The Effectiveness of Aftercare Services for African American Families Article

The Effectiveness of Aftercare Services for African American Families in an Intensive Family Preservation Program - Article Example Family preservation programs in general tend to focus on prevention of unnecessary placements and future maltreatments. Hence this evaluation study has been an outcome based study program. The study was conducted after evaluation of previous programs in which it was found that treatment programs designed for neglected families have found very little success due to consistent lack of social support. And in particular African American children in particular form a majority in foster care and are less placed compared to their white counter parts. This study was designed to check the effectiveness of a Family Enhancement Program (FEP) established in 1994 that examined the rates of placements and neglect. 2. Identify the research design (e.g., secondary analysis, group design) and the specific sampling design used. Discuss the appropriateness of the design used with respect to internal and external validity. A longitudinal study design was used for the study in which families that were admitted to the FEP program were taken for observation. The reports and placements 1 year prior to the admission of the family up to 1 year following the termination of the final family admitted were considered for the family. As reports pertaining to 1 year before and 1 year after the study program was only considered the validity of study was appropriate. 3. Identify the key variables that were measured. How was each variable operationally defined, and how was each measured? Describe the data sources, data collection procedures, and instruments used. Discuss the advantages and disadvantages of the measurement method used. The major variables that were considered and measured in the program were placements, neglect, aftercare and other variables. During the time period of the study the placements of children in foster care, family foster care, residential and assessment services and hospital placement were monitored. An episode was considered

Outline Research Into Institutional Aggression Essay Example for Free

Outline Research Into Institutional Aggression Essay Institutional aggression is aggressive behaviour displayed within an institutional situation such as a school or prison. Most research into institutional aggression has been conducted in prisons. One explanation of institutionalised aggression is the importation model- dispositional factors. This model suggests that prisoners bring (import) their own social histories and traits with them to the prison environment and these influence their subsequent behavious (Irwin and Cressey, 1962). Most of the aggressive behaviour studied in the prison situation is not specific to that situation- the same behaviour was carried out in wider society by the same individuals. Such people bring with them into a prison a ready-made way of behaving which they just use in their new institutional setting (Cheeseman, 2003). Irwin and Cressey realised the importance of different prisoner subcultures and identified three. Firstly; the criminal or thief subculture, the prisoner follow the norms and values that are present in the professional thief or criminal careers, such as not betraying one another and being trustworthy. Secondly; the convict subculture, the subject has been raised in the prison system. They seek positions of power and influence and are therefore most likely to turn to aggression or another maladaptive form of coping. and the conventional or straight subculture tend to be one-time offenders and were not part of a criminal or thief subculture before entering prison. They reject the other two subcultures and identify more with the prison staff. This group is least likely to be aggressive. The three subcultures are better at explaining offenders who do not reoffend then some other explanations of institutional aggression. It suggests we have some degree of free will and explains that some offenders will not re-offend.

Assessment Of Mrs Baker Nursing Essay

Assessment Of Mrs Baker Nursing Essay Upon admitting Mrs. Baker to the ER assist her into a gown. While assisting into the gown notice any skin issues, such as injury from the fall, or irritation from possible prior falls or injuries. Elderly people often have issues such as dehydration, of which the signs may be skin tenting, poor turgor, and red areas from pressure, ask about fluid intake and record capillary refill. Mrs. Baker, as a known diabetic, could have unhealed sores or ulcerations and signs of neuropathy, ask about any numbness or tingling. Assisting the patient into a gown may also determine if there are bladder and bowel continence issues. While assisting to gown use the opportunity to question the patient about what, in her opinion, happened. While asking about the incident, ask if there have been periods of light headedness or dizziness, apply a cardiac monitor and pulse oximeter, for observation. Ask the patient if there are any areas that hurt, or if there is any pain even unassociated with the fall. Whi le questioning the patient about what happened and the patients theory of why, evaluate speech pattern and level of orientation, the patients awareness of time and cognitive ability may be assessed at this time. Determine if the patient can provide an accurate account of the fall and what preceded the fall. While assessing the patient, it is essential to look at each system and watch for nonverbal signs of pain. Observe the patient, for signs of confusion and check for pupil response to light. Auscultating lung sounds, listen for adventitious sounds such as rhonchi, rales, or wheezes. Listen to determine if lung sounds are present in all lung fields. Auscultate heart sounds, listen for irregularities, is there a murmur noted. Evaluate cardiac monitor for arrhythmias. Question the patient about any chest pain, tightness, or heaviness. Palpate peripheral pulses, note if they are equal, note the quality if they are thread /bounding, and are pulses even on each side. Obtain vital signs such as blood pressure, orthostatic if possible as this is common with HCTZ and Lisinopril; maintain a 30 minute check on blood pressure readings, note rate and quality of respiratory effort along with oxygen readings. Ask again if the patient has any pain as pain may increase readings in blood pressure, respiratory rate, and pulse. The elderly are sometimes reluctant to report pain, thinking it is all part of the aging process and accepts it as a part of life. Many may not report physical discomfort due to the fear that they may lose independence or the risk of being viewed as a burden. Anxiety may also raise vital sign readings; attempt to explain all procedures to the patient. This not only contributes to trust from the patient, but also reduces some of the fear from the unknown. Listen to bowel sounds, indicate the presence of or lack of in all quadrants. Ask the patient about bowel pattern if possible when the last bowel movement was, palpate for any sign of tenderness or guard ing. Examine the face, hands, and feet for edema. While checking the lower extremities for edema, indicate the quality of pulses in the legs. Pay attention to color and texture of the skin in the legs and feet, note any sores or red areas, note capillary refill. Pay attention to the temperature of the legs as lower extremities blood clots is common. Again, it is necessary to explain the examination to the patient in order to reduce anxiety and to reassure the patient. If the patient is able, ask about medications and when was the last time they were taken. Ask about the time the last meal was eaten. Once the initial assessment is completed, explain to the patient that there will be some tests to assist in determining the medical problems at present. It is advisable to ask if the patient has questions for the nurse; this may aid in preventing any misunderstandings. Technological tools, uses, and benefits Some of the tools frequently used in the assessment, of any patient, start with auscultation and palpation. Listening to the patients verbal response is an advantage to the assessment; however, listening to the heart, lungs, and abdomen is required. To begin, start an IV site and obtain the needed blood for testing, this may prevent a delay in treatment. Be aware of the length of time the tourniquet is applied to the patient, quality of the lab draw is also a factor in the values obtained. After obtaining the blood work, begin a physical assessment. Listening to heart sounds may provide information about various cardiac problems such as a heart murmur; deviation in heart sounds may indicate a cardiac condition. Lung sounds may determine if there are pulmonary issues such as bronchitis, pneumonia, or pulmonary edema. Listening and palpation of the abdomen may indicate irregularities in the gut, such as an obstruction or potential aneurysm. Asking about pain or tightness in the chest m ay also indicate a possible cardiac condition. Ask about any history of chest pain or tightness. Noting the rate and respiratory effort, along with a continuous pulse oximeter, assist in determining pulmonary problems. Ask if there have been any problems with shortness of breath. Blood pressure readings, especially orthostatic in a falls patient may lead to indications leading to the fall. Along with the possible reason for the fall, this may also assist in the determination of medication misuse. The elderly may sometimes forget they have taken their medication and repeat the dosage. Obtaining a blood glucose level may also determine if the fall is related to hypoglycemia. Knowing or having an idea of when the last meal was eaten, and when the medications were taken, also assist in determining possible reasons for the fall. Having knowledge of the estimated fluid intake may also be useful as a tool in the analysis of causative agents. Dehydration in the elderly can cause confusion a nd light headedness. The continuous cardiac, oxygen, and blood pressure readings are necessary to watch for sudden changes that may occur. Cardiac monitors assist in determining if there are irregularities in the electrical conduction, in the heart, early detection and treatment may prevent further complications. Oxygen readings assist in determining the amount of capillary oxygen and profusion difficulty; this may indicate the need for supplemental oxygen before further decompensation. Frequent checks in blood pressure may be the first sign of sepsis in an elderly person. Other testing and tools used is a chest X-ray, viewing a chest X-ray aids in determining pulmonary issues not noted during the physical examine treatment for pulmonary issues can quickly be obtained. A CT scan of the brain, without contrast, may be used to rule out a brain bleed. A CT scan of the lungs, without contrast, will assess for possible pulmonary embolus. To use contrast, the results of the renal function are needed. Blood testing is critical in determining the bodily functions. Obtaining a complete blood count tells the general hydration, amount of volume and signs of infection with an elevated white blood count, hypervolemia can be promptly corrected; low red blood count indicates the lack of oxygen carrying capacity and may require a transfusion. A complete metabolic profile lends details of renal and hepatic function, as well as levels for key electrolytes such as potassium, sodium, magnesium, and glucose, this also aids in monitoring for metabolic acidosis or alkalosis. With lisinopril, it is common to see an elevation in bun, creatinine, and lowering of glucose levels. HCTZ is known for lowering the potassium, sodium, and magnesium levels. The combination of HCTZ and lisinopril are known to cause dizziness, and palpations and should be monitored closely especially in people with renal impairment and /or of advanced age. Cardiac enzymes are drawn to evaluate the cardiac muscle, to determine if there are cardiac issues. Arterial blood gases assist in determining the pulmonary system function, this also aids in determining respiratory acidosis or alkalosis. Another lab test highly beneficial is a urinalysis with culture and sensitivity. When there is a urinary infection in an elderly person, it may cause dizziness and confusion. The culture helps to determine the proper medication for the organism responsible for the infection. The urine tests also indicate if there are ketones or proteins being spilled in the urine; this is a frequent problem in diabetic patients. Obtaining a twelve lead EKG aids in determining any irregularities in the cardiac conduction, such as heart blocks and ventricular ectopy that are often seen as a result of low potassium. Blood cultures may also be required to determine if there is an infection. Frequently an opportunistic infection may lead to sepsis, and the elderly often do not present that ill until the infection is severe. T he elderly may not always present with an elevated temperature; this cannot be the only sign of illness. All the testing and the physical analysis will help to determine potential health issues, but the best source of information is to monitor the patient. Being aware of changes in the patient status and comfort level is required. Continuous visual monitoring may assist in treating sudden changes in the patient. Frequent questions pertaining to the comfort level are required in the elderly as they may be reluctant to admit pain. Explain that pain, of any level, can be addressed, and that comfort may assist in the treatment. Data collection prioritization It is essential to prioritize the data collection and report findings to the physician. The application of monitoring devices, such as a cardiac monitor, blood pressure machines, and pulse oximeter, may be done as the patient is being gowned. Visual inspection of the skin may also be done at this time. While gowning the patient, asking about medications and history may also be accomplished. Starting the IV site and obtaining blood work will get information to the physician quickly and should be done as soon as possible. Collect a finger stick for blood glucose, as this may determine if the patient is hypoglycemic. The EKG and ABGs are also critical information needed as soon as possible. A chest X-ray may be done next, along with a CT scan of the brain and lungs, without contrast. Collection of the urine for testing can be collected after the other departments have finished what needs to be done. As the patient is on a continuous monitor for cardiac, respiratory, and blood pressure i t is easy to monitor for changes. It is now appropriate to complete the physical assessment of the patient. This saves time while awaiting the results from lab, x-ray, and cardiopulmonary departments. Report any irregularity in the assessment to the doctor as soon as possible. While obtaining information from the patient, it is necessary to ask about pain and monitor for nonverbal cues during the assessment. Morphine, low dose (0.05mg/kg IV) for pain may be appropriate at this time as it decreases the oxygen demand from the heart and may reduce anxiety. Tylenol may not be the medication of choice until liver function is established. Advise the physician that the patient has been taking HCTZ, Lisinopril, and metformin. The combination of HCTZ and Lisinopril may cause dizziness and dehydration. Lisinopril also aids in lowering blood glucose levels, and should be monitored closely especially in people with renal impairment and/or of advanced age. This combination may also cause palpati ons and dizziness. HCTZ can cause electrolyte imbalances leading to alkalosis. The patient may also be experiencing a drug hypersensitivity to the lisinopril. Signs would include dyspnea, chest tightness, and arterial acidosis, requiring intubation (Hydrochlorothiazide and Lisinopril side effects, Drugs.com). If the patient was medicated for pain, check for relief of symptoms. Verbal affirmation should be listed on a scale of 1-10 according to the flacc scale. If the patient has pain relief, note this with the physician. Monitor for lab results and report any findings outside the normal range, the same with EKG, ABGs, x-ray, and CT scan. Monitor the patient for changes in mentation, and visible signs of changes. The elderly may have sudden changes; it is advisable to monitor closely. With continuous monitoring, and noting the change in status of Mrs. Baker, there would be more aggressive measures taken. A rapid response from respiratory therapy would be needed, and a request for the attending physician, for the mental status and respiratory changes and the possible need for increased measures such as intubation. A repeat of ABGs would be needed; STAT results are indicated. Radiology should be available for potential tube placement. All team members should be alerted for the possibility of a code blue alert. The staff needs to be monitoring the cardiac status at all times. With respiratory arrest, cardiac is soon to follow. Rapid response to changes in respiratory status can prevent further complications. Constant monitoring of the flacc scale may assist in monitoring the patients comfort level. A patient may show signs of discomfort by moaning, thrashing about, or facial grimace. Being aware of this may aid in the quality of patient care. The patient may not be a ble to tell that they hurt, but body language speaks volumes. If the patient is indicating that they are in pain, morphine at a low dose may be used (0.05mg /kg IV). Considering the slower metabolism of the elderly, it is necessary to medicate accordingly. This not only aids in pain relief, but also lowers the oxygen demand by the heart. Close observation of the patient is mandatory. If the medication is effective the signs observed will diminish and the patient will appear more relaxed, with little or no signs of pain (possible lower BP and heart rate, no facial grimace, more relaxed, less restlessness). The alert patient can verbalize the effectiveness of pain medications, with an unresponsive person we must rely on physical cues that are presented. Again, it is important to report pain relief to the physician and continue to watch for changes in the patient. Rapid evaluation and assessment, accurate data, and concise information are imperative to patient care. When assessing the elderly it is necessary to remember that due to the aging process, metabolism of medications may be slowed. With advanced age, there is also a reduction in renal and hepatic filtering. The elderly may also be reluctant to report pain. When caring for the elderly, it is necessary to keep their viewpoint in mind, and to explain procedures prior to the procedure. A reduction in anxiety may assist in a trusting relationship and aid in lowering blood pressure and heart rate. It is also helpful to remember that changes can occur rapidly with the elderly and that they may not always present as with a younger person. Keep an open mind and alert at all times.

Australia is at War Essay -- Prime Minister Robert Gordon Menzies

‘Australia is at War’ is a primary source from the year 1939 and is a speech by renowned Prime Minister Robert Gordon Menzies (1894 – 1978). This speech was delivered at the beginning of World War II declaring Australia’s participation and assistance to its â€Å"Mother Land†, Great Britain. World War II was developed and initiated by the infamous Adolf Hitler, a notorious German leader and the head of the Nazis. German’s invasion of Poland initiated Great Britain’s move towards force rather than their original approach of negotiations and peace, as stated in Prime Minister Menzies’ speech, â€Å"they [Great Britain] have kept the door of negotiations open; they have given no cause for provocation.† So the purpose of this source, Menzies speech, which was broadcasted on national radio, was to inform Australia of the drastic measures that were to be taken against Germany in the defence for their Mother Land. As Australia ha d only pronounced federation a mere thirty-eight years earlier, Great Britain was still referred to as the â€Å"Mother Land†, as it was still greatly depended upon it, concluding that when Great Britain had declared war upon Germany, as a result, Australia too was also at war. From Australia’s contribution to Great Britain began the rise of varies army reinforcement groups such as AIF (the Australian Imperial Force), RAAF (Royal Australian Air Force), RAN (Royal Australian Navy) and many more. Prime Minister Menzies announced this speech to the whole of Australia on a radio broadcast to enlighten the nation of the beginning of World War II, Australia’s involvement and the circumstances surrounding this catastrophe that affected the whole of the world. Robert Menzies was born on 20th of December 1894 in Victoria, Australia a... ...peech ‘Australia is at War’ spoken by Prime Minister Robert Menzies at the outbreak of World War II in 1939 is a trustworthy and accurate primary source. The national announcement broadcasted by Menzies himself was addressing Australia of their forces uniting and aiding Great Britain in their war against Hitler and Germany. Justifiable historians and authors such as Joan Beaumont, Allen Martin and Christopher Waters’ work corroborates with the contents and purpose of Robert Menzies speech to display its accurateness and reliability. Works Cited Beaumont, Joan. Australia's War 1939-45. Sydney: Southwood Press, 1996. Martin, Allen William. Robert Menzies: A Life. Melbourne: Melbourne University Press, 1993. Waters, Christopher. "The Menzies Government and the Grand Alliance During 1939." Australian Journal of Polotocs and History 56.4 (2012): 560-573.

Law of Constant Composition Lab Essay

Purpose: To determine the percent magnesium by mass in magnesium oxide and to observe if the percentage composition is constant by comparing class results. Hypothesis/Prediction: The percent composition by mass of magnesium in magnesium oxide will not change significantly with each group that conducted the experiment. The composition of each substance should stay the same and any differences must be due to some error. Materials:Magnesium stripCrucibleCrucible coverClay triangleIron ringRetort standTongsBalanceBunsen burnerProcedure:1.obtained a strip of magnesium between 30-40 cm long2.coiled magnesium strip into a tight roll3.measured the mass of the crucible and cover4.Added the magnesium strip to the crucible and measured the magnesium, crucible and cover together. 5.Partially covered the crucible with the cover and heated it using a Bunsen burner until the magnesium ignited. 6.Turned off Bunsen burner. 7.waited for combustion to proceed8.when the reaction appeared completed, heated the crucible again for another five minutes9.allowed crucible to cool for ten minutes10.measured the mass of the crucible, cover and magnesium oxideObservations:When ignited, the magnesium strip gave off a bright light. There was a colour change on the magnesium. It started out as silver and turned into a white colour. The combustion gave off a distinct odour. The end result was a white powder but some magnesium had been left in its original shape. According to the theory of J.L. Proust, a compound always has the same percentage composition no matter how it is prepared. For all three of our own individual groups trials, we obtained the same percentage composition and this satisfies Prousts theory. This is also accurate with what we have read in the textbook Chemistry 11 on the Law of Definite Proportions on pages 147 150. 2.What conclusion can you make upon the class results?The conclusions I can make based upon the class results are that the composition of a compound must vary because everyone had a different answer. In most cases, the percent composition of magnesium in the compound was very different from what my group achieved. However, sometimes, the classes results were quite similar to my own. The theory that C.M. Berthollet introduced about the composition of a compound was that a compound has an infinite number of compositions depending on the proportions of the components that were used in its preparation. His theory satisfies the results obtained from the whole class. Since every group had a different amount of magnesium they must also have had a different composition of magnesium in the compound formed, magnesium oxide. However, this is inconsistent with what we have been taught and with what is written in the textbook. Since the textbook is a more reliable source of information, I must conclude that the reason for this difference in results may be attributed to error on the part of the students conducting the experiment. 3.Which French Scientist would you tend to support? Explain. The French scientist that I support is J.L. Proust. I agree with Prousts theory because I believe that if the composition of a substance were to change, so would its properties. An obvious example of this is one stated in the textbook: water and hydrogen peroxide. The simple addition of a hydrogen atom to the compound of water can make a liquid that is essential to life become deadly. Since I know that the percent composition of a particular substance is the same no matter where, how or when it is made, I must agree with J.L Proust and support his theory. Sources of ErrorOne reason why a student may have obtained a higher percentage of magnesium than the rest of the class is: during the experiment, mass must have been lost. This could have been done in many ways. Often, the magnesium took too long to ignite and students began to put it straight into the flame to ignite it and then put it back into the crucible. Sometimes, the magnesium wilted and little pieces of it broke off. In addition, the magnesium would sometimes ignite and then extinguish itself. In the constant removal of the magnesium from the crucible, mass was lost in the form of ashes. When mass is lost during the experiment, the total mass of the compound is lower and when the mass of magnesium was divided by the total mass, yielded a higher percent of magnesium. One reason why a student may have obtained a lower percentage of magnesium than the rest of the class is: the magnesium did not properly combust. In many cases, the magnesium would extinguish itself and would not burn completely. This resulted in some white powder, ash, and some magnesium still in the same shape that it was when we began the experiment. This suggests that it did not burn with the rest of the magnesium ribbon and therefore, did not form the compound with oxygen. This would yield in a higher total mass than what it should have been and when the mass of magnesium is divided by the total mass, would give a lower percentage. The following calculation shows the actual percentage of Magnesium in the compound magnesium oxide. Molar mass of MgO = 24.3 + 16.0= 40.3For 1.00 mol of MgO:%Mg = 24.3 / 40.3 x  100= 60.3%Therefore, the actual percentage value of Mg in MgO is 60%The following calculation shows the percentage error for my own groups result% error = (experimental accepted) / accepted x 100= (72 60) / 60 x 100= 20%Therefore the percentage error for my group was 20%. ConclusionBased on the data collected by each group, the composition of a substance must change depending on the proportions of the components that were used in its preparation. However, as explained earlier, the textbook and the properties of matter state otherwise. Scientifically, if the composition of a compound was to change, so would its properties. The results obtained by the class are quite the opposite of what has already been proven by Proust to be true and therefore, I believe that the evidence obtained by our chemistry class is the result of many mistakes and cannot be used to convey the idea of the Law of Constant Composition which states that the composition of a specific compound is constant.

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