Factors that Increase Sensitivity to Nicotine Dependence

Factors that Increase Sensitivity to Nicotine Dependence Age of tobacco use initiation, concomitant tobacco use and nicotine dependence Ziyue Wu Abstract Introduction The growing use of tobacco products have strong negative effects on public health conditions such as cardiovascular disease, cancer and lung disease (MacKenzie, Bartecchi, Schrier, 1994). As the leading cause of preventable death in the U.S., tobacco use has been linked to the death of approximately 5 million people annually (Jha, Chaloupka, Moore, Gajalakshmi, Gupta, Peck, Asma Zatonski, 2006). Given the addictive nature of nicotine, many tobacco users are likely to become chronic smokers and to have difficulty achieving successful cessation. Most research on tobacco use has focused on cigarette smoking. Ethnicity and gender have been found to be associated with cigarette smoking behavior (Hu et al., 2006[LD1]). Further, psychiatric disorders have been shown to contribute to the transition from daily smoking to nicotine dependence (Dierker Donny, 2007; Breslau et al., 1998). Despite the large number of studies examining cigarette smoking and nicotine dependence, risk for dependence based on other types of tobacco use have received far less research attention. Different types of tobacco use (cigarette, cigar, pipe smoking, snuff, tobacco chewing) may predict nicotine dependence differently. Such difference may be more significant between smokeless tobacco users and smokers. Moreover, little is known about combined effects of tobacco use on risk for nicotine dependence. ways of tobacco use. Different types of tobacco use (cigarette, cigar, pipe smoking, snuff, tobacco chewing) may predict nicotine dependence differently. Such difference may be more significant between smokeless tobacco users and smokers. Concomitant smokers may follow a unique pattern. Also, age of the initiation of tobacco use may be correlated with current usage amount and number of ways of tobacco use. It remains uncertain that whether individuals with earlier onsets of tobacco use have greater risk of becoming nicotine dependent and using tobacco concomitantly. [LD2] By examining the data from The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), this study sought to (a) understand whether different ways of consuming tobacco might lead to different levels of sensitivity to nicotine dependence; (b) discover whether age of initiation of tobacco using behavior contributes to different levels of sensitivity to nicotine dependence; (c) find out whether age of initiation is associated with concomitant tobacco use, especially combined use of smokeless tobacco and smoking; (d) discover that which ways of tobacco did most concomitant users used first.[LD3] Method Sample The sample was taken from the first wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). NESARC, described by Grant et al. (2006publication year?)., has an unprecedented large sample size (n=43,093) to achieve stable estimates of even rare conditions. It represents the civilian, noninstitutionalized adult population of the United States, including residents of the District of Columbia, Alaska, and Hawaii. People that lived in households, military personnel that lived off base, and people that lived group quarters: boarding or rooming houses, nontransient hotels and motels, shelters, facilities for housing workers, college quarters, and group homes (Grant et al, publication year), were interviewed in a computer-assisted personal basis after consenting to participate. The present analyses were based on all the respondents. This sample was chosen to assess both current tobacco users and tobacco abstainers. Measures Use of Tobacco products use was measured by asking respondents whether they had used cigarettes/ cigars/ pipes/ snuffs/ chewing tobacco these products in past twelve month (â€Å"Had you used cigarettes/ cigars/ pipes/ snuffs/ chewing tobacco in past twelve months?†). Frequency of Ccurrent tobacco use was measured with the question ing behavior was evaluated by the frequency (â€Å"How often did you use cigarettes/ cigars/ pipes/ snuffs/ chewing tobacco in past twelve months?†) and quantity was measured with the question (â€Å"What was the usual quantity when you used them?†). Usage quantities of certain kinds of tobacco per month were estimated by multiplying midpoint of the range of each reported frequency per month and reported usual usage quantity. Age related measures selected as third variables and control variables included age, age at the onset of certain kinds of smoking behavior (â€Å"How old were you when you first used cigarettes/ cigars/ pipes/ snuffs/ chewing tobacco?†), age at the onset of using them daily use (â€Å"How old were you when you started using them daily?†), age at the onset of tobacco using behavior (â€Å"How old were you when using tobacco at the first time?†) and age at the onset of everyday tobacco useing behavior (â€Å"How old were you when starting to use tobacco daily?†). A variable reflecting number of kinds of tobacco used was created to separate concomitant tobacco users from single way users. For concomitant tobacco users, I created variables to show the current combination of ways in tobacco use and the combination of ways when the respondents started using tobacco[LD4][EW5]. A variable reflecting the number of years since the respondents started using tobacco w as also created by subtracting the age at the onset of tobacco using initiation from age at the interview. A categorical variable was also created to describe which combinations of tobacco use the respondents fell into, single way smoking, single way smokeless tobacco, concomitant use of smoking, concomitant use of smokeless tobacco, or concomitant use of smoking and smokeless tobacco. NICE!! Nicotine dependence related variable was â€Å"Nicotine dependence in past twelve month†. Data Analyses In the first question asked, Logistic regression was estimated to determinesee whether different ways of tobacco usieng predicted nicotine dependence independently. For the secondA second set of question, another logistic regression analyses were was conducted within each type of tobacco using behavior, with controlvariables for amount used usage amount, age, ethnicity and gender controlled, to verify the correlation between the age of initiation and probability in getting nicotine dependent. A two way interaction tested by Pearson Correlation Test was conducted to examinefind out association between age of initiation of tobacco using and current number of tobacco use ways. [LD6] Results Different tobacco uses and nicotine dependence More than one fourth (25.80%) of the respondents reported some forms of tobacco use in past 12 months. Among those who used tobacco in past 12 months, 89.216% (n=9,913) smoked cigarettes, 10.106% (n=1,119) smoked cigars, 1.93% (n=215) used pipes, 6.548% (n=720) used snuffs and 4.52% (N=502) chewed tobacco. Further, the number of average cigarettes smoked per month climbed towas 186.26 (SD=332.32), whereas the numbers of monthly uses of cigars, pipe smoking, snuffs and chewing tobacco are onlywere 2.108 (SD=27.61), 2.879 (SD=28.70), 4.108 (SD=38.38) and 1.94 (SD=24.71), respectively.. [EW7] Logistic regression was used to examine the association between different kinds of tobacco use and nicotine dependence, with covariatescontrolling for of age of tobacco use initiation, years using tobacco, ethnicity and gender. Cigarettes, snuffs and chewing tobacco were positively associated with nicotine dependence, while cigars and pipe smoking failed to independently predict nicotine dependence. [EW8] Age of onset, tobacco usage amount, and nicotine dependence The average age of onset of tobacco use was 16.548 (SD=5.21) years old, and the average number of years using tobacco was 32.108 (SD=17.37) years old. Of 18,943 subjects who reported ever using tobacco, 77.656% (n=14,693) started before adulthood. Logistic regression was used to estimate the association between age of initiation and nicotine dependence. Covariates included years using tobacco, ethnicity, gender and tobacco use. Age of onset of tobacco use was found to be negatively related to nicotine dependence, with earlier onsets associated with higher risks for nicotine dependence. Moreover, multiple regression was used to estimate the correlation between age of initiation and current tobacco useage amount, also with variables forcontrolling for years using tobacco, ethnicity and gender controlled. For users of most popular type of tobacco use, cigarette smokingers showed strong positive relationship between age of onset of cigarette smoking and amount of current smoking amount. Earlier onsets actually elevated was associated with a higher current cigarette smoking amount. NAnd number of cigarettes consumed was found directly linkedto be positively associated with likelihood of experiencing to nicotine dependence[LD9]. This result might serve as another clue for earlier onsets probably promoted risks for nicotine dependence. [EW10] Concomitant tobacco users and single way users Among theose 11,118 respondents who reported tobacco use in past 12 months, 10.3% (n=1,149) of them were concomitant users. Also, among 1144 concomitant tobacco users (total 1149) with available data, 54.655% (n=624) hadof them started smoking cigarettes as the first way to of usinge tobacco. In total, 71.3% (n=816) of respondents started using tobacco in smoking forms (cigarettes, cigars, pipes or combined smoking). Only 20.72% (n=237) of respondents first started using tobacco in smokeless form (snuffs, tobacco chewing or combined smokeless tobacco). The rest, only 8.39% (n=96) of respondents, first used tobacco in both smoking and smokeless tobacco. Also, among 1034 daily concomitant tobacco users, 70.50% (n=729) started smoking cigarettes first. REALLY NICE!! Outcome of the Pearson correlation tests for age of tobacco use initiation and current numbers of ways used showed a small, significant negative correlation (r= -0.11, pwas associated with a larger number of ways of using tobacco. elevated the probability in becoming tobacco co-users. Moreover, tobacco users were separated into different categories, single way smoking, single way smokeless tobacco, concomitant use of smoking, concomitant use of smokeless tobacco, or concomitant use of smoking and smokeless tobacco. Chi-square test was conducted to examine each of two different categories and nicotine dependence. Single way smokeless tobacco users were found to have lower probabilities of becoming nicotine dependence than all the other groups of users, except of the concomitant use of smokeless tobacco users. Also, the group of concomitant use of smokeless tobacco users were also found to have lower probabilities of nicotine dependence than co-users of smoking and smokeless tobacco[LD11]. [EW12] Discussion The present study sought to examine whether age of onset of tobacco use was associated with nicotine dependence and numbers of kinds of tobacco used. The study also aimed to examine whether different kinds of tobacco use were differently related to nicotine dependence. Further, itToabccoTobacco use was also examined amongthe tobacco use of concomitant users. Four major findings appeared. First, different ways of tobacco use were actually associated with nicotine dependence differently. Whereas cigars and pipe smoking failed to independently predict nicotine dependence, the other three kinds of tobacco, cigarettes, pipe smoking, snuffs and chewing tobacco were independently positively related to nicotine dependence. Second, age of onset of tobacco use was associated with nicotine dependence. An earlier initiation of tobacco use enhanced the probability of getting nicotine dependence. Third, age of onset of tobacco use also had correlation with number of kinds of tobacco use. An earlie r onset also elevated the probability of becoming concomitant users. Lastly, most of the co-users of tobacco started with smoking cigarettes. The finding of different directions of association with nicotine dependence in various kinds of tobacco may be explained by discrete habits and intentions of tobacco use. Of the five kinds of tobacco, cigars and pipe smoking failed to independently predict nicotine dependence (p=0.40). Two facts may be the causes of this may explain this explainationsexplanations phenomenon. First,First, most of the cigar smokers and pipe smokers were concomitant smokers. AIt is possible that among all cigar smokers (n=1,119) and pipe smokers (n=215), 62.02% (n=694) of cigar smokers and 74.88% (n=161) of pipe smokers were concomitant tobacco users. Second, most cigar smokers and pipe smokers did not consume large amount of cigar products. 80.07% (n= 896) of cigar users smoked less than or equal to 14 cigars per month. 60.93% (n=[LD13]131) [EW14]of pipe smokers used pipe smoking 18 times or less. Such small dose of intake may not result in enough variety of nicotine dependence. To sum up, cigar users and pipe users probably consumed these products not for satisfying the desire for nicotine but simply for a hobby. The correlation between age of tobacco use initiation and nicotine dependence showed that early initiation enhanced increased the probability of nicotine dependence. In the case of a special substance, the cigarette smoking, early initiation also elevated the current useage amount. of tobacco product[LD15]. This outcome is consistent with previous literature that stated early age of onset was associated with heavy smoking in later life (Chen Millar, 1998). Although early age of onset has been evaluated with its potential to enhance tobacco use amount, difficulty in tobacco cessation (Chen Millar, 1998; Khuder et al., 1999) and tobacco use frequency (Taioli Wynder, 1991), result of the present study has initiated strong implication that age of onset may also directly influence the possibility of becoming nicotine dependent. Moreover, the relationship between age of tobacco initiation and current kinds of tobacco use indicated that early onset also promoted the probability of becoming a current polytobacco users. Previous researchers have discovered that evidence that gender, ethnicity, education and income are related to concomitant tobacco use (Bombard, Pederson, Nelson Malarcher, 2007). However, the present study has shown evidence for the association between age of tobacco use onset and concomitant tobacco users. Further, the present study showed that a significantly large proportion of concomitant users started using tobacco by smoking cigarettes, and then stepped initiated into other kinds of tobacco. The direction of shifting among different tobacco products has been studied by others, and several various results have emerged. While some have suggested that smokeless tobacco products may act as gateway substances to cigarette smoking (Hatsukami, Nelson Jensen, 1991; Haddock et al., 2001), others have also proposed that cigarette smoking initiates smokeless tobacco use (Riley et al., 1996). There are also some researchers that have claimed none of them initiates the other (Wetter et al., 2002). The outcome of the present study suggests that cigarette smoking is likely to precede smokeless tobacco use. In the pair comparisons of different combinations of tobacco use, the group that only used one kind of smokeless tobacco showed a significantly lower probability ofin becoming nicotine dependent than groups of single way smokers, concomitant smokers and co-users of smoking and smokeless tobacco. The only group that was not significantly different did not show significantce variation in sensitivity to nicotine dependence from the group of single way smokeless tobacco users was the group of concomitant smokeless [LD16]tobacco users. One of the reasonable explanation of such phenomenon is that smokeless tobacco may be less addictive than smoking (Henningfield, Fant Tomar, 1997). Another explanation is that smokeless tobacco users might use less amount of tobacco products per month. The ANOVA of the combined amount of tobacco products used per month was conducted to test whether smokeless tobacco users had smaller amount of tobacco use. The result showed that the average usage amount of single way smokeless tobacco users was 97.94, which was significantly lower than those of single way smokers, concomitant smokers and concomitant users of smoking and smokeless tobacco, which were 408.22, 460.77 and 584.38. Strengths and limitations There are several limitations in the present study. First, only frequency of use and usual use quantity were available for estimating the amount of the tobacco products used per month. Such calculation was incomplete for reflecting the actual amount of use. Moreover, there was no measure for Conclusions and implications OUTLINE Briefly summarizing what you found (Summary) Take the main sentences of the results, don’t keep changing the words Finding 1, 2, 3: linking them to previous literature When talk about literature, don’t keep writing about the results Strengths and limitations Conclusions and implications: what should future research look at References Breslau, N., Peterson, E. L., Schultz, L. R., Chilcoat, H. D., Andreski, P. (1998). Major depression and stages of smoking: a longitudinal investigation.Archives of general Psychiatry,55(2), 161-166. Chen, J., Millar, W. J. (1998). Age of smoking initiation: implications for quitting.HEALTH REPORTS-STATISTICS CANADA,9, 39-48. Dierker, L., Donny, E. (2008). The role of psychiatric disorders in the relationship between cigarette smoking and DSM-IV nicotine dependence among young adults.Nicotine Tobacco Research,10(3), 439-446. Grant, B. F., Dawson, D. A. (2006). Introduction to the national epidemiologic survey on alcohol and related conditions.Alcohol Health Research World,29(2), 74. Haddock, C. K., Weg, M. V., DeBon, M., Klesges, R. C., Talcott, G. W., Lando, H., Peterson, A. (2001). Evidence that smokeless tobacco use is a gateway for smoking initiation in young adult males.Preventive medicine,32(3), 262-267. Hatsukami, D., Nelson, R., Jensen, J. (1991). Smokeless tobacco: Current status and future directions.British Journal of Addiction,86(5), 559-563. Hatsukami, D. K., Lemmonds, C., Tomar, S. L. (2004). Smokeless tobacco use: harm reduction or induction approach?.Preventive medicine,38(3), 309-317. Henningfield, J. E., Fant, R. V., Tomar, S. L. (1997). Smokeless tobacco: an addicting drug.Advances in dental research,11(3), 330-335. Hu, M. C., Davies, M., Kandel, D. B. (2006). Epidemiology and correlates of daily smoking and nicotine dependence among young adults in the United States.American Journal of Public Health,96(2), 299-308. Jha, P., Chaloupka, F. J., Moore, J., Gajalakshmi, V., Gupta, P. C., Peck, R., Zatonski, W. (2006). Tobacco addiction. Khuder, S. A., Dayal, H. H., Mutgi, A. B. (1999). Age at smoking onset and its effect on smoking cessation.Addictive behaviors,24(5), 673-677. MacKenzie, T. D., Bartecchi, C. E., Schrier, R. W. (1994). The human costs of tobacco use. New England Journal of Medicine, 330(14), 975-980. Riley, W. T., Kaugars, G. E., Grisius, T. M., Page, D. G., Burns, J. C., Svirsky, J. A. (1996). Adult smokeless tobacco use and age of onset.Addictive behaviors,21(1), 135-138. Taioli, E., Wynder, E. L. (1991). Effect of the age at which smoking begins on frequency of smoking in adulthood.N Engl J Med,325(13), 968-969. Wetter, D. W., McClure, J. B., de Moor, C., Cofta-Gunn, L., Cummings, S., Cinciripini, P. M., Gritz, E. R. (2002). Concomitant use of cigarettes and smokeless tobacco: prevalence, correlates, and predictors of tobacco cessation.Preventive medicine,34(6), 638-648. [LD1]You need to say what ethnic groups or which gender are more likely to use tobacco. It is not enough to say ethnicity and gender are associated with tobacco use. [LD2]This needs to be preceded by what the literature has shown on age of onset. In its current form, the paragraph comes a bit from left field for the reader. [LD3]You can include this in your results, but I don’t think it is on par with your other questions, so it does not need to be included here. [LD4]Not sure how to edit this, but a little less clear than earlier descriptions. [EW5]Describe the categories [LD6] We can discuss. [EW7]One decimal place for percentage and number Two decimal places for SD and SE [EW8]Add the sentence stating the likelihood, odd ratios and confidence intervals [LD9]Logistic regression? [EW10]Maybe I can delete it [LD11]Add the actual rates to this sentence. [EW12]Should I add some more details? [LD13] [EW14]Decide whether to delete it or put it in the result part [LD15] [LD16]

Virtual Child Ages 11-16

Maureen Gillespie PSY 206 – Dr. Greenspan Montgomery County Community College April 15, 2013 Assignment #2 Adolescence is defined as the transition between childhood and adulthood. Many changes happen at this stage. Adolescence involves things such as puberty, greater independence, and a time when someone begins to construct their identity. Identity means their life value and goals including a secure sense of who they are in terms of sexual, vocational, and moral ethics. In the next few paragraphs I will be discussing my Virtual Child, Maeve as she went through adolescence (ages 11- 16).I am going to delve into the different changes I saw in her and how they relate to theories proposed by Piaget, Erikson, Marcia, and Gardner. Each theory deals with development through adolescence and will help give a better understanding of this time in Maeve’s life. According to Piaget, around age 11 young people enter the formal operational stage. Here they develop the capacity for ab stract, systematic, scientific thinking. Whereas concrete operational children can â€Å"operate on reality,† formal operational adolescents can â€Å"operate on operations. They can come up with new, more general logical rules through reflection, rather than just using concrete things as objects of thought. (p. 301). Formal operational thought invokes verbal reasoning about abstract concepts. Adolescents doing things such as physics are examples of their operating within this stage. Maeve always did well in her math and science grades but, by 10th grade she was very enthusiastic about physics. She even went and entered one of her science projects into a county-wide science fair. Maeve has also taken, and done well, in art since the 7th grade.At age 14, Maeve's English class required she submit a poem into a school-wide contest. Maeve's poem took home first place in the contest, and her work was placed in a state-wide contest. Her work on art and poetry were reflections of h er inner feelings and were not just focused on concrete objects. As Maeve grew cognitively through this stage of her adolescence, she also went through a great deal of emotional and social change. These changes were obvious to us as her parents. These changes were signs that she could think logically and scientifically and was trying to put it all together to form her own identity.Identity is defined as a well-organized conception of the self, consisting of values, beliefs, and goals to which the individual is solidly committed. Erikson was the first to recognize identity as the major personality achievement of adolescence and as a crucial step toward becoming a productive, content adult. (p. 314) Identity is planted in an individual early in life, but it is not until late adolescence and early adulthood that people really take on the task and delve into finding their own identity.By age 12, Maeve began to argue with us over little things such as clothes, bedtime, and household chor es. These weren’t things we usually argued over, in fact we rarely argued at all, but as she changed emotionally, so did our arguments. She would talk frequently about what is and isn’t â€Å"fair. † Her moral development was forming as she started to differentiate her thoughts like this. As Maeve progressed through adolescence, she continued to grow morally and socially, but remained relatively easy going and well-behaved. She did well in school, saved her money, and was involved in after school activities.By the time she was 16, these actions proved she was responsible, and after practicing with me, she went for her driving test. She was just like any other teenager who wanted to hang out, go shopping, and drive around. But, she still always checked-in with us and was rarely late. She had begun to find her identity through independence and was doing well. Maeve was involved with sports and was looking happily ahead on her path towards college. But, late in 11t h grade, Maeve started to change for what could have been the worse.She had quarrels with girlfriends, engaged in a few senseless pranks, and began to date boys. At one point, as an act of defiance, she ran off with her boyfriend and they both got matching tattoos. During the times when she was feeling down, she wouldn’t talk much, but always knew she could. But, when Maeve was ready to talk, she was confident in herself and what she stood for. While her decisions weren’t always that irresponsible, we still found that we didn’t always agree with her. But for Maeve, she seemed to know she was in a trial and error phase of growing up and had to see what worked for her.We had to let her develop that. Much like Maeve’s trial and error phase, Erikson’s theory of identity versus role confusion explains psychological conflict of adolescence. This theory states that this conflict is resolved positively when adolescents achieve an identity after a period of exploration and inner soul searching. If a young person’s earlier conflicts were resolved negatively or if society limits their choices to ones that do not match their abilities and desires, they may appear shallow, directionless, and unprepared for the challenges of late adulthood. p. 314). Maeve luckily didn’t make many choices that were resolved negatively. These social and emotional changes weren’t always easy for the rest of the family to deal with, but they were a part of her growth. With us there to provide nurturing support, she was able to develop her own healthy identity after her period of â€Å"soul searching. † Researchers commonly evaluate progress in identity development on two key criteria derived from Erikson’s theory. These two criteria are exploration and commitment. Marcia yielded from this, four â€Å"identity statuses. These four statuses are: identity achievement, identity moratorium, identity foreclosure, and identity diff usion. Identity moratorium is exploration without commitment to value, foreclosure is commitment in the absence of exploration, and diffusion is an apathetic state where you don’t commit or explore. The following example shows how Maeve does not fit into either of these categories. As you know from previous examples, Maeve explored many social and behavioral changes in her adolescence. One conversation sits with me the most. I had a conversation once with Maeve after she was off the school bus in about 10th grade.She described a situation where she had a conversation with a good friend, heard her friend’s values, didn’t agree, and respectfully listened while providing feedback as necessary. She came home to tell me all about her values and how she didn’t openly or rudely oppose her friend just because her friend thought differently than she did. She also didn’t change her own values because of this. This is a perfect example of identity achievement which is defined as a commitment to values, beliefs, and goals, following a period of exploration. Maeve stayed true ith these beliefs, stayed on track with her goals in life, and is all set to go to the college of her dreams, because that is what she values. In looking at adolescence it is important to look at how they develop their intelligence. Howard Gardner developed a theory about various intelligences. He articulated seven criteria for a behavior to be considered intelligence. These were that the intelligences showed: 1. Potential for brain isolation by brain damage, 2. Place in evolutionary history, 3. Presence of core operations, 4. Susceptibility to encoding (symbolic expression), . A distinct developmental progression, 6. The existence of savants, prodigies and other exceptional people, 7. Support from experimental psychology and psychometric findings. Gardner chose eight abilities that he held to meet these criteria: spatial, linguistic, logical-mathematical, bodily-kin esthetic, musical, interpersonal, intrapersonal, and naturalistic. I believe that Maeve’s highest intelligences are logical-mathematical, bodily-kinesthetic, and interpersonal. She excels in her school work and is involved in higher level physics than that of her grade level.She participates in science fairs and enjoys using her mind to solve problems. She has always been a social butterfly and enjoys the outdoors. While she did play an instrument for some time, she didn’t enjoy it and wouldn’t be considered the musical type. While she is coordinated when playing sports, she has more than once ran into the trash cans while backing out of our driveway which would make me say she is not of the spatial intelligence. I also would consider a weaker intelligence for her to be linguistics. While she is intelligent it is not her strongest suit, as she isn’t the most eloquent speaker.In conclusion, there are many factors that come into play when a child is growing through adolescence. They change emotionally, spiritually, mentally, and physically. All of this is to work towards gaining a sense of self and identity to carry with them through adulthood. By taking the time and letting your child go through these phases with your background support, you are preparing your child to take on their world. References * Berk, L. E. (2010). Exploring lifespan development. (2nd ed. ). Illinois: Pearson College Div.

Preschool Education System Essay

Ramona is a hard-working, loving, single mother of two preschool aged girls, Theresa and Rosa. She works overtime every week, just to make ends meet for her and her children. Ramona and her children are in poverty. Unfortunately, statistics indicate that Theresa and Rosa will struggle to receive the quality preschool education they need to in order to succeed throughout Kindergarten, grade school, high school and into adulthood. According to one study by Sum and Fogs, students living in poverty rank in the 19th percentile on academic assessments, while their peers who are part of mid-upper income families rank in the 66th percentile on the same assessments (Lacour and Tissington, 2011). â€Å"The achievement gap refers to significant disparity in low educational success between groups of children: low-income and minority children as compared to higher income and non-minority children† (Early Education for All). This academic achievement gap is unacceptable and every child dese rves the chance to excel to their fullest potential in school, in order to prepare for adulthood. Preschool is a pertinent part of a young child’s education, which has been proven successful many times in preparing children for grades K-12, and beyond. â€Å"Practitioners and researchers alike contend that the enrichment of preschool makes a difference especially for children living in poverty† (Loucks, Slaby, and Stelwagon). By providing all children with access to preschool programs, the educational achievement gap can be reduced. Unfortunately, since preschool is not a government mandated educational requirement, preschool must be privately funded, leaving families who are unable to pay tuition costs are. This is an opportunity that Theresa and Rosa would miss out on because Ramona cannot afford the tuition. Because of these lasting cognitive and social development benefits that preschool can provide, it should federally funded educational requirement. Quality preschool education needs to be regarded as a constitutional right, not a socioeconomic privilege. There is an increasing educational achievement gap in the United States, between children of low-income families, and their peers, due to their limited access to a preschool education. It has been proven time and time again, that underprivileged children, who are not provided with the access to a preschool education, perform lower in later academic learning, than those who were afforded a preschool education. One study in California revealed that second and third grade students of low-income families who did not attend preschool were significantly less proficient in English and Mathematics (Loucks, Slaby, Stelwagon, 2005). Another California survey illustrated that poverty stricken children entering kindergarten were six months behind their wealthy peers in pre-reading skills. (Loucks, Slaby, Stelwagon, 2005). Children of low-income families are also much more likely to encounter environmental and health risk factors. (Early Education for All). These risks can potentially impede on a child’s readiness for school. For example, children living in poverty have been proven to begin kindergarten with significantly less mathematical knowledge than their peers. â€Å"This would suggest that the preschool experience is a mechanism to level the playing field and fully prepare students to succeed in kindergarten† (Loucks, Slaby, Stelwagon, 2005). By entering the early grades without having the proper pre-requisite education and skill sets, children run the risk of falling behind in class. When a student enters kindergarten unprepared, the students risk of grade retention increases, not only in kindergarten, but also in the grade school years to follow. Catching up to the required proficiency level becomes harder and harder for the student, and in some cases, the student will simply giv e up and either fail or drop out. Access to preschool education for these children can help to close the educational achievement gap, and prevent grade retention, by providing these children with the tools and skills necessary to prepare for Kindergarten and beyond. The United States of America prides itself on its educational standards, and even has ratified educational laws which require children to meet proficiency standards in reading and mathematics at certain grade levels, as indicated in the No Child Left Behind Act. The law incentivizes those school districts which show improvement in test scores, and enforce corrective actions upon those districts who continuously fail to improve student proficiencies. Still, these underprivileged children are left behind, and find it continually challenging to catch up, as the school grades progress. A child’s odds of academic accomplishment are maximized when attending a high quality preschool program, especially within the lower-income communities. This theory has been put to the test. In New Jersey lays a group of the thirty one most poverty stricken districts in the state called the Abbott Districts. The state of New Jersey granted these districts a program which funds preschool education within the districts to their children in order to close the achievement gap for poverty stricken students. The results were noteworthy, and the funds allocated to this cause were well spent. Children who attended this program improved on their math, language and literacy skills. The kindergartners who had previously attended the program closed the academic achievement gap by a remarkable fifty percent between their own literacy scores and those of the national average (Early Education for All, 2005). These results proved the program to be a great success. Studies have been conducted all over the United States, pertaining to children in poverty and the profound effect a preschool program can have on each child’s continued education. In a fifteen year follow up study in Chicago, Illinois, children who attended preschool were proven to be significantly more academically successful than their peers who did not attend preschool. At the age of thirteen, this group of children’s academic scores was sixty percent higher than those who did not attend. By the age of twenty, this same group who had attended preschool was thirty percent more likely to complete high school, and forty percent less likely to experience grade retention or be enrolled in special education classes (Early Education for All, 2005). It is important to remember, however, that although the strongest support for the advantages of preschool education indicates that underprivileged children benefit most, all children, regardless of socioeconomic status can benefi t academically from a preschool education. When a child has had the privilege of attending a quality preschool program, that child is also much more likely to adjust socially in adulthood, than those who did not attend a preschool program. According to Loucks, Sharon, Slaby and Stelwagon, those who have attended a quality preschool program are also less likely to have long periods of unemployment or welfare, and drop out of school. (â€Å"Why is preschool essential in closing the achievement gap?† par. 1). Adults who attended preschool as a child also have been proven to reduce delinquency and crime throughout adulthood (Barnett, 2008). Preschools are not only about cognitive learning, but they give a formal education to pre-kindergarten aged children on the developmental concepts of interaction with their peers. These lessons stay with the children through the remainder of their life. Without those lessons, many do not develop the social skills needed to succeed in our society. Preschool education is not only beneficial to the individuals who attend the programs, but it also benefits community and the local economy as a whole. Funds invested into preschool programs provide a significant return to the community. The RAND Corporation, a non-profit organization which provides objective analysis through surveys and research (The RAND Corporation), recently performed a study which found that for every on dollar invested into quality preschool programs for underprivileged children, two dollars and sixty-two cents was returned into the labor force and economy (Loucks, Slaby, and Stelwagon, Fall 2005). That is a two hundred and sixty percent return on investment. The direct return on this investment alone is more than enough to warrant a universal program. This study does not even include other potential indirect financial returns. Other financial returns from a public preschool investment would also be present in the lowering of state Medicaid costs, law enforcements costs, and other low-income assistance costs, such as food vouchers, homeless shelters and unemployment pay, which cost the government and tax payers a significant amount of money every year. Preschool is a necessary business investme nt for our economy to yield a higher return rate, than the current K-12 requirements today. The concept of a universal preschool program is not unheard of, not even in the United States. Most state government funded preschool programs are targeted toward children of lower income households. These programs have been put into place in a collaborative effort to close the educational achievement gap that exists in our society. However, some states, and even entire countries have already begun governmentally funding preschool programs, not just for underprivileged children whose families cannot afford the tuition, but for all pre-kindergarten aged children. In 1998, Oklahoma legislation ruled to make all four year olds eligible for a universal quality pre-kindergarten program (Sacks and Brown Ruzzi, 2005). Of course, a program as significant as this would not go without continued research and analysis. In a study performed between 2002 and 2003, significant supporting evidence was found which indicated that the program was a success. The study showed increased academic test scor es in the subjects of reading, spelling, writing and mathematics skills (Gormley, Gayer, Phillips and Dawson). Oklahoma is not the only state to equalize education for all children, regardless of their socioeconomic status. With the revenues from a state lottery, and the leadership of, then governor, Zell Miller, Georgia was the first state in the United States to offer a publically funded preschool program (Early Education for All, 2005). Similar to the findings in the study of Oklahoma’s program, Georgia’s program was also proven to be successful. A study found that more than eight percent of students who had attended the program ranked average or above upon evaluation third-grade readiness (Sacks and Brown Ruzzi, 2005). A universal preschool program is not just a theory waiting to be tested, it is already in effect in some areas, and is proving its value in this country’s educational achievement. If we do not put into place the appropriate interventions in the society, the educational achievement gap will only widen, costing more and more tax dollars, and most importantly, costing children the equal opportunity of prosperity in this country. This gap can be diminished significantly by providing each and every child in this country with the equal educational opportunity of a quality preschool program. Such a program provides this nation’s youngsters with the skills they need in order to meet the countries educational standards throughout the span of their education. It is unfortunate that in this land of opportunity and prosperity, that in order to grown and succeed; our children are subject to exclusion of such a beneficial educational tool, because of his or her parents’ inability to afford tuition costs. With our current economic status, our children, the future of this nation, must be provided every advantage possible in order to change this economy around. An investment should be made in our future today by providing a constitutional right to a quality and inclusive preschool program to all children. Works Cited Loucks, Sharon, Slaby, Robert, and Stelwagon, Patricia. â€Å"Why is preschool essential in closing the achievement gap?† Educational Leadership and Administration Fall 2005: 47+. Academic OneFile. Web. 7 Oct. 2012. Document URL: http://go.galegroup.com.ezp1r.riosalado.edu/ps/i.do?id=GALE%7CA142874683&v=2.1&u=mccweb_riosalado&it=r&p=AONE&sw=w Strategies for Children. â€Å"Early Childhood Education: A Strategy for closing the Acheivement Gap†. Spring 2005. Web. 06 Oct. 2012. Document URL: http://www.strategiesforchildren.org/eea/6research_summaries/07_AchievementGap.pdf Marcon, Rebecca A. â€Å"Moving up the Grades: Relationship between Preschool Model and Later School Success.† Early Childhood Research and Practice 4.1 (2002). 06 October 2012. Document URL: . Gormley, William T., Jr., Gayer, Ted, Phillips, Deborah and Dawson, Brittany. † The Effects of Universal Pre-K on Cognitive Development.† National Institute for Early Education Research. 06 October 2012. Document URL: http://www.crocus.georgetown.edu/reports/oklahoma9z.pdf Barnett, W. S. (2008). Preschool education and its lasting effects: Research and policy implications. Boulder and Tempe: Education and the Public Interest Center & Education Policy Research Unit. Retrieved 10/06/2012 from http://epicpolicy.org/publication/preschooleducation Sacks, Lynne and Brown Ruzzi, Betsy (2005). Early Childhood Education: Lessons from the States and Abroad: 2005. National Center on Education and the Economy. The New Commission on the Skills of the American Workforce. Retrieved 1027/2012. Document URL: http://www.ncee.org/wp-content/uploads/2010/04/Early-Childhood-Education.pdf Lacour, Misty and Tissington, Laura D. (2011). The effects of poverty on academic achievement.. Retrieved 11/03/2012. Document URL: http://www.academicjournals.org/err/pdf/pdf%202011/july/lacour%20and%20tissington.pdf The RAND Corporation. (n.d.). RAND Corporation: Obective Analysis. Effective Solutions. Retrieved November 03, 2012, from The RAND Corperation: http://www.rand.org/

Schizoid Personality Disorder Free Essay Example, 1000 words

SCHIZOID PERSONALITY DISORDER ID Number: of of School Estimated Word Count: 1,085 Date of Submission: November 15, 2011 SCHIZOID PERSONALITY DISORDER Introduction The schizoid personality is considered as one of the rarest types of personality disorders. It is also more common among the men than in women and those afflicted with this disorder can have little or no interest at all in developing normal relationships with other people. Unlike those diagnosed with the closest and almost similar disorders of schizotypal personal disorder and also the avoidant personality disorder, persons diagnosed with schizoid personality disorder do not have the characteristic cognitive perceptual distortions (schizotypal) nor the intense unexpressed desire to have relationships but avoid them due to exaggerated fears of rejection (avoidant type). A person diagnosed with schizoid personality disorder, however, shares the same features of the two other disorders in terms of social isolation and restricted or repressed emotional expression. The schizoid personality disorder differs from another almost similar disorder which is paranoid personality disorder in tha t it lacks the elements of mistrust and suspiciousness (Hales, Yudofsky and Gabbard, 2010, p. 303). In other words, it is very hard to spot except by someone who had been trained to diagnose it precisely and has therefore been rarely studied. We will write a custom essay sample on Schizoid Personality Disorder or any topic specifically for you Only $17.96 $11.86/page Discussion Some psychologists question the criteria used in schizoid personality disorder diagnosis as it suggests some cultural and social biases. This is because some people are different does not mean they are pathological or dysfunctional. The basis for this contrary claim is that people tend to discriminate those belonging in the minority and equate that with an illness, almost similar to the earlier case of homosexuality which had been removed from the list of mental disorders with the pioneering research done by Dr. Evelyn Hooker that homosexuals are normal people. Be that as it may, people diagnosed with the schizoid personality disorder share similar characteristics of those diagnosed with schizophrenia such as emotional detachment (coldness) and a blunted or a flattened affect.

“Sleep is the best meditation” â€Dalai Lama. This idea of...

â€Å"Sleep is the best meditation† –Dalai Lama. This idea of sleep as being peaceful and calm is nowhere to be found is Shakespeare’s play Macbeth. The normally accepted belief of sleep being associated with relaxation is reserved. Peaceful sleep is disturbed by horrific deeds that occur at night. From the night, one will see that sleep imagery shows acts of unnaturalness. By examining Shakespeare’s image of sleep, one can determine that sleep reinforces the idea of evil. Throughout the play the conventional idea of sleep as being a calm, restful time is switched around to demonstrate evil. When Macbeth is just about to murder Duncan in his sleep one sees his sleep is going to be disturbed. â€Å"Nature seems dead, and wicked dreams abuse the†¦show more content†¦Ã¢â‚¬Å"It is concluded. Banquo, thy soul’s flight. If it find heaven, must find it out tonight.† (Shakespeare 73) Macbeth is planning on killing Banquo and has planned to do it during the night. Macbeth uses the night to further himself in his own evil self interest. Also, after Macbeth murders Duncan, ones sees the evil deeds that happen at night, will only occur at night. â€Å"Give me the daggers. The sleeping and the dead are but as pictures; tis the eye of childhood that fears a painted devil.† (Shakespeare 47) This quote, plain and simple, compares sleep in the night and death to being virtually the same thing. When Lady Macbeth says this to Macbeth, the picture that the reader gets of sleep is of the devil, the most evil character known to man. This evil depiction of sleep is disturbing to the reader. Shakespeare uses this metaphor to show the evil of the night and that sleep and death come in pairs. Going along with the idea of night making sleep evil, one will see that sleep imagery of the night represents unnaturalness. Macduff is trying to plan the murder of Macbeth and he compares his death to the night. â€Å"Give me their instru ments. Receive what cheer you may: The night is long that never finds the day.† (Shakespeare 129) From this quote one can see that they are trying to overthrow Macbeth and the instruments are their weapons. The night, being associated with sleep, will never find theShow MoreRelatedSleep : Sleep And Sleep867 Words   |  4 PagesSleep Analysis As we learned in lecture, sleep is an important component in improving a person’s overall health. Because sleep is vital for cognitive function and available time to spend sleeping is limited for college students, like myself, it is advantageous to change sleeping behaviors to maximize the benefits sleep can provide. After tracking my sleeping schedule for a week, I have noticed some patterns and behavior that may be affecting the quality of sleep I am getting. Based on my sleep journalRead MoreSleep And Memory Of Sleep Essay1222 Words   |  5 Pagesessential factor is sleep. 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Supply and Demand Simulation - 1060 Words

Supply and Demand Simulation ï ¿ ½ PAGE * MERGEFORMAT ï ¿ ½1ï ¿ ½ Supply and Demand Simulation University of Phoenix ECO/365: Principles of Microeconomics October 26, 2009 ï ¿ ½ Supply and Demand Simulation IN THE UNIVERSITY OF PHOENIX SIMULATION (2003), APPLYING SUPPLY AND DEMAND CONCEPTS, A SITUATION IS PRESENTED CONCERNING THE SUPPLY AND DEMAND OF TWO-BEDROOM RENTAL APARTMENTS IN ATLANTIS. THROUGHOUT THE SIMULATION SCENARIOS ARE PRESENTED AND CHOICES MUST BE MADE REGARDING FACTORS THAT AFFECT DEMAND AND SUPPLY, AND THEREFORE, EQUILIBRIUM (UNIVERSITY OF PHOENIX, 2003, PARA. 5). CAUSE OF CHANGES The changes in supply and demand in the simulation are caused by different factors throughout the simulation. The causes included changes in vacancy†¦show more content†¦Summary of Results _Scenario One_ In the first scenario the monthly rental rate needed to be determined to reduce the vacancy rate to about 15%, while maximizing profits. The change in the demand was due to the rental rate; lowering the rental rate to $950 increased the quantity demanded to 1900 with a surplus of 100, and maximized profits to $1.81 million. _Scenario Two_ In the second scenario, the goal was to reduce the vacancy rate to zero percent. The possibility of leasing out all 2,500 apartments at the current rate of $1,100 meant that the business would not be profitable due to the increase in maintenance costs. Increasing the rental rate to $1,550 covered the maintenance costs and increased the number of apartments GoodLife was willing to supply. _Scenario Three_ In the third scenario, the Atlantis Housing Survey provided statistics regarding the demand for two-bedroom rental apartments in Atlantis. The survey found an imbalance in the quantity demanded and quantity supplied at the current rental rate of $1,550. Lowering the rental rate to $1,050 removed the imbalance and created equilibrium in the market. _Scenario Four_ In the fourth scenario, Lintech Inc. relocated to Atlantis and increased the population in the city. The demand for apartments increased, while the supply of apartments did not change causing a shift in demand to the right causing a shortage. Increasing the rentalShow MoreRelatedSupply and Demand Simulation1030 Words   |  5 PagesSupply and Demand Simulation ECO/365 Supply and Demand Simulation In the supply and demand simulation a neighborhood called Atlantis is given for the setting. Atlantis is a small city with open spaces, low population, and a low crime rate. There are plenty of sidewalks and street systems for easy access to the highway. The housing in Atlantis is detached homes and apartments. The supply and demand simulation consists of microeconomics and macroeconomics. 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This simulation was an exercise in applying the supply and demand concepts based on current market trends. The property manager is required to adjust the monthly rental rate of two-bedroom rental apartments and number of apartments available. Supply and demand within the simulation were manipulated by the rates chargedRead MoreSupply And Demand Simulation Analysis1189 Words   |  5 PagesSupply and Demand Simulation The economy is a practice that relies on principles and concepts. The different focuses are based on a Macro and Micro perspective that creates the commercial and consumer environment. It is important to understand how these principles and concepts relate to the environment to create strategies that will, in return create profit and confident investments. The supply and demand simulation highlighted the important of just that from a commercial setting. 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The simulation names the user the property manager; responsible for vacation residents, new pricing for units, and advertising. The property manager makes decisions in circumstances including the changing

Retained Surgical Sponge Legal Case free essay sample

In October, 2013 The Joint Commission (TJC) released a sentinel event alert pertaining to the prevention of retained surgical items. These retained items could have serious consequences for the patient. According to The Joint Commission Sentinel Event Alert, 2013 Issue 51, incidents of retained objects reported to TJC totaled 772 from 2005 to 2012, sixteen resulting in death and 95 percent of these cases requiring additional treatment. Over the course of my seventeen year career as an operating room circulator, the fear of being involved in a case resulting in a retained surgical item was always on my mind. This fear sparked my interest in researching a legal case involving a retained surgical sponge ultimately resulting in the patient’s death. I will present the case, provide an analysis, and the outcome of the Estate of Genrich versus Ohio Insurance Company, 2008 WI 67. Case Summary In July 2003, a male patient underwent abdominal surgery for an ulcer. He developed an infection and on August 8, 2003 it was determined a surgical sponge was left in the abdomen. We will write a custom essay sample on Retained Surgical Sponge Legal Case or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page He was taken to the operating room in order to remove the retained sponge. After this surgical procedure, he did not recover from the complications of sepsis and the patient died on August 11, 2003. His wife filed a law suit on August 9, 2006 against the doctors and staff involved in the initial surgery (Estate of Genrich v. Ohio Ins. Co. , 2009). RETAINED SURGICAL SPONGE 3 Analysis In my opinion, given the facts of this case, the wife had legal grounds for a lawsuit. Hardwired systems are in place in the operating room to prevent the adverse event of a retained surgical sponge. The surgical count is a standard procedure in operating rooms. As stated by Steelman and Cullen (2011), retained sponges continue to be an issue throughout the country. In cases involving retained sponges, the nursing documentation reflected the count as being correct. In my experience, counting is a standard of care in the operating room. The operating room circulator counts with the surgical technician to ensure that all sponges are accounted for at the conclusion of the case. The surgeon relies on the staff in the room to identify surgical counts as correct or provide notification of incorrect counts. Based on this information and upon a initial review of this case, I had no doubt the wife would receive monetary compensation for her lawsuit. The incident of a retained surgical sponge is negligent, and according to Stiller, Thompson, and Ivy (2010), fail to uphold the standards of patient safety and quality, resulting in the liability of the health care professional. Outcome To my surprise, the Supreme Court of Wisconsin ruled in favor of Ohio Insurance Company based on the fact that the state of Wisconsin has a three year statute of limitation. To make this judgement even more complex, the wife filed her lawsuit on August 9, 2006, two days under the three year anniversary of his death (Estate of Genrich v. Ohio Ins. Co. , 2009). However, the court concluded that his injury resulted from the retained sponge, was the start of the three year limitation. The initial surgery occurred on July 24, 2003. The court determined that the negligent act occurred during the initial surgery. The sponge that was left in the RETAINED SURGICAL SPONGE 4 abdomen caused the infection which ultimately resulted in the patient’s death (Estate of Genrich v. Ohio Ins. Co. , 2009). Conclusion In my opinion, the legal system failed in this case. One fact missing during the research of this case is the reason the wife waited three years to file a lawsuit. I found myself continuing to ask why the lawsuit was not filed immediately upon her husband’s death. Regardless of this fact, the wife suffered the loss of her husband due to the negligence of the physician and staff. Granted, when humans are involved, error is inevitable. One can hope that there will be understanding by the victims of the human error factor. However, the fact is the sponge should have been counted prior to incision and upon abdominal closure. A discrepancy should have been noted and it was not. The court concluded that the moment the sponge was left in the abdomen, the legal clock started ticking. In my opinion, a wrongful death lawsuit can only be filed when a death has occurred, not when the incidents leading to the death occur. If this had been the case, the wife would have met the statute of limitations and the judgement possibly would have been in her favor.