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Cows Milk and Constipation in Children

Cow’s Milk and Constipation in Children

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Introduction

The growth and development of a child is of utmost importance to the parent. It is well recognized that a parent would do anything to ensure proper growth and development. However, it goes without saying that the worries that occupy the highest point in any parent’s mind are the fear of ailments. This is especially considering that they not only have a bearing on the overall welfare of the child, but may also have fatal consequences. Of course, there are variations as to the seriousness of any condition that affects young children. Nevertheless, one of the most common ailments in young children is constipation.

Constipation may be defined as the difficulty or delay in defecation that occurs for a period of two or more weeks. It is worth noting that constipation may have functional or organic causes. Functional constipation is arguably the most common category of constipation. It is diagnosed based on an individual’s physical examination and history and is also referred to as nonorganic constipation, fecal withholding or idiopathic constipation. There are various causes of nonorganic constipation including bathroom avoidance, attention deficit disorder, sexual abuse, coercive toilet training or even fear of the toilet. This category of constipation often starts after the neonatal period.

In the western world, it is common to seek treatment for Chronic Functional Constipation for postneonatal children. It is estimated that 3% of the general pediatric outpatients are suffering from CFC. It also takes up 25% of the pediatric gastroenterology consultations and 36% of the pediatric visits (Crowley et al, 2008. Pp.29). However, it is impossible to determine the real prevalence of constipation, thanks to variations in definitions, as well as management.

Chronic Functional Constipation refers to a condition where an individual has one bowel movement in a period between 3 and 15 days. Its main characteristics include strain in defecation, painful bowel movement, hard stools that have increased diameter. It is usual for an individual to withhold so as to avert the possibility of an unpleasant bowel motion. The treatment of this category of constipation is founded on the principle that lack of exercise, behavioral or psychological problems, low consumption of fluids and dietary fibers are the key causes of CFC, with management incorporating laxatives, fecal disimpaction and toilet training, as well as high intake of fluid and fiber. However, the long and repetitive treatment is often shown as ineffective, which shows that there exists no clarity as to the exact etiology of constipation. The deficiency of a sustainable and effective treatment poses a herculean problem for healthcare professionals and patients.

Nevertheless, there has been increased advances in understanding of the mechanisms that result in constipation with the sole aim of coming up with an effective therapeutic approach. It is well recognized that a third of children suffering from constipation will go on having the problem well into their adulthood. This is a contradiction of the commonly held notion that constipation has to disappear prior to or during puberty. It has always been suggested that lower consumption of residue-rich foods such as vegetables and fruits, coupled with excess consumption of dairy desserts and milk are seen as a likely connection between milk products and constipation. Recent times have seen increased interest in cow’s milk proteins as direct causes of constipation via immune mediated mechanism. This etiology has especially been supported by the resolution of manometric and histological abnormalities in patients who live on cow’s milk-free diets. However, few literary works have been written to examine the influence that cow’s milk has on pediatric, chronic constipation. In addition, the withdrawal of cow’s milk as a treatment option has not impacted on the medical community, as well as the published guidelines pertaining to the management or treatment of patients with this condition. This study aimed at showing that the consumption of cow’s milk has the potential to cause constipation in children.

Hypothesis: Cow’s milk consumption may cause constipation to children.

Methods

In the article by Irastorza et al (2010), Investigation into the effects of cow’s milk and the role it plays as far as constipation in children was carried out. The study involved children aged between 6 months and 14 years, who had been referred to a tertiary pediatric gastroenterology clinic for the period between October 2006 and 2007. The study excluded children who had been taking drugs that result in constipation, or those who had previous abdominal surgery, anatomic abnormalities, pilodinal sinus or a sensitive pelvic floor. The study involved 69 children. The history of patients was taken alongside the conduction of physical examinations. The researchers evaluated the consistency of the stools with the use of a semiquantitative scale of 5 points.

The study incorporated four phases. In the first phase, there was no diet change in the first week. The second phase started at the second week and progressed for three weeks. The parents were required to withdraw cow’s milk from the diet. However, cow’s milk was replaced by hydrolyzed cow’s milk-protein formula for children aged less than 2 years while rice milk was used in the case of those older than 2 years. However, soy milk or even products that incorporated soya were excluded as there is heightened prevalence of allergies to soya among cow milk-allergic children.

Children who were not responsive to phase II of the study went through to the end while those whose constipation was resolved after the three weeks went on to phase 3, with cow milk reintroduced for another three weeks. In phase 3, children would be provided with 500 ml of cow milk daily. Children who did not contract constipation in phase 3 completed the study while those who relapsed to constipation had cow milk withdrawn for another three weeks, which made phase 4.

In another study by Andiran et al (2003), two groups comprising of 30 children between 4 months and 3 years were examined. The first group was composed of children suffering from chronic anal fissure and constipation, with surgical causes having been excluded while the second group had normal children. Children in the first group had not been subjected to any previous treatment using laxatives or other therapies. Constipation diagnosis was done based on a history of low frequency of stools, as well as the painful elimination of stool. The children’s daily consumption of CM, as well as breastfeeding duration, were investigated among other clinical features. In both categories, dietetic and clinical parameters were made of height or weight percentiles, breastfeeding from birth to weaning, and daily cow’s milk consumption as either cow’s milk formula or cow’s milk. The consumption of milk was registered in multiples of 50 ml for the dietetic records.

Another study by Crowley et al, 2008 examined the literature that had been written later than 1980 and only incorporated studies on children between 4 and 15 years pertaining to the relationship between cow’s milk intake and the occurrence of constipation in children.

Strengths and weaknesses

All these studies were comprehensive and thorough in the manners in which they were done. However, the first study was limited in the capacity to incorporate conclusive evidence pertaining to other likely immune mechanisms of constipation. The third study was limited on the number of materials from which it sought its information. One of the key limitations of the study by Crowley et al (2008) is that it incorporated children belonging to varied ages. It is worth noting that it is unlikely to have similar conclusions in children belonging to different age groups. In addition, the research faced challenges as to the materials it could incorporate. The study could not rely on research from a single group as its results have not been replicated in other settings. On the same note, this review was limited in the fact that it did not incorporate studies carried out in languages different from English, while there is likelihood that some evidence may have been excluded. Nevertheless, the study incorporated immunological and biochemical analyses indicating an association between cow’s milk protein and constipation, thereby offering a likely, biological explanation for the correlation between the two.

Discussion

Irastorza et al (2010) article showed a clear cause and effect link between the ingestion of cow milk and chronic constipation in over a third of children who participated in the study. This was shown through resolution and relapsing of constipation in the first five days of cow’s milk withdrawal, as well as reintroduction in the respondent children, which is a suggestion of intervention pertaining to late allergy reactors. This underlines the fact that if constipation is proven to be a presentation of food allergy, it has to be classified as delayed symptoms.

The results in Andiran et al (2003) article showed that, young children and infants who had chronic constipation or anal fissure consume higher amounts of dairy products or cow’s milk than children who had normal bowel habit. The research also showed that, short breastfeeding duration and early bottle feeding on cow’s milk plays a key role in developing anal fissure and constipation in young children and infants. These findings suggest that anal fissures and constipation may, in fact, be secondary results of intolerance to cow’s milk, particularly cow’s milk protein allergies. It is imperative that prospective studies are done confirm or negate this contention. Nevertheless, this argument is supported by the findings pertaining to increased prevalence of other atypical signs.

While Crowley et al, 2008 were limited as to the number of articles that they could incorporate in the study, their systematic review confirmed their hypothesis that cow’s milk proteins incorporate a causal role in the occurrence of chronic functional constipation in children. However, not much research has been done on this area, despite it being a common quandary in pediatric practice.

Conclusion

The three studies showed incorporated conclusive evidence that cow’s milk has a causal role in the occurrence of constipation. This is due to the incorporation of proteins in the milk. The evidence indicated that there was a causal link between the condition and milk protein, with some children showing increased prevalence of sensitivity to cow milk protein.

References

Andiran, F., Dayi, S, & Mete, E, (2003). Cows milk consumption in constipation and anal fissure in infants and young children. Journal of Pediatric Child Health

Irastorza, I., Iban˜ez, B., Delgado-Sanzonetti, L & Maruri, N &Vitoria, J.C, (2010).Cow’s-Milk–free Diet as a Therapeutic Option in Childhood Chronic Constipation. JPGN

Crowley, E., Williams, L., Roberts, T., Jones, P & Dunstan, R (2008). Evidence for a role of cow’s milk consumption in chronic functional constipation in children: Systematic review of the literature from 1980 to 2006. Nutrition and Dietetics.

Sir Alex Ferguson Case

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Sir Alex Ferguson Case

Indeed Sir Alex Ferguson is undeniably the most successful manager in British football antiquity. It is undisputable that Ferguson led Manchester United to success despite the challenges he underwent at the start of his career in the club. Coaching a team without winning any tittle is not an easy thing (Elberse & Dye 1-3). Ferguson’s greatness and achievement can be linked with his patience at the club. Also it may possible that Fergusson’s style of play that he instilled in his players that was purely attacking football earned him a place in the football world.

Claim that Fergusson prioritized youth player development may not actually define his preference and style of football. With the likes of Ryan Giggs, Paul Scholes and the transfer of Robin Van Persie from Arsenal football club, who according to football profession, was not a young player are some of the indications that Fergusson did not prioritize youth development. In fact youth development should not be linked with his success. Instead, Fergusson preferred quality players and it can therefore be said that he was a manager who fully understood the kind of employees he wanted to keep the fire burning. Nevertheless, Fergusson literally succeeded in the English Premier League by making Manchester United club scoop nineteen league titles and two champions’ league trophies (Elberse & Dye 2-5).

Sir Alex Fergusson’s success in the football world can further be measured in terms of the fierce rivals he faced both in the English Premier League and globally. Actually, knocking out clubs like Liverpool football club was not an easy task but through hard work and better strategies, Fergusson managed to topple Liverpool. He was also faced by clubs whose owners had very strong financial muscles such as their neighboring Manchester City and the Russian’s billionaires, London based Chelsea football club. It therefore apparent that Sir Alex Fergusson’s strategies were superior to the finances and some great football styles played by clubs such as Arsenal. Indeed, Fergusson achieved what may not be easy for any manager to achieve in the football world (Elberse & Dye 4-8).

Football is really the most popular sport in the world with a good number of players, viewers and heavy financial investment. Additionally, English premier League is regarded superior to other League’s globally because of the ability to contribute a lot of revenue as well as the popular support it enjoys worldwide. English premier League football clubs have a larger worldwide support thus increasing their global viewers. on the other hand, the Champions League is the most lucrative tournament which, for sure, earned Manchester united $72 million in prize money for being runner up in the 2010-2011 season. Nonetheless it was not easy for Fergusson to successfully and simultaneously win both the Champions League and the English Premier League. Fergusson claims that Pressure and competition placed on him by the local clubs and tribalism to be the main reason behind the inability to win more Champions League trophies as he won English Premier League titles. This may not be genuine reason behind failure to severally capture the most lucrative global football tournament (Elberse & Dye 5-9).

Other football clubs like Barcelona and Bayern Munich have managed to reach the peak of the tournament or even win the Champions League titles and their local League trophies easily. It is obvious that the main hindrance was the intense competition from other European clubs. Fergusson’s role in Manchester united was wider than any other football manager because his degree of control was wider. He also allowed open communication with the Manchester united director as a way of getting things done smoothly and efficiently. He had his own policies and beliefs that guided his actions and eventually great performance in Manchester United (Elberse & Dye 4-7).

Fergusson is an individual who learned from his previous mistakes and improve of his successes. After his clash with the chairman of St. Mirren FC, he later developed a good and strong relationship with Aberdeen FC’s chairman thus leading to his success at the club, including winning European Cup defeating European giants such as Bayern Munich ad Real Madrid. His success as a professional footballer however cannot be linked with his achievements as a manager. There is a great distinction between a great manager and a good player particularly as far as management skills is concerned. Fergusson simply possessed wonderful management skills that made his career as a football manager more successful than his career as a player (Elberse & Dye 5-10).

Fergusson’s entrance in Manchester United in 1986 evidently reflected his management style of instituting discipline and family wood in the club. This resulted into many successes that included five EPL tittles out of six probable occasions between 1995 and 2001. He encouraged team spirit and understood his opponents before any game. He dwelt on expansion of talent centers and the club’s scouts in order to nature young talents. Indeed Ferguson initially believed in youth talents as was seen when he consistently played young David Beckham, Gary Neville and Paul Scholes despite complaints from fans which eventually earned the club a tittle in the EPL. It is however likely that this trend did not continue for a very long time (Elberse & Dye 7-10).

Fergusson largely depended on a strategy that encouraged and corrected players whenever they did not perform well. This was actually a great disciplinary action which propelled the players to up their performance particularly in the last fifteen minutes. He always believed and instilled belief that Manchester United would win despite employing tactics that encouraged gradual buildup. He admitted his mistakes and forged ahead without waste of time. Ferguson strategically managed Manchester united in such a way that the key players would play significant games while other young players were played in less important games. This is however not a big issue because every manager would certainly do the trade off to avoid embarrassment and somehow maintain positive performance (Elberse & Dye 9-13).

Sir Alex Ferguson was also very consistent when it came to training sessions. He maintained skills and tactics which he deemed important although he left his assistants to lead the sessions as he observed the players performance from a distance. This was actually very unique of his strategy because most coaches would not delegate such kind of activities to their subordinates for fear of making mistakes or just disbelief (Elberse & Dye 11-14). It is undisputable that Sir Alex Ferguson has left a mark, not only in English Premier League but also in the football coaching and in the Manchester united fraternity.

Works Cited

Elberse, Anita & Dye, Tom. “Sir Alex Ferguson; managing Manchester United.” Harvard Business School 513.51 (2012):1-25. Print

CPG for reducing medical errors

Executive summary

This document covers the definitional aspects and nature of medication errors and adverse drug events (ADEs) affecting hospitals in New Zealand and Australia. The document contains the clinical aspects of medication errors prevention via an elaborate evidence-based approach that takes into account the role and involvement of all relevant stakeholders. The documents also contain details for the assessment, features, investigation, management, and discharge of medication error cases.

This guideline applies to all hospital staff. Some of the people it applies to include;

Medical Staff

Nursing and Midwifery staff

Pharmacy staff

All the Allied Health Care Professionals as well as Health Care Scientists who are involved in the administration of medication.

This policy also affects the operation of Pre-registration Healthcare Professionals Students such as Pharmacy, Nursing and Medical students who are directly or indirectly involved in any given medication process while under direct supervisions.

The policy also affects the operations of all staff members who are involved in the prescription, dispensing as well as administration of drugs.

Any staffs who take the initiative to promptly report any case of medication error will not in any way be subject to any form of disciplinary action unless of course it’s under any of the following conditions.

Where the staff member behaved in a malicious or criminal manner

Where the staff is guilty of gross negligence and carelessnes

Introduction

The development of elaborate clinical procedure guidelines for use in reducing medication errors is important for the assurance of quality health care and safety within the medical health facilities. According to Grober and Bohnen (2004,p.39), medication errors are a major source of public health concern and pose a great threat to the safety of patients. As healthcare institutions seek to contain the “errors” as a matter of both research and clinical priority, the answer to one of the most daunting clinical equations still remain: What set of clinical procedures exists for handling or reducing medical errors? In order to reduce medication errors, a systematic measurements of its various incidents on the basis of a clear and yet consistent definitions of its constituents are a necessary prerequisite for an effective and holistic solution to be devised.

The definition of the concept of medication error has remained elusive. In this regard, we shall roughly define it as any event that is preventable but could cause or lead to the prescription and taking of inappropriate medication that mat lead or cause inappropriate use of medication or harm to patient while in the control of a given health application or patient harm while under control of a health care professional, consumer or patient (Porché , 2008, p. 16)

The issue of patient safety is of utmost importance in health care. Its importance is further amplified by a growing number of literature showing high incidence of medication errors (Brennan et al,1994; Leape et al, 1991; Wilson et al, 1995; Wilson et al,1999; Thomas et al.,1999).This is coupled with the rising number of highly publicized cases of medical errors that have raised the level of public concern on the very safety of our modern healthcare delivery systems.

According to Nichols et al (2008, p.276) adverse drug events (ADEs) are at the moment associated with between 2.4 % to 3.6 % of all admissions to Australian health care facilities. Preventable errors in prescribing, dispensing, as well as administration of drugs in the Australian hospitals contribute to 24% of ADEs (Runciman et al, 2003; Bates et al,1995; Barber & Dean,1998). In a study conducted in the UK, close to 1.5 percent of medication orders had clearly identifiable errors out of which 0.4 percent were deemed to be potentially serious (Dean et al, 2002).

Types of medication errors

According to Nichols et al (2008, 277), three types of medication errors are the most common. They include errors due to slips in intention in memory lapse, errors of judgment in medication planning (also called rule-based errors), and finally, errors due to a general lack of knowledge (commonly referred to as knowledge-based errors) (Reason, 1990). According to Reason (1990), the systems approach to cases of human errors clearly distinguishes between the active mistakes committed by hospital staff and the latent (related to the system) conditions that inherently makes mistakes more likely like fatigue and busy workload. All in all, medication-related activities in health care facilities are usually carried out within very busy and quite potentially distracting environments, a scenario that seemingly increases with latent conditions that may further predispose medical staff to errors.

In order to reduce cases of medical errors, healthcare providers must accurately identify their main causes, come up with solutions, as well as measure the success of the installed improvement initiatives. At the same time, accurate evaluations of the incidents of medication errors on the basis of clear and yet consistent definitions are necessary for the best route of action to be taken.

Scope and purpose of this document

This guideline applies to all hospital staff. Some of the people it applies to include;

Medical Staff

Nursing and Midwifery staff

Pharmacy staff

All the Allied Health Care Professionals as well as Health Care Scientists who are involved in the administration of medication.

This policy also affects the operation of Pre-registration Healthcare Professionals Students such as Pharmacy, Nursing and Medical students who are directly or indirectly involved in any given medication process while under direct supervisions.

The policy also affects the operations of all staff members who are involved in the prescription, dispensing as well as administration of drugs.

Any staffs who take the initiative to promptly report any case of medication error will not in any way be subject to any form of disciplinary action unless of course it’s under any of the following conditions.

Where the staff member behaved in a malicious or criminal manner

Where the staff is guilty of gross negligence and carelessness

This document covers the definitional aspects and nature of medication errors and adverse drug events (ADEs) affecting hospitals in New Zealand and Australia. The document contains the clinical aspects of medication errors prevention via an elaborate evidence-based approach that takes into account the role and involvement of all relevant stakeholders. The documents also contain details for the assessment, features, investigation, management, and discharge of medication error cases.

Definitions of a Medication Error

The following list gives examples of scenarios where medication errors can occur. Near Misses in any of the sections below should also be considered. The definitions have been divided into sections according to the National Patient Safety Agency (NPSA) Safety in doses: medication safety incidences in the NHS (2007).

This is not a conclusive list, therefore managers, clinicians, and Clinical Governance

Managers must use professional judgment before addressing the issue at hand.

Prescribing Errors

• Deviation from Policy and Guidelines relating to Management of Medicines

• Medication prescribed to the wrong patient

• Transcription errors

• Prescribing without taking into account the patients clinical condition

• Prescribing without taking into account patients clinical parameters e.g. weight

• Prescription not signed

• wrong medication/rate/dose/route prescribed to the patients

Dispensing Errors

• Dispensation of medication to the wrong patient

• Patient dispensed wrong medication / dose / route

• Patient dispensed an out of date medicine

• Deviation from Policy and Guidelines relating to Management of Medicines

• Incorrect labeling of medication

Preparation and Administration Errors

• Wrong infusion rate

• Patient administered an out of date medicine

• Medication administered to the wrong patient

• Medication omitted without a clinical rationale

• Medication incorrectly prepared

• Patient administered the wrong medication / dose / route

• Wrong timing of medication administration

• Deviation from Policy and Guidelines relating to Management of Medicines

Monitoring Errors

•Deviation from policy and guidelines relating to management medicine

•Failure to provide the patient with correct information regarding their medication e.g. when to take, what it is for, side effects

• Failure to monitor therapeutic levels

• Failure to monitor patient / carer who is undertaking self medication

• Patient allergic to medication but the medication was prescribed and/or dispensed and/or administered

Actions to be taken on discovery of a medication error

Immediate actions to be taken

Assess the condition of the patients ad then take the necessary actions for maintaining their stability (see appendix)

Immediate reporting of the error to the nurse in-charge/ person in-charge or line manager

Seek immediate advise from the institution’s Pharmacy on the possible outcomes of the given medication error

In case of a dispensing error, the manager of the local pharmacy must be informed and the incorrect medication should be returned to the pharmacy for correct re-dispensing.

The incident report form must then be completed following the hospital’s policy for the management of staff and patient safety. All relevant charts must be photocopied and statements obtained. The incident must then be documented in the facility’s patient case notes

The line manager must ensure that the incident form is appropriately completed and the situation/case escalated appropriately (such as to the Clinical Governance manager, Matron or Education and Practice Development Teams). It is necessary that this take place in an expeditious manner in order to allow for a more timely investigation in cases of more serious events.

The out of hours facility Duty Manager must then be informed.

Medium Term Actions

Medium term actions involve the systematic review of the main or root causes of the medication error. The necessary Root Cause Analysis checklist must be used with the involved staff available. For errors that are of moderate nature, the Patient Safety Team as well as Senior Pharmacy staff must be involved.

After the Root Cause Analysis and by means of an incident tree, the line manager may deem it necessary to stop the involved staff member from taking part in any medication prescribing, dispensing as well as administration duties until thorough critical incident reflective exercise has been conducted.In such a case, the Head Nurse must be consulted by the line manager.

Suspension of affected staff and ways of addressing competency concerns

There are instances when it becomes necessary to stop staff from prescribing, dispensing or administration of medication. This issue must be respected and taken care of within the existing the critical incident reflective exercise.

The line manager while working with the Clinical Tutors and Matron must undertake a thorough critical incident reflective exercise with the affected medical, clinical or pharmaceutical member of staff. This must be carried out in less than a week after the error is reported.

A signed copy of the agreed actions as indicated in the critical incident reflective exercise must be kept on the affected staff member’s personal record/file and then reviewed according to the laid down appraisal procedures

Long Term Actions

As a major part of the long term actions after medication error, the Directorate Senior Management team comprising of the Clinical Director , Clinical Governance Manager and Head of Nursing must put in place clear proicedures for reviewing information on medication errors (obtained from Datix) to be used for the identification of common trends and themes. Any concerns regarding medication errors must then be pointed out and then be appropriately escalated.

A copy of the Root Cause Analysis Checklists must then be mailed/sent to the Principal Pharmacist in charge of Clinical Governance. The results will then be entered in special database and then appropriately analyzed for common themes and trends. The outcome would then be reported to Australia Medicines management Board.

Informing the affected Patient

The hospital acknowledges that open communication is important whenever things go wrong.

The affected patient must be informed by the nurse in-charge or the consultant team and an appropriate apology given. That apology must never be treated as an admission of liability

The patient’ consent must be sort before informing other mebers of the family or any other third party for that matter

If the Senior Nursing or Consultant feels that there is a compelling medical reason not to discuss the medication error event with the patient or relative, then a clear record must be made of such decision in the patient’s case notes.

There are instances when it becomes necessary to stop staff from prescribing, dispensing, or administration of medication. This issue must be respected and taken care of within the existing the critical incident reflective exercise.

The line manager while working with the Clinical Tutors and Matron must undertake a thorough critical incident reflective exercise with the affected medical, clinical, or pharmaceutical member of staff. This must be carried out in less than a week after the error is reported.

A signed copy of the agreed actions as indicated in the critical incident reflective exercise must be kept on the affected staff member’s personal record/file and then reviewed according to the laid down appraisal procedures

Discussion

Management of Medical Errors

Several empirical research suggest that error in clinical medicine results in grater harm, it is estimated that more than quarter of all medical errors around the world can be prevented. Additionally, effective error management strategies are available especially in clinical practice. This can best be done by involving individuals from all relevant professional groups.

Stakeholder Involvement

Medical stakeholders can come up with several interventions to mitigate medical errors in clinical practice. For instance, they can test existing systems to ensure they actually catch errors that injure patients; improve regulation and remove disincentives for vendors to provide clinical decision support; implement clinical decision support judiciously; make existing quality structures meaningful; consider consequent actions when designing systems; promote adoption of standards for data and systems; develop systems that communicate with each other; and use systems in new ways; to measure and prevent adverse consequences;

Specific recommendations should be; to implement bar-coding for medications, blood, devices, and patients; to implement provider order entry systems, especially computerized prescribing; and to utilize modern electronic systems to communicate key pieces of related data such as markedly abnormal laboratory values. Increases in the use of information technology appropriately, in the health care especially the introduction of clinical decision support and better linkages in and among systems, resulting in process simplification, could result in substantial improvement in the safety of patient.

References

Bates DW, Cullen DJ, Laird N, et al.1995 Incidence of adverse drug events and potential adverse drug events. Implications for prevention. JAMA; 274: 29-34. HYPERLINK “http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7791255&dopt=Abstract” t “pubmed” <PubMed>

Barber ND, Dean BS.1998, The incidence of medication errors and ways to reduce them. Clin Risk 1998; 4: 103-106.

Dean B, Schachter M, Vincent C, Barber N. 2002Prescribing errors in hospital inpatients: their incidence and clinical significance. Qual Saf Health Care 2002; 11: 340-344. HYPERLINK “http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12468694&dopt=Abstract” t “pubmed” <PubMed>

Grober, E.D and J.M.A. Bohnen. 2005. “Defining Medical Error.” Canadian Journal of Surgery48: 39–44.

Nichols et al ,2008.Learning from error: identifying contributory causes of medication errors in an Australian hospital.Med J Aust; 188 (5): 276-279.

Reason J.1990. Human error. New York: Cambridge University Press, 1990

Runciman WB, Roughead EE, Semple SJ, Adams RJ.2003. Adverse drug events and medication errors in Australia. Int J Qual Health Care 2; 15 Suppl 1: i49-i59. HYPERLINK “http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14660523&dopt=Abstract” t “pubmed” <PubMed>

Appendix

Assessment

Medical errors are manifested in patients as adverse medical events. Before event thinking on how to reduce medical errors, it is important for this guideline to outline ways of assessing the genuine cases of medical errors as evidenced from patients admitted as a result of adverse medical events.

What is an adverse event?

An adverse event (AE) or side effect is any unfavorable and yet unrelated change in the function, structure, as well as chemistry of a patient’s body that is temporarily associated with the use of a given drug/medicine. In other words, it is the undesired or harmful affects that result from the use of a given medication.

Serious adverse events must be treated as a matter of MEDICAL ERMERGENCY. This is because it can lead to:

Death

Hospitalization

Significant disability/ patient incapacitation

Discomfort and pain

Congenital anomaly

Cancer

Overdose

A principal investigator (trained physician) must be involved in the assessment of the nature of care that an adverse medical event patient requires. Physical symptoms must be evaluated together with laboratory results.

Treatment should never be unblinded unless under emergency conditions

The emergency unblinding procedures must be followed as prescribed in the existing hospital protocol

The unblinding process should be discussed with the sponsor if conditions allow

Subject’s safety is paramount

Documentation

The cases of adverse events must be documented. There must be;

A description of the patient’s experience

The onset, the duration as well as date of resolution

Assessment of causality

Treatment given

Outcome of the treatment

All the relevant documentations must be obtained. These include;

Hospital admissions, notes and discharge summaries

Lab reports

Medication data

Procedure reports

All these documents should always be completed and then forwarded to the relevant sponsor representatives.

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Craig, Anderson, et al the influence of media violence on youth, psychological science in the public interest, 2003, Vol.4 (3

Craig, Anderson, et al the influence of media violence on youth, psychological science in the public interest, 2003, Vol.4 (3) p. 81-110.

The article “the influence of media violence on youth” was published for the National Institute of Mental Health but due alterations effected by the surgeon general without prior knowledge of these authors; they opted to publish it on their own. They modified the report and updated several sections before publishing it in the psychological science in the public interest. The report was then availed to the public through the periodical’s site.

There are a total of eight authors who have served in different capacities in the department of psychology from their respective universities and colleges. The lead author, Craig Anderson has been awarded a Fellow status by the American Psychological Society and the American Psychological Association. The other authors have diverse knowledge on psychology and other related areas as they have written several publications on psychological issues. Present among them is the dean of the college of communication thus providing great assistance in the area of communication and its impact on the society. One can therefore say that the article was written from an expert’s point of view since a great deal of consideration was taken before the publication was made public. The fact that they felt the Surgeon General’s copy was mere representation and not an actual publication was clear indication that they took their time and would not provide anything less than the actual report.

The authors have taken a new method of looking at media violence and whether adverse effects are as a consequence of these games. They look at scientific methods within which they can either prove or disapprove the previous studies that have implicated media violence on causing aggression among the viewers. They also want to look for ways within which they can create mitigating measures for any adverse effects that may be perpetuated by these games or interactive media. They begin by classifying the different types of aggression that are possibly not well elaborated in the many researches that are carried out. Several federal agencies like the 2000 federal commission report; professional groups like the Eron, Gentry & Schlegel’s 1994 report for the American psychological association; and individual researchers like John Steinfield have all in one way or the dealt with the issue of media violence and its effect on the youth (p.82).

The purpose of these authors is to bring out the scientific conclusion on the effects of media violence on the youth by answering five critical questions (p.82). First, what does research say about the relationship of violence, aggression and the media? Secondly, the theoretical explanations on how media violence produces its effect on aggressive and violent behavior. Third, what moderator effects can be applied to reduce the influence of the characteristics that are most influential? Who are most susceptible to the characteristics? Fourthly, how accessible and widespread is violence media especially to the youth? Last but not least, how can the society counteract the effect of media violence on the individuals most susceptible? These questions provided a basis for their research and the basis for this report. They prepared this report to suite all types of audiences that may be interested in reading such a research. Whether professionals or not, the audience can readily understand what is being relayed by the authors. The research carried out by these authors is conclusively detailed to fit the audience that comes across these findings.

The most important aspect that is perpetuated by these authors is that there are several factors that should not be overlooked by other researchers who would like to venture in this area of psychology. They also serve to dispel allegations that media is the sole cause of aggression but reiterate that there are a number of factors that come to play when violence is looked at greater details. Violence is as a result of various effects that come from long term conditions placed on an individual. Other than media, other factors come alive when an individual becomes aggressive (p.84). The authors try to look at these other aspects and alienate the ones that are directly linked to the media and violent interactive media. They look at the meta-analysis of different researches that have been carried out over the last four decades and look for evidence that directly links media to aggressive behavior. The authors try to distinguish between inherent factors and external factors that lead to aggression and look for intervention measures that would otherwise be used for moderating these behaviors. Sparse reviews suggest counter-attitudinal and parental mediations as core interventions that could be used to reduce these characteristics. They cite reports that have been published earlier to show just how different researchers perceived violence depicted by the media (p.90). As a basis for their discussion, they look at the meaning of different aspects portrayed by other researchers on the area of violence and tend to delineate the media from being the major cause of violence. Though studies show that children who watch other children fighting in the media are less likely to call an adult when faced with a similar situation, the authors contemplate that an individual who takes violence as a means of settling quarrels will definitely accept violence as a solution.

The authors’ approach on this topic is very insightful they offer new directions on the way the media can be involved and how certain measures can be taken to drastically reduce the expected results. They look at a myriad of solutions that distinguish the major types of aggression and how they can be detected and solved. They term short term effects of violence as coming as a result of observational learning, imitation, arousal and excitation, and priming. This may be true but according to social cognition, these imitations could only occur if an individual has had a pressing issue that he sees solved particularly via violence. If there are any issues at home and an individual sees someone in the same situation solving it through murder, the individual will then take that as an option. If a male adolescent has in any way been harassed by a female and then sees a violent treatment of women in a movie, then there are higher chances of the individual being assaultive in the way they handle women (p.95). Long-term effects are seen as a result of observational learning, atomization of aggressive schematic processing and emotional habituation. So far, the authors agree with my point of view that the media is not the direct cause of violence and aggression but a recipe for an aggravated individual who has not found a way of dealing with their own problems.

My idea is that violent media does not lead to aggressive behavior and these authors have just proved that. They suggestive that violence will only be a result if the model used is attractive or similar to the viewer in that they can identify with the situations presented. Only associated stimuli cause resultant behavior which in this case is aggression. This, the authors cite, is critical especially when the society is involved. If the society condones violence, then the situations affecting the individual could be related to that environment and solved in such ways. They answer questions concerning the use of scientific research to quantify behavioral practices in a way that is easy to understand and digest information therein. They tackle the critical questions adequately and provide detailed information that is helpful for other researchers willing to carry out extensive research in this area. They also provide a basis for others who would like to use this information as their foundational argument. For the readers, they aid them in understanding the various ways in which they can assist individuals addicted to these games and different ways in which they can help reduce cases of aggression especially among the youth.

Works cited:

Craig, Anderson, et al the influence of media violence on youth, psychological science in the public interest, 2003, Vol.4 (3) p. 81-110.

Space according to Virilios’ Overexposed City

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Space according to Virilios’ Overexposed City

Virilio argues that technologies like automobile, train and airplane did not fundamentally present problems for the representational paradigm that understands speed and communication forces to produce effects that are visible, but distorted and interrupted the rationalized space of the industrialization city of the 19th century. To him surfaces of architecture formed boundaries and cities still well composed on locale clusters and space was still managed appropriately. Guided by his proximity law, Virilio argues that the relevant analysis interval shifts to time from space and finally to light- to the waves that allows the relativization and interactivity of time and space, with the passage to the absolute speed of today’s telecommunication from the mechanical transport of a past era. To him, the future’s city is the pleasure or the result of interval. As it follows, when the interval is light, essentially proximate space results to electromagnetic proximity and the grid of the city to the network of information; teleaction replaces immediate practice and chronopolitics replace geopolitics (Virilio 542- 49).

According to Virilio, this is the city that is overexposed, whose images range from the moderately benevolent ubiquity of computer screens, televisions and fax machines to the horrifying forced entry of the nuclear flash into the darkest recesses of Hiroshima. To him, space has disappeared. For in the city that has been overexposed, the organism of architecture is not opaque anymore, it is not occlusive and it has been inscribed with information that is visible just like the body of humans, on which it took its ideas and inspiration from, vulnerable and porous to the intrusion forces that are just as visible as an electron, and just as less real. These distinctions, there and here, exterior and interior, and private and public, on which architecture depends on, are no longer useful and they no longer hold, and the resulting territory insecurity ranges into one’s own body from the cities (Virilio 542- 49).

His later works pursued the notions of the fusion of biology, technology, and the way the environment is arranged, and points out to us that destruction and perception can be distressingly coterminous. This article, however, explores the notions of disappearance and shows new ways which one can use to analyze the structures of a city that can no longer be seen in the locations and materials that realize it. Since the current system of the world is not as global as fundamental, like a shot of a cinema of the night tables of the author receding into pixels that are one dimensional, information technology becomes the only representational solution to the new representational challenges. According to these arguments, it is clear that Virilio thinks and indicates that space has disappeared (Virilio 542- 49).

To further indicate and express this point, an example of a statement made by the mayor of Philadelphia in the 1960s when the black revolts were in full swing is used. The mayor pointed out that ‘….from now on, state lines cross inside the city….. (Virilio 543). While this statement was largely a political reality for numerous individuals in the United States, it more essentially opened onto a dimension that was more meaningful and wider especially because the Berlin wall had just been put up. Since this time, the statement the mayor made kept on being proved true. This is exemplified by the case of Belfast and Londonderry whereby the two streets recently were marked with a yellow line. This band was supposed to divide Catholics and Protestants, before the two warring groups moved away leaving a no- man’s land behind that even created a stronger division between these two neighborhoods (Rondanini 234- 54). After this, another city, Beirut followed suit with its west and east regions, its local frontiers, mined boulevards, and tunnels. It is argued that this declaration made by a large American metropolitan leader underlined general phenomenon that affected provincial cities and capitals (Virilio 542- 49).

This phenomenon of compulsory bashfulness, in which industrial companies, just like cities, suffered the first effects of an economy that was multinational, led to an essential redeployment of cities. On one hand this led to the disruption of some cities that were predominantly working – class cities like Sheffield, and Liverpool in England, St. Louis and Detroit in the US, and German’s Dortmund. On the other hand, new city centers came up around large international airports- what are referred to as the metroplex. These airports were build with the beginning of the international economic crisis that occurred in the 1970s for the purposes of conforming to the imperatives in defense against buildings that were hijacking cities and were no longer build in respect to the traditional constraints of technology, but were build to reduce the risk of contamination by terrorists (Virilio 542- 49).

Sites were designed to discriminate between a non- sterile zone from a sterile zone. All circuits and breaks of circuits, as well as, the general traffic flow were put through a discriminatory system of transit. As it follows, the architectural forms of the buildings became less the outcome of the individual personality of architects than of the required precautions taken for the safety of the public. As the last gateway of the state the airport was more established as a fort, the train station or the harbor of the past, the place where it is necessary to regulate communication and exchange. For the same reason, it also became the appropriate field to exercise high surveillance and intense control experimentation. A border and air patrol was also established, and their exploits on antiterrorism made news headlines.

From this time, it was not simply matter of segregating the suspected or contagious person through confinement like it was done in the past, but rather of intercepting the threat in the course of their journey so as to examine his clothing and baggage electronically; thus the sudden abundance of cameras, detectors, and radar at compulsory passageways (Virilio 542- 49).

Absurdly, the very equipment and technology designed and developed for the greatest freedom in travel provided for a model for prison incarceration. In the past, in a number of residential areas in the US, security was performed only by televisions that well closed- circuit connected to police headquarters. In supermarkets, banks, and highways, several tollbooths were erected to resemble the old city gates, too show that the passage rites are no longer broken, that they have in turn become immanent (Virilio 542- 49).

With such a perspective without horizons, the manner through which an individual gains access to a city is not through a city gate, or a triumph arch, but rather through an audience system managed and controlled electronically whose users are not really inhabitants of the city or privileged residents as they are interlocutors who are permanently on the move. From this point, continuity breaks occur a few times within the boundary of an urban space that is physical or its register than within a time’s span, a span that industrial and technology redeployments have incessantly restructured through sets of interruptions like unemployment, company closures and work schedules that are variable; and through simultaneous or successive transformations that have managed to reorganize and organize the milieu of the city, like, for example, the large townhouses located near Lyons whereby the inhabitant turnover rates went so high that it resulted to the destruction of a residential complex otherwise seen as satisfactory (Virilio 542- 49).

It is argued that since men first began to make use of enclosures, the idea of what a boundary was has gone through different changes which concern both what it faces and façade. To the screen from the fence, the surface of boundaries has been continually altered, either imperceptibly and perceptibly. Its more current changes are maybe that one of the interface. The queries of a city’s accessibility then must be rephrased to ask whether a greater metropolis still has a façade. To ask at what time the city can be indicated to facing us. The author further argues that the popular expression of the past century that people had of saying that they are going into the city has been notably been replaced by going to the city. This according to the author embodies an uncertainty concerning relations or associations of the opposites, as if individuals were no longer ever at the city’s front but always inside it. If the city still is located and takes a considerable amount of land, or a geographical position, it no longer keeps in touch with the ancient division between a country and a city, nor with the opposition between periphery and center (Virilio 542- 49).

The axiality and the localization of the layout of the city faded some time ago. It is argued that the suburbia was not the sole culprit of this dissolution. The very opposition extramural versus intramural was itself made weak by the revolution in the communication and telecommunications development and in transportation, which in turn resulted to the vague conurbation of a city fringe. The author puts it that we are currently witnessing a phenomenon that is paradoxical in which the construction opacity materials is virtually being done away with. With the emergence of structures that are portative, curtain walls made of transparent materials and light are replacing the faced made of stone at the same time that the paper used for tracing, plexiglass and acetate used in project surveys are replacing the opaque characteristic of papers (Virilio 542- 49).

The issue of disappearance of space is further emphasized by Henri Lefebvre who launched a search for a unitary theory of mental, physical, and social space with the declaration that, ‘…..the fact is that around 1910 a certain space was shattered. It was the space of common sense, of knowledge, of social practice, of political power, a space hitherto enshrined in everyday discourse, just as in abstract thought, as the environment of and channel for communications…..’ (Lefebvre 177). He further points out that perspective and Euclidean space have disappeared as reference systems, along with other past commonplaces like history, town, paternity, traditional morality, the tonal music system, among others.

Daniel Defert, on the other hand, argues that for almost twenty years, spaces remained substantially misunderstood and unexplored. He further puts it that urbanism and architecture do not constitute an entirely autonomous or isolated field (Defert 280- 81). Tom McDonough is another author who talks of disappearing and disappeared space. This particular author argues in one of his articles that under capitalism that is advanced, ‘…. Everything that was directly lived has moved away into a representation…..’ (McDonough 254). Just as Lefebvre argued, this author puts it that the corollary to this in spatial discourse was that space that was directly lived in or what he referred to as the representational space had gone away into the space of the perceived and conceived or what he called the representations of space. He argues that concrete, social space was denied in favor of abstract, mental space, or commodity’s free space. According to him, however, this thoroughly dominated space was not faultless, in fact, he argues that it was filled with contradictions, hidden and covered by an ideology that was homogenizing.

These contradictions are what according to the author made it possible for the struggle resulting from the situationist project; the construction of spaces and exploration of psychogeography that made the difference. The experimental behavior of situationists and their inhabiting practice was an operation or activity in space that had become dominated that meant to contest or compete for the retreat of the directly lived into the representation of realm, and hence, to compete or challenge the society’s organization of the spectacle itself. This, just like the other two authors, supports that claims by Virilio that space has already disappeared.

Works cited

Defert, Daniel. ‘Foucault, Space and the Architects’. 1997. Print

Lefebvre, Henri. From ‘the Production of Space.’ From La Production de l’espace. Paris: Anthoropos, 1974. Print

McDonough, Tom. ‘The Naked City’.

Rondanini, Nunzia Architecture and Social Change Heresies II, Vol. 3, No. 3, New York, Neresies Collective Inc., 1981. Print

Virilio, Paul. ‘The Overexposed City.’ La Ville Superposee from L’espace critique. Paris: Christian Bourgeois, 1984. Print

Craigs Crocodiles, Inc. Income Statement For The Year Ended 31st Jan. 2009

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Instructor:

Course:

Date:

Craig’s Crocodiles, Inc. Income Statement For The Year Ended 31st Jan. 2009

2009

Operating Activities $

Revenue (Sales)300,000

Credit Sales 160,000

Net Sales 460,000

Purchase (300,000)

Gross Income 160,000

Expenses

Warehouse hire24,000

Office space12,000

Bad debts60,000

Shipping cost25,000(121,000)

NIBT 39,000

Workings

Bad Debts and Collection Expenses = 0.2 x 300,000

= 60,000

The Lease Contract between Craig’s Crocodiles, Inc. and Pauly Property Management Services

Opening

The two parties entered into an agreement over lease of warehouse and office spaces. The three year contract was signed by both parties in January 2008. Since Craig’s Crocodiles, Inc. did not have enough resources to construct their own properties (offices and warehouses) for the crocodiles, the company opted to outsource these services from Pauly Property Management Services. In the process, a contract was signed, an indication agreement. However, having realized significant growth and development in their investments, Craig’s Crocodiles, Inc. opted to have bigger space with the capacity to accommodate their growing numbers. Craig’s Crocodiles, Inc. now feels that it is time to move to relatively bigger and spacious rooms.

Findings

From the above case, it can be established that the two parties has entered into a contractual agreement over a specified period of time, 3 years in this case. This constitutes a contract, then, it represents a deliberate, voluntary, and legally bidding contractual agreement between these two competent parties. Whether written or implied, this lease contract is part of the common law that holds the parties to it and must be honored. This contractual relationship between Craig’s and Pauly Property is evidenced by the offer, acceptance of this lease offer, and the valid (valuable and legal) consideration. Therefore, both Pauly Property Management Services and Craig’s Crocodiles, Inc. acquire the duties and rights to each other. Though the existence of this contractual-relationship should not apply that it is not avoidable, not void, or not enforceable, all the parties to the lease contract are legal protected.

Since this is a lease contract, the contractual arrangement therefore calls for the user (lessee) to honor his part of the agreement by paying the property owner (lessor) the agreed monetary compensation for the use of the asset (warehouse and office spaces in this case). Given that the warehouse is a tangible property, this lease contract is therefore referred to as rental agreement as the user agrees to rent the warehouse rented out by Pauly Property Management Services. Since this is a periodic lease, the Craig’s Crocodile is under no obligation to honor the contractual agreement for the specified lease period (3 years).

Closing

Any attempt to terminate the lease contract before the 3 years period elapse is contrary to the contractual agreement and constitute a breach of the lease contract between the parties. Craig’s Crocodile intention to pre-maturely terminate the contract without the consent of the lessor (Pauly Property Management Services) attracts legal actions that include compensation for the damage caused. Therefore, Pauly Property Management Services is justified and legal correct to demand a financial compensation for the lost lease rent for the remaining two years of the contract. In addition to the lost rent, Pauly Property Management Services will suffer other damages that attract compensation of a fair financial value.

Pauly Property Management Services should also sue and be awarded for punitive damages (exemplary damages) that the breach of lease contract has caused them. Punitive damage is often awarded to the injured party as compensation to the plaintiff for the damages and losses suffered as a result of the harm that Craig’s Crocodiles, Inc. has caused the lessor. This penalty is also aimed at punishing Craig’s Crocodiles, Inc. (the defendant) for their outrageous misconduct, hence deterring the defendant from any similar misbehavior done intentionally, like in the case of Craig’s Crocodiles, Inc by disregarding the contractual interests and rights of Pauly Property Management (the plaintiff). This punitive damage is the “quasi-criminal” because it stands halfway between civil and criminal law. Therefore, the $300,000 punitive damage fine is justified and legally backed.

Summary of Three Articles

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Summary of Three Articles

This article on higher education by Clark Kerr brings and shows the research university in a new light, that of a new century. In the article, the author argues that the multiversity is now facing numerous challenges with few certainties. It is shown how university leaders can assume different roles like those if foxes or hedgehogs in the current world. To show what attitudes universities should adopt in this age, he gives five different points of recommendations. One of them is that universities should be more privatized, and that they should rely more on tuition. Another point is that there should be more federalization, with the third point being that there should be more cultivation of general support from the public. The other two points are that more attention should be paid to using resources effectively and that universities should focus more on pluralistic leadership (Kerr 186- 196).

The other article is by Ellen Goldring and Claire Smrekar, and is about magnet schools. The two authors argue that these schools are being established in more systems today to allow for racial diversity and improve scholastic standards and come up with a wide range of activities and programs for the better satisfaction of the needs, interests and talents of all students. The authors utilize a number of surveys to indicate the importance of magnet schools and point out that there is a huge need for the desegregation of schools in current times for the better satisfaction of needs and talents of all students (Goldring and Claire 17- 34).

Frederick Rudolph the author of the next article that talks about college movements. He talks about different movements that occurred in different universities and colleges like the movements that happened in the University of North Carolina, Princeton, New Miami College, Wabash College, and Emory College among others. The author argues that the institutions in these movements in the US intended to be institutions that are democratic for a democratic society. As it follows, they represented of the best and worst of a society. He implies that these movements at the most resulted from individuals putting their faith in man, and their belief in progress (Rudolph 45- 67).

Works cited

Goldring, Ellen and Claire Smrekar. Magnet Schools and the Pursuit of Racial Balance, 17- 34. Print.

Kerr, Clark. The uses of the University, 186- 196. Print

Rudolph, Frederick. The College Movement, 45- 67. Print.

Crate Training Program Dealing with Sexual Harassment in the Office

Crate Training Program: Dealing with Sexual Harassment in the Office

Name

Institutional Affiliation

Training module:

Training Module for Dealing with Sexual Harassment in the Office.

Introduction

I settled on designing a training module for the employees to create awareness on sexual harassment and mechanisms of combatting it. These are outrageous sexual acts subjected to all genders at work place whilst most of the employees are ignorant of the handling this issue. Their ignorance leaves them vulnerable to the perpetrators who have the audacity to continue victimizing them while taking advantage of their ‘illiteracy’ on it. Employees of all genders are the ideal audience for the program. The senior officers such as Supervisors and managers will be enlightened on how to handle, engage their junior officers without perpetrating this indecent and assisting them in case they are victimized. By the end of the program, I hope the employees will have in depth understanding of the issue and the proper measure that should be taken by the employees when they are victimized.

Syllabus

Sexual Harassment

Manifestations of sexual harassment

Common perpetrators of sexual harassment

Common victims of sexual harassment

Course of Action for victims

Reporting to a senior

Asking for immediate help for extreme cases such as rape

Legal action

Personal precautionary measures.

Description of training:

The training module will enlighten the employees the sexual harassment acts and how the victims can approach the issue successfully. Both male and female employees will be the target audience. The whole training session is expected to last for around three hours with two breaks that last for seven minutes at different intervals.

Purpose of training:

Creating sexual harassment awareness in workplaces can promote mutual respect and decency how employees interact with each other. Most of the employees do not totally understand acts related to it what makes it important to enlighten them. Therefore, this training module is aimed at teaching the employees what sexual harassment, discipline its perpetrators and the measures that should be taken in case they happen to be the victims. The managers should be reliable in offering legal assistance to the victims. The employees will feel that their respect is adhered therefore promoting their confidence at work. The perpetrators will have to change their indecent behaviour since their victims will no longer be ignorant on the issue.

The objectives of this course are:

To shed light on various types of sexual harassments that workers face in offices.

Explaining to employees the characteristics of a sexually harassed workers in order to enable them to identify them and offers all the essential assistance required such as ensuring that the culprits are accountable of their indecent actions.

Teach the employees the legal approach to sexual harassment and legal actions that the victims should undertake in order to have justice.

Ensure employee understand various ways in which they can keep sexual bullies at bay.

Teach employees the actions or measures that one needs to take at a personal level to reduce cases of sexual harassment in the office.

Course Outline

Introduction

Sexual harassment is a common crime around the office that often goes unreported.

The victims avoid reporting victimization due to the shame associated with it since it’s a form of sexual abuse.

Sexual harassment refer to sexual requests in order to make favours, sexual advances, physical or verbal harassments which are sexual in nature.

Types of Sexual harassment that occur in the office

Groping

Rape

Requesting for sex for favours.

Physical or verbal harassments which are sexual in nature.

Inappropriate sexual advances.

Common perpetrators of sexual harassment

Managers

Supervisors

Project leaders

Chief Executive Officers

Recruiters

Progress assessors

Common Victims

Female or male secretaries

Female junior or new employees

Young or junior male employees

New job applicants.

Employees seeking promotions.

Dealing with Sexual Harassment

Reporting to a senior

a) The victim can report the perpetrator to a manager or team leader

b) If the perpetrator is a manager, reporting to an even more senior manager can help

c) It is also advisable to report to law enforcement if necessary

Asking for immediate help for extreme cases such as rape.

If caught unawares by an office rapist, employees need to shout.

They also need to call other employees as they fight back.

Legal action

There are times when the company or employer might be reluctant to take action or be the perpetrator

At such times legal action is necessary

Gather evidence and give it to an attorney

Be confident while going through all these and seek psychological help if necessary

Confide in a trusted friend as you handle the legal issues

Personal precautionary measures

Dressing in a respectable manner

Keeping off sexual talk if it sends wrong message to others

Knowing to spot potential perpetrators and avoiding them

Reporting minor harassment as it leads to major harassment later on

Trying to be in the company of someone around the office as much as practicable.

Lesson Plan

Duration: 2 hours (15minutes break).

Participants: 40-50 participants per session.

Goals

Describe Activities Materials Feedback/Assessment Time

Introduction

By the end of this segment, trainees will:

a) Explain what sexual harassment is and give examples. -Defining sexual harassment

Video depicting sexual harassment Letting trainees give ideas on what has been discussed 30 min.

Perpetrators and Victims By the end of this segment, trainees will:

Name perpetrators

Name victims -Defining a victim,

Perpetrator and their differences.

Literature on sexual harassment Letting trainees discuss the shared ideas 30 min.

3. Dealing with sexual harassment

By the end of this segment, trainees will be able to:

Explain what Anti-Discrimination Act is

Explain the role of the Equal Employment Opportunity Commission

Show how the Civil Rights Act of 1964 prohibits sexual harassment

Explain personal precautionary measures against offenders and sexual harassments legal approach. -Explain ADA and EEOC

-Ask trainees to share ideas on what they think needs to be done

-Show the role of public officers such as sheriff and attorney in sexual harassment.

Video, PowerPoint presentation on ADA and EEOC Letting trainees share what they have learned in the segment 30 min.

Conclusion: Trainees should have in depth understanding of sexual harassment at the end of the program.

-Ask trainees pointed questions on what has been covered. Video content Letting trainees share ideas on the content. 30

min.

Material and resources:

Video player and screen.

Sexual harassment hand outs.

Spacious hall or room.

PowerPoint projector.

References

Civil Rights Act of 1964 (1964). Civil Rights Act Transcript. Retrieved October 6, 2013 from Civil Rights Act

United States Equal Employment Opportunity Commission (1967). The Age Discrimination in Employment Act of 1967. Retrieved October 6, 2013 from http://www.eeoc.gov/laws/statutes/adea.cfm

Cream Learning Strategy. CREAM is a learning strategy. A group of methods makes you a fruitful learner.

Cream Learning Strategy      

Name

Affiliation  

CREAM is a learning strategy. A group of methods makes you a fruitful learner.

The letter “C” stands for the word Creativity. This is an erudite innovativeness. An imaginative individual has certainty to utilize individual style in his work (Hayashi, Bourdeau & Mizoguchi, 2010).

The letter “R” stands for Reflective. An individual with this examines and assesses his own execution and draw lessons from it. To be an intelligent individual one ought to gain from his past encounters and apply them in future, he ought to gain from his mix-ups and make an effort not to rehash them.

The letter “E” refers to the word effectiveness. An effective individual sorts out his space, time and needs. Successful study aptitudes must be drilled keeping in mind the end goal to be composed and enhance your learning propensities and styles (Hayashi, Bourdeau & Mizoguchi, 2010).

The letter “A” stands for activeness. An active learner strategy is the point at which you include yourself by and by in work, and afterward endeavors to get it going. To be a dynamic learner one ought to participate effectively in every one of his activities.

The letter “M” stands for motivated. A motivated learning strategy is the point at which you appreciate learning. To be a spurs learner one ought to dependably discover approaches to make your learning fun and intriguing. In the event that an individual has all these learning systems, he will without doubt be an extremely effective learner (Hayashi, Bourdeau & Mizoguchi, 2010).

Reference

Hayashi, Y., Bourdeau, J., & Mizoguchi, R. (2010). Strategy-centred modelling for better understanding of learning/instructional theories. International journal of Knowledge and web Intelligence, 1(3), 187-208.