Author: admin

Los Angeles Union Station

Name

Lecturer

Course

Date

Los Angeles Union Station

Introduction

Laus or Los Angeles Union Station is currently the major rail way station in Los Angeles, California and it’s the biggest passenger terminal railroad the Western part of the United States.

Most recently, the railway station evolved into the largest main transport hub for those who live in South California. It currently, serves about sixty thousand passengers on a daily basis on their en route to Amtrak for the longer distance trains locomotives, Regional trains of Amtrak California, computer driven trains of Metro link as well as many more metro rails and light rails.

In addition, the Patsaouras Transit Plaza equally serves many more bus lines that are run or operated by municipality carriers and Metro. In closing the in the introduction, it is worth affirming that the station was started in nineteen thirty nine. It was then called Los Angeles Union Passenger Terminal. It hence, replaced the formerly known La Grande Station together with the Central station that was constructed in the nineteen nineties.Historical background Los Angeles was developed after a stringent measure was undertaken to in nineteen twenty six. This election process gave voters or electorates a chance to make a choice between building a large network of elevated railways or undertake to construct a much smaller union railway station that would consolidate or bring together several different railway terminals.

Unfortunately, the electioneering process took a racial inclination and it was this political development that led to the construction of the current Los Angeles. Upon proposal, the Union Station was constructed within ten the central business union of Los Angeles former China Town.

Given the chronic racial prejudice of the time, those who held contrary views became proponent of the fact that, union stations should not be constructed within the middle of Chin a Town. But, instead, there should be demolition of China Town Surroundings. This received an a narrow approval from the voters

In nineteen eighty, the station was put on the national registrar of historical places thus becoming Los Angeles cultural monument.

In nine teen ninety two, train lines such as, Antelope Valley Line, San Bernardino Line and Ventura County Line .in nineteen ninety three, San Bernardino train line was completed together with the Orange CountVentura County Liney Line.

In nineteen ninety four, Metro’s Red Line and Riverside Line had started functioning. In two thousand, there was the conversion of Platform one into metro’s gold line and electric light rails.

Historical evolution of the place

In 1920s, there was a measure that aimed at the establishment of the union station. This was subjected to the ballot by the people of Los Angeles. This was to enabled them decide between the construction of a network of elevated railways and the construction of a far much smaller union station.

Next the railway station was opened in the early 1940s. This gave it the green light to begin transacting its business for example, the opening of Los Angeles Union Passenger Terminal, that had replaced the former central station and La Grande Station.

In 1950s to 1960s, the services of the union station replaced La Grande Station and Central Station . the union station also served a number of highways such as; Atchison, Southern Pacific Railroad, Topeka and Santa Fe Railway, and Union Pacific Railroad, as well as the Pacific Electric Railway and Los Angeles Railway .

In the late 1960s, the union station went through less patronage due to the completion from air travel and the rise other automobiles.

In 1980s, there were plans underway for high speed train system that would link Northern and Southern California. This was proposed by the then Governor Jerry Brown.

In 1990s, and in particular nineteen ninety six the California High-Speed Rail Authority got formed to that began formal planning in an attempt to prepare for a ballot contest in nineteen ninety eight or in two thousand.

In 2000, the ballot contest that was formally scheduled to 2004 general election was altered after the legislature voted in order to move it to 2006 and consequently to 2008 where it was approved with a minimal margin of fifty two point seven percent.

The initial cost of the San Francisco-to-Anaheim section was initially approximated by the Authority as at thirty three million dollars in two thousand and eight. Yet a revised business plan that was released in two thousand and eleven by same Authority placed the sum cost at sixty five point four billion dollars. Finally, there was an implementation plan that was approved in two thousand and five which estimated that, it could take about decade to develop and start the operations of an initiation section of California high-speed train.

In 2010, the Board of Directors casted votes the led to the beginning of the building of the initial part of the system from Madera to Fresno. By the close of December 2010, there was the in cooperation of an additional six hundred and sixteen million dollars into the federal funds that was transferred from states that called off their high-speed rail plans. The first section of building was extended to Bakersfield. In addition, some three hundred million dollars was re allocated in two thousand and eleven. This led to the extended funding.

In 2012, Obama administration issued California’s high speed rail plan a go ahead. Obama fast tracked the project. This streamlined the permitting process.

Lastly, in 20013, there was a joint venture from Tutor Perini/Zachary/Parsons which then announced that it had implemented a contract with the consent for the design and building initial Madera to Fresno section of the California high-speed rail system. The contract was estimated to be approximately nine hundred and eighty five million dollars with an addition of fifty three million miscellaneous.

Transit station on El Monte Bus way

A transit way station for Metro Silver Line together with some other transit buses plying on the El Monte Bus ways is built on the southern part of Patsaouras Transit Plaza.

This was enabled by funding from tolls collected from Metro Express Lanes project.

The station will permit buses moving in the either directions on the bus ways to serve the union stations with very little delay for passengers to other different stations. Upon completion, there would be a bridge that would facilitate the passengers’ movement from Patsaouras to the bus way station through the Transit Plaza to. This will help do away with a very long walk across the Union Station premises to the present stop located on the El Monte Bus way at Alameda Southern California Regional Interconnect Project

Union Station will be a prime hub for California High-Speed Rail System on completion.

Los Angeles Union Station Transportation Center

Los Angeles Union Station Transportation Center is planned to be a new bus way terminals to the upper level.

Description of the present conditions, relative to the past.Union Station is enclosed on garden potions on either side. It has a waiting room with the passengers exit. The rear end of the inner walls is covered with many marble while the fore end is covered with acoustical tile. The floor is terra cotta tile sandwiched with a strip of an inlaid marble that is inclusive of travertine.

The main building is attached to the south with a station restaurant. In contrast to the past, it is worth making note of the fact that, much development has occurred and much more is even on the way given the future intentioned development. For example, Angeles Union Station Transportation Center

Los Angeles Union Station Transportation which would aid in the transfer of canters from Park & Ride of L.A. Metro, Foothill Transit, Orange County Transportation Authority, Santa Clarita Transit, Burbank Bus, LADOT, Commuter Express, Big Blue Bus, LAX Flyaway Bus, Torrance Transit and Antelope Valley Transit to another flyover closer to towards a Metrolink, Amtrak and Metro Gold Line Platforms and finally to a newer glass elevator in the future.

In addition, California High-Speed Rail

Union Station will also be a hub for California High-Speed Rail System. It is projected that on completion, -passenger will be able to get to the move from Union Station to the planned Tran bay Terminal at San Francisco within less than three hours. This I do believe will be far much better than before.

Moreover, Metro is currently researching on modalities of how to best synchronize tracks together with the platforms meant for high speed train within the union station.

A number of options have been brought forth such as; an aerial structure over and above the current platforms that are in place, a beneath structure under Alameda, a beneath structure below Vignes as well as an aerial structure in the east of Vignes. Altogether, these plans are inclusive of a new concourse that is meant for high-speed rail passengers with three platforms composed of six tracks.

Lastly, former Run-Through Tracks Project

The Federal Railroad Administration had come up with a plan to construct run-through tracks within the Union Station. This would also have a great import on the current classy state of the union station per se.

My current perceptions.I am deeply moved by the development of Los Angeles Union Station. This is due to the fact that, the designers had a magnificent imagination. This has largely contributed too much of the architectural designs that have greatly been borrowed even in academic circles.

Union Station was party designed by John Parkinson and Donald B. Parkinson. They were helped by a conglomeration of architects, such as Jan van der Linden.

The modalities in necessitating the movement of people and commodities from one place to the other have been largely eased by the development of the union station. This is due to the looming fact that, about sixty thousand people can use the station on their day to day business. This has enormously eased communication from among people.

Administratively has equally been less burdensome due to the development of this railway union station. This is due to the fact that, administrative business can be easily transacted with a lot of ease. Administrators can move from place to place if need be. They can equally make follow ups in different t parts of the region.

Business as well as other related commercial practices too has largely and speedily evolved due to this development. This leads to speedy transfer of both goods and services from one place to another. Federal workers are also able to move from their far flung residential areas to their work stations with very little restrain if any.

I must also confess that the fact that, the construction of their rail station was politically motivated has led to collective acceptance of its usage per se. This is out of the fact that the people felt part and parcel of its establishment. This can be underscored by their overwhelming turn out in the ballot process even though; the approval was with a miner margin of about fifty three percent.

Culturally, the union station has been accredited as a national monument. As such it plays a potent role in the preservation of the cultural orientation of the people of Los Angeles. This facilitates both local and international tourists.

It equally acts as a revenue hub after the tourists depart. In the same length, it has enhanced self pride of the local in habitants who identify with it. The unions rail way station, has also eased academic processes since, it has been a darling for many student researchers. It has similarly motivated architectural ambitions among those who have passion for architectural design. The union stations have been also used by lecturers and students as they move from their residential areas to their learning institutions.

Good transport and communication network has led to speedy rise and development of industries. This has been enabled by faster transportation of industrial finished products to the market. Along the same breath, it has similarly bolstered the transportation of raw materials to the factories and this has reduced the production cost as well as speeded up the transformation of these raw materials into f9inished products too.

The union station of Los Angeles has bolstered interaction of people leading to cultural exchange. This has led to increased interracial tolerance. This has weakened the social ill of racial discrimination. This has been feasible out of the fact that, as people interacts and socializes; they are able to learn from each other. They thence, appreciate their difference and acknowledge the fact their diversity is of great strength when properly harnessed. This has led to a better co existence between and among people of different kind. The developed nationhood has furthered common understanding and collectivity among the populace that use the railway station. With this positive relationship, countries have enabled their citizens to move freely to other countries which have boosted trade greatly.

Last but not least, the union stations have provided employment opportunities to many citizens as well as local and immigrants. This enables them meet their family needs and assist them in meeting their obligations to the national government in such areas as paying taxes which helps the government in running its programs. They become economically empowered so that they do not rely on welfare programs.

It is therefore my subtle opinion that, the union station of Los Angeles has greatly contributed to the overall common good of those that it affects remotely or directly. Directly in that it has provided a more comfortable way of transport that people can easily access, being that it is modern and indirectly in that it has been able to create employment to many people both country wide and nationwide among others.

Cited works

Steve Hymon (October 17, 2012). “Ribbon cutting this morning for new platform at Los Angeles Union Station!””Los Angeles Metropolitan Lounge opening next Monday, 9/23”. Flyertalk. Retrieved 19 September 2013.Bottles, Scott (1987). Los Angeles and the Automobile: The Making of the Modern City. Berkeley, CA: University of California Press. p. 156.

Axelrod, Jeremiah (2009). Inventing Autopia: Dreams and Visions of the Modern Metropolis in Jazz Age Los Angeles. Berkeley, CA: University of California Press. p. 193.

“Regional Rail Capital Funding Plan for FY 2012-13”. Los Angeles County Metropolitan Transit Authority. July 18, 2012.

Katches, Mark (January 31, 1993). “Red Line Rolls to Raves – It’s Smooth Railing As L.A. Subway Opens”. Daily News of Los Angeles.Los Angeles County Metropolitan Transportation Authority. pp. 38–66. Retrieved 13 July 2013.Matthew R. Poole (2010). Frommer’s Los Angeles 2011. Frommer’s. p. 30.

Critical Analysis and Reflection

Critical Analysis and Reflection

Name:

Institutional Affiliation:

Date:

Introduction

This paper seeks to effectively provide an analysis of the critical thinking and reflection and how they are used in the re-assessment and re-analyzing of the different situation that need attentive examination and this is to be done on the basis of how, why and when facts and nursing distortions mix up. The objective of this paper would be achieved on the basis of how it makes learner to be able to handle situations professionally and give out desired results on the grounds of the company’s set strategies and objectives (Ashby, 2006). In this paper, I reflect on the clinical application of my major: gaining more confidence in the assessment of patients who are coming in for admission in a psychiatric setting.

Course Description

In respect to this study, the main words to be discussed under this section as the key elements to the study are buzz phrases like; critical thinking and critical reflection of the study practice. In accordance to these phrases, Scriven’s definition has been adopted to provide additional help to the definitions. According to his views, critical thinking is an intellectually disciplined process that vigorously and skillfully conceptualizes, relates, examines, manufactures and appraises information collected from scrutiny, experience, reflection, reason and information dissemination as a guide to belief and action (Scriven and Paul 2004). This skillful conceptual application is a very crucial concept that learners and clinical professionals in their day to day operations.

In respect to reflective practices, Duffy’s description was been adopted as a tool for intentional mental processing that is normally used in complex situations aimed at fulfilling objectives and purposes that are set presently or in future. Reflection affords ways through which nurses could assess practice as an individualized improvement process (Duffy 2007). I was able to establish that a reflective process was active, persistent and carefully judgment of any belief or form of knowledge.

Purpose of the clinical learning need

Nursing study is one of the essential requirements in the global society as human beings are faced with different health challenges that nobody can naturally tell the source and appropriate diagnosis without undergoing g nursing study. Nursing learning consists of a wide range of medical fields ranging from simple diseases to very complicated ones such as psychiatric infections that require neurosurgeries (Alsop & Ryan, 1996). The key aspects that will be looked at in this study would be learning of nursing as a career profession and working under nursing.

The core plan and accreditation of the education of nursing units is mainly for three key reasons. The first step in acquiring the nursing skills and knowledge is through attending of the nursing classes where learning on the basis of the nursing units is undertaken. There is an international set of the nursing units that students undertake in their nursing syllabus while at school in different academic levels as far as nursing profession is concerned (Aitken, 2003). The initial accreditation of the units of nursing education seeks to contact the ACEN in order to begin the appropriate process of candidacy. As part of the learning process in nursing, the units of the nursing education will be assigned a professional staff member in order for him/her to mentor the students during their study.

The service of mentoring is provided mainly to facilitate a self-review faculty and general planning. The readiness of the program to be applied for is determined by the faculty of the administrative and program officers of the organization that takes role of governorship. This is when the student initial accreditation and candidacy application can be done. The decision of undertaking the nursing study at any international or even national nursing should be done on the basis of an in-depth program of self-study in relation to the accreditation standards of ACEN and the appropriate Criteria (Ashby, 2006). As long as the commission of ACEN grants accreditation to any program, all graduated students or those students that graduated after the coming of the accreditation cycle at the time which they visited site was performed will be fully recognized as international graduates of nursing program that is accredited.

Purpose of the academic learning need

The field in which I am, there are many challenges and in order to be able to tackle them, there is need for one to have knowledge in addition to skills gained through clinical learning as I have indicated in the above section (Baumgartner, 2001). Knowledge is gained by going through the academic learning process effectively and orderly. By effectively and orderly, mean covering the whole syllabus that is covered in the respective courses through going done. The academic learning process requires that an individual must successfully cover the course syllabus at one level, attain a degree certificate and be allowed to undertake the next level.

The most technical and challenging part of it all is where I had to go in the laboratory or theater to attend to a psychiatric patient lying in a bed. In most cases when you learn in class, you enjoy and almost forget that it will come to such a time of real action. Critical thinking and reflection really help in such like cases, because you personal conscience might mislead you when you are overcome by fear and terror (Pierce 2008). This time calls for relaxing, focusing and mentally taking yourself back to theory in academic learning.

Therefore, I realized that in psychiatric field, doctors encounter challenging situations such as a patient suffering from psychiatric problem being out of control but the key to handling any of such challenges relies on you understanding during the academic learning. I being a doctor, I require skills, experience, and knowledge that are acquired in academic learning. Therefore, based on this, it can be confirmed that there is a greater need for academic learning for all types of medical professionals (Riddell 2007). Critical thinking and reflection on what is learned in academic field is the key to the application of the knowledge learned in academic institutions.

Literature Review:

I searched for the literature material that provided detailed information about the need for academic and clinical learning in nursing and found many reasons as to why I need academic and clinical learning for my career (Aitken, 2003). The fact that nursing profession and medical sectors are the key sectors in human life has made many people to write a lot of information about why the learning in nursing is highly required. The historical books I found in the field provided that the health and disease problems that our ancestors went through are the key reasons for the introduction of academic and clinical learning in the field (Duffy 2007).

I found out that the main source of the nursing knowledge that I use has its origin in the academic learning that I undertook and continue undertaking. It opens my brain and enlightens me on the key procedures and concepts to be used in my field. On the other hand, the experience and ability that enables me tackle situations that are challenging and sometimes seems to be impossible come from clinical learning (Meltzer 2008). The literature material further confirmed that only academic learning or clinical learning as a single learning discipline does not make one fit and ready to handle all challenges in the medical field. Therefore, these two aspects of study are rendered crucial and very important in perfecting any medical relate career like mine.

Scholarship work had identified four features that were critical in order to guide student’s reflection activities. Students are advised to find the right guide, develop a reflective framework, be aware for what might unfold and take a deeper reflection on the holistic situation. Whenever there is the right guide, it facilitates the process of keeping the right guide, other than the problem solving process. I realized that the former work done by preceding practitioners provided points of reference for my skills which I read in medical newsletters and journals.

The experiences I read formed my resource base for advice, information, challenging experiences for self evaluation and discovery (Duffy 2008; Yorke 2006). I later on fathomed that being proactive in any field of study especially like the case of nursing, majorly prepared me to be open to new ideas devoid of inherent prejudices in me. As a learning practitioner revisiting past experiences showed me reflective of processes that entrenched my comprehension of new skills that I had learned beforehand (Lindberg 2007).

In my critical analysis I came across a study that determined whether critical thinking had any effect on job performance. Nursing practitioners were asked whether they experienced satisfaction while serving in the Intensive Care Unit (ICU). The findings showed that critical thinking and reflection were linked to job satisfaction. The findings also indicated that the scale of satisfaction among nurses went up after they got involved in thought reflection. I also came to understand that the nurses had a chance to gain insight into how they worked and improved their self worthy (Vinjie and Mittelmane 2007; Yorke 2006; Smith et al 2009).

When seeking employees most employers placed emphasis on attributes, skills, knowledge and attitudes. Self efficacy, critical thinking and reflection skills were the most sought after in employees (Smith et al 2009). The new trend in pedagogical methods was towards is expansion of teaching beyond academic knowledge. It focuses on skills that are necessary to find the way to successfully and satisfactorily improve the professional practice (MCMahon, Patton and Tatham 2003).

Program student learning outcome

Reid defined reflection as a process of appraising experience to be able to portray, analyze, assess and inform about a learning process (Reid, 1993). In this discussion, I seek to contextualize situations of professional performance so that I can learn, grow and develop in professional practice. This process of reflection is important to me so that I can assess myself within the context of experience to be able to gain experience towards problem solving (John, 2000).

The reason why self-reflection is important is because it brings within me transformational learning which can be gradual and life changing (Baumgartner, 2001). In order for reflective learning to be realized, one must reflect by going back and pondering over past events, new insights indifferent dimensions of the situation. This tool is very vital in the approach one can give to issues related to the patient care. The primary care which is part of the reflective model is very important in that it helps the patients manage their conditions and enables them to offer informational kind of assessment, behavioral and also emotional kind of support they could be in need of from their next of kin (Alsop & Ryan, 1996). One can be able to make some sort of reflections on how the patient feels and may decide to give the necessary help that can enable them get better without necessarily undergoing intensive care and treatment.

My process of self-reflection and critical thinking begun during my placement to a hospital institution psychiatry unit charged with the role of assessment of patients and forwarding them to the lead physician. At this moment, I realized apart from the theoretical knowledge within me, I needed something else without which I felt empty. This was self confidence which enabled me to face various challenges and situations of in-coming patients. The process begun at 8.00 a.m. in the morning to 5.00 p.m. for about 7 hours, but to me what mattered most was the self reflection process of how I behaved before patients, what should be done and how it should be done.

Curriculum (The Situation)

What led to the main challenges that are mainly faced in the nursing profession happens in a case where a patient code-names as Maria Crowley for the purpose of this assignment comes in a medical firm for treatment (Mishler 2006). The hardship is mainly experienced when Maria who is a patient goes before a nursing officer while undergoing severe depression and when the doctor observes her keenly, he realizes that she has already given up in life and does not appreciate her environment and people anymore (Clayton, et al, 2005). The doctor faces a hard time trying to convince her that she should have hope and that the medication she is given will help her if she concentrates and pays attention to the doctor’s prescriptions.

Before leading her to the psychiatric laboratory for further assessment, there arises need to conduct armature appraisals though amid mixed confusion, surprise, empathy and helplessness for lack of knowing what to ask or say in the middle of the session. For once, I ran short of supportive resources for the patient. My physiological state at this moment had a big impact on providing information for myself efficacy and confidence. My mood states of anxiety, stress, confusion and helplessness instilled concerns of vulnerability to poor performance. However, upon deeper reflection I concluded that I had all the resources at my disposal all I needed was confidence and self efficacy (Chen, Gully & Eden, 2004). I needed to tell myself beyond any reasonable doubt that I could do it just as my mentor.

When the lead psychiatrist took over all I could do was to take notes in my reflective diary. I could gather from the conversation that ensued that Maria had had a nasty past where she lost her family in a grisly road accident. She lost her husband, four kids and a sister. A year later she had not been able to overcome the trauma she underwent. She complained of seeing her family crashing and hearing cries of pain anywhere (Alsop & Ryan, 1996). She had difficulty with sleep, focus and at was unable to perform any task. This had caused her a job as high school teacher. Community workers on duty spotted her in the streets and admitted her to the mental institution for check up and possible treatment from acute depression.

Patients were already in low self esteem hence needed an environment of support and encouragement (Gardner and Pierce 1998). A health care provider who possessed high confidence levels in the areas of communication and clinical skills because it had an effect on patient outcome expectancies. When there was confidence in the nurse it enabled her/him to assess patient’s concerns and make right decisions. Whenever some success was registered t contributed to me robust belief in my personal efficacy (Bandura 1997). At the same time, failure undermined self efficacy and self confidence. My confidence influenced my critical thinking and my performance and communication skills.

Alignment of the Course by Assessments, Outcomes, and Standards

Effect of My Personal Needs on Professional Development: Another important aspect was that my needs affected my professional development. Having less confidence was not good for me. This tied down my abilities to handle the situation at hand. On the contrary, wanting to perform well or above board made me to be over-confident (Hecimovich & Violet 2009; Rose, Ruktalis & Schuckit, 2005; Chen, Gully & Eden 2004). This was a limitation to me because I could end up believing to be right even when committing medical errors. By engaging in critical thinking, self confidence I became aware of sound judgments that provided my basis for solving problems in a more rational way.

Application of a Reflective Model: The case of the reflective model is very vital in analyzing the effective mode of learning. I combined various skills in application of the reflective model. Effective learning came about with many tactics taking shape in the session. Through observation of how the lead psychiatrist handled the session was a critical stage. Paying attention to challenging areas while taking notes into my diary became handy, as I could gain new insights and have a third eye on the how I could have done it better. I adopted Kolb’s learning cycle which emphasized on experiential learning (Proctor & Rosen, 2004). For Kolb concrete experience phase is crucial since you relate to what happened, how you did it or would have done it and how you applied your ideas in the situation. In Maria’s case I discovered limiting mood states that tied down my potential. I needed positive resources of self efficacy and self confidence.

Another important phase according to Kolb’s cycle is reflection. This involved reviewing the experience in my mind and exploring what I did, what others said while taking lessons and noting in my reflective diary. In the abstract, conceptualization phase, I went further to understand what happened in the session by asking from my mentor, colleagues and more research leading to discovery of new ideas about how things are done. The last phase involved active experimentation that was concerned with trying out new ideas that I gathered from my past experience and reflection process (Sackett, Straus &Richardson, 2000).

Selection of Critiquing Tool: From my experience and what I observed from my mentor, reasoning in nursing could comprise of eight elements of thought which is consistent with Paul’s findings. The elements aid the learner in selection of the right tools. Purposeful thinking could be determined by the problem or issue at hand. One needs to understand what the thinker is trying to figure out (Aitken, 2003; Bittner, 1998). Other elements could be the overall end goal: frame of reference or held world view; held assumptions; central concepts and ideas; evidence or data; various interpretations or inferences and the eventual consequences that follow based on decisions we take (Eastbrooks, 1998).

The Strengths and Weaknesses of the Methods and research Process used.

Data collection methods relied mainly on observation techniques. Observations are sometimes guided by perceptions and attitudes that are inherent in us. Observations are experiential and far more enriching to the learner (Alsop & Ryan, 1996). The main weakness of this method is that it is subject to many individual interpretations hence makes it difficult to standardize findings. Secondary literature provided mainly scholarly contributions to the topical issue. The process of reflection has been criticized for advancing held beliefs and practices. There lies the cultural risk and personal risks that are involved. Not all people feel empowered by the reflective process (Paul, 1990).

Conclusion and Recommendation:

I learned that as a nursing practitioner I needed to understand the right questions for the right situation. Studies are consistent on the fact that critical reflection increased job satisfaction and reduced nursing turn-over rates. I also found congruence in the fact that employers were therefore in pursuit of employees that exhibit such skills in their career. Institutions of higher learning had adopted critical reflection as part of their curriculum compulsory for all nursing students (Ashby, 2006). Furthermore, on more reflection, self efficacy and confidence for a nursing learner was a crucial aspect to forming the right attitudes and mood states required for better performance. Mentorship, supervision and individual observations were critical experiential tools essential for self discovery.

References

Aitken LM. (2003) Critical care nurses’ use of decision-making strategies. J Clin Nurs. (12):476–83

Alsop A & Ryan S (2006) Making the most of fieldwork education: A practical approach. Stanley Thornes, Cheltenham

Ashby, C. (2006). The benefits of reflective practice. Practice Nurse. 32 (9), 35-7.

Alvesson, M. & Sköldberg, K. (2000) Reflexive Methodology: New Vistas for Qualitative Research (London: Sage Publications).

Acheson D. (2008) Independent Inquiry into Inequalities in Health Report. London, HMSO,

Atkinson AB. (2010) On the measurement of inequality. Journal of economic theory, p. 2: 244±263.

Beaglehole R, Bonita R. (2008) Public health at the crossroads: which way forward? Lancet, New York, p, 351: 590± 592.

Baker, S. (1990) Reflection, Doubt, and the Place of Rhetoric in Postmodern Social Theory, Sociological Theory, 8 (2), 232-245.

Barnett, R. (1994) The Limits of Competence, Knowledge, Higher Education and Society (Buckingham, SRHE and The Open University Press).

Barnett, R. (2000) Realizing the University in the age of supercomplexity (Buckingham: The Society for Research into Higher Education and Open University Press).

Biggs, J. (2003) Teaching for Quality Learning at University (2nd edn) (Buckingham: Open University/SRHE).

Birch, M. & Miller, T. (2000) Inviting intimacy: the interview as therapeutic opportunity, International Journal of Social Research Methodology, 3, 189-202.

Bleakley, A. (2009) From reflective practice to holistic reflexivity, Studies in Higher Education, 12 (3), 315-330.

Bolam, B., Gleeson, K. & Murphy, S. (2003) “Lay person” or “Health expert”? Exploring theoretical and practical aspects of reflexivity in qualitative health research, Forum: Qualitative Social Research, 4 (2), Art. 26.

Boud, D., Keogh, R. & Waller, D. (2005) Reflection: Turning Experience into Learning. Kogan Page: London.

Boud, D. & Walker, D. (2009) Promoting reflection in professional courses: the challenge of context, Studies in Higher Education, 23 (2), 191-206.

Brockbank, A. & McGill, I. (2008) Facilitating Reflective Learning in Higher Education (Buckingham, Society for Research into Higher Education/Open University Press).

Brookfield, S. (2007) Developing Critical Thinkers: Challenging adults to explore alternative ways of thinking and acting (Milton Keynes: Open University Press).

Brookfield, S. (1993) Self-directed learning, political clarity and the critical practice of adult education, Adult Education Quarterly, 43(4), 227–242.

Burawoy, M. (1998) Critical sociology: A dialogue between two sciences, Contemporary Sociology, 27 (1), 12-20.

Bandura A. Self-efficacy: the exercise of control. New York: W.H Freeman; 1997.

Baumgartner LM (2001) An update on transformational learning. New Directions for Adult and Continuing Education, p. 89:15-22. Jossey-Bass, San Francisco.

Colbourne, L. & Sque, M. (2004) Split personalities: Role conflict between the nurse and the nurse researcher, Nursing Times Research, 9 (4), 297-304.

Chen G, Gully SM, Eden D. General self-efficacy and self-esteem: toward theoretical and empirical distinction between correlated self-evaluations. J Organ Behave. 2004; 25(3):375–95.

Duffy, A. (2008). Guided reflection: a discussion of the essential components. British Journal of Nursing. 17(5), 334-339

Duffy, A. (2007). A concept analysis of reflective practice: Determining its value to nurses. British Journal of Nursing. 16, (22), 1400-1407

Murray CJL et al. U.S. (2005) patterns of mortality by county and race, Harvard School of Public Health and National Center for Disease Prevention and Health Promotion, New York, Cambridge

Antonovsky A. (2007) Social class, life expectancy and overall mortality, New York, Milbank Memorial Fund quarterly, p. 1967, 45 (2): 31±73.

Marmot M et al. (2007) Social inequalities in health: next questions and converging evidence. Social science and medicine, New York, John and Peter Publishers, p. 44: 901± 910.

Whitehead M (2009) The concepts and principles of equity and health, International journal of health services, Washington DC, Cambridge Publisher, p. 1992, 22: 429± 445.

Feinstein JS. (2013) The relationship between socioeconomic status and health: a review of the

Literature. Milbank quarterly, New York, p. 71 (2): 279± 322.

Kaplan GA, Lynch JW. Whither studies on the socioeconomic foundations of population health? American journal of public health, Washington DC, p. 87: 1409±1411.

Wagstaff A et al. (2011) On the measurement of inequalities in health. Social science and medicine, New York, p. 33: 545±557.

Manor O et al. (2007) Comparing measures of health inequality. Social science and medicine, Washington DC, p. 45: 761±771.

Mackenbach JP, & Kunst AE (2008) Measuring the magnitude of socioeconomic inequalities in health: an overview of available measures illustrated with two examples from Europe. Social Science and Medicine, p. 44: 757±771.

Sen A. (2007) On economic inequality. Oxford, Clarendon Press, New York. P. 13, 346

Valkonen T. (2009) Problems in the measurement and international comparisons of socioeconomic differences in mortality. Social science and medicine, 1993, 36: 409±418.

Appendices:

Appendix 1:

INCLUDEPICTURE “https://lh4.ggpht.com/s-SlLobV3y8f8RaRRU6UAlRU27dV-mxlTsUo7BbsuiCInFq1k0jJIDjtfz1PlbfwS1E=h900” * MERGEFORMATINET

Appendix 2:

INCLUDEPICTURE “http://www.brainboxx.co.uk/a3_aspects/images2/GIBBS2.jpg” * MERGEFORMATINET

Appendix 3:

INCLUDEPICTURE “http://www.enquirylearning.net/ELU/Issues/Research/Res1Ch9D.GIF” * MERGEFORMATINET

Appendix 4:

INCLUDEPICTURE “http://www.socwork.net/sws/article/viewFile/7/26/38” * MERGEFORMATINET INCLUDEPICTURE “http://t3.gstatic.com/images?q=tbn:ANd9GcTyf90-zHLx_Q6WjawBzmUB6DF1WXlisrF_Bbi3l5pWB34uyxhlGw” * MERGEFORMATINET

Appendix 5:

INCLUDEPICTURE “http://epltt.coe.uga.edu/images/2/23/EltModel.gif” * MERGEFORMATINET

Appendix 6:

INCLUDEPICTURE “http://www.emeraldinsight.com/content_images/fig/0860220301001.png” * MERGEFORMATINET

Nathan Pust

Name

Lecturer

Course

Date

Nathan Pust

Introduction

Nathan Pust is a ten-month old infant born on 1/2/2012. During his birth time, he was having a weight of 11 pounds 4 ounces with a height of 19 inches. This was a very good record indicating that he was in a right condition and would be assured of a healthy growth if provided with the entire medical and any other necessary attention. Because of this, he has now been taken to a kindergarten centre where he is expected to interact with fellow infants, caretakers, strangers and the new environment. However, his current observation found out that his body weight has increased to 21 pounds while his height increasing to 27 inches since he was born.

Reaction to People

During the observation carried out at the kindergarten, Nathan, just like any other infant, should a lot of mixed reactions to the people he was exposed to. First, he interacted well with other infants who were brought next to her. He felt attracted to them and could be seen communicating with them using smiles. The same reaction was observed between him and the caregivers. He did not show any form of fear whenever he was introduced to these people. I think this must have been so, because of the rapport they had established. They had become familiar to him.

However, Nathan did not feel attracted to the adults he was exposed to. He was so afraid of them and could attempt shy away from them if they attempted to move closer to him. This was worsened when he was brought closer to strangers whom he had never met before. Here, he was so frightened, avoided them and openly cried. This indicates that he has not fully developed and has narrowed his environment to the small number of people he frequently interacts with.

Exploration

Nathan was so adventurous. Despite spending a long time next to his caregivers, he kept on crawling from place to place. This includes places where he would see attractive objects and other infants whom he would interact with. According to this observation, he was fond of an object which looked so attractive for him. It is here where he would get nice toys and dolls to play with. This is why it not only remained attractive for her, but for many other children who are cared for in this institution.

Body Movements

Nathan had an ability to move from place to place. This could happen by moving his body parts and the whole body whenever he wanted to change position. For instance, he would move his face when looking for an object which was carried by one of caregivers. He would move his face to catch up with the movement of the object which seemed attractive for him.

At the same time, Nathan could move the whole of his body whenever he wanted to change position to another location so as to do whatever thing he felt would please him. He was crawling with his limbs as the most active parts of his body.

Affordance

Nathan is an active child. He showed a lot of affordance in the way he conducted himself. In other words, he looked a very light headed toddler who did not find it difficult to cope up with the prevailing conditions in the kindergarten. He could autonomously use his efforts to improve his walking abilities by moving his feet step by step. This proved that he had high cognitive skills and could suit his immediate environment.

Habituation

Nathan indicated habituation to certain objects which were more pleasing to her. When presented with attractive objects such as food, toys and conspicuous flowers, he would identify with them. As a result, he took quite a long time while still looking at them. However, this would even continue when such objects were taken away from him. Meaning, he had developed a schemata for such objects making it easy for him to identify them at all the times. This showed that he is a very active infant who can identify with his immediate environment.

Nathan did this selectively because he could not just look at everything in the same way. According to the observations made, he would only spend a long time starring at the attractive objects. However, anything which could not please him could not be treated in the same way. For instance, when she had been frightened by a stranger, he would dissociate himself with them. He would not even admire an object given to him by such scaring faces.

Hidden Objects

The way Nathan looked at the hidden objects indicated that he was progressively developing his cognitive skills. The habituation skills extended beyond just looking at objects for a considerably long time to looking at the hidden objects. He was doing this because he believed that the objects were still there.

This justifies the cognitive theory of human development which states that human mind and intelligence undergo a series of progressive stages. It determines the development of intelligence in that it enables people at certain chronological age to show certain cognitive behaviors. According to Nathan, his cognitive abilities could not convey to hi the information that the hidden object could not b seen unless placed behind a transparent object. This is abstract reasoning popular with infants of Nathan’s age.

Temperament

Nathan’s temperament was used as a very important tool in determining his interactions with his fellow toddlers, caregivers, strangers and the world at large. He showed a complex of traits including anger, emotion, hyper-activity and fear. Because of his excessive energy, he could uncontrollably move from place to place trying to touch and taste anything he came across. He could wander form the bed to the kitchen and to the play ground to use anything valuable to him.

At the same time, his emotions were extremely hot. He would cry profusely whenever offended by anybody or denied to do something which would be detrimental to him. When taken next to strange people, he would be so afraid. In fact, he mostly responded by crying. This means that he had a great fear against these people.

Language

Nathan must be a first learner. At this stage of growth, he was mastering language skills and could communicate by bubbling. Hence, he often found it easier to utter vowel sounds such as oooo, aaaa, iiii, eeee and uuuu. More surprisingly, he went ahead to pronounce single common words such as mama. This must be the most common word he was using at home when interacting with his parents.

Unfortunately, it was extremely difficult to communicate to him. In most case, when shouted at, he would burst into wailing. However, he could read lips and interpret certain gestures especially when being given food and anything interesting to him.

Stoic epistemology

Name

Lecturer

Course

Date

Stoic epistemology

Knowledge is a philosophical concept which has been quite challenging to understand. Over the years, philosophers came up with diverging ideas about it. Precisely, it took a very long time for them to agree on the sources of knowledge. This sparked a very hot debate amongst the philosophers. Zeno emphasized on the role of “moral and intellectual perfection” in the acquisition of knowledge. According to his school of thought, reason can also be considered as a source of knowledge. To the stoicism, the acquisition of the right knowledge can be instrumental in identifying the truth and distinguishing it from a fallacy. However, this is not a simple thing to achieve because of the generalizations and misconceptions commonly encountered in the pursuit of knowledge.

The application of reason as a source of knowledge is quite fundamental. It can help an individual to be privy with the truth as a result of the use of wits and critical thought. Meaning, there should be the use of senses and the mind. Whereas the senses are instrumental in receiving sensations from the immediate surroundings, the mind is used to enhance responses. A proper coordination between the two is so critical. If any of them is impaired, it will be impossible for a person to get information about the objects around him before sieving it to unveil the truth. The constant flow of pulsations is used in the establishment of phantasia which is necessary for the acclimatization of a person to an object. These arguments are showing and reflecting clearly an element of inadequacy. There should be a clear understanding of the stoicism concepts for a person to be able make logical arguments.

As the stoics formulate, the mind should be a proper status to be able to perform its operations perfectly. Since it has an ability to judge, it can eventually enable a person to establish the truth. It is such a judgment that the mind uses to approve or reject an impression before eventually creating an impact to the person. The judgment creates an impression in the mind which grants a person an ample opportunity to differentiate the truth and falsehood. As Long and Sedley (2002, p112) examine, this demonstrates that ‘there should be a cordial relationship between these two organs because without them, nothing much can be achieved.’ Another important thing to know about this judgment is that the whole process does not necessarily occur in a similar manner. While other impressions take a very short time to be fully approved, others take considerably longer time duration. These are beliefs or opinion and they are manifested by different people in different ways to serve ego.

Surely, it is not an easy thing to achieve a full conviction and comprehension without the incorporation of reason. However, it is unfortunate that not all the people possess such a trait. It is only the sages who can be accredited to be having a full stoicism. Their full achievement implies that they can go beyond a mere belief since they have ability to verify the premises before making a conclusive judgment. Unlike them, many people have been unable to ascertain the truth. They do not have the skills to critically analyze a situation before making a productive and fruitful elevation of the mind. Thus, they cannot methodically examine situations and come up with the truth regarding the objects with which they are confronted. This explains why many people have been finding it difficult to make rational judgments for them to distinguish the truth in real life situation. This should be part of an argument.

Meanwhile, Stoics came up with the idea of “graspable” presentation.” This was also important in resolving the controversies which surrounded the inclusion of sense as a credible source of knowledge. As indicated earlier, knowledge had been a very contentious topic amongst the philosophers. However, despite their knowledge of such controversies, the stoics decided to take a low profile regarding the use of sense as a source of knowledge. Thus, they came up with this term to help people in distinguishing between the truth and false information. As a complex concept, a person is said to be able to do this in case they use such sense-perceptions to represent the actual truth in an accurate manner. it is a ‘graspable’ presentation that can use such perceptions to ascertain the truth.

To qualify for such a stature, it is essential for a person to be in a position of distinguishing the truth from falsehood or fantasy. It is a common thing for people to experience fantasies in their day to day experiences. However, these should not be confused with reality because they are quite distinct from each other. This was justified by (Aetius, 4.12.1) who said that “experiences in the soul which occurs as the result of no presented object, as in the case of people who fight with shadows and punch at thin air. For a presented object underlies the presentation, but no presented object the ‘phantastic.’ Besides, the presentation should be made to account for the object that is making it to be in existence. There should be a clear statement to focus on such objects since they help in tracing and understanding their source.

In his definition of this term, Zeno said it refers to a presentation originally coming from an existing object that was produced, molded and shaped just like it (the source object). This implies that each object has some form of uniqueness which are only associated with it. Hence, it requires a proper knowledge not to be altered at all times. I would like to be skeptical about this position because it is actually difficult for two different objects to be completely identical. Meaning, there may be a possibility of a false presentation resembling an original one. This is a very complex concept which needs to be approached more carefully. Many people have not been able to make such distinctions. It is advisable for them to be so keen on their judgments. This is the same problem identified in the given arguments. It proves a lack of adequate knowledge on presentations. There are elements of weak arguments which indicate inadequate mastery of knowledge.

Stoicism played a very significant role in resolving the controversy that surrounded the sources of knowledge. Despite its earlier disapproval by a section of scholars, sense-perception was recognized not only as a source, but as a reliable one. However, I would like to emphasize that this should not just be accepted like that. In my opinion, I would like to suggest that it should be accepted only if used under the right conditions. Some contexts may warrant it as a credible source of knowledge. This is mainly due to the fact that these sense-perceptions are not presented in a similar manner. in other words, some may present their objects sufficiently while others do not. This means that some of them are able to give true judgments while others giving false ones. In this case, not all of them can be relied upon even if Cicero regarded them as the messengers of truth.

Indeed, ‘graspable’ presentations are useful in helping people to understand facts. a proper understanding of an object is useful in distinguishing between the truth and falsehood. This in turn, is useful in making accurate, right and rational judgments. After all, stoics hold that self-perception is a significant thing because it is he starting point for the knowledge. All the forms of knowledge come from experience and/or self-perception. This justifies why even false expressions which are experienced by the mad or during sleep are dependent on it. What is false may not be easy to perceive. Thus, it is crucial to differentiate it from what is true.

In conclusion, I would like to acknowledge that knowledge is a very complex thing. Everyone should strive to seek it. As Zeno found out, it should begin from self-perception because it can be used as a foundation for knowing the truth and differentiating it from falsehoods. Everyone should be conscious of these facts to be able to make rational judgments to be in a position of resolving their day to challenges.

Works Cited

Long, A.A. and D. N. Sedley The Hellenistic Philosophers 2 vols. Cambridge: Cambridge University Press, 2002.Print.

The call of the prophet

Name

Lecturer

Course

Date

The call of the prophet

Introduction

Prophets are people who are set aside and are only held onto account by God alone. In most instances the prophet was expected to convey the message of God without expecting appraisal from the people. At the same time, there are instances where in the message presented by him or she may receive opposition. This is most often an indication that, his message is of God since, it is po9stulated by Jesus Christ that, Prophet are less often welcomed and rejection for sake of word of God is part and parcel of the divine ministry.

In the co temporal tines, there are many self proclaimed prophet who have mistaken the knowledge of God for prophecy. Even though they are largely gifted in religious knowledge and wisdom they are always unable to take their religious flock through a spiritual breakthrough.

The prophet of God or rather true prophets are called .these calling can be done through numerous modes such as visions, dreams, intimate experience with the divine being and excreta.

Prophets can only be called by God himself. This is due to the fact that, the obligation of calling a prophet is God’s sovereign decision and the calling is usually sudden and can happen to anyone since God is not respecter of persons of men per se (Rowley, 1956)

For example, Prophet Isaiah needed serious conviction that later on had to sustain him in the course of his ministry. Likewise prophet Jeremiah, calling came through a silent voice from God when he was still young. The voice did indicate to him, the he was known long before he was even conceived.

He Bible says that, ‘’God’s word came to me saying that, before I formed you in the womb I knew you, before you were born I set you apart; I appointed you as a prophet to the nations.” “Ah, Sovereign Lord,” I said, “I do not know how to speak; I am only a child.” But the Lord said to me, “Do not say, ‘I am only a child.’ You must go to everyone I send you to and say whatever I command you. Do not be afraid of them, for I am with you and will rescue you,” declares the Lord. Then the Lord reached out his hand and touched my mouth and said to me, “Now, I have put my words in your mouth. See, today I appoint you over nations and kingdoms to uproot and tear down, to destroy and overthrow, and to build and to plant” (Jer 1:4-10).

Similarly, Amos was very mindful over his business and day to day activities when his call beckoned. His background was far off from all attachments to prophetic works. It is therefore imperative to make an assumption that prophetic ministry was the least of his extortions.

After the call, Amos found his earthly ambitions hit a brick wall or hitting a dead end. The Bible record that, ‘’Then Amaziah said to Amos, get out, you seer! Go back to the land of Judah. Earn your bread there and do your prophesying there. Don’t prophesy anymore at Bethel, because this is the king’s sanctuary and the temple of the kingdom.” Amos answered Amaziah, “I was neither a prophet nor a prophet’s son, but I was a shepherd, and I also took care of sycamore-fig trees. But the Lord took me from tending the flock and said to me, ‘Go, and prophesy to my people Israel.’ Now then, hear the word of the Lord. You say, ” ‘Do not prophesy against Israel, and stop preaching against the house of Isaac’ (Amos 7:12-16).

The Body

Marks of a Prophet

There are modalities of identifying a true prophet of God such as, it is expected that a prophet of God should not only live on the high planes of dignity and discipline and principle, but they must also bear the following marks; they should be passionate about the will of God, they should have the gift of foresight into God’s intended plan as well as have a great insight into the intentions of God to his creation and people.

Confirmation of a Prophet

It is largely put forward that, The Almighty God prepares his prophets through a season. It is this mode of preparation through which a prophet is confirmed. Call is confirmed by preparation. It is equally emphatic to make note of the fact that, there is a very long period between the time when the calling is done and when the ministry is commenced. Those who are called to be prophets are always expected therefore exercise patience be able to cultivate a culture that can meet the high standard of God.

It is therefore imperative that those who are called to the ministry of prophecy should be well able to pay the price. This ids because the ministry comes along with, humiliation, ridicule, lack and excreta. (Helm, June.).

For example, before /one becomes a prophet, there must be the existence of Royal or a Divine command. The Bible asserts that, to the surprise of many among the living, that is despised and ignored are /in most cases chosen to disapprove of the things that are of men. This is out of the fact that, God almighty does not think like mankind does. This is drawn from the fact that, men asses or judge by the facial outlook or from what they can see while, God judges from an individuals spiritual orientation.

This underscores the reason as to why most prophets are often unwelcomed by their peers and community members. They equally face an outrage from the people they are to preach to. Lars admits that, to make a prophet acceptable and popular among the people is to disarm him or her from the body message that he or she is supposed to proselytize.( Christopher Forbes).

In addition go the above biblical annunciated; prophets are gifted with an ability to prophesying on our lives .Apostle Paul writes that prophecy is guided by faith. ( 1 Corinthians 12: 7 }

Conclusion

It is imperative to assert that, the call to the ministry of prophecy is sacred or divine. It is individual based, sudden and at the same time it calls on the individuals to maintain their life on the high planes of dignity and discipline. In the course of their ministry, they are to come to terms with rejection, humiliation and disappointments as well as lack for the sake of the gospel.

However, the training through which God takes them before they are called is adequate enough to give them the valor required to overcome t5he challenges of their ministry.

Cited works

H. H. Rowley. 1956. Prophecy and Religion in Ancient China and Israel. New York: Harper & Brothers.

David Edward Aune. 1963. Prophecy in Early Christianity and the Ancient Mediterranean World. Grand Rapids, Mich.: Eerdmans.

Christopher Forbes. 1997. Prophecy and Inspired Speech: in Early Christianity and Its Hellenistic Environment. Peabody, Mass.: HendricksoHelm, June., Prophecy and Power among the Dogrib Indians, University of Nebraska Press, 1994

Critical Analysis of a Literary Work and Personal Position

Critical Analysis of a Literary Work and Personal Position

Author

Institution

Introduction

The importance of medical research can never be understated as far as safeguarding the health and wealth of the human race is concerned. This is especially considering that health has a bearing on the wealth creation capacity of individuals. Needless to say, there has been a proliferation of ailments, some of which have proved extremely difficult to treat. This has triggered a flurry of studies and medical research and experiments, all in an effort to come up with a comprehensive understanding of the varied aspects of the ailments including the symptoms, causes, risk factors, and especially the most appropriate and effective treatments and prevention measures for the ailments. Needless to say, the medical research has largely involved the use of animals before the medications or interventions can be tested on human beings. This, however, does not negate the fact that human subjects have also been increasingly used in such research studies.

Nevertheless, the use of human subjects introduces a number of ethical issues. This is especially with regard to informed consent, confidentiality of the particulars of the subjects and especially with regard to the outcomes of the research. Informed consent refers to the process by which a patient that is fully informed would take part in the varied choices pertaining to his or her healthcare. It is based on the ethical and legal right pertaining to the fact that patient has to direct the things that happen to his or her body, as well as the ethical duty that the physician has to allow for the involvement of the patient in his or her healthcare. Informed concept is, essentially, a crucial component of the research process, in which case it entails going beyond obtaining the patient’s signature on a form. It is always imperative that the investigators, researchers and physicians educate the potential subjects on all aspects pertaining to the research so as to ensure that they come up with a truly informed decision pertaining to whether they would like to take part in the research or not. It is imperative that their informed consent is given voluntarily without coercion and has to be based on a clear comprehension of all aspects pertaining to the participation, as well as the manner in which the results pertaining to the experiments in which they participate will be used.

Patient privacy, on the other hand, revolves around the capacity of a patient or subject having control pertaining to the extent, circumstances and timing of sharing himself or herself intellectually, physically, and behaviorally with other people (Plomer, 2005). It underlines the right of an individual to restrict access by other people to certain aspects or elements of their person that may include identifying information, thoughts, as well as information that is incorporated in their bodily fluids and tissues. This has a close relationship to confidentiality, which revolves around the process of safeguarding the privacy of an individual. It pertaining to the manner in which information that a patient has disclosed to a physician or researcher in a relationship of trust is treated, with the expectation that such information will not be disclosed to unauthorized parties without permission (Plomer, 2005). Scholars have noted that the necessity of safeguarding the privacy of personal information is usually weighed against the necessity of sharing the information that incorporates the potential to benefit the public good. The development of innovative and new medical treatments necessitates that information is shared from DNA sequencing, repositories and databanks, quality assurance efforts, as well as public health measures (Plomer, 2005). It is imperative that researchers have a clear comprehension of the manner in which the competing values would be viewed, as well as the manner in which the goals of the researchers can be balanced against the competing needs. It is imperative that the type of health information that is collected is balanced against the magnitude of harm that would occur in instances where unauthorized disclosure of the information occurs (Plomer, 2005).

While there have been numerous cases involving the violation of informed consent requirement, patient privacy and confidentiality, none has been more popular than the case of Henrietta Lacks. Indeed, these are the ethical issues around which Rebecca Skloot’s book “The Immortal Life of Henrietta Lacks” published in 2010 revolves.

Summary of the book

The book outlines the story of, Henrietta Lacks, a young black woman who was diagnosed with cervical cancer on January 29th 1951. Henrietta was taken to John Hopkins Hospital, which was the only hospital closest to her home that treated blacks. At this time, it was generally believed that noninvasive cervical cancer was not fatal unlike the invasive type. However, Richard TeLinde, a cancer expert in the Hopkins at the time disagreed and stated that the noninvasive type was simply the formative stages of the invasive type, in which case it should be treated just as seriously. TeLinde was infamous for using human subjects in experiments without their knowledge or consent. He had been trying to develop living samples derived from normal cervical tissue, as well as from living samples of both invasive and noninvasive cervical cancer so as to compare them. He got in touch with George Gey, the head of research on tissue culture in Hopkins, who was determined to develop the first immortal human cells that would be continually dividing and constantly replenish themselves without dying. When Gey got the supply of cervical cancer tissue from TeLinde from the women in Hopkins, he got a chance to try growing living samples from the tissue. The tissues delivered were for the women that visited Hopkins including Henrietta. However, what separated Henrietta Lacks’ cells from those of other women is that they were not simply surviving but also growing with a mythological intensity. Her cells and tissues, therefore, formed the foundation of tissue culture. Indeed, the tissues have been replicated and cloned under the pseudonym HeLa cells, taking up the first two letters of Henrietta Lacks (Skloot, 2010). Underlining the intense replication and reproduction is the fact that almost every tissue culture lab in the world incorporates some HeLa cells. Of particular concern, however, is the fact that neither Lacks nor her family were informed about the use of the cells in the experiments or even had their consent sought. In fact, the family came to know about the use of the cells about in 1973 when researchers came looking for them asking for their cells to be used in studies (Skloot, 2010). Indeed, scientists investigating HeLa started using Henrietta’s husband and children in experiments and research without obtaining informed consent (Skloot, 2010). Ironically, as much as the HeLa cell line formed the basis for a significant number of medical advances such as chemotherapy, polio vaccines, gene mapping, cancer drug tamoxifen, in vitro fertilization, as well as treatment for diseases such as Parkinson’s disease, leukemia and influenza, her family has been living in poverty and has not benefited much from her cells. Skloots notes that one of Henrietta Lacks’ sons is living in the streets as a homeless man, while her daughter who tries to obtain knowledge about the mother that she never knew cannot even afford health insurance (Skloot, 2010). Even more appalling is the fact that the DNA information of Henrietta Lacks has been published and given to other companies without the consent of the family. This is a direct affront on the privacy of the family and the right to have their personal information kept private and only used within the direction of the family (Skloot, 2010).

Critical analysis

Needless to say, the story outlined in the book touch immensely on research ethics. This is especially with regard to informed consent. It is worth noting that, all factors held constant, Dr. Gey and Dr. TeLinde undertook this research without following the due procedure pertaining to informed consent. This is especially considering that they used to subject their patients to experiments without the patients’ knowledge or even without obtaining the informed consent from the patient (Skloot, 2013). This trend was continued about 20 years after the death of Henrietta Lacks, when scientists started contacting the family and even subjected them to further experiments without their informed consent (Skloot, 2013).

An informed consent that is ethically valid for research must incorporate a number of components or meet some conditions. First, it is imperative that the informed consent incorporates disclosure where the potential participant is informed as fully as the researchers possibly can about the nature, as well as the purpose of the research, procedures that would be used, expected benefits to both the society and the participant, not to mention any foreseeable stresses, risks, discomforts and alternatives to the participation of the patient in the research. This disclosure should also incorporate a statement outlining the procedures that have been put in place to safeguard the anonymity and confidentiality of the participant, as well as any available medical treatment or compensation in case of research related injuries. Second, informed consent must incorporate understanding where the participant has clear comprehension of the things that have been explained and is provided with a chance to ask any questions he or she has and have them answered. This underlines the fact that the document pertaining to informed consent must avoid technical jargon and be written in the simplest layman’s language. Third, the informed consent must incorporate voluntariness, where the participant voluntarily makes the decision to participate in the research without any coercion on the side of the investigators or researchers. It is worth noting that such participants should also not be offered any promises of benefits that would be unlikely to result from their participation. Fourth, informed consent must incorporate competence where the participant is sufficiently competent to give his or her competence. In instances where the participant is not sufficiently competent as a result of an emergency, disease or mental status, it would be imperative that the investigators get the informed consent of a designated surrogate who would only provide the consent if the participation is in the best interests of the patient.

Needless to say, the researchers involved in this case did no fulfill any of the conditions stipulated. Not only did they not inform Henrietta Lacks or her relatives of the fact that her cells would be used in the experiment, but the investigators continued hiding the fact even after her death. Indeed, it’s not surprising that her family was surprised to be approached by scientists twenty years after Henrietta’s death. These scientists proceeded to involve them in research without seeking their informed consent either.

On the same note, it is worth noting that the privacy of the patient’s information was not protected. This would be evident from the manner in which the cells have been replicated, reproduced and sold to numerous companies and laboratories around the world. This information was released some years ago by a certain newspaper either deliberately or by mistake. While the information was later taken off the company’s website, it had already been downloaded by 15 people, which means that such information could be in unauthorized hands already (Skloot, 2013). Researchers had insinuated that the cells have undergone so much change over time that they could not accurately tell or reveal anything about the Lacks. However, Skloot, in an opinion column at the New York Times noted that such claims are far from accurate as scientists have used a certain public website, uploaded the HeLa’s genome and obtained a report that is full of Henrietta Lacks personal information, as well as that of her family (Skloot, 2013). This only means that the personal information of great grandchildren of Henrietta stands at risk of falling into the wrong hands, which is not desirable. It is worth noting, however, that the use of the pseudonym HeLa was an effort to cover the identity of the person from whom the tissues had been derived. Indeed, Gey had tried to give other names when asked about the source of the HeLa cells. While the motive for this may be unclear, the efforts were clearly not sufficient to protect the information.

Nevertheless, while these issues are pertinent, it is worth noting that the research was done at a time when laws pertaining to informed consent or even patient privacy laws were yet to be as comprehensive as they are today. Indeed, it was not uncommon for physicians to undertake research or experiments on their patients without the patient’s consent or even knowledge.

Personal opinion

While there may be differing opinions as to the importance of obtaining an informed consent in the case of Henrietta or any other human subjects, I hold the opinion that informed consent should be a requirement for any research involving human subjects.

First, informed consent guards against the exploitation of the subjects or even their coercion to take part in a research that they were unwilling to take part in, to start with. The basis of informed consent remains that the individual or potential subject will have varied aspects pertaining to the research in which his participation is being sought explained to him or her in a simple language that allows for full comprehension of all the elements. It allows them to ask questions and seek answers to any issues that are unclear to them before or even in the course of the research. This means that there is little chance that they would be exploited as was the case for the Lacks, who were shoved between laboratories and scientists and experiments without informed consent. It is understandable that they became extremely skeptical about any individuals that called to enquire about Henrietta’s cells that they initially do not even want to be associated with the research by Sckloot.

Moreover, the informed consent requirement would allow for the safeguarding of the confidentiality and privacy of the personal information of the human subjects that participate in the research. The case of Henrietta Lacks presents extreme complexity especially with regard to the importance of sharing such information among scientists without seeking the consent of the owner of such tissues. Of course, it is well acknowledged that sharing such information among the experts in the medical research field has been extremely crucial to the entire world as far as the advances in medicine are concerned (Miller, 2012). However, it is imperative that one acknowledges that there were certain risks to which the subjects or their descendants were exposed. For example, personal information pertaining to such health matters may be used to discriminate against the descendants of Henrietta Lacks in cases of employment opportunities.

In addition, it would allow for the trickle down of the benefits that would result from the research to the subjects. It is well acknowledged that informed consents would not incorporate benefits that the subjects would reap from their participation in the research. However, informed consent allows the human subjects to have relative control over the manner in which their tissues are used or even the experiments to which they are subjected. It is highly regrettable that despite the fact that Henrietta Lacks’ cells are used by almost every individual that has taken any medicine stronger than aspirin, yet her family and descendants can barely afford to pay their way through life (Miller, 2012). The industry that is set upon HeLa cells is undoubtedly a multi-billion dollar one, yet the descendants of the person whose cells set its foundation cannot even afford health insurance. Informed consent would, therefore, have allowed the family to patent the cells, in which case they would at least have had a semblance of benefits from the same.

However, some scholars have argued for limited protection of the privacy of the information derived from such research especially in instances where there is bound to be immense benefit to the public good (Miller, 2012). Indeed, there have been opinions to the effect that not only were no laws flouted in failing to get an informed consent from the patient but also that such a consent would have restricted the immense benefits that have been derived from the cells. Of course, it would be inaccurate to ignore the immense contribution that the HeLa cells have made to the medical world (Miller, 2012). The argument would not revolve around limiting their use in enhancing the medical field, rather it revolves around the treatment of the human subjects not as tools and instruments in the lab but as human beings who have their own feelings and thoughts as to what should happen to any part of their body that is used in the advancement of science.

In conclusion, the use of human subjects in medical research introduces varied controversies especially with regard to informed consent and the privacy of personal information of the subjects. This is the case for Henrietta Lacks, a black woman whose cancerous tissues were obtained without her knowledge or consent and used in developing the current multi-billion industry cell tissue industry. Her cells have been widely circulated around the world in almost every cell tissue lab. Ironically, her family still lives in abject poverty unable to afford the basic amenities including healthcare insurance. In addition, the privacy of her health information has been violated with some scientists allowing for access of her genome by the public.

While there may be differing opinions, enforcement of informed consent would be imperative in every research involving human subjects. This would protect the human subjects from exploitation, ensure that their privacy is protected and ensure that they reap the maximum benefits from the research.

References

Skloot, R (2013). The Immortal Life of Henrietta Lacks, the Sequel. The New York Times Sunday Review. Retrieved from HYPERLINK “http://www.nytimes.com/2013/03/24/opinion/sunday/the-immortal-life-of-henrietta-lacks-the-sequel.html?pagewanted=all&_r=0” http://www.nytimes.com/2013/03/24/opinion/sunday/the-immortal-life-of-henrietta-lacks-the-sequel.html?pagewanted=all&_r=0

Skloot, R. (2010). The immortal life of Henrietta Lacks. New York: Crown Publishers.

Plomer, A. (2005). The law and ethics of medical research: International bioethics and human rights. London: Cavendish.

Miller, T. (2012). Ethics in qualitative research. London: SAGE.

Letter to the Instructor. MY CLASS WORK CHALLENGES

Name

Lecturer

Course

Date

The Letter to the Instructor

Dear Sir/Madam,

RE: MY CLASS WORK CHALLENGES

Please, take this as a treatise of the above subject.

I am an English student in this class. I must confess that have greatly benefited from your instructions and guidance in this course. However, I have encountered a number of weaknesses as a writer such as; low language command, inadequate level of creativity as well as failing to adequately meet the needs of my targeted audience.

These weaknesses have given me difficulty in developing into a good writer. In an attempt to redressing these weaknesses, I have attempted to undo my poor reading habits, my being indifferent to literary works and my failure to develop a passion for literary creativity.

These weaknesses have prompted me to invest more in creativity so that I may adequately meet the appalling needs of my targeted audience. I am now able to retain my readers’ attention and interest throughout the story. I am also able to inspire joy and pleasure from those who read my works. I also believe that, my readers are now able to retell my captivating creative piece of literary works more easily since the literature are richer in imagery, folklore, proverbs and excreta.

Have also attempted to be more relevant to the desired needs of my specified audience as well as read more in an attempt to develop my language command and improve the coherence of my language too. In this light, have developed interest in the works of other. This has enabled me to learn from them too. This has greatly made me realize m attendant mistakes and as such have been able to right my wrongs in the preceding precepts.

Have attempted to equally add passion and love to writing and writing resource materials that are of great relevance in writing. This has altogether led to my greater developed capacity for quality writing. I strongly believe that I will derive fulfillment in it over time due to the fact that my writ will be very outstanding.

Moreover, I have cherished consultations and inquiry into this field. This has enriched me with adequate knowledge that has greatly improved my writing capacity per se.

In conclusion, I must also admit that have developed an ardent passion for research in this field of study and this has also contributed greatly to my current level of language competence and my strong capacity in writing as well.

In spite of the above redressed challenges in the course of my study, I must also admit my bias in the type of essays that we handled as a class. For example, the essay that pleased me most pleased was the one with the leadership come political inclination while the one that pleased me least was that which was laden with emotional connotations that on love.

There was little difficulty in the essays that we completed in this class. The essays were within our ability to handle properly well. I must equally add that the format of the class very good too. There was prompt lecture feedback, the quality of notes was equally high and the subsidiary or complementary materials were an apt resource too.

Last but not least, the text book was overly helpful I n entirety since, it gave us guidance, and the methodological flow that enabled us develop a capacity for competent writing.

Yours faithfully,

Your name.

Critical Analysis of a Narrative El-Dorado A Kansas Recessional

Name:

Institution:

Course:

Tutor:

Date:

Critical Analysis of a Narrative: El-Dorado: A Kansas Recessional

Introduction

A narrative usually presents an account of events and seeks to inform the reader about what actually happened. It is a common form of literature that is employed for various purposes. It is often characterized by different attributes that range from the content of the story to the rhetorical characteristics. Various writers assume different styles although the ultimate goal is often to inform the reader about certain events. Of course this is achieved through employment of a host of artistic styles that basically uphold the interest of the reader. It is against this background that this paper provides a critical analysis of the narrative ‘El-Dorado: A Kansas Recessional’ in light of the comprehensive notes of narrative analysis. It is believed that this would enable the reader to not only understand the content of the narrative but also to appreciate the role of artistic features that are employed.

The narrative revolves around a man named Colonel who had various experiences that were influenced by the social and economic changes that were being experienced during this time. He is deceived in to selling off his business so that he could make investments in El-Dorado. He falls for the trap and together with a couple of other men; they leave Solomon Valley with their fortune and head for El Dorado to make vital investments. On reaching there, they realize that it did not have the attributes that they were told before leaving Solomon valley. However, they are made to believe that most of the inhabitants had gone to the east on business operations and would be back in spring. In addition, they realized that the entire investments in the region were owned by a few individuals who also assumed top positions in the society.

In spring, the Gunts, who were their main hosts, leave the place on the premise that their father was dying and required them to be at his bedside. It then dawned on the inhabitants that they had been deceived and shortly after, the creditors destroy and take their property. The population reproaches Colonel who seemed to have had close relations with the Gunts. Notably, he was unaware of their dealings and their relationship had been largely superficial. They are left to wallow in poverty and lead desperate lives. The narrative winds up by indicating that one of the Gunts, Apollo who had returned to El- Dorado at night to pick certain belongings is bitten by a snake. Colonel finds his body, takes the money he had and buries him after saying prayers for him. Afterwards, he leaves with his horse, never to return to El- Dorado again.

Notably, the plot of the story is closed because it provides sufficient regarding the main character and even explains his fate. However, it is also noteworthy that the fate of other inhabitants of El- Dorado is unknown. Nonetheless, it can be contended that the fact that it provided all information regarding the main character makes it closed. The events of the story take a period of two seasons that translates in to approximately half a year. However, the discourse time can be posited to be during the early industrial revolution period. Notably, technology had not reached all segments of the population although it was highly anticipated. In addition, financial institutions were known to the population but their legality had not been clearly established. This was a distinct characteristic of the period of the early industrial revolution in America. At this point, it can be ascertained that the inherent coherence in the narrative is contributed to by the harmonic relationship between the narrative order and the discourse order. In particular, it can not be disputed that the events and characters of the narrative reflect the ideals that were experienced during the early industrial period.

The narrative has numerous characters although the main ones include Connell and the Gunt family that was represented by Apollo. Colonel is portrayed to be kind hearted when he gives the woman food and water when she was traveling to Solomon Valley with her sons. In addition, despite having been offended by Apollo, he says prayers for him and buries him. Apollo on the other hand is portrayed to be deceitful when he convinces part of the inhabitants of Solomon valley including Colonel to sell their properties and deposit the finances in their family bank. However, it should be acknowledged that this trait is largely shaped by his background and inherent family pressure. In addition, he is also secretive as he never told Colonel about his family regardless of them having been close friends. Hence in this regard, it can be posited that while Apollo has a round character, Colonel’s character on the other hand is flat. With regard to setting, the narrative takes place in two different places; Solomon valley and El- Dorado. The events that characterize this are clearly delineated in the narrative.

The narrator of the story can be posited to be a third person. This is because s/he does not directly involve the self in the narrative. Rather s/he gives an account of the events and the relative comments and judgments. Furthermore, it can be contended that the narrator in this context is all knowing. This is because of the fact that s/he is able to provide rich information about all the characters. S/he reveals to the reader the mind of the characters an even predicts their actions. Notably, the author seems to have a clear understanding of the characters and although s/he retains some vital information in a bit to uphold suspense, it can be agreed that he knows and understands the nature of the characters as well as the events in the narrative. For instance, despite having known that the man in digging a hole at night was Apollo, s/he refrains from revealing this to the reader and instead uses Colonel to inform the reader accordingly.

Seemingly, the author explores a number of themes that include poverty, ignorance and deceit. To begin with, the description of the living conditions in Solomon valley implies that the inhabitants are poor. Indicators of this include malnutrition and lack of a diverse economic base. This is perpetuated by the harsh climatic conditions that do not support local production. These conditions make the population vulnerable and are easily deceived in to selling their sole sources of livelihoods in order to invest in other areas. The theme of ignorance on the other hand is manifested when the inhabitants from Solomon valley fail to make vital inquiries regarding the nature of the investment. They are easily deceived and even fail to question the contradictory conditions that characterize El-Dorado.

At this juncture, it can be argued that this scenario is contributed to by their extreme poverty levels that give them limited choice. Nevertheless, it would still have been imperative for them to employ objectivity when dealing with such sensitive issues. The Gunt family capitalizes on this vulnerability and employs deceit at their advantage. The author presents these themes in an apt manner as they overlap and augment each other towards developing a central theme.

Further, the author employs various stylistic devices to capture and maintain the interest of the reader. For instance, his or her use of verbal irony that is exemplified through phrases such as ‘water came from the rock’ and ‘verdure from desert’ is instrumental in evoking responsive emotions in the reader as it implies a sense of despair. Furthermore, he employs dialogue to explore the feature of event branching. This does not only contribute to the development of the plot but it also breaks the narration monotony.

Conclusion

From this analysis, it is certain that the author of this narrative has a clear understanding of the vital components of an ideal narrative. Despite presenting the plot in an effective manner, s/he employs a host of stylistic and rhetorical devices that uphold and maintain the interest of the readers. In addition, he explores various themes that augment each other towards underscoring the central theme of despair. Despite being all knowing, s/he uses his characters and events to reveal different information to the reader and break the mounting suspense. It is in this consideration that this paper concludes by ascertaining that knowledge of vital components of literature is fundamental in successful writing.