018, 17 maternal deaths for every 100,000 live births in the U.S. — a ratio more than doubled that of most other high-income countries (Exhibit 1). In contrast, the maternal mortality ratio was three per 100,000 or fewer in the Netherlands, Norway, and New Zealand (para.8-9).

The other high-income countries in Europe have fewer maternal deaths because they have more supplies, i.e., hospital physicians from different locations, higher quality care for normal pregnancies, child care for routine or sick babies after birth, and postpartum. The cause of maternal deaths in the U.S. is low supplies of hospitals and doctors. Patients have fewer options to select physicians and quality facilities services.

 

 

References

Rook. (2018). How does healthcare in Europe work? Blog. JP griffin group employee benefits broker. https://www.griffinbenefits.com/blog/how-does-healthcare-in-europe-work

SPOR. (2022). US healthcare system overview – background. SPOR. https://www.ispor.org/heor-resources/more-heor-resources/us-healthcare-system-overview/us-healthcare-system-overview-background-page-1#:~:text=Coverage%20Overview,health%20insurance%20plans)%20market%20coverage.

Tikkanen, R., Gunja, M. Z., FitzGerald, M., & Zephyrin, L. (2020). Maternal mortality and maternity care in the United States compared to 10 other developed countries. Issue briefs, Commonwealth Fund.

Physiology homework help

Reply to each students discussion post 1-2 paragraphs. Your responses to peers need to be substantive, with constructive suggestions, critique, or insights. You are expected to use in-text citations and list of references to support your posts.

Rasita Lau (students name)

The U.S. has different health insurance plans, such as private insurance through an employer, Obamacare for low income, and Medicare vs. Medicaid. According to Delivery health care in America by Shi ( 2019), the author mentioned about Medicaid that “The Medicare program, also referred to as Title 18 of the Social Security Act, finances medical care for three groups of people: (1) persons 65 years and older, (2) disabled individuals who are entitled to Social Security benefits, and (3) people who have the end-stage renal disease (ESRD— (p. 232) those people who are age over 65 and up, including a disabled person, etc., will be cover by Medicare and Medicaid with no costs or low costs” (p.232)

For people getting health insurance through their work (HMO and PPO), the employer will pay part of the premium, and the workers will pay at least ten percent of it. For HMOs, the workers will spend less money on the monthly premium plan, but they have to use doctors and hospitals in the approval area. For PPOs, employees who purchase this plan can use any medical facilities they want to go to, but the monthly premium is a little high. Shi wrote about a function and how to be reimbursed for health insurance that “with the other two parties being the patient and the provider. The payment function has two main facets: (1) determining the methods and amounts of reimbursement for the delivery of services and (2) the actual payment after services have been rendered (p.246).

The employer’s private health insurance is a large group that will pay most medical expenses. The workers will pay part of the bills that the insurer does not cover. This could be 10 or 20 percent of the medical cost, depending on the agreement of each plan. “Services covered by an insurance plan are referred to as benefits. Each health insurance plan spells out in a contract both the type of medical services it covers and the services it does not cover” (p.233).

Medicare and Medicaid

The U.S. has different plans, such as insurance will be private health insurance that will pay part of the bill, and Medicaid will be a government fund to cover part of the expenses.  According to the textbook Delivering health care in America, by Shi, (2019), “Part A, the Hospital Insurance portion of Medicare, is an actual entitlement program. Throughout their working lives, people contribute to Medicare through special payroll taxes; hence, they are entitled to Part A benefits regardless of their income and assets” (p.232).  Those people have to have a work history of at least 40 credits to be eligible for Medicare (Shi, 2019).

Medicare Part B

Shi continues that, “Part B, the supplementary medical insurance (SMI) portion of Medicare, is a voluntary program financed partly by general tax revenues and partly by required premium contributions” (p.  234). The third-party of insurance will pay some portion, which patients will pay out of pocket for a co-pay. That could be a large amount of money before the insurer starts to pay the bill.  For example, John purchases health insurance from Anthem Blue cross for $200 for a monthly premium. The deduction in that plan state that he has to pay the deduction $7000 before the insurance starts paying the medical bill.

The different methods of different insurance plans, or lack of insurance, will affect the consumer is patients who are willing to pay high premium have more choice of care. Sometimes they do not have to wait to see a specialist to receive a treatment to service for people who are using low-cost health insurance get less chance to access healthcare facilities they want. Sometimes they have to wait for an extended period to get special treatment and service. Another issue of healthcare delivery service is the overcharging of fees from providers, because of physicians, surgeons, etc. that based on incentives. So, the providers can increase the prices when patients receive the service.

Tiffani Gottschalk (students name)

Within the U.S healthcare system there are three main components of health financing. These main components are loosely coordinated and are known as financing, insurance, and payment. On a broader level, financing refers to the process of managing funds that ensures there are enough medical resources available in which all U.S citizens are able to receive healthcare services. On a personal level, financing refers to the actual payment’s individuals must make to receive healthcare services from providers. Currently, there are many types of health insurance plans available and they differ based on what the consumer prefers when it comes to financing and care available. From a basic standpoint, individuals with health insurance are able to have some or all of their healthcare costs paid by an insurance company in exchange for monthly premiums. Payment refers to the process of healthcare providers being paid or reimbursed for the services they provide to their patients. 

Unlike many other developed countries, the U.S has a multi-payer system that is financed through more than one entity. These entities include both the public and private sector. “More than one-third of the U.S. population is covered under various public insurance programs” (Shi & Singh, 2019). Public health plans are financed by the government and individuals who have access to these types of health plans will be eligible based on certain qualifying criteria. A few of the public health plans available to qualifying U.S citizens are:

•    Medicare: Individuals must be 65 years or older, have one or more “disabilities,” or have a qualifying end-stage renal disease (ESRD). 
•     Medicaid: Families with children who receive support from the Temporary Assistance for Needy Families (TANF), individuals who receive supplemental security income (SSI), families with income that is equal to or less than 133% of the federal poverty level (FPL). 
•    Veteran Health Administration: Individuals must have served and receive at least 10% compensation from a service-connected disability.

Private health insurance plans are also available for individuals who do not qualify for public health plans under certain criteria, and these plans can be bought through the federal health insurance marketplace, private marketplace, or private companies. The most commonly known uses of private insurance are employees who gain employer-based healthcare coverage through their jobs. Some examples of private insurance include:

•    Group Insurance
•    Managed Care Plans
•    High-Deductible Health Plans

Different types of healthcare plans have a direct impact on the consumer because it will ultimately lead to how many healthcare services they will attempt to receive or receive. The concept of “moral hazard” shows us that consumers are more likely to be motivated to receive healthcare services if their services are covered by their health insurance. As discussed previously, consumers who lack healthcare insurance are more likely to have poorer health outcomes due to the services they are not receiving.   

Currently, the U.S healthcare system has many types of reimbursement methods that physicians receive compensation through for their services delivered. Based on research, reimbursement methods do have an impact on the type of care physicians provide to their patients. Fee-For-Service (FFS) compensates the physicians on the “number of services performed”. Capitation compensates physicians “per patient per time period”. Salary compensates physicians as a fixed payment, “per period of time”. All of these reimbursement methods are known to influence physician behavior in different ways. According to the article, “Physician Payment Methods: A Focus on Quality Cost and Cost Control”, fee-for-service is known to motivate physicians to perform a higher quantity of healthcare services to a higher number of patients. Capitation reimbursement can lead physicians to accept healthier patients and dump out less healthier patients as this would require less work for the physician and still reward them for the amount of patients they provided care to. With salary reimbursement, physicians are more able to tend to their patient needs without the focus on billing services. However, they are likely to see less patients than fee-for-service physicians (Rudmik et al., 2014). Different reimbursement methods can either lead to higher quality of care or decreased quality of care depending on the incentives that are being provided to physicians through different types of compensation. 

Rudmik, L., Wranik, D., Rudisill-Michaelsen, C. Physician payment methods: a focus on quality and cost control. BMC. Retrieved from https://journalotohns.biomedcentral.com/articles/10.1186/s40463-014-0034-6#

Shi, L. and Singh, D.A. (2019). Delivering Health Care in America: A Systems Approach. 7th Edition. Sudbury, MA: Jones and Bartlett Publishers.

Physiology homework help

Criticisms of binding arbitration include the fact that decisions are imposed by outsiders, which runs counter to voluntary two-party contract bargaining and arbitrators lack political accountability.  Many of you may have noticed the prevalence of binding arbitration clauses in your daily lives in areas such as consumer purchases, hospital admission forms, and even in various uses of internet resources.  With this in mind, go to documents and find the “Labor Arbitration” exercise.  In this exercise, take a position (Union or Management) and defend your position that the grievant was wrongfully discharged (union position) or correctly discharged (Management).   Use pertinent provisions of the collective bargaining agreement to support your position. 


Physiology homework help

SALIENT CULTURAL CHARACTERISTICS

Age > 6%

Disability > 7%

Religion/Spirituality > 6%

Ethnic/Racial Identity > 12%

Social Class > 12%

Sexual/Affectional Orientation > 3%

Indigenous Backgrounds > 2%

National Origin > 10%

Gender Identity > 8%

Gender Expression > 12%

Size > 6%

Assigned Sex at Birth > 12%

Physiology homework help

Pioneers and Progress: 1896-1936
(selected readings)

The Cold War Olympics, 1948- 1988
(selected readings)

*

Origins of Modern Olympic Games

  • Originated in Athens in 1896
  • Evolved into one of the most significant social forces of the 20th century
  • Purpose:

To produce an international athletic festival

Bring people together

Promote world peace

Educate the youth of the world

*

Modern Olympic Games

  • Promote ideals of fair play

Character formation through participation

  • Games promote ideals

Peace, harmony, cooperation

Transcend political barriers

*

Spirit of Olympism

  • Viable social force
  • Integral part of the modern Olympic Movement
  • “Way of life based on the joy of effort and mutual respect” (Coubertin)
  • Olympic Games are inclusive

Promote peace and understanding throughout world

*

Architect of the Modern Olympic Games: Dr. William Penny Brookes

  • Father of British Physical Education
  • 1850 – the Wenlock Olympic Class

made ceremony and pageantry an important feature of this event

1860 – known as Wenlock Olympian Society

  • Worked with the Zappas family, J. Gennadius, and Pierre de Coubertin to revive Olympic Games in Greece

*

Architect of the Modern Olympic Games: Baron Pierre de Fredy de Coubertin

  • Dedicated his life to educational reform:

Focused on improving French pedagogy and revitalize the youth of France

Games were a means to this end

  • International travels influenced his plan

Athletic competition would be the catalyst

  • Promoted athletics throughout France and gained control over amateur sport

*

Baron Pierre de Coubertin

*

Baron Pierre de Coubertin, 1915

Image source: Library of Congress Prints and Photographs Division, Washington, D.C.

Reestablishing the Games

  • June 23, 1894: Coubertin organized Sorbonne International Congress
  • International Olympic Committee (IOC) formed during that Summer

Coubertin elected IOC Secretary General; became IOC President after 1896 Games

1924 Olympic Games in Paris were Coubertin’s last as President

*

The 1st Olympiad: Athens, 1896

  • Preparation for the Games

Construction of the stadium

Money

Legitimizing Olympic Games

  • Participation in the Games

Track and field, gymnastics, target shooting, and fencing matches

241 male athletes from 13 National Olympic Committees (NOC’s)

William Sloane of Princeton University assembled and trained the American team

American James Connolly won the first Olympic medal in triple jump

*

Athens, 1896

*

Olympic stadium in Athens, built for 1896 Games

Image source: Photo © R. Mechikoff

The 2nd Olympiad: Paris, 1900

  • Governing body of French sport did not cooperate with IOC
  • Official and unofficial Olympic events caused controversy
  • 997 athletes from 24 NOCs participated
  • Female athletes made their first Olympic appearance in tennis and croquet
  • First appearance: Golf, polo, rugby, cricket

*

The 3rd Olympiad: St. Louis, 1904

  • St. Louis wanted Games along with Louisiana Purchase Exposition

Games were originally awarded to Chicago

James Sullivan and Pres. Roosevelt changed

Coubertin refused to attend

  • Games were primarily American event
  • 651 athletes from 12 NOCs participated, including the first Africans to compete in the Games
  • American women: competed & won all archery events
  • 1st and only time American football was an event

Canada—gold; U.S.—silver

*

The 4th Olympiad: London, 1908

  • Games were held in conjunction with the Franco-British Exhibition
  • 2,008 athletes from 22 NOCs participated
  • 37 women from 4 countries competed
  • Games became involved with political turmoil and nationalism

Flag issues

British advocacy of the creed of fair play versus American attempts to devise their own, more favorable scoring systems

*

The 5th Olympiad: Stockholm, 1912

  • Last Olympiad for Russia until 1952
  • Women’s swimming, equestrian, modern pentathlon
  • Olympic trials ensured best American athletes
  • Hosted 2,407 athletes from 28 nations
  • 48 women athletes represented 11 nations
  • Competitors included Jim Thorpe, Douglas McArthur, George Patton, Avery Brundage
  • Stockholm, 1912 video

*

Stockholm, 1912

Members of the 1912 U.S. Olympic squad; Jim Thorpe is wearing a

turtleneck warm-up sweater

*

Members of the 1912 U.S. Olympic squad

Image source: Library of Congress Prints and Photographs Division, Washington, D.C.

Stockholm, 1912

100-meter race, won by Ralph Craig of the United States

*

100-meter race from the 1912 Olympic Games, Stockholm

Image source: Library of Congress Prints and Photographs Division, Washington, D.C.

Stockholm 1912: Jim Thorpe

  • Won both pentathlon and decathlon
  • Accused of playing semipro baseball less than one year after Stockholm
  • Thorpe admitted to playing baseball and being naïve about amateur rules
  • Stripped of medals by USOC and IOC
  • 1983: medals restored posthumously

The 7th Olympiad: Antwerp, 1920

  • Games initiated tradition of Olympic oath and five-ring Olympic flag
  • Paavo Nurmi, distance runner from Finland, made Olympic history

One of greatest distance runners of all time

*

Participation of Women

  • Coubertin not in favor of women competing
  • Mme. Millait established Federation Feminine Sportive Internationalle (FSFI)

Organized First Women’s Olympic Games 1922

  • 1920 Olympiad – 65 women from 13 nations competed

*

The 10th Olympiad: Los Angeles, 1932

The most grandiose athletic festival in modern history

1332 athletes from 37 nations

Spirit of Olympicism and cooperation

The 11th Olympiad: Berlin, 1936

  • Politicians used Games for blatant political purposes
  • Hitler tried to undermine ideal of Olympism

Used games to send message of Nazi superiority

  • American athletes threatened boycott
  • Wanted Nazis to allow other races to compete

*

The 11th Olympiad: Berlin, 1936

  • Torch run was initiated in the opening

ceremonies

  • 3,963 athletes competed from 49 nations; 331 women athletes
  • American Jesse Owens was a superstar
  • Americans collected 56 medals

*

Berlin, 1936

The Nazi Olympics

*

Jesse Owens at the start of his winning 200-meter run, 1936 Olympic Games

Image source: Library of Congress Prints and Photographs Division, Washington, D.C.

Olympic Interim

  • Next Olympic Games not until 1948
  • Coubertin dies in 1936

Count Henri de Baillet Latour successor

Dies suddenly

  • J. Sifried Edstrom was elected IOC president during 1946 London meeting

*

The 19th Olympiad: Mexico City, 1968

  • Most controversial ever

Severe clashes between students and police

Tlatelco Massacre

Threatened staging of the Olympics

  • 6 days of rioting

150,000 students seeking “autonomy”

  • Athletes participated in political demonstrations during the Games

*

The 19th Olympiad: Mexico City, 1968

  • Games marked a radical departure from past Olympic politics
  • U.S. Olympians John Carlos and Tommie Smith staged a Black Power demonstration on the victory stand
  • Black Power Conference: Olympic Project for Human Rights emerged
  • Black Power Salute

*

The 19th Olympiad: Mexico City, 1968

  • 5,516 athletes from 112 nations competed
  • American Olympic contingent was the largest in attendance
  • U.S. fared well in swimming and diving
  • Americans continued to dominate men’s basketball

*

The 20th Olympiad: Munich, 1972

  • Cold War between East and West

Student activism declined

Political terrorism increased

  • Many countries in political turmoil
  • Eleven nations boycotted the Games

*

The 20th Olympiad: Munich, 1972

The Munich Massacre

  • Sep. 5: Arab terrorists kill 11 Israelis
  • Israel & New York Times call end to Games

Memorial for slain Israelis

Games resumed

  • Egypt, Kuwait, Syria: left Munich
  • After Games: Israeli war planes attacked Arab guerrilla bases
  • Munich Report

*

The 20th Olympiad: Munich, 1972

  • 7,134 athletes competed from 121 nations, 1,059 women
  • Frank Shorter of U.S. won the marathon
  • American swimmers dominated
  • Finn, Lasse Viren, won gold medals in the 5,000 and 10,000 meter races

*

The 23rd Olympiad: Los Angeles, 1984

  • LAOOC: first corporate Olympiad in history
  • First time Games generated “surplus,” $200 M
  • LAOOC was allowed to sell corporate sponsorships and to negotiate television contracts
  • Historically IOC had all money rights

The 23rd Olympiad: Los Angeles, 1984 cont.

  • IOC agreed to the demands of the LAOOC

Commercialization of the Games

The 23rd Olympiad: Los Angeles, 1984 cont.

Political atmosphere

  • Russians angry because of American boycott of 1980
  • LAOOC officials: numerous trips to Moscow
  • Propaganda war between U.S. and U.S.S.R.
  • 8 weeks before the Games, the Soviet Union cited “security concerns” as a reason to withdraw its team from the Games

Payback for the U.S. boycott in 1980

Los Angeles, 1984: Notables

  • 6,829 athletes competed from 140 nations
  • 1,566 women athletes competed
  • U.S. athletes dominated the games
  • U.S. men’s volleyball won its first gold medal
  • U.S. basketball teams won gold
  • Carl Lewis: star of the games

4 gold medals in track and field

The 32nd Olympiad: Tokyo, 2020

Physiology homework help

Week 3 – Signature Assignment Rubric

HCA 600 – US Healthcare System

Week 3 Signature Assignment For Portfolium: (40 points) 3 to 5 pages.

To a large extent, factors such as where we live, the state of our environment, genetics, our

income and education level, and our relationships with friends and family all have

considerable impacts on health, whereas the more commonly considered factors such as

access and use of healthcare services often have less of an impact” (World Health

Organization, 2015).

Reflect on the statement above both from an individual and public health views. Do you

agree? Why or why not? Considering the history, philosophy and values in public health, how

does this influence your approach to improving health of the population? Building on the

learning resources and your own research, what recommendations would you have for

improving equality and equity in healthcare?

• 3-5 pages. Provide at least three (3) scholarly references to support your assessment. Apply

APA format for all your formatting, citations, and references.

Program Learning Outcome:

▪ CLO6- Design alternative approaches to address significant healthcare issues.

▪ CLO8- Explain the social, political and economic determinants of health and how they

contribute to population health and health inequities

▪ CLO9 – Explain public health history, philosophy and values

Process: Each student will be assessed via an individual scholarly paper

QA Criterion: The student will prepare a well-researched paper with graduate level

analysis and synthesis of ideas

Criteria Meets Requirements

100-96%

Good – Requires

Improvement

95-80%

Fair – Requires

Improvement

79-60%

Unsatisfactory

> 60%

Main points,

analysis,

synthesis and

Supporting

Statements.

30%

• Clearly introduces
the issues and

evaluates the

concepts of equity

and equality in

access and quality

of care at both

individual and

public health

• Clearly introduces
the issues but the

evaluation of the

concepts are weak or

partial.

• Provides sparse
supporting

statements and

• Introduction and

evaluation of the

concepts are weak or

partial.

• Provides sparse
supporting

statements and

sources to

• Poorly or fails to
introduce the issues

or evaluate the

concepts.

• Provides little to no
supporting

statements and

sources.

levels.

• Provides
supporting

statements and

sources to

substantiate main

points.

sources to

substantiate main

points.

substantiate main

points.

Considers

Implications

40%

• Considers all
relevant

implications with

in-depth analysis of

the history,

philosophy and

values that

influence equality

and equity in

healthcare.
• Provides clear

analysis and
synthesis of
recommendations
for improving
equality and equity
in healthcare.

• Provides supporting
sources to
substantiate main
points.

• Considers some
relevant implications
with respect to history,
philosophy and values
influencing equality
and equity in
healthcare, but not
comprehensive.

• Limited analysis and
synthesis of
recommendations to
improve equality and
equity in healthcare.

• Limited or lacking
sources to support the
main points.

• Considers limited
implications with
respect to history,
philosophy and values
influencing equality
and equity in
healthcare.

• Limited analysis and
synthesis of
recommendations to
improve equality and
equity in healthcare.

• Limited or lacking
sources to support the
main points.

• Fails to consider
implications or
recognizes them
incorrectly.

• Minimal analysis
and no synthesis of
recommendations.

Mechanics,

Length and

Organization

20%

• Has less than 5
spelling and

grammatical errors

• Meets length
requirement.

• Logically organized
and sequenced.

• Content flows from
one concept to the

next via transitions.

• Supporting details
are used effectively

to demonstrate

comprehension of

the assignment.

• Has more than 6
spelling and

grammatical errors

• Supporting details are
not used effectively to

demonstrate

comprehension of the

assignment.

• Has more than 6
spelling and

grammatical errors

• Length requirement
not met.

• Not well organized
and sequenced.

• Content flows poorly.

• Supporting details are
not used effectively to

demonstrate

comprehension of the

assignment.

• Many spelling and
grammatical errors

• Length requirement
not met.

• Poor organization
and flow.

• None or very limited
details to

demonstrate

comprehension of

the assignment.

Sources and

APA format

10%

• Uses valid
sources and valid

format for in-text

citations and

references

• Follows correct
APA format for

all citations and

references.

• Some errors in
sources and in-text

citations and

references

• Incorrect APA
format.

• Limited use sources
and errors with in-

text citations and

references

• Incorrect APA
format.

• Lacking proper
citations and

references.

• Incorrect format
for citations and

references.

Physiology homework help

CHCECE025 – EMBED SUSTAINABLE PRACTICES IN SERVICE OPERATIONS.

Formative assessments.

Activity 1

Give an example of an environmental, social and economic sustainability strategy; write a brief explanation on how it could address sustainability.

Activity 2

Choose a situation in an organisation that you think warrants change and describe what you would do to ensure sustainability. (100words)

Activity 3

List three ways in which the management of each of the following, waste, energy and toxins, will help support nature. If necessary conduct your own research.

Activity 4

1

What are 10 components of sustainability strategies?

2

Choose a situation in an organisation that you think warrants change and describe how you would include children in the development and implementation of sustainability strategies. (100-150 words)

Activity 5

1

Choose an activity that children could participate that utilises three natural or recycled resources. Activities could focus on one that implicates parents, a particular cognitive ability, or preparing the learning environment. (100-150 words)

2

Where would you find information about the environment? List what you might find in a resource kit (commonly used in sustainability programs). (75-100 words)

Activity 6

Think about how you could introduce an infant, toddler, preschooler and a school aged child to the natural world and outdoor space. Design a strategy that could be implemented and utilised for each child and highlight what you would need to do differently in the case where the child had special needs. (100-200 words)

Activity 7

1

What should be considered when creating a garden space for children? (75-100 words)

2

What can children learn from being part of a gardening project? (75-100 words)

3

What should be considered when disposing of waste? (75-100 words)

Activity 8

1

What are ethics? (80 words)

2

How do ethics relate to sustainability in the education and care services? (75-100 words)

3

What are the Three Es of sustainability?

4

Write a short report (150 words) on how ethical dilemmas for waste disposal affect education and care services.

Activity 9

Choose two experiences with the potential to provide insight into how either a child or an adult could participate in sustainable practice.

Activity 10

1

What is the difference between a policy, procedure, and code of practice? (100-150 words)

2

How can policies and procedures reflect sustainability? (100-150 words)

Activity 11

1

Describe how you can monitor the need for change to a service’s philosophies, policies, or procedures. (100-150 words)

2

What consultation strategies can be used to involve stakeholders in change to a service’s sustainability culture? List four strategies.

Summative assessment 1

Question 1

How can you identify sustainable practices and opportunities for change? (100-150 words)

Question 2

How could you model sustainable practice? (100-150 words)

Question 3

What are the goals of waste management strategies? (100-150 words)

Question 4

Where can you access copies of the National Quality Framework (NQF), National Quality Standards (NQS) and the Early Years Learning Framework (EYLF)? Where can more advice, support and information about the NQS, NQF and EYLF be found? When navigating the EYLF what are the five outcomes that you will find information about?

Question 5

Explain the difference between qualitative and quantitative evaluation processes. (100-150 words)

Question 6

What can a service do in relation to cleaning and maintenance to support sustainable practice? (100-150 words)

Question 7

How can a policy be structured to signal a service’s intent in relation to sustainability? (100-250 words)

Question 8

What are the ethical dilemmas relating to sustainability? (100-150 words)

Physiology homework help

Voices of Diversity: Race and Ethnicity

© 2021 Walden University, LLC 1

Voices of Diversity: Race and Ethnicity
Program Transcript

KATHY PURNELL: Welcome to the Voices of Diversity. We’ve built a series of short

conversations into the course to model and encourage meaningful conversations

around what some might consider difficult or sensitive topics. I’m Dr. Kathy Goodridge

Purnell, the program coordinator for inclusive teaching and learning, and the diversity

subject matter expert and social work educator who helped to develop this new diversity

course for the Barbara Solomon School of Social Work here at Walden University.

Today we’re here with social work faculty to discuss a few questions, which is part of

our Voices of Diversity series.

EMMETT ROBERTS, JR: Hi. I’m Dr. Emmett Roberts. I am a core faculty member at

the Barbara Solomon School of Social Work, and I’ve been a Walden faculty member

since 2013.

LEIGH HICKS: Hello. I’m Dr. Leigh Hicks. I am a core faculty also at the Barbara

Solomon School of Social Work, and I’ve been here since 2018.

EARL BRADFORD SMITH: Hello, everyone. Dr. Earl Bradford Smith, contributing

faculty. And I’ve been with Walden University since 2018.

KATHY PURNELL: We’re here to talk about race and ethnicity. We know those two

words have created a firestorm for hundreds, if not thousands of years. So the first

question is, the discomfort around race and ethnicity can often be difficult for some to

discuss or even understand. Why is this? And why is this not as difficult for others?

LEIGH HICKS: I believe that it brings conflict to some, but when you have a purpose, it’s

one of those things where you understand that your purpose is bigger than the

personalities that surround you. And so that makes it more effective to talk about those

issues.

EMMETT ROBERTS, JR: I think it’s an issue of power. And so those who have power

want to control the narrative and those who don’t have power want to talk about the

impact of those who have power. And so it can be a very contentious conversation topic

because some people say, well you’re saying that I have power that I really don’t have,

and other people are not agreeing with that.

Voices of Diversity: Race and Ethnicity

© 2021 Walden University, LLC 2

EARL BRADFORD SMITH: I believe sometimes people are apathetic towards talking

about the issues because they are afraid of– or insensitive to other people. So that

insensitivity creates that unknown factor of people not becoming aware and not being

able to reach out to another person in a positive way.

KATHY PURNELL: Let me follow up with this piece, this first question, right? We’re all in

the room, we can see what we look like, we all have different stories and experiences,

OK? You can hear I have an accent, but I’m Caribbean, British Caribbean, married to an

African American. But what is a defining moment or a personal story that you’d like to

share about race or ethnicity?

EARL BRADFORD SMITH: My defining moment was coming through high school long

ago, which were predominantly white Catholic schools, and being the one and only in

the schools taught by brothers and sisters, and then going on to a historically Black

university in Nashville, Tennessee. So that was quite a culture shock. And then

proceeding on to be a member of the United States Marine Corps in which the color

was green, and everyone reached out and wanted to be a part of the team.

LEIGH HICKS: I think my dynamic moment is I was a deputy sheriff and predominantly

in South Carolina in a Southern state. So as a Black female, I went through different

challenges, and even with the racial inequality that we saw go on with police officers

and young Black men, I experienced a lot of negativity towards that because I was a

Black female in that field.

EMMETT ROBERTS, JR: And I think for me, personally it happened for me when I was

three. My mom for my whole adult life has been a housekeeper. And so she worked for

white families that had money. And I started out at three years old that I was the live

doll, and that’s kind of the way I look at it as I grew older, of a five-year-old white female.

I was her playmate. That was what I was. And I was very aware of being different.

KATHY PURNELL: I remember being called out with my name by a teacher in 1975.

She called me the equivalent of the N-word. And that defined the whole– my life’s work.

As I said, I never want to be like her, but I never questioned who I was as a result of that

moment. I somehow learned as a young kid to be empowered and educate and help

other people.

Voices of Diversity: Race and Ethnicity

© 2021 Walden University, LLC 3

There are deep historical and current contexts associated with race, the topic of race

and ethnicity, especially in America. How does this resonate with you as a social work

professional and why?

LEIGH HICKS: Well, I think it’s important to address cultural diversity. As a social

worker, being able to understand cultural diversity, cultural competence, cultural

awareness is all important. Also, I think that being able to be up front about it is

important, because it is happening. And then, again, as I stated earlier, understanding

that there are different personalities that surround us but being able to understand what

the purpose is.

EMMETT ROBERTS, JR: For me, I think I– as Dr. Hicks has talked about, looking at it

professionally, being very aware that I’m a Black man in America, and that means

something to some people. And it’s not very positive. And so I always like to bring it to

the classroom to say, with what I have, the resources that I have, if it’s a challenge for

me, I can only imagine what it would be for people who don’t have the resources that I

have.

EARL BRADFORD SMITH: My response to that question through my experience have

been being a role model at all levels, whether it be K-12 or in higher education or social

work practice and mental health, children and youth services or medical and/or school

that I’ve done. So I think that has been a really important aspect.

And secondly, being able to provide an historical context in which the undergraduate

and/or graduate students, too, so they have a better understanding of the injustices

historically that various people have gone through or experienced.

KATHY PURNELL: I think just touched on a very important piece in understanding

history. And we know that there are some concerns around the perception of what

history is and how it should be taught around race and/or ethnicity– i.e., Critical Race

Theory and that many people up in arms and– we know that there’s something special

about storytelling and passing on information to empower, to teach, to bring harmony as

well. But sometimes you’ve got to do the hard work and look at the historical pieces

while we’re working to bring people together.

So what are some helpful strategies to encourage culturally responsive practice or even

think about it in terms of education? We’re social work educators. Some of you are

Voices of Diversity: Race and Ethnicity

© 2021 Walden University, LLC 4

practitioners. How do you integrate or at least identify helpful strategies to encourage

culturally responsive practice?

I think about the first step and the GIM model, engagement. Engagement is very

important. Being able to engage with whoever you’re around. Also, building rapport is

important. Being able to establish those relationships are very important. And once

you’re able to establish relationships, and I believe diversity can be on a– we can

understand diversity, and we’ll be able to understand the sensitivity around it and

everything will work out for the best.

EMMETT ROBERTS, JR: Well, Dr. Leigh, you’re a lot nicer than me because I’ll admit

that it may be some difficult conversations that we need to have.

KATHY PURNELL: Yes, sir.

EMMETT ROBERTS, JR: –as a practitioner, I– as a practitioner and also as an

educator, having those conversations with students about, it’s not your client’s

responsibility to teach you about their culture, it’s their responsibility to share with you

about who they are and how they are seen or impacted by the world. But it’s your

responsibility as a practitioner that when you have those questions, that you use the

resources that you have to go out and explore new things. That you’re the person who

takes the initiative and not expect to sit in your office or on the phone or on camera and

everybody brings what they need or they think they need to you. That you have some

responsibility in that encounter.

LEIGH HICKS: And Dr. Emmett, you’re right. I think for me, it’s because I’m able to look

at it from different lenses as a law enforcement, as a social worker, and just as a human

in general. So I think that’s why, but I do agree with you. Definitely they need to take

that opportunity to do it. But I have that perspective from different lenses.

EARL BRADFORD SMITH: I can also build on what my colleagues are saying as far as

varying perspective, which has been so important to me. But making learning creatively

contextual I think is important. Which connecting the teaching learning to the real world

in 2021 and what’s happening in our society, I think that’s so, so significant. And those

conversations, and we can build on them in a positive way in the classroom.

Another idea that I’ve tried is to readapt the classroom environment, and that means

integrating assignments or experiential learning or quizzes or case studies around

Voices of Diversity: Race and Ethnicity

© 2021 Walden University, LLC 5

diversity, equity, and inclusion. And I think that expands or activates students’ prior

knowledge and makes them more aware of their strengths and weaknesses.

And then the last part is integrating partnerships or guest speakers. Having them come

in, I think, from the community. Like Walden University is– it’s a part of a larger

community, and I know there’s many great professionals out there in the world that will

just be wonderful but are role models for our students.

KATHY PURNELL: Yes. I love all of the ideas. The lenses, the various perspectives.

We’re talking about how we see, how we look, how we do, how we apply, how we

evaluate, how we assess. And the responsibility that each individual has to do the work.

Because I know, during when the George Floyd murder happened, there was a call for

what can we do as practitioners, what can we do with social workers as educators, as

organizations to address and create these spaces for these conversations?

And we saw the doors open for chief inclusion officers. Consultants were in great

demand. Some of our students were, well, what can we do? Even our leadership in–

across the board, but what can we do and how can we do this better? As you think

about today’s topic and the conflict around it, and the fact that we all live as Black

African-American, African-Caribbean individuals, and we know what that means and we

have experiences that we could talk about, what would you like the students to consider

or even take away from this topic or this discussion?

EARL BRADFORD SMITH: Knowledge of ways or strategies to increase their self-

awareness. And then secondly, to be able, like my colleague mentioned earlier, to

expand their knowledge in invariant various resources. And I think that’s important. And

the third aspect, which is to keep growing and developing your skill set, your awareness

skills, and practices around diversity, equity, and inclusion. And to face your fears, and

not be afraid to make the mistakes and to say that I am uncomfortable with this

particular people.

KATHY PURNELL: That takes courage. That last piece takes courage.

LEIGH HICKS: And I’ll say, I agree with my colleague. Everything that he said, I believe,

is accurate, and I believe in order to find that, possibly doing a SWOT analysis where

you can understand your strengths, your weaknesses, the opportunities that are out

there, and any threat. So any threats that may be out there that you are having a hard

Voices of Diversity: Race and Ethnicity

© 2021 Walden University, LLC 6

time dealing with a certain population or if that’s a weakness for you, being able to do a

SWOT analysis and determine that.

KATHY PURNELL: I like that. That’s the sheriff coming out right there.

EMMETT ROBERTS, JR: I like that, and I think for me, one of the things that I push at is

helping everybody to understand that we’re all different. And that as we explore that and

as we understand how different we are, then we understand how much alike we really

are. And that self-exploration. That as you figure out who you are and where you’re

going, that you understand you’re not going by yourself, and that there are others and

on the same journey that you’re on. And you can be of help or of hinder. But in the long

run, it’s best for us– it’s best for us to help each other. Because we’re all on the journey

together.

KATHY PURNELL: I’m a storyteller. And I think that– and that’s something that being a

Caribbean, you hear stories. You hear stories around the table in the morning, stories at

lunchtime, stories when you’re at the markets. You bump into people and there’s always

a story. And I think– just thinking about what you said, Emmett, if people would take the

time to just ask someone about their experience, their story, how they see, what lens

are they using to look at these issues, and listen in not a defensive manner, but in a

manner that will open the floor and the door for true connection.

So I would like to see students think about creating space so that those stories can

happen, but they also listen. And as Dr. Smith said, face the fears. And to do that

analysis. What am I thinking? What am I feeling? Why am I responding to this? Know

our own stories. Know our own biases. Know– just know ourselves so that we can do

the work and continue on this journey as you mentioned.

I thank you for taking the time and providing the nuggets today so that we can continue

with these conversations beyond the Voices of Diversity. Thank you.

Physiology homework help

Medical Terminology: Eyes and Ears

PT116 Unit 4 Assignment

Combining Forms

Meaning

blast/o

blephar/o

chromat/o

conjunctiv/o

corne/o

cycl/o

dacry/o

dipl/o

emmetr/o

glauc/o

ir/o

irid/o

kerat/o

lacrim/o

macul/o

mi/o

mydr/i

nyctal/o

ocul/o

ophthalm/o

opt/o

optic/o

papill/o

phac/o

phot/o

presby/o

pupill/o

retin/o

scler/o

stigmat/o

uve/o

vitre/o

acous/o

audi/o

audit/o

aur/o

auricul/o

cerumin/o

cochle/o

labyrinth/o

mying/o

ot/o

salping/o

staped/o

tympan/o

blast/o

blephar/o

chromat/o

conjunctiv/o

corne/o

cycl/o

Suffixes

Meaning

-ician

-metrist

-opia

-opsia

-tropia

-cusis

-otia

Sound It Out

Directions: Sound out each term and write it in the blank. Spelling counts!!!

off-THAL-mik

KAIR-ah-toh-plass-tee

RET-in-al

kon-junk-tih-VYE-tis

op-TOM-eh-trist

glau-KOH-mah

hem-ee-ah-NOP-ee-ah

ah-STIG-mah-tizm

in-trah-OCK-yoo-lar

LAK-rim-al

my-OH-pee-ah

KAT-ah-rakt

PYOO-pih-lair-ee

KOR-nee-all

foh-toh-FOH-bee-ah

KOK-lee-ar

OH-toh-plas-tee

AW-dih-tor-ee

mir-IN-goh-plass-tee

VER-tih-goh

tim-pah-NOM-eh-tree

oh-TYE-tis

oh-TOL-oh-jist

tin-EYE-tus

AW-dee-oh-gram

Word Building

Build a term that means:

Meaning

drooping eyelid

paralysis of ciliary body

double vision

pertaining to within eye

softening of sclera

retina disease

incision into eardrum

surgical repair of ear

instrument to measure hearing

eustachian tube inflammation

New Word Building

Build a single medical term for each phrase below.



Medical Term

pertaining to the conjunctiva

pertaining to the cornea

pertaining to the iris

pertaining to tears

pertaining to the eye

pertaining to the pupil

pertaining to the retina

pertaining to the sclera

inflammation of the choroid

retina disease

one who measures vision

eye paralysis

double vision

removal of eyelid

softening of the sclera

pertaining to hearing

hearing specialist

pertaining to the ear

pertaining to the cochlea

pertaining to the eardrum

small ear

ear pain

surgical repair of eardrum

incision into the labyrinth

pus flow from ear

Multiple Choice

Bold or highlight the correct answer.

1. The outermost layer of the eye, referred to as the “white” of the eye, is the

a. sclera.

b. choroid.

c. iris.

d. pupil.

2. The medical term for nearsightedness is

a. astigmatism.

b. hyperopia.

c. myopia.

d. presbyopia.

3. The condition characterized by an increase in intraocular pressure is

a. cataract.

b. strabismus.

c. trachoma.

d. glaucoma.

4. The term for involuntary, jerky movements of the eye is

a. glaucoma.

b. nystagmus.

c. myopia.

d. strabismus.

5. The medical term for pinkeye is

a. retinitis.

b. scleritis.

c. blepharitis.

d. conjunctivitis.

6. The medical term for normal vision is

a. hyperopia.

b. myopia.

c. emmetropia.

d. presbyopia.

7. Which of the following is not one of the ossi- cles of the ear?

a. utricle.

b. malleus.

c. incus.

d. stapes.

8. The medical term anacusis means

a. pain in the ear.

b. impairment of hearing.

c. absence of hearing.

d. hearing loss due to aging.

9. In conductive hearing loss,

a. the sound is conducted normally through the external and middle ear but defective in the inner ear.

b. sound transmission is blocked in the middle and outer ear.

c. sound transmission is blocked in the middle and inner ear.

d. sound is conducted normally through the external ear but defective in the middle and the inner ear.

10. The medical term for ringing in the ears is

a. vertigo.

b. tinnitus.

c. hertz.

d. hordeolum.

Page| 1

Physiology homework help

The Evolution of Disease

You will create a timeline of the world’s disease and vaccine evolution for this assignment. For example, you may start with the Spanish Flu, which begins around 1918. Then, list each disease, the onset of the disease, where the disease originated, and death. For vaccines, list who developed the vaccine, by-products used to create the vaccine, how it was administered to the public, and whether it is still used today.

Be creative, including images and graphics if possible. Your timeline should be well-organized and well designed. You may use any software you choose to complete the assignment. However, it is the student’s responsibility to ensure that the assignment file is accessible.


Any file not accessible will receive a grade of zero, with no exceptions. No Late Submissions will be accepted.


Example of Timelines

United Nations Timeline Chart (Timeline Chart example)

How to Create a Timeline Infographic - Venngage

Physiology homework help

TECHNICAL WRITING

A L L I S O N G RO S S , A N N E M A R I E H A M L I N , B I L LY M E RC K , C H R I S RU B I O, J O D I N A A S ,

M E G A N S AVAG E , A N D M I C H E L E D E S I LVA

Open Oregon Educational Resources

Technical Writing by Allison Gross, Annemarie Hamlin, Billy Merck, Chris Rubio, Jodi Naas, Megan Savage, and Michele DeSilva is
licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise
noted.

C O N T E N T S

Acknowledgements vii

External Link Disclaimer viii

CC BY (Attribution)
Introduction 1

1. PROFESSIONAL COMMUNICATIONS

1.1 Texting 7

1.2 E-mail 8

1.3 Netiquette 10

1.4 Memorandums 12

1.5 Letters 15

2. AUDIENCE ANALYSIS

2.1 Types of audiences 21

2.2 Audience analysis 22

2.3 Adapting your writing to meet your audience’s needs 24

3. PROPOSALS

3.1 Some preliminaries 29

3.2 Types of proposals 30

3.3 Typical scenarios for the proposal 31

3.4 Common sections in proposals 32

3.5 Special assignment requirements 34

3.6 Proposals and audience 35

3.7 Revision checklist for proposals 36

4. INFORMATION LITERACY

4.1 Information formats 39

4.2 The information timeline 42

4.3 The research cycle 43

4.4 Research tools 44

4.5 Search strategies 49

4.6 Evaluate sources 55

5. CITATIONS AND PLAGIARISM

5.1 Citations 61

5.2 Plagiarism 65

6. PROGRESS REPORTS

6.1 Functions and Contents of Progress Reports 69

6.2 Timing and Format of Progress Reports 70

6.3 Organizational Patterns or Sections for Progress Reports 71

6.4 Other Parts of Progress Reports 72

6.5 Revision Checklist for Progress Reports 73

7. OUTLINES

7.1 Creating and using outlines 77

7.2 Developing the rough outline 79

8. CREATING AND INTEGRATING GRAPHICS

8.1 Deciding which graphics to include 83

8.2 Other considerations: audience 84

8.3 Other considerations: placement and context 86

8.4 Samples 87

8.5 Guidelines for graphics: a final review 90

9. ETHICS IN TECHNICAL WRITING

9.1 General Principles 95

9.2 Presentation of information 98

9.3 Typical Ethics Issues in Technical Writing 99

9.4 Ethics and documenting sources 102

9.5 Ethics, Plagiarism, and Reliable Sources 103

9.6 Professional ethics 104

10. TECHNICAL REPORTS: COMPONENTS AND DESIGN

10.1 Cover letter 107

10.2 Cover page 108

10.3 Abstract and executive summary 110

10.4 Table of contents 113

10.5 List of figures and tables 115

10.6 Introduction 117

10.7 Body of the report 119

10.8 Conclusions 124

11. BASIC DESIGN AND READABILITY IN PUBLICATIONS

11.1 On Style Conventions 133

11.2 Concept 1: Know Your Audience 135

11.3 Concept 2: Know your Purpose 141

11.4 Concept 3: Make Your Publication More Inviting Using Basic Principles of
Readability: CRAP

143

11.4 Concept 3: Make Your Publication More Inviting Using Basic Principles of
Readability: CRAP, continued

163

11.4 Concept 3: Make Your Publication More Inviting Using Basic Principles of
Readability: CRAP, continued

168

11.4 Concept 3: Make Your Publication More Inviting Using Basic Principles of
Readability: CRAP, continued

173

11.5 Slides and PowerPoint presentations 179

11.6 Conclusion 181

12. EMPLOYMENT MATERIALS

12.1 Preparation 185

12.2 Resume Formats 189

12.3 Resume Sections and Guidelines 195

12.4 Cover Letters 201

12.5 Next Steps 204

13. COMMUNICATING ACROSS CULTURES

13.1 Understanding Culture 209

13.2 Understanding Cultural Context 211

13.3 Deepening Cultural Understanding 212

13.4 Defining Intercultural Communication 214

14. THINKING ABOUT WRITING

14.1 Getting Curious 219

14.2 Genre, Genre Sets, Genre Systems 221

14.3 Methods for Studying Genres 228

14.4 Conclusion 236

AC K N O W L E D G E M E N T S

About this free online technical writing textbook

Much of this text, published under a Creative Commons license, was originally developed by Dr.

David McMurrey, who is both a technical writer and a college instructor. For more about him and his

original work, please visit his biography page at: https://www.prismnet.com/~hcexres/index.html.

He kindly gave his text a CC-BY license at our request so that we could adapt our text from it. We

extend our sincere appreciation to Dr. McMurrey, the team of consultants at Saylor University whose

work shared via open educational resources is also featured in this text, and the host of educators,

librarians, and professionals who have shared their creations with a Creative Commons license. Our

thanks as well to our colleague, Dr. Eleanor Sumpter-Latham, whose work we consulted and adapted

into this text.

Additional materials have been adapted or created by Annemarie Hamlin, Chris Rubio, and Michele

DeSilva of Central Oregon Community College, and Megan Savage, Jodi Naas, Allison Gross,

and Billy Merck of Portland Community College.

We also extend our gratitude to Open Oregon Educational Resources for the grant funding to

pursue this project and especially to Amy Hofer of Open Oregon for her knowledgeable and helpful

answers to many questions.

TECHNICAL WRITING vii

E X T E R N A L L I N K D I S C L A I M E R

This textbook links to external websites over which the authors have no control. The authors have

made efforts to ensure that external links are accurate and operational, but problems are inevitable. If

you find a problem, please report it to Michele DeSilva at michele.desilva@gmail.com.

viii ALLISON GROSS, ANNEMARIE HAMLIN, BILLY MERCK, CHRIS RUBIO, JODI NAAS, MEGAN SAVAGE, AND MICHELE DESILVA

I N T RO D U C T I O N

Technical writing courses introduce you to some of the most important aspects of writing in the

worlds of science, technology, and business—in other words, the kind of writing that scientists,

nurses, doctors, computer specialists, government officials, engineers, and other such people do as a

part of their regular work. The skills learned in technical writing courses can be useful in other fields

as well, including education and social sciences.

To learn how to write effectively for the professional world, you will study common types of

reports, special format items such as lists and headings, simple techniques for creating and using

graphics in reports, and some techniques for producing professional-looking final copy.

Technical writing courses build on what you have learned in other writing courses. But there is

plenty new to learn! If you currently have a job in which you do some writing, you will discover that

you can put what you learn in your technical writing course to immediate use.

A B O U T T E C H N I C A L W R I T I N G

While technical communication is essential in a wide range of fields and occupations, technical

writing is also a fully professional field of its own with degree programs, certifications,

and—yes!—even theory. It is a good field with a lot of growth and income potential, and an

introductory technical writing course is a good way to start if you are interested in a career in this

field or will work in a career in which writing is a component.

W O R K P L AC E W R I T I N G

However, many students of technical writing courses are not necessarily planning for a career as a

technical writer. That is why this course provides you with an introduction to the kinds of writing

skills you need in practically any technically oriented professional job. No matter what sort of

professional work you do, you are likely to do some writing—and much of it may be technical in

nature. The more you know about some basic technical writing skills, the better job of writing you’re

likely to do. And that will be good for the projects you work on, for the organizations you work in,

and—most of all—good for you and your career.

T H E M E A N I N G O F “ T E C H N I C A L”

Technical communication—or technical writing, as the course is often called—is not writing about a

specific technical topic such as computers, but about any technical topic. The term “technical” refers

to knowledge that is not widespread, that is more the territory of experts and specialists. Whatever

your major is, you are developing an expertise—you are becoming a specialist in a particular technical

TECHNICAL WRITING 1

area. And whenever you try to write or say anything about your field, you are engaged in technical

communication.

I M P O RTA N C E O F AU D I E N C E

Another key part of the definition of technical communication is the receiver of the information—the

audience. Technical communication is the delivery of technical information to readers (or listeners

or viewers) in a manner that is adapted to their needs, level of understanding, and background. In

fact, this audience element is so important that it is one of the cornerstones of this course: you are

challenged to write about technical subjects but in a way that a beginner—a nonspecialist—could

understand. This ability to “translate” technical information to nonspecialists is a key skill to any

technical communicator. In a world of rapid technological development, many people are constantly

falling behind. Technology companies are constantly struggling to find effective ways to help

customers or potential customers understand the advantages or the operation of their new products.

So relax! You don’t have to write about computers or rocket science—write about the area of

technical specialization you know or are learning about. And plan to write about it in such a way that

even Grandad can understand!

R E A L LY T E C H N I C A L W R I T I N G

Keep relaxing, but you should know that professional technical writers do in fact write about very

technical stuff—information that they cannot begin to master unless they go back for a Ph.D. But wait

a minute! The technical documents have to ship with the product in less than nine months! How do

they manage? Professional technical writers rely on these strategies to ensure the technical accuracy

of their work:

• Study of books, articles, reports, websites related to the product

• Product specifications: what the product is supposed to do, how it is designed

• Interviews with subject matter experts: the product specialists, developers, engineers

• Product meetings during the development cycle

• Live demonstrations of the product

• Familiarization with similar, competing products

• Experimenting with working models of the product

• Subject matter experts’ review of technical writers’ work for technical accuracy and completeness

Of course, experienced technical writers will tell you that product development moves so fast that

specifications are not always possible and that working models of the product are rarely available.

That’s why the subject matter experts’ review is often the most important.

T E C H N I C A L- W R I T I N G A N D AC A D E M I C W R I T I N G C O U R S E S

You have probably taken at least one academic writing course before this one, so you will be familiar

with some of the practices of writing for your college classes. The video below will introduce you to

some of the differences between academic and technical writing.

2 ALLISON GROSS, ANNEMARIE HAMLIN, BILLY MERCK, CHRIS RUBIO, JODI NAAS, MEGAN SAVAGE, AND MICHELE DESILVA

In technical-writing courses, the main focus is typically the technical report, due toward the end of the

term. Just about everything you do in the course is aimed at developing skills needed to produce that

report. Of course, some technical-writing courses begin with a resume and application letter (often

known as the cover letter), but after that you plan the technical report, then write a proposal in which

you propose to write that report. Then you write short documents (memos, emails, outlines, drafts)

where you get accustomed to using things like headings, lists, graphics, and special notices—not

to mention writing about technical subject matter in a clear, concise, understandable way that is

appropriate for a specific audience.

Caution: You should be aware that technical-writing courses are writing-intensive. You will

probably write more in your technical-writing course than in any other course you have ever taken. If

you are taking a full load of classes, working full time, and juggling unique family obligations, please

consider whether this is the right time for you to take technical writing. Consult with your professor

about the workload for this class in order to make your decision.

C H A P T E R AT T R I B U T I O N I N F O R M AT I O N

This chapter was derived by Annemarie Hamlin, Chris Rubio, and Michele DeSilva, Central Oregon

Community College, from Online Technical Writing by David McMurrey – CC: BY 4.0

TECHNICAL WRITING 3

1. PROFESSIONAL COMMUNICATIONS

Professional communication in written form requires skill and expertise. From text messages to

reports, how you represent yourself with the written word counts. Writing in an online environment

requires tact, skill, and an awareness that what you write may be there forever. From memos to letters,

from business proposals to press releases, your written business communication represents you and

your company: your goal is to make it clear, concise, and professional.

Chapter Attribution Information

This chapter was derived by Annemarie Hamlin, Chris Rubio, and Michele DeSilva, Central Oregon

Community College, from the following sources:

• Online Technical Writing by David McMurrey – CC: BY 4.0

• Professional Writing by Saylor Academy – CC: BY 3.0

• Communicating Online: Netiquette by UBC Centre for Teaching, Learning and Technology –

CC: BY-SA 4.0

1 . 1 T E X T I N G

Text messages and e-mails are part of our communication landscape, and skilled business

communicators consider them a valuable tool to connect.

Whatever digital device you use, written communication in the form of brief messages, or texting,

has become a common way to connect. It is useful for short exchanges, and is a convenient way to stay

connected with others when talking on the phone would be cumbersome. Texting is not useful for

long or complicated messages, and careful consideration should be given to the audience. Although

texting will not be used in this class as a form of professional communication, you should be aware of

several of the principles that should guide your writing in this context.

When texting, always consider your audience and your company, and choose words, terms, or

abbreviations that will deliver your message appropriately and effectively.

T I P S F O R E F F E C T I V E B U S I N E S S T E X T I N G

• Know your recipient. “? % dsct” may be an understandable way to ask a close associate what the

proper discount is to offer a certain customer, but if you are writing a text to your boss, it might be

wiser to write, “what % discount does Murray get on $1K order?”

• Anticipate unintentional misinterpretation. Texting often uses symbols and codes to represent

thoughts, ideas, and emotions. Given the complexity of communication, and the useful but limited

tool of texting, be aware of its limitation and prevent misinterpretation with brief messages.

• Contacting someone too frequently can border on harassment. Texting is a tool. Use it when

appropriate but don’t abuse it.

• Don’t text and drive. Research shows that the likelihood of an accident increases dramatically if

the driver is texting behind the wheel. 1 Being in an accident while conducting company business

would reflect poorly on your judgment as well as on your employer.

C H A P T E R AT T R I B U T I O N I N F O R M AT I O N

This chapter was derived by Annemarie Hamlin, Chris Rubio, and Michele DeSilva, Central Oregon

Community College, from the following sources:

• Online Technical Writing by David McMurrey – CC: BY 4.0

• Professional Writing by Saylor Academy – CC: BY 3.0

1. Houston Chronicle. (2009, September 23). Deadly distraction: Texting while driving, twice as risky as drunk driving, should be banned. Houston

Chronicle (3 STAR R.O. ed.), p. B8. Retrieved from http://www.chron.com/opinion/editorials/article/Deadly-distraction-Texting-while-

driving-should-1592397.php

TECHNICAL WRITING 7

1 . 2 E – M A I L

E-mail is familiar to most students and workers. It may be used like text, or synchronous chat, and

it can be delivered to a cell phone. In business, email has largely replaced print hard copy letters for

external (outside the company) correspondence, and in many cases, it has taken the place of memos

for internal (within the company) communication.1 E-mail can be very useful for messages that have

slightly more content than a text message, but it is still best used for fairly brief messages. Many

businesses use automated e-mails to acknowledge communications from the public, or to remind

associates that periodic reports or payments are due. You may also be assigned to “populate” a form

e-mail in which standard paragraphs are used, but you choose from a menu of sentences to make the

wording suitable for a particular transaction.

E-mails may be informal in personal contexts, but business communication requires attention to

detail, awareness that your e-mail reflects you and your company, and a professional tone so that it

may be forwarded to any third party if needed. E-mail often serves to exchange information within

organizations. Although e-mail may have an informal feel, remember that when used for business, it

needs to convey professionalism and respect. Never write or send anything that you wouldn’t want

read in public or in front of your company president.

T I P S F O R E F F E C T I V E B U S I N E S S E – M A I L S

As with all writing, professional communications require attention to the specific writing context,

and it may surprise you that even elements of form can indicate a writer’s strong understanding of

audience and purpose. The principles explained here apply to the educational context as well; use

them when communicating with your instructors and classroom peers.

• Open with a proper salutation. Proper salutations demonstrate respect and avoid mix-ups in case

a message is accidentally sent to the wrong recipient. For example, use a salutation like “Dear Ms.

X” (external) or “Hi Barry” (internal). Never use the title Mrs. as you cannot assume a woman is

married. If the gender of a person is not evident, use their entire name, like this: “Dear Sam Jones”

• Include a clear, brief, and specific subject line. This helps the recipient understand the essence of

the message. For example, “Proposal attached” or “Your question of 10/25.”

• Close with a signature. Identify yourself by creating a signature block that automatically contains

your name and business contact information.

• Avoid abbreviations. An e-mail is not a text message, and the audience may not find your wit

cause to ROTFLOL (roll on the floor laughing out loud).

1. Guffey, M. (2008). Essentials of business communication (7th ed.). Mason, OH: Thomson/Wadsworth.

8 ALLISON GROSS, ANNEMARIE HAMLIN, BILLY MERCK, CHRIS RUBIO, JODI NAAS, MEGAN SAVAGE, AND MICHELE DESILVA

• Be brief. Omit unnecessary words.

• Use a good format. Divide your message into brief paragraphs for ease of reading. A good e-mail

should get to the point and conclude in three small paragraphs or less.

• Reread, revise, and review. Catch and correct spelling and grammar mistakes before you press

“send.” It will take more time and effort to undo the problems caused by a hasty, poorly written e-

mail than to get it right the first time.

• Reply promptly. Watch out for an emotional response—never reply in anger—but make a habit of

replying to all e-mails within twenty-four hours, even if only to say that you will provide the

requested information in forty-eight or seventy-two hours.

• Use “Reply All” sparingly. Do not send your reply to everyone who received the initial e-mail

unless your message absolutely needs to be read by the entire group.

• Avoid using all caps. Capital letters are used on the Internet to communicate emphatic emotion

or yelling and are considered rude.

• Test links. If you include a link, test it to make sure it is working.

• E-mail ahead of time if you are going to attach large files (audio and visual files are often quite

large) to prevent exceeding the recipient’s mailbox limit or triggering the spam filter.

• Give feedback or follow up. If you don’t get a response in twenty-four hours, e-mail or call. Spam

filters may have intercepted your message, so your recipient may never have received it.

Figure 1 shows a sample email that demonstrates the principles listed above.

Figure 1. Sample email

From: Steve Jobs <sjobs@apple.com>
To: Human Resources Division <hr@apple.com>
Date: September 12, 2015
Subject: Safe Zone Training

Dear Colleagues:
Please consider signing up for the next available Safe Zone workshop offered by the College. As you know, our department is working toward

increasing the number of Safe Zone volunteers in our area, and I hope several of you may be available for the next workshop scheduled for Friday,
October 9.

For more information on the Safe Zone program, please visit http://www.cocc.edu/multicultural/safe-zone-training/
Please let me know if you will attend.
Steve Jobs

CEO Apple Computing
sjobs@apple.com

C H A P T E R AT T R I B U T I O N I N F O R M AT I O N

This chapter was derived by Annemarie Hamlin, Chris Rubio, and Michele DeSilva, Central Oregon

Community College, from the following sources:

• Online Technical Writing by David McMurrey – CC: BY 4.0

• Professional Writing by Saylor Academy – CC: BY 3.0

TECHNICAL WRITING 9

1 . 3 N E T I Q U E T T E

Netiquette refers to etiquette, or protocols and norms for communication, on the Internet. We create

personal pages, post messages, and interact via online technologies as a normal part of our careers,

but how we conduct ourselves can leave a lasting image, literally. The photograph you posted on your

Facebook page or Twitter feed may have been seen by your potential employer, or that nasty remark

in a post may come back to haunt you later.

Following several guidelines for online postings, as detailed below, can help you avoid

embarrassment later.

K N O W YO U R C O N T E X T

• Introduce yourself.

• Avoid assumptions about your readers. Remember that culture influences communication style

and practices.

• Familiarize yourself with policies on Acceptable Use of IT Resources at your organization. (One

example of a college’s acceptable use policy can be found here: https://www.cocc.edu/

departments/its/network-administration/files/

cocc_acceptable_use_of_information_technology_resources_12.pdf/ )

R E M E M B E R T H E H U M A N

• Remember there is a person behind the words. Ask for clarification before making judgement.

• Check your tone before you publish.

• Respond to people using their names.

• Remember that culture and even gender can play a part in how people communicate.

• Remain authentic and expect the same of others.

• Remember that people may not reply immediately. People participate in different ways, some just

by reading the communication rather than jumping into it.

• Avoid jokes and sarcasm; they often don’t translate well to the online environment.

R E C O G N I Z E T H AT T E X T I S P E R M A N E N T

• Be judicious. What you say online is difficult to retract later.

• Consider your responsibility to the group and to the working environment.

10 ALLISON GROSS, ANNEMARIE HAMLIN, BILLY MERCK, CHRIS RUBIO, JODI NAAS, MEGAN SAVAGE, AND MICHELE DESILVA

• Agree on ground rules for text communication (formal or informal; seek clarification whenever

needed, etc) if you are working collaboratively.

AVO I D F L A M I N G : R E S E A RC H B E F O R E YO U R E AC T

• Accept and forgive mistakes.

• Consider your responsibility to the group and to the working environment.

• Seek clarification before reacting.

• Ask your supervisor for guidance.*

R E S P E C T P R I VAC Y A N D O R I G I N A L I D E A S

• Quote the original author if you are responding to a specific point made by someone else.

• Ask the author of an email for permission before forwarding the communication.

* Sometimes, online behavior can appear so disrespectful and even hostile that it requires

attention and follow up. In this case, let your supervisor know right away so that the right

resources can be called upon to help.

C H A P T E R AT T R I B U T I O N I N F O R M AT I O N

This chapter was derived by Annemarie Hamlin, Chris Rubio, and Michele DeSilva, Central Oregon

Community College, from Communicating Online: Netiquette by UBC Centre for Teaching,

Learning and Technology – CC: BY-SA 4.0

TECHNICAL WRITING 11

Physiology homework help

6051 Discussion 1 – Week 3 Nw

Discussion 1: Voices of Diversity: Race and Ethnicity

How do you even begin to talk about race and ethnicity? And, specifically in a social work context, how do you broach these topics with clients, families, and communities? In 1994, eight American men of various backgrounds (African, Asian, European, and Latino descent) sat down together in a room to talk about race. What followed was a raw, emotional, and difficult conversation that peeled back the layers of racism’s impact. Although the Color of Fear film is decades old now, the need to talk about race remains.

For this Discussion, you view one such conversation among faculty and then analyze what you observed, considering the various perspectives and how they may inform social work practice.

To Prepare:

· View the Voices of Diversity: Race and Ethnicity video showing Social Work faculty sharing perspectives and experiences related to race and ethnicity.

· Reflect on the video, identifying ideas, experiences, or statements that resonate with you, as well as strategies that were described.

By Day 03/16/2022

Analyze what you learned from the Voices of Diversity video regarding perspectives and experiences related to race and ethnicity. Specifically:

· What idea, experience, or statement resonated with you the most, and why?

· What is one strategy described in the video that you will apply toward your self-awareness and/or cultural competence? How might this strategy help when working with a client who is racially or ethnically different from you?

Follow rubric

Initial Posting: Content

14.85 (49.5%) – 16.5 (55%) Initial posting thoroughly responds to all parts of the Discussion prompt. Posting demonstrates excellent understanding of the material presented in the Learning Resources, as well as ability to apply the material. Posting demonstrates exemplary critical thinking and reflection, as well as analysis of the weekly Learning Resources. Specific and relevant examples and evidence from at least two of the Learning Resources and other scholarly sources are used to substantiate the argument or viewpoint.

Follow-Up Response Postings: Content:

6.75 (22.5%) – 7.5 (25%) Student thoroughly addresses all parts of the response prompt. Student responds to at least two colleagues in a meaningful, respectful manner that promotes further inquiry and extends the conversation. Response presents original ideas not already discussed, asks stimulating questions, and further supports with evidence from assigned readings. Post is substantive in both length (75–100 words) and depth of ideas presented.

Readability of Postings

5.4 (18%) – 6 (20%)

Initial and response posts are clear and coherent. Few if any (less than 2) writing errors are made. Student writes with exemplary grammar, sentence structure, and punctuation to convey their message.

Required Readings

Sue, D. W., Rasheed, M. N., & Rasheed, J. M. (2016). Multicultural social work practice: A competency-based approach to diversity and social justice (2nd ed.). Jossey-Bass.

· Chapter 6: Racial/Cultural Minority Identity Development (pp. 151–177)

· Chapter 7: White Racial Identity Development (pp. 179–206)

· Chapter 12: Multicultural Organizational Change: Antiracist Practice and Social Justice (“Antiracist Practice and Social Justice” section, pp. 359–368 only)

National Association of Social Workers. (2020, June 10). Anti-racism now and forever more. https://www.socialworkers.org/News/News-Releases/ID/2187/Anti-Racism-Now-and-Forever-More

Walden University. (2021, March 18). A message on anti-Asian racism. https://www.waldenu.edu/news-and-events/walden-news/2021/3-18-a-message-on-anti-asian-racism

Required Media

Center for Prevention MN. (2021, January 26). What is structural racism? [Video]. YouTube. https://www.youtube.com/watch?v=ZllrF9EB-lY

Note: The approximate length of this media piece is 1 minute. 

Science Animated. (2021, March 16). Navigating white privilege – the key to achieving anti-racism in social work [Video]. YouTube. https://www.youtube.com/watch?v=rstAt9da4_k

Note: The approximate length of this media piece is 2 minutes.

Voices of Diversity: Race and Ethnicity

Time Estimate: 17 minutes

Voices of Diversity: Race and Ethnicity Program Transcrip included in a different document

Physiology homework help

DOMINANT AND NON-DOMINANT
CULTURAL CHARACTERISTICS

Age > NEUTRAL

Disability > NEUTRAL

Religion/Spirituality > SOMEWHAT DOMINANT

Ethnic/Racial Identity > SOMEWHAT NON-DOMINANT

Social Class > NEUTRAL

Sexual/Affectional Orientation > DOMINANT

Indigenous Backgrounds > DOMINANT

National Origin > NEUTRAL

Gender Identity > NEUTRAL

Gender Expression > NEUTRAL

Size > SOMEWHAT NON-DOMINANT

Assigned Sex at Birth > NEUTRAL

Physiology homework help

Nicolae Testemitanu State University of Medicine and Pharmacy

REGULATION

on the development and defense of the licentiate thesis

Page 1/18

APPROVED

minutes of the session of the Senate

no. 3/7 of 25.03.2021

REGULATION

on the development and defense of the licentiate thesis at

Nicolae Testemitanu State University of Medicine and Pharmacy

of the Republic of Moldova

I. GENERAL PRVISIONS

1. This Regulation establishes the main rules regarding the development, structure, graphic

design and defense of the licentiate thesis at Nicolae Testemitanu State University of

Medicine and Pharmacy (hereinafter “University”) and is developed on the basis of the

following provisions:

• Education Code no.152 of July 17, 2014;

• Government Decision No. 482 of 28 June 2017 on the approval of the Nomenclature

of Professional Training and Specialties in Higher Education;

• Regulation on the organization of licentiate (cycle I) and integrated studies, approved

by the MECR Order RM no. 1625 of 12.12.2019;

• The Framework Regulation on the organization of the final exam for higher

education, approved by Order of the Minister of Education No. 1047 of 29.10.2015

• The framework plan for undergraduate (cycle I), master’s degree (cycle II) and

integrated higher education, approved by order of the Minister of Education, Culture

and Research no. 120 of February 10, 2020;

• Regulation on the organization of licentiate (cycle I) and integrated (Bachelor and

Master) studies at Nicolae Testemitanu State University of Medicine and Pharmacy

of the Republic of Moldova approved by the Senate no. 2/2 of 27.02.2020

• Regulation on the organization of the graduation examination in integrated higher

education at Nicolae Testemitanu State University of Medicine and Pharmacy of the

Republic of Moldova, no. 1/8 of 06.04.2017;

• Regulation on the prevention of academic plagiarism within the IP Nicolae

Testemitanu State University of Medicine and Pharmacyof the Republic of Moldova,

no. 2-p§3 of 25.03.2015;

• The Charter of Nicolae Testemitanu State University of Medicine and Pharmacy

registered at the Ministry of Justice on 29.01.2020.

2. Licentiate thesis is a component stage of the Licentiate Examination in licentiate higher

education (cycle I) and of the Graduation Examination in integrated higher education (cycles

I+ II).

3. The licentiate thesis is an important component in the assessment of the graduate’s

knowledge and scientific activity it tests the skills to conceive and conduct independent

research as well as to draw up and present the results of the research according to the

rules of the scientific community.

Nicolae Testemitanu State University of Medicine and Pharmacy

REGULATION

on the development and defense of the licentiate thesis

Page 2/18

4. The development of the licentiate thesis is aimed at:

• development of the graduates’ skills to conduct research and acquire the research

methods in the specialty field;

• systematization and application of the theoretical knowledge in the specialty in the

process of development of practical solutions, specific to the field of professional

training or the realization of the case studies;

• appreciation of the graduate’s capacities and the degree of training for individual post-

graduate professional activity.

5. Faculty Dean’s offices, as the case, will ensure the plagiarism verification of the licentiate

thesis.

II. CHOOSING OF THE THEME AND THE SCIENTIFIC ADVISOR

6. The theme of the licentiate thesis is proposed by the departments / teaching chairs and

placed in the Didactic Module of the University Information Management System

(further – SIMU).

7. The dean’s offices will approve the themes of the theses proposed by the departments /

chairs for each study program, after which they become accessible to the students in

SIMU.

8. From the list proposed by chairs in SIMU, the students select the theme of the license

thesis, usually, by the end of semester VIII of studies for the programs of integrated

higher studies lasting 6 years, semester VII – for the programs of integrated higher studies

with the duration for 5 years; VI semester – for the higher education programs.

9. In order to coordinate the development of the thesis, the departments / chairs confirm a

thesis advisor. University professors, associate professors, lecturers or university

assistants with a scientific degree of the departments / chairs may be appointed as

scientific advisors.

10. The themes for the licentiate thesis can be edited and modified with the approval of the

scientific advisor of the thesis, being approved by the head of chair.

11. The student can change the theme and / or the scientific advisor only once, after being

informed and with the approval of the initial scientific advisor and the Faculty Dean.

Changing the theme and the scientific advisor is no longer possible starting with the first

semester of the last year of study.

12. A scientific advisor may coordinate a maximum of 5 theses (cumulative in all study

programs) for one academic year. The Dean’s Office will coordinate the number of

licentiate theses made within the chair according to the number of students at the faculty

and of the teaching staff at the department / chair.

Nicolae Testemitanu State University of Medicine and Pharmacy

REGULATION

on the development and defense of the licentiate thesis

Page 3/18

III. STRUCTURE AND PRINCIPLES OF THE LICENTIATE THESIS

DEVELOPMENT

13. The licentiate thesis must demonstrate the student’s ability to work with literature relevant

to the subject. The thesis should be developed correctly from the point of view of

methodology, data analysis and argumentation, have a logical structure, be written in

scientific language. The aspect must be in accordance with academic standards and

comply with the scientific writing recommendations (structure, wording, bibliography)

provided in Section IV of this Regulation.

14. The license thesis can be carried out in the form of:

• original research work (dicriptive study, analytical study, clinical, pre-clinic

experimental, clinical case study, case series, etc.)

• literature synthesis work.

15. Licentiate theses are developed and written in Romanian or in the language of the

student’s studies.

16. The structure of the diploma thesis comprises the following sections:

• Title page;

• Declaration of responsibility, signed by the author;

• Contents;

• List of Abbreviations;

• Introduction;

• The content of the work as follows:

a. Original research work:
✓ Chapter I. The bibliographic analysis of the theme;

✓ Chapter II. Material and methods of research;

✓ Chapter III. Own results and discussions;

✓ General conclusions;

✓ Bibliography

✓ Annexes (if required);

b. specialized literature synthesis work:
✓ Methodology for selecting bibliographic sources (databases, period, keywords;

inclusion and exclusion criteria, etc.);

✓ The main part, consisting of 1-2 chapters

✓ Discussions;

✓ Conclusions;

✓ Bibliography.

✓ Annexes (if required);

16.1. Title page – is done in accordance with Annex 1.

16.2. Declaration of responsibility – is written in accordance with Annex 2 and is placed
after the title page.

Nicolae Testemitanu State University of Medicine and Pharmacy

REGULATION

on the development and defense of the licentiate thesis

Page 4/18

16.3. Contents – it is recommended to be placed at the beginning of the work, after the
Declaration, where the names of the chapters, the subchapters, the other parts of

the thesis and the corresponding pages are written.

16.4. List of Abbreviations (as the case) – the international abbreviations, unanimously
accepted in the field of the theme of the thesis, are used.

16.5. Introduction, where the following are recorded:
a. the actuality of the problem;

b. purpose and objectives of the research;

c. the practical importance of the work (as the case).

The volume of the introduction should not exceed 2-3 pages.

16.6. For the original research theses:

✓ Chapter I. „The bibliographic analysis of the theme”. It will carry out a critical

evaluation of the relevant literature for the research theme, will have a concrete

name, reflecting the theme of the research. The section will contain analysis of

different bibliographic sources on the thesis: scientific articles, monographs,

manuals, guides, clinical protocols, etc. published in the country and abroad. The

main theories, explanatory templates, showing the development and progress of

recent research, and possible gaps or limitations, will be presented. The chapter

will be structured on subchapters, which will correspond to the research

objectives. The chapter will present the theoretical framework of the studied

problem and will not exceed 30-35% of the number of pages of the theses. The

priority will be given to the literature of the last five years (at least 50 %).

✓ Chapter II “Material and methods of research” (if necessary, will be structured

in subchapters) will include the general characteristic of the study – the type of

study, the design of the research, the material studied; research methods, etc. and

the methodology of mathematical and statistical analysis of the obtained results.

The volume of this compartment will not exceed 3-4 pages and should answer the

following questions:

• what was the study material (if applicable, name, group, series, producer,

country);

• sampling mode (if applicable);

• type of study chosen, according to research

• reagents and standards used (if applicable) – chemical name, quality,

concentration, manufacturer, country of origin;

• the equipment used (type, model, producer, country of origin);

• which parameter / parameters are / is to be assessed and assessment methods;

• what was the way to obtain the reagent solutions, stock, working;

• what were the working conditions, including the way of preparing the sample

for analysis (if applicable);

• the statistical methods used and the substantiation of their use.

The information must be sufficiently precise for a reader to reproduce and verify

Nicolae Testemitanu State University of Medicine and Pharmacy

REGULATION

on the development and defense of the licentiate thesis

Page 5/18

the reported work.

✓ In Chapter III “Own results and Discussions” the results, which will be in

accordance with the design and the research methods used, will be presented. In

this part of the paper the tables and figures, which will present the results of the

research and the discussion of these, the statistical processing of the data and the

own opinion of the research, will be included. Interpretation of own data will be

done by reference to data from the literature, indicating similarities and

differences.

16.7. For specialized literature synthesis work:

✓ The main part can consist of 1-2 chapters, which will contain:

• description of the relevance of the research topic, the situation in the field and

the controversies registered;

• presentation of the types of studies carried out in the field (for example:

descriptive or analytical, observational or experimental, etc.) and the

techniques used without a detailed description of the experimental procedure

and how they are applied;

• description of the most important results, published in recent scientific articles;

• dynamic development and scientific progress in approaching the proposed

topic for research;

• finding certain thematic aspects, being highlighted various opinions and

conclusions of the authors;

• use of figures and / or tables (with source indication), to support the synthesis

of results, made by the author of the publication or to present the most relevant

results taken directly from the scientific article.

✓ The Discussion section is described in a separate chapter, the purpose of which

is to interpret the exposed narrative material, which will include:

• interpretation, critical analysis and explanation of the literature review exposed

in the main part;

• mentioning and explaining the limits of the research (synthesis) performed on

the topic of the thesis based on the objectives set;

• mentioning the aspects of the license thesis insufficiently addressed in the

literature in the field in order to suggest future research directions;

• the interpretations offered must logically lead to conclusions.

16.8. Conclusions will be briefly written out on points that will contain a summary of
the results obtained and will reflect their opinions and personal contribution in

studying and elucidating the problem addressed.

16.9. The Bibliography will contain bibliographic sources used in the paper. It will be
made up according to international requirements (Annex 3). The references will be

presented in a numerical sequence according to the alphabetical order of the names

of the first authors with the preservation of the unique numbering. References to

bibliographic sources are indicated in square brackets, inserted into the text, for

Nicolae Testemitanu State University of Medicine and Pharmacy

REGULATION

on the development and defense of the licentiate thesis

Page 6/18

example – [8]. In the case of licentiate theses in the form of narrative synthesis of

the literature, the minimum number of bibliographic sources will be 40.

16.10. In the Annexes various materials (survey questionnaire, investigations, schemes,
photographs, case study, etc.) relevant to the study undertaken will be included. If

some aspects of the research have been published or communicated in the scientific

manifestations, copies of the summaries or scientific articles in the original

documents and the active participation certificates, will be obligatory presented in

the annexes. Own publications must be cited in the “Bibliography” section.

IV. RULES ON THE GRAPHIC ASPECT OF THESES

17. The theses should be written on white paper, A4 sized, 210 x 297 mm, on one side of the

paper.

18. The pages of the thesis will have the following fields: left – 30 mm, up and down – 20

mm, on the right – 15 mm. All pages of the thesis, except for the title sheet, will be

numbered, the number placed in the center of the page, down. Repeating and absence of

pageing is not allowed.

19. The thesis will be computerized, using the Times New Roman font – 12 pt, at 1.5 intervals

and using the appropriate diacritical marks (ă, î, â, ș, ț). When capitalizing titles,

capitalization and font 14 are allowed, as well as highlighting certain words with Bold or

Italic.

20. Each section of the thesis will start from the new page. The chapters will be capitalized,

bold, centered, numbered with Arabic numerals (1; 2); the word “chapter” is not written.

The subchapter titles are written in lower case and are numbered in Arabic numerals (1.1,

1.2, 2.1, etc.) The first line of each paragraph starts with a 1 cm paragraph. (Annex 4).

(as amended by Senate Decision No. 16/7 of 28.11.2018).

21. Formulas, tables and figures are numbered consecutively without taking into account the

chapter number, for example:

✓ figure 5 – in the explanatory text or Figure 5. – in the title of the figure, which is placed

below the figure using the font Times New Roman Regular, Centered (Annex 4);

✓ table 7 – in the explanatory text and Table 7. – in the name of the table, placed above it,

using Times New Roman, Regular, Centered (Annex 4);

✓ the formula is placed at the beginning of the line, and its number – at the end of the

line (Annex 4);

✓ if necessary, mention the data source in the table / figure under the title of the table /

figure aligned between the left and right margins, indicating the name of the author /

s, title of the work, publisher, year, page, or address of the online source (in the same

way as the Bibliography is done);

✓ If there are tables that contain notes, they will be written immediately after the table,

not in the bottom of the page or in the body of the table.

Nicolae Testemitanu State University of Medicine and Pharmacy

REGULATION

on the development and defense of the licentiate thesis

Page 7/18

22. In the thesis it is allowed to abbreviate combinations of words, compound words, words

commonly used in accordance with international abbreviations, unanimously accepted in

the scientific community and provided that they do not create difficulties in reading the

text and do not cause ambiguities.

23. Notes, corrections, letter outlines, erasures, spots, page additions, etc. are not allowed in

the thesis.

24. The thesis will have an average volume of 30-45 pages.

V. DEFENSE AND ASSESSMENT OF THE LICENTIATE THESES

25. Completion of the thesis is subject to obtaining the agreement of the scientific advisor by

admitting the student to the prior defense at the department / chair / discipline.

26. The licentiate thesis in its final form will be submitted to the department / chair for prior

defense at least one month before the deadline indicated for defense.

27. Prior defense will be made at the department / chair / discipline meeting, during which

students will present the obtained results (Power Point).

28. The student is admitted to the public defense of the license thesis within the Assessment

Board, if the license thesis presented at the prior defense has been approved by the

department / chair / discipline, fact confirmed by the extract from the minutes stating the

student’s name, the qualification “admitted”.

29. The thesis will be covered after its approval at the meeting of the respective department

/ chair / discipline and will be presented 10 days before the final defense to the

Assessment Board, the composition of which will be approved by order of the rector. In

case of defending the thesis online, it will be presented in PDF format.

30. The department / chair / discipline will present in the Dean’s office all the theses

developed within the chair in electronic format the PDF version, which is kept in the

Dean’s archive.

31. The thesis defense will be public and will be held in the open session of the Assessment

Board at the chair / department in which the student dveloped the license thesis, in the

presence of at least 2/3 of the number of members, in the form of a summary presentation

of the thesis by the author, supported by Power Point presentation, for which he is granted

up to 15 minutes.

32. If the theme of the licentiate thesis is interdisciplinary, the interdisciplinary Assessment

Board will be created by the rector’s order.

33. The chairman of the Assessment Board coordinates the defense of the license theses, asks

questions, gives notes, ensures the preparation of the minutes and is responsible for

complying with the provisions of the Regulation.

Nicolae Testemitanu State University of Medicine and Pharmacy

REGULATION

on the development and defense of the licentiate thesis

Page 8/18

34. The members of the Assessment Board ask questions, give grades and perform any other

tasks established by the chairman, for the smooth running of the license theses defense.

35. The Secretary of the Board asks questions, gives grades and ensures his administrative

activity: checking and preparing the classrooms for public defense, taking the license

theses, taking the assessment sheets of the commission to the Dean’s ( one per student),

taking and verifying the materials of presentation by the students of the license theses, as

well as other attributions given to him by the Chairman of the Commission for the smooth

running of the theses defense.

36. The licentiate thesis will be assessed according to the following criteria:

– the quality of writing the license thesis and observing the structuring rules;
✓ carrying out of the study / research itself;

✓ bibliography quality;

✓ quality of oral presentation and aswering of Board’s questions;

✓ confirmation of research results publication (article, thesis, report, poster).

37. The decision on the mark for license thesis defense will be taken at the closed assessment

board meeting, according to the evaluation algorithm and using of assessment sheet

(annex 5), based on the criterie for final assessment of the licentiate theses (annex 6).

38. When the scientific advisor is a member of the assessment board, he will not take part in

the thesis assessment.

39. The final mark of the presented thesis will be calculated by the arithmetic average of the

Assessment Sheets drawn up in accordance with the model in Annex 7 by the members

of the Board.

40. The results of the paper’s defense will be communicated to the students on the same day

after the assessment board meeting.

41. The marks obtained by the candidate will be reflected in the minutes of the Assessment

Board meeting, the student’s record-book and the Supplement to the Diploma.

42. The absence without good reason on a licentiate thesis defense or the obtaining of a mark

less than “5” is qualified as a failure of the graduation / licentiate examination.

43. Final mark is written in arabic numerals (it will be rounded to 0,5 decimals in favour of

the student) and in letters.

44. Students have the right to appeal the Board’s decision one day after the announcement

of the Graduation examination results and are recorded by the board’s secretary in the

register of appeals.

45. Appeals will be examined by the Appeal’s Board, approved by the rector’s order during

one day after it’s submission. Appeals examination is registered in the separate minutes

signed by the members of the Examination and Appeals Boards.

Nicolae Testemitanu State University of Medicine and Pharmacy

REGULATION

on the development and defense of the licentiate thesis

Page 9/18

46. Appeals Board checks and assesses the presentation again (based on the on-line

registration) and the licentiate thesis. The changing of the appealed mark is done by

raising or decreasing of it and remains conclusive.

47. If the licentiate thesis has been assessed with a mark less than “5”, the thesis can be

defended next year at the next session of the graduation examination. the Board decides

whether, is necessary to change the theme of the thesis.

48. The insufficient mark (1-4) got for the thesis does not deprive the student of the right to

take the computer assisted examination stage.

V. FINAL PROVISIONS

49. This Regulation enters into force on the date of its approval by the SUMPh Senate.

50. All subsequent amendments and additions to this Regulation enter into force upon their

approval by the SUMPh Senate.

51. The Deans of Faculties have the obligation to make public the Regulation on the defense

of the licentiate thesis on the faculty webpage.

Signed by:

First Vice rector,

vice-rector for academic issues _____________ Olga Cernetchii

Vice-rector for Research _____________ Stanislav Groppa

Head of Department of

Didactics and Academic Management _____________ Silvia Stratulat

Head of Unit of Academic

Management Quality _____________ Virginia Salaru

Dean of Faculty of Medicine no 1 _____________ Gheorghe Placinta

Dean of Faculty of Medicine no 2 _____________ Mircea Betiu

Dean of Faculty of Pharmacy _____________ Nicolae Ciobanu

Dean of Faculty of Dentistry _____________ Oleg Solomon

Nicolae Testemitanu State University of Medicine and Pharmacy

REGULATION

on the development and defense of the licentiate thesis

Page 10/18

Annex 1. Title page

Ministry of Health, Labor and Social Protection of the Republic of Moldova
(font 14, Bold, Centered)

Nicolae Testemitanu State University of Medicine and Pharmacy
(font 14, Bold, Centered)

FACULTY NAME
(font 14, Bold, Centered, Uppercase)

Department/Chair of name
(font 16, Bold, Centered)

Licentiate thesis
(font 15)

THEME OF THE THESIS IN CAPITAL LETTERS (font 18,
Bold, Centered)

SURNAME, first name of the student (font 14, Bold, Centered)

Year __, group __

Scientific advisor:

Surname and name of the scientific advisor(s) (font 14, Bold)

Scientific degree, didactic degree (font 14, Bold, Italic)

Chisinau, year

Nicolae Testemitanu State University of Medicine and Pharmacy

REGULATION

on the development and defense of the licentiate thesis

Page 11/18

Annex 2

DECLARATION

I, Name, Surname, hereby declare on my own responsibility that the licentiate thesis

entitled “The Complete Title of the License Thesis” is prepared by myself, the materials

presented are the results of my own research, are not plagiarized from other scientific papers

and have not been presented at another faculty or higher education institution in the country

or abroad.

I also declare that all sources used, including the Internet, are indicated in the

licentiate thesis, in compliance with the plagiarism avoidance rules:

✓ all fragments of text reproduced exactly, even in my own translation from another

language, are written with reference to the original source;

✓ rewriting of the texts of other authors in my own words has the reference to the

original source;

✓ summary of other authors’ ideas has the exact reference to the original text;

✓ work methods and techniques taken from other sources have exact references to

original sources.

Date _______________________

Graduate _______________________ ___________________
(Surname Name) (Signature)

Nicolae Testemitanu State University of Medicine and Pharmacy

REGULATION

on the development and defense of the licentiate thesis

Page 12/18

Annex 3. Examples of bibliography presentation

The editing of the bibliography will be done in strict compliance with (letters type, order of

quotes, punctuation marks) the following model:

✓ for articles the following things are mentioned: author’s name, title of the article, magazine
name, year of appearance, volume, first and last page.

Example:

1. Baranețchi I., Prisacari V. Factori de risc în infecțiile septico-purulente nosocomiale de
profil traumatologie și ortopedie. Studiu descriptiv transversal. În: Moldovan Journal of

Health Sciences. Revista de Științe ale Sănătății din Moldova. 2016, 2 (8), p.15-27. ISSN

2345-1467.

2. Casian D. A. Regarding an alternative treatment for varicose veins: ligation plus foam
sclerotherapy. In: Dermatologic Surgery. 2012, 38(1), 146-147. ISSN 1524-4725. doi:

10.1111/j.1524-4725.2011.02212.x (IF: 1,798).

3. Chung DR, Zang WS, Kim SB et al. Treatment of herpetitis B virus associated
glomerulonephritis with recombinant human alpha-interferon. In: Am J Nephrol, 1997,

17:112-117.

4. Hotineanu V., Moraru V., Bujor P., Bujor S. Cholelithiasis – epidemiology, risk factors and
etiopathogenic aspects: Up-to-Date. In: Jurnal de chirurgie, 2014, X, 2, p. 101-104. NSN

1584-9341.

✓ for books the following things are mentioned: authors’ names, title of the book, publishing
house, place of appearance, year of appearance, first and last page.

Example:

5. Ciobanu Gh. Resuscitarea cardiorespiratorie și cerebrală. Volumul 1. Serghienco-
Ciobanu, L. (red. șt.). Chișinău. Nova-Imprim; 2014.

6. Popovici I, Lupuleasa D. Tehnologie farmaceutică, Ed. Polirom, Iasi, 2001.

✓ all the bibliographic sources included in the licentiate thesis must be in the final bibliographic
list. For the sources downloaded from the internet, web page addresses will be noted. In the

final bibliography, they must be at the end of the list:

Example:

7. Jones ET, Miles C. Computing networking. 2nd edition. Derby, Bugle Press; 2002.
Disponibil la: http:/www.imperial.ac.uk/library/digitallibrary [accesat la 10.06.2007].

Note: 1. Articles published online may not have the number of pages.

2. If some parts of the thesis were published or communicated during scientific events, the thesis
will incorporate a copy of the abstracts or scientific articles from the original documents

(magazine, abstract book). These articles will be mandatory cited in the Bibliography.

Nicolae Testemitanu State University of Medicine and Pharmacy

REGULATION

on the development and defense of the licentiate thesis

Page 13/18

Annex 4. Examples of writing chapters, tables, formulas and figures

Physiology homework help


Overview

Required Resources

https://health.gov/healthypeople/objectives-and-data/browse-objectives#social-determinants-of-health

The focus of this discussion board is to address the impact of at least one of the social determinants of health on an identified health concern in the US, e.g., infant mortality rate, obesity, cardiovascular disease, or immunization.  The CDC (Centers for Disease Control and Prevention) and the Healthy People 2030 websites will be useful.

The initial post will consist of one (1) paragraph describing/explaining the SDOH that you consider having the greatest impact on the overall health of populations in the US.  Give an example of one (1) specific population within the US that is heavily impacted by the chosen SDOH.  Write a second paragraph explaining the relationship among the chosen SDOH, the US population, and the population where you live.

You will respond to two (2) of your peers in this class.  The details for each component of the discussion board follow. 

Instructions

For the initial post:

For this discussion, we will explore Social Determinants of Health (SDOH) in the United States.

Healthy People 2020 list these five key areas of SDOH: (a) Economic Stability; (b) Education; (c) Social and Community Context; (d) Health and Health Care; and (e) Neighborhood and Built Environment.  Using some of the resources provided to you in Instructional Materials, as well as 
at least 1 scholarly journal article,
 write one paragraph describing/explaining social determinants of health. Choose the SDOH that you feel most strongly about and explain why you find this SDOH to be so impactful to the overall health of populations in the U.S. Give an example of a specific population within the U.S. that is heavily impacted by this SDOH. Remember to focus on the United States in this discussion board.

Initial post:

· You must post your initial posting before you can view your peers’ posts.

· The lenght of this discussion is to be 250-300 words.

· Two (2) references are required for the initial DB post with at least one reference being a scholarly journal article. The textbook may be used as a reference, but it does not count towards the minimum required references.  Spacing and references for Discussion Boards must adhere to the APA 7th Edition formatting.