The key features of situation ethics Essay Example for Free

The key features of situation ethics Essay Examine the key features of situation ethics. Then outline the main weaknesses of situation ethics. How far do these lead to a rejection of the theory? Despite the view of Kant, and many Christian people, that it is not ethical to only act after assessing the implications of a moral action, since the 1960s a view that situation ethics is an effective way to judge an action and its consequences has emerged in the secular community. However, it is also necessary to acknowledge the Christian ethos in order to fully make a decision on the ethical viability of something in such an ephemeral world. Situation ethics is a theory most commonly associated with the work of Joseph Fletcher, an American professor and one of the key pioneers in bioethics, and J.A.T. Robinson, a New Testament scholar, author and a former Anglican bishop of Woolwich. Fletcher wrote a book called Situation Ethics, which was published in 1966, a time when the ephemeral nature of the country was highly accentuated by political matters; Women were more commonly going to work, following the suffrage movement before the war and their valued contribution to the war effort during it, President John F. Kennedy of the United States had been assassinated and there was a large amount of shock and horror surrounding the brutal Vietnam war. Furthermore, Martin Luther King had left his legacy at this time, even though it would be many years before the divisive pre-civil rights attitudes and laws were truly shaken off, and the sexual revolution that occurred in the 1960s, where the invention of the pill came about, and sexual promiscuity was finally accepted. Also, the emergence of the teenager, a concept that had not been acknowledge before as a type of person with his or her own music, fashion and politics, the consequential growing power of the student movement and the rebellious spirit of the rock and roll culture that went hand in hand with the aforementioned new young adults power, when combined with the other reasons mentioned above, all meant that the scene was set for a radical shift in the social power base. The church, in particular, did not see this impending shift in power as an appealing prospect. The British Council of Churches in 1964 appointed a Working Party that set out to Prepare a Statement of the Christian case for abstinence from sexual intercourse before marriage and faithfulness within marriageand to suggest means whereby the Christian position may be effectively presented to the various sections of the community. They wanted to convey a sane and responsible attitude towards love and marriage in the face of the misleading suggestions conveyed by much popular literature, entertainment and advertising. They also observed that a widespread feeling, especially among Christian people, that recent years have witnessed a general lowering of moral standards, and that this is particularly evident in the realm of sexual behaviour. The Church put much emphasis on a report called The Sexual Behaviour of Young People by Michael Schofield, saying that they wanted to reassess where Christian moral truth lay. The report was conducted in 1965, and concluded that in the 1960s young people were exposed to these factors; greater independence; more money in their pockets and purses; the weakening of family bonds and religious influences; the development of earlier maturity physically, emotionally and mentally; the impact of modern books, television, periodicals. 1963 saw the publication of an extremely controversial book that threw the Church into disarray and disagreement. J.A.T. Robinsons Honest to God is a theological text in which the author challenges the traditional view that God is watching over the world as a supreme power in a three-storied universe, instead suggesting, in conjunction with Paul Tillich, a German-American theologian and Christian existentialist philosopher, that God should be understood as the ground of our being as opposed to a deux ex machine, a phenomenon that cannot be explained, which influences and interferes with the world while remaining detached from it. This book was also in support of the new morality outlined in Joseph Fletchers article The New Look at Christian Ethics published in the Harvard Divinity Bulletin before the more famous Situation Ethics book. Fletcher had written in this that Christian ethics is not a scheme of codified conduct. It is a purposive effort to relate love to a world of relativities through a casuistry obedient to love. In other words, the new Christian morality for man come of age, a phrase coined from Dietrich Bonheoffer, was not based on law, or rather, perhaps, on one law only: the law of love. To illustrate their beliefs on new morality over old, both Fletcher and Robinson cited the examples of Jesus and the Pharisees, which were meant to exemplify new morality and old morality respectively. Whilst the Pharisees elaborated the Torah to accommodate every possible situation, the example of Jesus say You who are not guilty of sin may cast the first stone in John 8:2-11, after a woman who had been caught in adultery was sentenced to stoning. This is an example of Jesus demonstrating love, passion and integrity and showing the weakness of using absolute laws as a meaning of judging individual moral cases. Fletcher further observed that Bultmann [A German theologian] was correct is saying that Jesus had no ethics if we accept, as I do not, that his definition of ethics was a system of values and rules intelligible for all men. This gives the implication that a system of moral codes is unnecessary. Both Fletcher and Robinson acknowledged that the shift from a supranaturalist view of ethics to a situationalist or existentialist view of ethics would not be universally popular. This was shown as early as 1956 when the Pope Pius XII anticipated this, and consequentially banned the view from all seminaries. Protestants, however, were equally suspicious, as they realised it meant that nothing can be labelled as universally good or bad. However, Robinson argued the only way to deal with situations was situationally, not prescriptively. He said Whatever the pointers of the law to the demands of love, there can for the Christian be no packaged moral judgements for persons are more important even than standards. Robinson argued that a situationalist view should be applied to divorce law. Questioning the conservative view that marriage created a supernatural, unbreakable bond between two people, he argues that the metaphysical bond that binds two people in marriage can be broken through divorce depending on the situation surrounding it. In the book Honest To God, Robinson wrote It is not a question of Those whom God hath joined together let no man put asunder: no man could if he tried. For marriage is not merely indissoluble: it is indelible. He believed that it was potentially damaging and out-dating to believe that divorce was an impossibility. He thought it was time for humans to seek liberty from such supernaturalism thinking, and be ready to leave behind the restrictions of the old moral law if love was best served by so doing. Fletcher and Robinson identified agape love, a term used to distinguish the different types of love known as agape, philia, storge and eros, as the only intrinsically good thing, and it was defined by William Barclay as unconquerable good will; it is the determination to seek the other mans highest good, no matter what he does to you. Insult, injury, indifference it does not matter; nothing but good will. It has been defined as purpose, not passion. It is an attitude to the other person. This kind of love is highly demanding or, as Barclay suggested, a highly intelligent thing. It is not random, fatalistic, romantic love that cannot be demanded. Rather, agape love is required of one human being to another, and demands that the whole personality be involved in a deliberate directing the will, heart and mind. To employ agape, it is conceivable that laws must be put aside, although this may leave many legalists and supernaturalisms without a reliable foundation on which to maintain their position of moral superiority. Fletcher wrote If the emotional and spiritual welfare of both parents and children in a particular family can be served best by a divorce, wrong and cheapjack as divorce commonly is, then love requires it. Joseph Fletcher identified three approaches to morality: Legalism, a conservative, rule-based morality like that of the Pharisees, or as Fletcher said, a morality in which Solutions are preset, and you can look them up in a book a Bible or a confessors manual; Antinomianism, the polar opposite of legalism which means that no rules or maxims can be applied to a moral situation; and situationism, a midway decision between the other two positions, or, as stated in Situation Ethics, The situationist enters into every decision-masking situation fully armed with the ethical maxims of his community and its heritage, and he treats them with respect Just the same he is prepared in any situation to compromise them or set them aside in the situation if love seems better served by doing so. Fletcher developed his theory by drawing on a wide range of cases that could not be resolved by applying fixed rules and principles; for instance, the famous case of Mrs Bergmeier who deliberately asked a Russian prison camp guard to make her pregnant so she could be released to return to her family in Germany. Furthermore, Fletcher even developed four presuppositions of situation ethics: Pragmatism, which demands that a proposed course of action should work, and that its success or failure should be judged according to the principle; Relativism, which rejects such absolutes as never, always, perfect, and complete; Positivism, a concept which recognizes that love is the most important criterion of all; and finally personalism, a concept which demands that people should be put first. He then went on, developing his opinion on how agape love should be understood conceptually, and how it should be applied as a theory in situation ethics. He said that not only is love always good, but that it was the only norm, appealing to Jesuss teaching in Mark 12:33 that the most important commandment is to love God and love your neighbour. Hr also said that love and justice are the same, and love is justice distributed, that love is not liking and always wills the neighbours good and that situation ethics is a teleological theory that identifies the ends or the outcome of the actions as the means of assessing its moral worth. Finally, he said that because there is no way of knowing in advance whether something is right or wrong because every situation is different, the situationist must be prepared to make every moral decision afresh. Some believers believe that morality consists of obeying the commands of God as directly revealed by him through scripture and the Church. They believe that what is morally good and what is morally bad is pre-determined by what God has said through scripture and other means, and that to contradict the views of God is to be immoral and bad. This view was backed up by Kant in his deontological approach to ethics, as he said that moral rules are good in themselves and should be obeyed irrespective of the consequences. Professor Gordon Dunstan also agreed with this, saying It is possible, though not easy, to forgive Professor [Joseph] Fletcher for writing this book, for he is a generous and loveable man. It is harder to forgive the SCM Press for publishing it. In contrast to Fletcher, William Barclay adopted a conservative view on Christian ethics, challenging the so named new morality of Fletcher on several grounds. He argued that it is highly improbable for someone to be presented with the extreme circumstances presented by Fletcher, so it is not reasonable to base the principle of situation ethics on these such matters. He wrote in Ethics in a Permissive Society, It is much easier to agree that extraordinary situations need extraordinary measures than to think that there are no laws for ordinary everyday life. He also suggests that Fletcher overestimates the value of being free from rules and the constant decision-making processes that this forces humans into. If it were the case that agape could always be fairly and accurately dealt out, then laws would be redundant. As it is, there are no such guarantees, and so a degree of law is necessary for human survival. Barclay believes that law is essential for a variety of reasons: because it clarifies experience; because it is the means by which society determines what a reasonable life is; because it defines crime; because it has a deterrent value, and because it protects society. He also says that Fletcher was unrealistic in his observation on how truly free humans are to make decisions and judge the moral worth of something when not shackled by any laws. Barclay particularly emphasises that law ensures that humans do not make an artificial distinction between public and private morality, and was quoted as saying A man can live his own life, but when he begins deliberately to alter the lives of others, then a real problem arises, on which we cannot simply turn out backs, and in which there is a place for law as the encourager of morality. In summary, Barclay criticised Fletcher for his miscalculated optimism about the ability of humans to be morally good while remaining free of personal prefere nce and consequential bias. How can we arbitrate a case in which two people reach different conclusions about an action, yet both claim to be acting in the interests of love? In the same year that the scandalous Honest to God by J. A. T. Robinson came into publication, Susan Howatch composed a novel named Scandalous Risks in which a number of characters face moral dilemmas, and attempt to examine each of these while conceptually following situation ethics. In one scene we see a character called Venetia seeking the help of another called Father Darrow in an attempt to understand the way in which her romantic friend rationalises and conducts their relationship along the lines of situation ethics. The, so to speak, moral, of this story is that situation ethics is idealistic and cannot work, despite its obvious theoretical benefits. Rarely do our real-life situations conform to the neat solutions that would apparently be available to us if we applied the principles of ethical theory. An overall conclusion must be drawn from both parts a) and b) of this essay collectively. It seems that the argument is relatively balanced debating the validity of Robinsons and Fletchers approach to moral-decision making. It is commonplace to strive for the freedom to make choices situationally, whether or not it be within the framework of agape, although this is constrained by not only the law, but also by the moral judgment of others. In this age, when we might suppose that secularism and liberalism would have a stronger hold on religions than previously, organizations such as Silver Ring Thing and True Love Waits are encouraging young people to take a vow of celibacy, which infers a return to traditional sexual ethics. Perhaps, instead of offering a realistic answer to morally-challenging situations, situation ethics offers a tantalising alternative to structured and relatively inflexible law-based morality.

Examination of the Cardiovascular System

Examination of the Cardiovascular System The child should be undressed appropriately to the waist. In the older child, the examination easily performed with the patient sitting over the edge of the bed or even on a chair. Preferably, examine the younger child on the parents lap. Removing a toddler from his parents is less likely to yield good clinical signs and more likely to yield a screaming child. For examination of femoral pulses, the child should be in the supine position. Warm your hands by rubbing them against each other. STEPS OF THE TASK You should use the middle three fingers of your dominant hand to palpate the pulses against the underlying bone. The finger tips are used for palpation as they have maximum sensitivity. While palpating, the artery is stabilized by the proximal and distal fingers and the thrust of the pulse is felt by the middle finger. Partial occlusion of the artery by the distal finger improves the thrust of the pulse wave on the middle finger. Palpate all the pulses listed below first on the right and then on the left side. Always compare the respective pulses on both sides except the carotids. In case of carotids, palpitating both sides can induce cerebral ischemia and can cause the patient to faint. Carotid (dont palpate both sides simultaneously) Palpated at the level of thyroid cartilage along the medial border of the sternomastoid muscle either with finger tips or thumb (left thumb for the right side and vice versa) Brachial Palpated with the elbow flexed along the medial aspect of the lower end of the arm Radial felt at the lower end of the radius on the anterior aspect of the wrist, medial to the styloid process with the patients forearm slightly pronated and wrist semiflexed Femoral (DO NOT FORGET FEMORALS) felt in the middle of the groin with the leg slightly flexed and abducted and foot externally rotated. Dorsalis pedis can be felt on the dorsum of the foot lateral to the extensor hallucis tendon in the middle third of the foot Posterior tibial felt posterior to the medial malleolus and anterior to the Achilles tendon. For assessing the pulse rate, use brachial pulse in an infant or toddler and radial pulse in older children While counting the pulse rate, count for 15 seconds and multiply by 4. But tell the examiner that ideally, you would like to count for one minute. However, if the pulse is irregular, then count for one full minute and also count the heart rate by auscultation. Rhythm while looking for the rhythm, one looks for the gap between the pulse waves and comment on their regularity. Volume This is a highly subjective sign. It describes the thrust (expansion) of the pulse wave and reflects the pulse pressure. If high volume, always check for collapsing nature. (Hold the right forearm of the patient by your hand in such a way as the radial artery is under the head of the metacarpals of our hand. Lift the patients entire upper limb vertically by 90à ¯Ã¢â‚¬Å¡Ã‚ °and feel for the sudden and exaggerated rise and fall of the pulsations of radial artery.) Character This describes the form of the wave and various types are decided by the rise, peak and waning of the wave. It is best appreciated in carotids. Radio femoral delay (femoral pulse appears following a time delay after radial suggests coarctation of aorta) POST- TASK Make sure you dont leave the child exposed. Thank the child/ parent for co operation if no further examination is planned VIGNETTE Characteristics of pulse should be described as follows Rate Rhythm Volume Character Symmetry Radio-femoral delay Rate Comment on rate as normal, tachycardia or bradycardia based on age specific heart. In general, for children over 3 years of age pulse rate >100 beats per minute is tachycardia and pulse rate Tachycardia has poor specificity and always make sure child is not anxious/ febrile before attributing significance Bradycardia in a child is usually point to underlying pathology once exercise (athletes), drug intake (Digoxin, beta blockers) is ruled out. Rhythm Reported as regular, Regularly irregular and Irregularly irregular Regular there is a normal variation of heart rate on breathing sinus arrhythmia. It is present in most children. Regularly Irregular: abnormal beats occur at regular intervals pulsus bigeminus, coupled extrasystoles (digoxin toxicity), Wenckebach Phenomenon Irregularly Irregular no specific gaps between the waves Extrasystoles are common in normal children and disappear with exercise. Atrial fibrillation is another common condition which causes an irregularly irregular pulse. Comment on the pulse deficit i.e. the difference between heart rate and pulse rate Volume High volume anemia, carbon dioxide retention or thyrotoxicosis Low volume pulse is seen in low cardiac output states. Character Slow rising and plateau (pulsus parvus et tardus) severe aortic stenosis Collapsing pulse e.g. aortic incompetence Pulsus Paradoxus- pulse is weaker or disappears on inspiration e.g. Constrictive pericarditis, tamponade, status asthmaticus Jerky pulse normal volume, rapidly rising and ill sustained.-suggestive of hypertrophic obstructive cardiomyopathy Pulsus bisferiens two peaks felt during systole, seen in the presence of moderate artic stenosis and severe aortic regurgitation Pulsus alternans Pulse wave with alternate small and large waves seen in severe left ventricular failure and arrhythmias Symmetry Unequal or absent pulses may be suggestive of previous surgery e.g. Blalock-Taussig shunt, repaired coarctation, cervical rib or absent radial pulse OSCE CHECKLIST PRIOR TO THE TASK Hand washing or using alcohol rub Asks the name and age of the child, if already not told by the examiner Explains the purpose of his/ her visit and what he/ she is going to do Positions the patient appropriately TASK Uses the middle three fingers of the dominant hand to palpate the pulses Palpates all the pulses first on one side and then on the other side Compares pulses bilaterally Does not palpate the carotids simultaneously Counts the pulse rate at least for 15 seconds If pulse is irregular, then counts for one full minute and also counts heart rate Looks for Radio femoral delay While describing the pulse, comments on rate, rhythm, character, volume, symmetry and radio-femoral delay POST- TASK Makes sure that the child is not left exposed Thanks the child / parent for co operation Task: MANUAL Measurement of blood pressure PRIOR TO THE TASK Mercury sphygmomanometer should be used as aneroid sphygmomanometer loses accuracy on repeated usage. Choose the appropriate size cuff the cuff bladder should cover at least 2/3 of the length of the arm and 3/4 of the circumference . Cuff size should always be documented. Make sure that the child is calm and not crying or agitated Child can be either seated or in the supine position Any clothing over the arm should be removed THE TASK The convention is to measure BP in the right arm in a calm but awake subject. If conditions differ from this they should be documented with the reading. The elbow should be supported and flexed and should be at the level of the heart. The cuff is wrapped around the upper arm with the bladder centered over the middle of the arm. Approximate estimation of the systolic blood pressure is done initially by inflating the cuff fully and then deflating slowly and smoothly while palpating the radial pulse. Systolic blood pressure is noted at the point when the radial pulse returns. Following this, the blood pressure is recorded by auscultatory method which is the more accurate measure. The diaphragm of the stethoscope is placed over the brachial artery along the medial aspect of the lower end of the arm below the edge of the cuff. The cuff should be inflated to 30 mm above the palpatory systolic blood pressure and then deflated slowly and smoothly at the rate of 2-3 mmHg per second. Systolic blood pressure is recorded at the point when clear, repetitive tapping sounds are just heard. Diastolic blood pressure is recorded when the sounds disappear. In some children, instead of disappearing, the sounds muffle first before disappearing. In this case, the value at which the sounds muffle should be recorded as the diastolic pressure if the difference between the point of muffling and disappearance of the sounds is greater than 10 mmHg. POST- TASK Make sure you do not leave the child exposed. Thank the child/ parent for co operation if no further examination is planned While interpreting the readings, the state of the child should be taken into account. Values should be compared to normal values with reference to the age/height and sex of child. VIGNETTE In infants, instead of radial, brachial pulse should be palpated. Sometimes, auscultation can be difficult in infants in which case systolic pressure by palpation should be documented. If measuring a lower limb pressure, the same cuff can be applied to the lower leg and a foot pulse palpated. It is advisable to measure the blood pressure in both upper and lower limbs. When coarctation is suspected, it is imperative that blood pressure is recorded in both arms and one leg. The same should be done is cases of hypertension and in those who have had shunt surgeries as in Blalock Shunt. While recording blood pressure in the lower limb, a larger appropriate size cuff should be used and auscultation is done over the popliteal artery. The sounds which are heard while auscultating are called as Korotkoffs sounds and has five phases. Phase 1 is the first heard clear, tapping sound, phase 2 is intermittent murmur like sound, phase 3 is the loud tapping sound, phase 4 is the muffling of sounds and phase 5 is disappearance of the sounds. Occasionally, the sound might disappear after the Korotkoff sound phase 1 before reappearing later. This auscultatory gap can lead to either underestimation of the systolic blood pressure (if prior estimation of blood pressure by palpation is not done) or overestimation of diastolic blood pressure is the auscultation is not continued till the end. In atrial fibrillation, phase 4 of Korotkoff sound should be used for recoding diastolic blood pressure. Pulsus paradoxus is best appreciated while recording blood pressure by auscultation and is identified by recording the value at which the tapping sounds are heard only during expiration and the value at which the sounds are heard both during inspiration and expiration. When the difference between the two values is greater than 10 mmHg, pulsus paradoxus is said to be present. Pulse pressure is the difference between systolic blood pressure and diastolic blood pressure. A weak pulse is associated with narrow pulse pressure and is seen in cardiac failure, shock, aortic stenosis and constrictive pericarditis. Pulse pressure is wide in aortic regurgitation, hyperthyroidism, anemia and febrile states. OSCE CHECKLIST PRIOR TO THE TASK Washes hands or uses alcohol rub Explains the purpose of his/ her visit and what he/ she is going to do Positions the patient appropriately Chooses mercury sphygmomanometer Chooses the appropriate size cuff Removes any clothing over the arm TASK Supports the elbow and keeps it at the level of the heart. Wraps the cuff around upper arm with the bladder centered over the middle of arm Estimates systolic blood pressure by palpatory method Uses brachial pulse in infants for palpatory method Estimates systolic blood pressure by auscultatory method Uses diaphragm of the stethoscope for auscultation POST- TASK Makes sure that the child is not left exposed Thanks the child / parent for co operation Records blood pressure as estimated by palpatory and auscultatory method including the site and the position of the child Interprets the blood pressure Task: Evaluation of jugular venous pulse PRIOR TO THE TASK The room should be adequately lit for the assessment of jugular venous pulse The patient should be in semi-reclining position with the trunk at 45à ¯Ã¢â‚¬Å¡Ã‚ ° to the bed. The head and the back should be well supported with a pillow under the head. The head should be positioned in the midline THE TASK Stand on the right side of the patient and assess the jugular venous pulse. The torch should be shined from the left in an oblique direction and the jugular pulsation is observed Jugular venous pulse is located just lateral to the clavicular head of the sternomastoid muscle. Pulsations of the jugular veins should be differentiated from the carotid pulsations as discussed below. The jugular venous pressure is assessed by measuring the vertical distance between the top of the jugular venous pulsations and the sternal angle (angle of Louis). In cases where the top of the jugular pulsations is not visible at 45à ¯Ã¢â‚¬Å¡Ã‚ °, increasing the reclining angle up to 90à ¯Ã¢â‚¬Å¡Ã‚ ° can make the top of the pulsations obvious. The assessment is done when the child is breathing quietly Look for hepato-jugular reflex. This performed by exerting firm and sustained pressure on the right upper quadrant of the abdomen and looking for an elevation in the jugular venous pressure by 2-3 cm. POST- TASK Make sure you do not leave the child exposed. Thank the child/ parent for co operation if no further examination is planned VIGNETTE Assessment of jugular venous pressure is rarely important in the younger child. It is also difficult to obtain an accurate reading because of the short neck in children It can be generally measured easily if the child is greater than 10 years Jugular Venous Pulsation Carotid Pulsation Pulse lateral to sternomastoid Pulse medial to sternomastoid Better seen Better felt Multiple waves seen Single wave Abdominal pressure makes the pulsations prominent Abdominal pressure has no effect Valsalva maneuver makes the pulsations prominent Valsalva maneuver has no effect Can be obliterated with pressure Cannot be obliterated with pressure The right jugular vein is in a straight line with the right atrium and is more likely to show the pressure effects than the left jugular vein which has more tortuous course and is more likely to kinked. This can lead to false elevation of the jugular pressure. In patients with highly elevated JVP, the pulsation may be seen only below the angle of jaw. In such cases, increasing the reclining angle to 60à ¯Ã¢â‚¬Å¡Ã‚ ° or more makes the pulsations more obvious. Turning the head slightly towards the contralateral side can make the pulsations prominent, if the pulsations are not obvious. JVP consists of a, c and v waves and x and y descent. a wave is due to right atrial contraction, c wave is due to bulging of the tricuspid valve and v wave is due to atrial filing. x descent is due to atrial relaxation and y descent results from ventricular filling and tricuspid valve opening. The sternal angle (angle of Louis) is taken as the reference point as it roughly corresponds to the middle of the right atrium. JVP is elevated in congestive cardiac failure, fluid overload, constrictive pericarditis, pericardial tamponade, tricuspid stenosis and tricuspid regurgitation. Non-pulsatile elevation of JVP is seen in superior vena cava obstruction. a wave are absent in atrial fibrillation. Large a waves: are caused either by hypertrophied right atrium in response to decreased right ventricular compliance as in pulmonary hypertension and pulmonary stenosis or contraction of atrium against resistance as in tricuspid stenosis. Cannon a waves are giant a waves seen in early systole and is caused by contraction of the atrium against a closed tricuspid valve. It is usually seen in complete heart block and ectopics. Large v waves are seen in tricuspid insufficiency. Sharp x and Sharp y descents are seen in constrictive pericarditis and restrictive cardiomyopathy. OSCE CHECKLIST PRIOR TO THE TASK Washes hands or uses alcohol rub Explains what he/ she is going to do Makes sure that the room is adequately lit Positions the patient in semi-reclining position with the trunk at 45à ¯Ã¢â‚¬Å¡Ã‚ ° to the bed Supports the head with pillow to ensure relaxation of the neck Positions the head in midline TASK Stands on the right side of the patient and assesses the right jugular venous pulse. Locates the jugular pulse correctly If the jugular pulse is not obvious, then makes it obvious by turning the head slightly to the left and shines the torch from left obliquely if necessary Measures the jugular venous pressure correctly Looks for hepato-jugular reflex. POST- TASK Makes sure that the child is not left exposed Thanks the child / parent for co operation Lists the differences between carotid pulse and jugular pulse Task: general inspection of the body with reference to cardiovascular system PRIOR TO THE TASK Introduce yourself to the child and carer and ask for permission to examine For inspection, the room should be well lit. Ensure that the lights are turned on and the windows are open The child should be undressed appropriately to the waist. In older child, the examination is easiest to perform while they sit over the edge of the bed or even on a chair Examine the younger child on the parents lap. STEPS OF THE TASK LOOK GENERAL General well being Well/ Ill looking child Interest in the surroundings Sick child will not be interested Size of the child thin small, thin tall, well nourished and tall, well nourished and short. Degree of breathlessness classify as none, mild or severe Environment (Equipment) oxygen mask, nasal cannula, intravenous catheter, pulse oximetry, feeding tube/ gastrostomy, LOOK SPECIFIC Head look at the size (microcephaly or macrocephaly) and shape (dolichocephaly) Face Normal or dysmorphic features, malar flush Conjunctiva pallor, jaundice (refer chapter on general examination) Mouth Using the pen torch, take a quick look in the mouth and look for the presence of age appropriate teeth, abnormal teeth and caries. Ask the child to stick their tongue outwards and upwards towards the nose and examine the tongue for central cyanosis. Hands and fingers pallor; clubbing; polydactyly and syndactyly; Oslers nodes; Janeway lesions; splinter haemorrhages. Examine both the hands quickly. Difference in colour between limbs POST- TASK Make sure that the child is not left exposed Thank the child / parent for cooperation VIGNETTE Always think whether the findings combine to form a recognizable clinical syndrome. It is preferable to inspect the child in sunlight than in artificial light. Children with chronic cardiac conditions are usually thin and small for age. Breathlessness is classified as mild when the child has only chest recession, and there is no contraction of sternocleidomastoid or nasal flaring and severe when all three are present Microcephaly can be associated with some of the intrauterine infections and genetic disorders like congenital rubella syndrome and Edwards syndrome Dolichocephaly (increased antero-posterior diameter) is seen in ex-preterms Syndromes with dysmorphic facial features Downs syndrome almond shaped eyes (due to epicanthal folds); Brushfield spots (light colored spots in the iris); small, flat nose; small mouth with a protruding tongue; small, low set ears; round faces; flat occiput Turners syndrome prominent, posteriorly rotated auricles with looped helices and attenuated tragus; infraorbital skin creases; mildly foreshortened mandible Williams syndrome broad forehead; short nose with broad tip; full cheeks; wide mouth with full lips Noonans syndrome downwards slanting eyes with arched eyebrows; epicanthal folds; broad forehead; nose with wide base and bulbous tip; pointed chin Marfans syndrome long, thin face; deep-set eyes; down-slanting palpebral fissures; receding chin; dolichocephaly; malar hypoplasia; enophthalmos DiGeorge syndrome small ears; asymmetric facies; small mouth and chin Malar flush plum coloured malar eminences Hutchinson (conical) incisor is seen in congenital syphilis (patent ductus arteriosus) and enamel hypoplasia in Ellis-van Creveld Syndrome (atrioventricular canal, ventricular septal defect, atrial septal defect, and patent ductus arteriosus). Caries tooth may be a cause of infective endocarditis in congenital heart disease. In preaxial polydactyly, the extra digit is on the radial (thumb) side while in postaxial polydactyly, it is on the ulnar (little finger) side of the hand. Oslers nodes are painful, red, raised lesions found on the hands and feet and is seen in infective endocarditis Janeway lesions are nontender, macular lesions, most commonly involving the palms and soles and seen in infective endocarditis. Splinter hemorrhages appear as narrow, red to reddish-brown lines of blood that run vertically under nails. Splinter hemorrhage can be associated with infectious endocarditis, systemic lupus erythematosus, and trauma OSCE CHECKLIST PRIOR TO THE TASK Washes hands or uses alcohol rub Explains what he/ she is going to do and ask for permission to examine Positions and exposes the child appropriately Makes sure that the room is adequately lit TASK Looks for the following general points General well being Interest in the surroundings Size of the child Degree of breathlessness Environment (Equipment) Looks for the following specific points Head size and shape Face Conjunctiva Mouth Hands and fingers Difference in colour between limbs POST- TASK Makes sure that the child is not left exposed Thanks the child / parent for co operation Task: INSPECTION OF THE CHEST PRIOR TO THE TASK Introduce yourself to the child and carer and ask for permission to examine For inspection, the room should be well lit. Ensure that the lights are turned on and the windows are open The child should be undressed appropriately to the waist. In older child, the examination is easiest to perform while they sit over the edge of the bed or even on a chair Examine the younger child on the parents lap. STEPS OF THE TASK Look tangentially from foot end of the bed in supine patients and from the sides in sitting patients. Look for the following and comment Shape of the Chest symmetrical or asymmetrical Symmetry of chest expansion Scars Pulsations Observe for apical impulse, parasternal, suprasternal, epigastric pulsations. Spine for scoliosis POST- TASK Make sure that the child is not left exposed Thank the child / parent for cooperation VIGNETTE Common asymmetrical chests Pectus carinatum: also called pigeon chest, deformity of the chest characterized by protrusion of the sternum and ribs. It may occur as congenital abnormality or in association with genetic disorders such as Marfans syndrome, Morquio syndrome, Noonan syndrome, Trisomy 18, Trisomy 21, homocystinuria, and osteogenesis imperfecta. Pectus Excavatum: also called funnel chest, deformity of the anterior wall of the chest producing sunken appearance of the chest. It may occur in rickets, Marfans syndrome and spinomuscular atrophy. Harrisons sulcus: horizontal indentation of the chest wall at the lower margin of the thorax where the diaphragm attaches to the ribs. It may occur in conditions with increased pulmonary blood flow or chronic asthma. Scars: lateral thoracotomy scar results from closure of patent ductus arteriosus, tracheoesophageal fistula repair and Blalock Taussig shunt. Central sternotomy scar is seen after open heart surgery and lobectomy. Children can have drainage scars in epigastrium, subclavian/axillary scars from pacemakers and scars following cardiac catheterization in the groin and neck. Pulsations: Apical impulse will be shifted peripherally due to cardiomegaly, collapse of left lung or fluid in the right pleural cavity Parasternal pulsations can occur due to right ventricular enlargement or enlarged left atrium pushing the right ventricle. The most common cause of suprasternal pulsations is dilated aorta due to aneurysm or markedly increased blood flow. Epigastric pulsation may be seen in thin children, right ventricular hypertrophy and abdominal aneurysm. Scoliosis should be looked for in the standing and not in sitting position OSCE CHECKLIST PRIOR TO THE TASK Washes hands or uses alcohol rub Explains what he/ she is going to do and ask for permission to examine Positions and exposes the child appropriately Makes sure that the room is adequately lit TASK Looks tangentially from foot end of the bed in supine patients and from the sides in sitting patients Looks for the following points and comments Shape of the Chest Symmetry of chest expansion Scars Apical impulse, parasternal, suprasternal, epigastric pulsations Spine for scoliosis POST- TASK Makes sure that the child is not left exposed Thanks the child / parent for co operation Task: PALPATION OF THE CHEST PRIOR TO THE TASK Introduce yourself to the child and carer and ask for permission to examine The child should be undressed appropriately to the waist. Position the older child so that they sit over the edge of the bed or lie down on the couch Examine the younger child on the parents lap. Warm your hands for palpation STEPS OF THE TASK Be gentle with palpation Apical Impulse: Place the palm of the whole hand flat over left chest wall to get a general impression of the point of maximal impulse. Next, lay the ulnar border of the hand on the chest parallel to rib space where the impulse was felt and try to locate the apex. Finally palpate with the fingertip of the index or middle finger to localize the apical impulse and define its character. Use the left hand to palpate the carotid artery to time the apical impulse. With the finger of the right hand still in place over the apex beat, palpate the manubriosternal joint (angle of Louis) which is present just below the suprasternal notch and is felt as a prominence with the left hand. It corresponds to the second intercostal space. Slide the index finger and count down the next few intercostal spaces until you locate the intercostals space that is level with the apex beat. Look at the position of the apex with reference to the midclavicular line. If the apical impulse is not readily palpable in the supine position, ask the child to lie on their left side. If the apex beat is not still palpable, try on the right side in case of dextrocardia. Parasternal pulsation and heave: With the fingertips, palpate over the left sternal edge to find the parasternal pulsations. With the child lying in supine position, place a pencil lateral to the left sternal edge and look tangentially for lifting of the pencil. Next, place the base of your hand just lateral to the left sternal edge and palpate for a parasternal heave. If parasternal heave is present, try suppress it by exerting pressure with base of the hand. Thrills are best felt with fingertips. Time the thrill with carotid or brachial pulse. Palpate the following areas. Apex of the heart 3rd to 5th intercostal space along the left sternal border Pulmonary area (left second intercostal space) Aortic area (right second intercostal space) Suprasternal area Carotids POST- TASK Make sure that the child is not left exposed Thank the child / parent for cooperation VIGNETTE Apical impulse is the farthest inferior and lateral maximal cardiac impulse on the chest wall. It results from the heart rotating, moving forwards and striking against the chest wall during systole. Apical impulse is normally felt in the 4th left intercostal space on the midclavicular line. It may be difficult to palpate in obese children and in pericardial effusion. Displaced apex Tension pneumothorax and pleural effusion (push apex away from the lesion) Pulmonary fibrosis and collapse (pull towards the side of the lesion) Left ventricular hypertrophy apex is displaced down and out Right ventricular hypertrophy apex is displaced outwards Skeletal abnormalities Quality of apical impulse (normal apex lifts the palpating fingers briefly) Sustained (increased amplitude and duration) pressure overload (aortic stenosis) Hyperdynamic or forceful (increased amplitude but not duration) volume overload (mitral incompetence and aortic incompetence) Tapping palpable first heart sound of mitral stenosis Parasternal pulsations Palpable 2nd heart sound reflects pulmonary hypertension. Parasternal heave is present in right ventricular hypertrophy or left atrial enlargement pushing the right ventricle. There are three grades of parasternal heave Grade I heave identified by lifting of the pencil alone and not the heel of the hand Grade II easily identified, can be suppressed with pressure Grade III lifts the heel of the hand and cannot be suppressed with pressure Thrill is a palpable murmur that felt like a purring cat. While describing the thrill, describe the site and phase of cardiac cycle. When thrill is present, the accompanying murmur is by definition at least 4/6 in intensity. OSCE CHECKLIST PRIOR TO THE TASK Washes hands or uses alcohol rub Explains what he/ she is going to do and ask for permission to examine Positions and exposes the child appropriately Warms hands before TASK Palpates gently Apical Impulse Places the palm flat over left chest wall to get a general impression Keeps the ulnar border of the hand parallel to rib space Palpates with the fingertip to locate the apical impulse Palpates the carotid artery

Causes Of Mental Health And Bullying In Prison Criminology Essay

Causes Of Mental Health And Bullying In Prison Criminology Essay Prisons as places of deprivation of liberty have existed since time immemorial, yet prisons as we know them today places where offenders are sent by the Criminal Justice System as a punishment for their behaviour -are a product of the industrial age (Maguire et al, 2005). Ideally the reason behind the imprisonment is according to Section 142 of the Criminal Justice Act 2003 (cited in Elliott and Quinn) to punish ,deter and rehabilitate the offender . The main aims of these three areas is concerned with the recognition that the criminal has done something wrong. It then locates them in an institution which by taking away their freedom, is designed to deter them from further offences upon release, punish them for the offence already committed, and then tries to rehabilitate them, so that they are less likely to commit further offences upon release, either because they learn to see the harm they have caused, or because, through education and training, they find other ways to spend thei r time. The process of rehabilitation would change them into law abiding citizens. What is more it is believed that it would persuade other potential criminals that such activates are not beneficial in other words it would deter people from committing further crime ( Elliott and Quinn,2008). While in theory such an idea seems to perfectly fit the purpose of punishment, in practice significant amounts of negative experience such as intensive growth of bullying and mental health problems, are present within the prisons environment, together with overcrowding and poor living conditions, failing to deliver the successful processing of such a plan (Elliot and Quinn, 2008). The aim of this essay is to compare and contrast causes of mental health and bullying in prison, as well as detect any, if possible, links between bullying and mental health among prisoners Farrington defined bullying as the repeated oppression of a less powerful person by a more powerful one. He claimed that it usually includes three different elements. The first element includes physical , verbal or psychological attack with intent to cause harm , fear or distress . The second is an imbalance of power , where a more powerful person is oppressing the less powerful one, and thirdly it includes a continuous series of incidents between these same people over some period of time. Mental health is defined in Section 1(2) of the Mental Health Act 1983 as Mental illness, arrested or in completed development of mind, psychopathic disorder and another disorder or disabilities of mind. Although as shown above there is a huge difference in what constitutes bullying and mental health, there is no doubt that both of them can be caused by similar factors such as social and environmental causes (for example overcrowding) , physical causes and psychological causes(Ireland,2002; WHO, 1998). The physical environment in prisons such as overcrowding, quality of accommodation, availability of contact with friends and family, lack of stimulation in the form of activities , may have an impact on the prisoners mental health as well as contributing to the development of bullying in prison. According to Maguire et al. (à ¢Ã¢â€š ¬Ã‚ ¦) the imprisonment rate in England and Wales is the highest in Western Europe, and according to the official prison statistics for England and Wales the total prison population has increased from around fifty-one thousand in 1995 to over eighty-four thousand in 2009. What is more overcrowding in prisons may lead to increased depression, stress, boredom and nervous breakdown, leading to serious breaches of prison discipline, violence and riots. The cause of prison overcrowding and an increase in the prison population is a result of a greater number of convictions and the absence of the availability of prisons places. Further equally important factors are change in criminal justice policy, tightening of sanctions, resulting in longer prison sentences. Reducing funds for the prison also indirectly cause aggression among prisoners.(though less  staff,   causing  tension  among  overworked  staff, which then affects the inmates). Prisons have a limited capacity, and the prisoners have certain rights that should not be violated. Factors such as lack of liberty, as in many of the prisons where prisoners are locked-up for twenty three hours a day, lack of, or limited, communication with friends and family , usually without any privacy, all contribute to the problem. What is more, prisons take away the prisoners free will. They can no longer freely decided where to live, with whom to associate and how to fill their free time and must follow the discipline imposed by prison rules and prison officers. Physical causes such as their individual characteristics or biological make-up may have some influence on the causes of bulling and mental health in prisons. According to Ireland (2002) prisoners mostly come from social environments where emphasis is placed on toughness and the ability to protect oneself and when entering prison these characteristics are magnified. However such behaviour while being in prison may be linked with bullying other usually weaker and disturbed inmates ( Irleand, 2002) According to Farrington (à ¢Ã¢â€š ¬Ã‚ ¦) the people who tend to bully are more likely to have children who will be bullies, and people who tend to be the victims of bullying tend to have children who will become the victim of bullying. The same may apply to prison inmates who tend to be weak, with low self-esteem and with a low capacity for coping with the prison environment and they are more likely to become victims of bullying than people who are characterized as strong , confident and agg ressive. Also individual genetic make-up might put some prisoners more at risk than others to suffer from mental illness or become victims of bullying because they are less able to adapt or cope with certain environments or they become one of the bullies as they possess the physical skills which give prisoners the ability to bully others physically , verbally or indirectly. Moreover those suffering from any injuries while being in prison, which may have been caused by being involved in a fight with another prisoner, can also experience changes to their personality and in some cases may cause the beginning of schizophrenia, psychosis or self harm. Psychological factors such as a prisoners emotional and mental state of mind , especially when the prisoner has experienced any form of physical or sexual abuse or there have been any other potentially traumatic events in the past can affect his behaviour in prison. While there is a huge proportion of prisoners suffering from such trauma prior to imprisonment, many will experience such trauma as an effect of imprisonment (Crighton and Towl, 2008). Generally prisons are harsh places , where discipline and routine are the essence of daily life causing being in prison to be a stressful experience . Additionally according to (Crighton and Towl, 2008) prisoners appear to be at a high level of risk with factors associated with poor traumatic responses from childhood onwards. . Psychological factors especially emotional responses (Irleand, 2002) in terms of bullying will probably be heightened for the victims . Prisons can be aggressive and threatening environments especially for the first time prisoners . They may be fearful of what may happen to them. Undeniably fear is seen as a necessary component in definitions of bullying in the prison environment. Moreover fear may impact prisoners other emotions such as anxiety, nervousness and feelings of unimportance which may display behaviourally through self harm or social avoidance. Despite the similarities in causes for mental health and bullying in prison we can also see differences . One of them is unquestionable the difference between the definition of mental health and the definition of bullying. Likewise once in prison , prisoners enter a highly structured social environment that negotiates for power and dominance, where dominance over other weaker inmates is one way of gaining acceptance , satisfaction , status and respect among other prisoners. Hence bullying is often seen as a normal part of prison life that helps to gain this dominance over other inmates. Furthermore bullies who remain at the top of the hierarchy among other inmates, through their dominance will often get other prisoners to run errands and do jobs for them which are against prison regime, and so they can remind unidentified and hence will not be punished . While the condition of an individuals mental health consists of a number of different factors and elements. mental health is primar ily our resistance to all of our difficult situations , events, phenomena and our emotional and psychological survival partly depends upon an individuals ability to tolerate the deprivations of prison. Additionally according to Viggiani (2007) most prisoners come from the poorest or most socially excluded tiers of society and often have the greatest health needs. Prison may therefore be the worst place to send them given that, in the main, they are likely to be highly vulnerable or susceptible to poor health, hence mental disorders. Mental disorder may also be the cause of committing the offence, and hence imprisonment. As Rubin (1972:398 cited inà ¢Ã¢â€š ¬Ã‚ ¦) says certain mental disorders are characterized by some kind of confused , bizarre, agitated, threatening, frightened, panicked, paranoid or impulsive behaviours and as a consequence they may lead to inappropriate , anti-social or dangerous acts. Individual mental health may be managed and treated either by medication or di fferent treatment programs (handbook), while in order to prevent bullying prisons should focus on making changes to the prisons environment which would include changing the supervision of the prisoners area, increased security for controlling and monitoring, educating staff and prisoners about bullying, improving communication between prison staff, or even increasing the stimuli for prisoners. This include raising the number and qualities of activities and programs available for prisoners. Undoubtedly, despite the similarities and differences between bullying and mental health, one may lead to the other ( Ireland, 2002; Farrington,à ¢Ã¢â€š ¬Ã‚ ¦.) . As mentioned above bullying constitutes aggressive behaviour in which an individual manipulates and dominates others in order to obtain a goal, whether it is social or material. In order to classify the behaviour as bullying it must represent repeated and unprovoked acts of aggression , which include physical , verbal or psychological attack (Irleand,2002; Farrington, à ¢Ã¢â€š ¬Ã‚ ¦.). Indeed bulling can cause immediate harm and distress to victims and have negative consequences on their mental health. Victims may feel psychologically or physically distressed and experience pain, and prisoners who have been the victims of bullying may experience a range of feelings such as anger, fear, anxiety ,paranoia , distress, hopelessness or depression (Ireland,2002) which can lead to avoidance, social isolation and therefore mental illness in prisoners. In conclusion despite the idea that prisons should rehabilitate and change offenders into law abiding citizens, we can see that prison is a modern form of slavery no matter what its ideological justification is. Prisoners mental health and bullying is a growing problem in prisons . Instead of rehabilitating and changing prisoners into well managed and well behaved citizens, in many cases it changes them into more aggressive and troublesome inhabitants very often with physical and mental problems, which makes it harder for them to reintegrate with the society and with present times.

The Relevance of Edith Wharton’s Roman Fever to the Modern World Essay

The Relevance of Edith Wharton’s Roman Fever to the Modern World According to the World Health Organization, â€Å"of the 75 million children under five in Africa a million and a half die each year of pneumonia.† As distressing and sad as this statistic is, it points out the great danger pneumococcus still is to young people in the developing world. It’s in the developed world, but at a time before antibiotics, at a time when acute respiratory ailments posed an even greater but still preventable threat to the younger set that concerns us here and that inspires a deeper look at the full implications of respiratory disease. The WHO goes on to say that acute respiratory infection (ARI) â€Å"is one of five conditions which account for more than 70% of child mortality in Africa.† So not only is pneumonia prevalent, it is still deadly. The danger it poses to young people has life-influencing ramifications, ones with an incredible emotional content. Though more treatable now, as we’ll see later, the persistence of pneumonia f its in with the puzzle as it presents itself, since it is linkable to a much more fundamental human ailment. In Edith Wharton’s â€Å"Roman Fever† we also see ailments of a pulmonary and life-changing import. Indeed, the entire story seems shot-through with infection. Wharton writes of Mrs. Slade and Mrs. Ansley, both widowed, both taking their daughters to Rome on holiday as they had been. Their own intertwined histories Wharton describes at the story’s onset as â€Å"all of the movings, buyings, travels, anniversaries, illnesses† (emphasis mine) (751). Wharton then begins the tale with illness. It is only as the narrative progresses that we get a sense of how important illness is to become: Yes; being the Slade’s widow wa... ...an be treated with antibiotics, it can be treated with aversion therapy or the simple addition of marriage. Other love preventatives such as war and country music are both quite feasible and can actually be very profitable for Western nations, though they seem a little cruel, especially the latter. Wharton’s â€Å"Roman Fever† at the very least points the way; it is a warning that love and pneumonia are inextricably linked, an idea that we’d do well to pay more attention to today when the ease of a high technology lifestyle fosters an arrogance that all the world’s problems have been solved. Works Cited Wharton, Edith. â€Å"Roman Fever.† Edith Wharton: Collected Stories 1911-1937. New York: Literary Classics 2001. 749-62. World Health Organization. â€Å"Childhood Diseases in Africa† Fact Sheet N 109. March 1996. 14.3.2003 http://www.who.int/inf-fs/en/fact109.html

Methods and Effects of Prenatal Genetic Testing Essay -- Science Biolo

Methods and Effects of Prenatal Genetic Testing I. Introduction Prenatal genetic testing has become one of the largest and most influencial advances in clinical genetics today. "Of the over 4000 genetic traits which have been distinguished to date, more than 300 are identifiable via prenatal genetic testing" (Morris, 1993). Every year, thousands of couples are subjecting their lives to the results of prenatal tests. For some, the information may be a sigh of relief, for others a tear of terror. The psychological effects following a prenatal test can be devastating, leaving the woman with a decision which will affect the rest of her life. For couples with previous knowledge of genetic disorders in their family and concerned parents, prenatal genetic testing is part of the regular pregnancy checkup. Making an appointment with a genetic counselor may seem strange or even frightening for some, still others view it a very common step being taken by many Americans today. The desire to have a "normal" child is held by every parent and only now are we beginning to have the ability to select for that child. In preparation to receiving genetic testing, the parents are required to meet with a genetic counselor. A detailed description of the testing methods are reviewed with the couple as well as the risks which are involved with each. Upon an understanding of the procedures, the counselor discusses the many possible outcomes which could be the result of the diagnosis. Finally, before any tests are performed, anxieties from either of the parents are addressed as well as the psychological well-being of the parents. II. Methods of Genetic Testing Procedures performed today are designed to evaluate the probability that a fet... ...s. Clarke, A. (1994). Genetic counseling: Practice and principles. London: Routledge. Fackelmann, K. (1994). DNA dilemmas: Readers and 'experts' weigh in on biomedical ethics. Science News, 146, 408-499. Mennuti, M. T. (1989). Prenatal diagnosis-Advances bring new challenges. The New England Journal of Medicine, 320, 661-663. Morris, D. T. (1993). Cost containment and reproductive autonomy: Prenatal genetic screening and the American health security act of 1993. American Journal of Law & Medicine, 20, 295-316. Spielman, B. (1995). [Review of Women and prenatal testing]. Journal of Law, Medicine & Ethics, 23, 199-201. Rothenberg, K. and Thomson, E. (1994). Women and prenatal testing. Columbus: Ohio State University Press. Watson, J. D., Gilman, M., Witkowski, J., Zoller, M. (1992). Recombinant DNA. New York: W. H. Freeman and Company.

Juvenile Deliquency Essay

How does juvenile delinquenct affects an individual education The investigator has discovered that juvenile delinquency effects on individual education in many ways majority of the respondents said that criminal record viewed possessed by a juvenile delinquent is viewed negatively when applying for a job or trying to go overseas because of delinquent activities the juvenile the juvenile caught doing by the law. Failure to achieve set goal is cause by juvenile hiding away from school to do delinquent activities. Another factor is that juvenile could be expel from school because of getting into fights, stealing and having arguments with teacher. When applying for a job is also another factor which juvenile delinquency may affects an individual’s education due to the fact that the juvenile as expel from school and didn’t get subject needed to qualify for the job. Common causese of juvenile delinquency Having concluded on the deemed roots of juvenile delinquency the resident believed that poverty mostly causes juvenile delinquency in community x. This is because most parents in this community are unemployed and cannot feed their children, so out of hunger these children will go of the out way to do delinquent things just to have a meal. Neglect also causes juvenile delinquency reason being is that every juvenile needs love and attention. If a child is not getting attention they needs due to the fact that he/she is living in a single parent family, the child will seeks the easiest and quickest way to get attention. Thus this child might get attention from someone who is delinquent and this person might motivate the juvenile to do negative act, this was stated by the resident. Peer pressure was also indicated as a cause by the resident this is because every child do what they are motivated to do or what they see their peer is doing and things its good. A small amount of the responden ts agrees that physical and mental is a cause. They said that every juvenile who is being abuse tend to react negatively to person in the society and have an hatred in their heart who tries to be nice to them. Effective ways to reduce juvenile delinquency There are many effective ways which could be used to reduce juvenile  delinquency. A large percentage of the stated that juvenile needs more access to information because if they get more information the juvenile will know the penalties which they have to face after committing the delinquent act. Introducing more guidance is also another way to reduce juvenile delinquency because if the juvenile is guided in the right path they will not stray from it. Having seminar will help delinquent persons to learn certain values and attitude, and that if being delinquent they will only be poor contributors to the society. Parenting skill seminars will also help reduce juvenile delinquency because parent attends the seminars would be thought certain things like they must not be neglect full to their children which may leads to juvenile seeking attention and find it at the wrong place.

Pushing Paper Can Be Fun Essay

1.Organizational and Personal Outcomes – What performance problems is the captain trying to address? Behavior- Officers not doing paperwork, or when done, is incomplete. Result – Cases being lost, due to poor reporting. The officers lack motivation and perceive filling out reports as boring. 2.Goal Statement – What would be a desirable outcome? A desirable outcome would be that officers perceive their jobs to include paperwork, and that they understand the value and importance of filling reports adequately and correctly in an assigned time frame. 3.What has the Captain already tried doing to solve the problem? To help motivate the officers, team competitions were established. These were based on the excellence of the reports. The competition provided no reward. An idea suggested to the Captain is to include financial rewards as incentives, based on the number of conviction records. These are also related to motivational factors. 4.Using the MARS Model to diagnose the possible causes of the unacceptable behavior and to explain what the Captain should do to resolve the situation. The MARS Model outlines the four major factors in determining individual behavior and results. The four major factors consist of Motivation, Ability, Role Perceptions and Situation Factors. Motivational: The police officers are lacking motivation when it comes to doing paperwork. Their paper work is frequently put off or completed inadequately. They are aware that promotion is not based on how well they complete paperwork; rather it is based by simply staying on the force for a certain number of years. Ability: I would assume that officers do not receive adequate training on proper report making while attending the police academy. Also some officers may have more of an aptitude than others when it comes to writing. Role Perceptions: The officers perceive their job as peace, law and order. They think of paperwork as boring and routine. A possible issue is that they don’t understand the value attached to providing an adequate and correct report. This perception may have been established due to improper training, the rookies are being taught by other officers, who themselves have never been formally trained. The personalities of the officers as well as their personal values play a role in how they perceive their job to be. Situational Factors: The case did not mention any situational factors; however there is one possible factor. There isn’t enough funding for rewards, so little, that layoffs are being considered. This poses a problem in that, if officers are laid off then there is less of them to perform the task, thus making the issue worse, not improving it. Suggestions: First off in order for things to improve, it needs to start with the Captain. He himself claims the work to be routine and boring; this attitude passes down to his fellow officers. Something as simple as changing his perception, would help motivate the officers. Secondly, all officers including the Captain should be retrained. This will insure consistency throughout. Fewer cases will be lost, and establishing future incentive plans will be must easier. Thirdly, The Captain could decrease the hours officers spend out on the streets, and allocate more time for the officers to complete their paper work. Motivation by Punishment: If a case were to lose due to a faulty report, then the officer responsible for filling the form would have to attend a training session. To avoid the officers from falling back into the same habit, he could also punish them with a week of traffic duty. (I believe most cops prefer to be fighting crime, not issuing traffic tickets). Motivation by Incentive: As the case study mentioned, the police station is experiencing a budget crunch. An affordable method could be to provide officers with free perks, for completing their paper work adequately, correctly and on time. Such things as: first pick of the squat car, which area/street they prefer to patrol and being able to choose cases that interest them most.