Impact Of Cardiopulmonary Resuscitation Education Use Of Difibrillator Nursing Essay

Impact Of Cardiopulmonary Resuscitation Education Use Of Difibrillator Nursing Essay Poor knowledge and skill retention following AED and CPR training for nursing and other medical staff has been observed. Resulting of the increasing of the mortality rate CPR and AED training are important for nursing staff and is important as the nurses often are the first witness for the victim with cardiac arrest in hospital setting. The outcome of teaching approach is necessary to improve the knowledge and skill of the nurses and other medical team that increase the survival rate. Aim The aim of this literature review was to describe teaching approaches for cardiopulmonary resuscitation education in relation to acquired skills and knowledge in the use of an automated external defibrillation in a cardiac arrest situation in a clinical setting. Method The authors have selected a literature review for this study and key word that used are Cardiopulmonary resuscitation and education, nursing, continuing, cardiopulmonary resuscitation, nursing skill and education and cardiopulmonary resuscitation. Papers published two month ago since 04-2011 from many sources, such as books and Pubmed database including 10 years period. Those published paper in English language which covers strategies to improve the knowledge and skills of the nurses and other medical staff in cardiopulmonary resuscitation and automated external defibrillation using. In addition manual research has been used to get more information. Result There are many different teaching approaches can be used in cardiopulmonary resuscitation and automated external defibrillation training such as ; Digital Video Disc without manikin, DVD with manikin with scenario, peer tuition and instructor facilitated methods which the best method. The quality of education in cardiopulmonary resuscitation and automated external defibrillation training can be affected by the type of teaching approach which has been used. The education and refreshment of cardiopulmonary resuscitation and automated external defibrillation training can enhance skill and knowledge of nursing staff and give self confidence during resuscitation time and in using automated external defibrillation, which can lead to increase the survival rate and improve the quality of patients life. Conclusion Nurses in hospital setting who seldom encounter cardiac arrest, should received automated external defibrillation and cardiopulmonary resuscitation training to avoid time delays in resuscitation. Staff should be evaluated by using manikin with feedback system and expert instructors to ensure the quality f chest compression are satisfied at the time of training. The availability of resuscitation training equipment in unit and ward can enhance the nursing staff for self education and refresh their skill and knowledge. INTRODUCTION Each year in United States of America there are 325,000 victims of sudden cardiac arrest. The mortality rates due to cardiac arrest are frequently observed in most of emergency situation, which is most often the result of ventricular tachycardia (VT) according to Mosesso, Shapiro, Stein, Burkett, Wang (2009). Moreover, cardiovascular attacks cause one third of all deaths in the world today (Lindstrand, Bergstrà ¶m, Rosling, Rubenson, Stenson Tylleskà ¤r, 2010). The nursing staffs are often the first witness for cardiac arrest in a hospital setting (Dwyer, Mosel, 2002; Gombotz, Weh, Mitterndorfer Rehak, 2006). Moreover, the nurses are more efficient in training of automated external defibrillation (AED) as stated by Xanthos et al.2009. Bardy et al (2008) point out that due to the effectiveness of automated external defibrillation, it becomes recommended in public places such as; public places are: airports, schools, restaurants, planes, and crowded places. Furthermore they recommend that the AED machine is red in color with instructions for use. In spite of the effectiveness of AED in cardiac patients, a better understanding and knowledge about the use of AEDs is required (Hancock, Roebuck, Farrer Campbell, 2006; Martinez-Rubio, et al.2003).Therefore, the authors` see a need to explore how Cardio-Pulmonary Resuscitation (CPR) education can enhance and improve nursing skills and knowledge in the use of AED in order to reduce mortality rate in cardiac patients. BACKGROUND Automated external defibrillation www.priceit.in AED is an electronic devise which has two paddles; sternum and apex which can help to deliver the shock to the heart of the patient. This machine has been created and upgraded to convert the VT and Ventricular fibrillation (VF) to sinus normal heart rhythms, which are the most emergency situation that needs immediate medical intervention (Anas, Lee, Hasan, 2010). Moreover AED may be used in hospital setting or out of the hospital setting (Nettina, 2001). Winkle (2010) stated that around 250 000 victims are dying in United States of America every year caused by cardiac arrest 40% are resulting of VF.Therefore medical staff must be aware ,trained in using AED to enhance the quality of life of cardiac arrest patient. However, using this machine needs medical education and knowledge as stated by (Ammirati et al.2011).As mentioned above Brown, Rittenberger, Ammon, Harrington Guyette (2010) stated AED can have affect only in shockable rhythms like VF. Types of automated external defibrillation There are two types of AED: Monophesic which gives (360 joules) and the secound type is Biphasic which gives 150-200 joules (Sraj, 2005). The different between the two types: according to (Sraj, 2005): Feature Monophesic Biphasic Direction of the current Moves in one direction only from paddle Moves in both direction (first positive direction then in milliseconds in a negative direction Joules Form 360 150 (Some machines can go up 200) Potential myocardial damage More damaging less damaging Efficacy 93% in laboratory trails 99% in laboratory trails Ventricular tachycardia (VT) Ventricular tachycardia is a heart rhythm described as a run of three or more premature ventricular contractions (PVCs) (Lewis, Heitkemper, Dirksen, OBrien Bucher, 2007, p. 854). VT clinical association VT occurs with Coronary Artery Disease (CAD), cardiomyopathy, significant electrolyte imbalance, mitral valve prolapse, long QT syndrome, some medicine toxicity like digitalis and central nervous system disease. Furthermore, this type of dysrhythmia can be notice in non cardiac patients (Lewis et al, 2007). VT clinical significance Patient with VT may be found with pulse or pulseless and VT if persistent can lead to decrease in Carbon monoxide (CO) due to decreasing of ventricular filling times and loss of atrial contraction. All this finding can lead to several complications which include; hypotension, pulmonary edema, cerebral blood flow will decrease and cardiopulmonary arrest (Lewis et al, 2007). VT treatment This type of dysrhythmia can be treated simply if the causes identified like; electrolyte imbalance and ischemia. If the VT is monomorphic (patient has appearance of all the beats match each other in each lead of a surface electrocardiogram) and patient with pulse, Procaimade, Sotalol, Amiodarone or Lidocaine Intravenous injection (IV) can be used. If the patient in polymorphic (has beat-to-beat variations in morphology) VT with prolonged baseline QT interval Magnesium, Isoprterenol, Lidocaine Intravenous injection can be administer. If the patient has no pulse it must be taken in high priority level emergency case, in this condition CPR and defibrillation are the first line if treatment (Lewis et al, 2007). Ventricular fibrillation (VF) Ventricular fibrillation is described as a heart rhythm witha severe derangement of the rhythm characterized on electrocardiogram (ECG) by irregular undulation of varying shapes and amplitude (Lewis et al., 2007, p. 855). VF clinical association VF can occur in acute myocardial infarction (MI), myocardial ischemic disease like Coronary Artery Disease and cardiomyopathy. Furthermore this type of abnormal heart rhythm can be associated with coronary reperfusion after fibrinolytic therapy. Other VF clinical associations are like electric shock, hypekalemia, drug toxicity and acidosis (Lewis et al, 2007). VF clinical significance Patient with VF can be found unconscious, pulseless and apneic condition and if this type of dysrhythmia not treated immediately and rapidly patient will die (Lewis et al, 2007). VF treatment VF is life-threatening condition and the best treatment for this dysrhythmia is the CPR and Advance Cardiovascular Life Support (ACLS) with using defibrillation immediately if available (Lewis et al, 2007). Cardiac arrest It is the sudden loss heart function either the victim is diagnosed as a heart disease or not, which occur within minutes after symptoms appear. (American Heart.org.2011). Cardiopulmonary resuscitation (CPR) Cardiopulmonary resuscitation is a combination of oral resuscitation (mouth-to-mouth breathing), which supplies oxygen to the lungs, and external cardiac massage (chest compression), which is intended to normalize cardiac function and blood circulation(Kozier, Erb, Snyder Berman, 2008, P.1419). American Heart Association (2011) has emphasized the updated CPR guidelines for the chest compression rate is rate is 100 compressions per-minute. Defibrillation It is a process of administering the electrical shock to an individual heart for stop any abnormality heart impulse such For VT and restore the normal heart rhythm (Kozier, Erb, Snyder Berman, 2008). Public Access Defibrillation (PAD) It is a program that improves the automated external defibrillator in public facilities (Federal occupational health,2010). Cardiopulmonary resuscitation / automated external defibrillation provider An employee, who has finished or completed training in CPR, in addition has knowledge and understands an AED operation (Sraj, 2005). Chain of survival It is that access which concentrates on the increasing of the survival chance .according to these components: Early access to care (local emergency medical system number) Early CPR. Early defibrillation. Early advance of care. www.circ.ahajournals.org Sequence of actions when nursehealth provider is using an automated external defibrillator These procedures should be following when the patientvictim is unconscious or not breathing Start with calling for help then start with CPR if the AED not available immediately. 1-When the AED arrives: Continue CPR until the AED is switched on in case of more than one rescuer. If you are alone stop CPR and switch on the AED. Follow the voice instruction. Pads attaching to the patientvictim chest (the positive pad is placed on the patientsvictims left chest below the nipple, whereas the negative pads is placed on the victimspatients right upper chest above the nipple to the right from patient s perspective of the sternum). Be sure that no body touches the patientvictim during the AEDis analyzing the rhythm. 2-When the shock is needed: . Be sure that nobody is touching the patientvictim. Push the shock button as instruction Follow the voice instruction. 3-When no shock is needed: Continue CPR using a ratio of 30 compression to 2 rescue breathes Follow the voice instruction. Doing these procedures till the patient starts to regaining consciousness signs such as coughing, movement and breathing or you become tired (Nettina, 2001; Sraj, 2005). Precautions in the use of automated external defibrillation Sraj (2005) has emphasized several precautions which must be taken into consideration by the AEDs operator before using it. Furthermore, these precautions are very important in keeping the operator and the patient in a safe and secure environment. These precautions are; Unresponsiveness The rescuer should check the patients level of consciousness, pulse and any signs of life like moving or coughing. This step is very important step to avoid any problems or misusing of AED. Wet chest Due to water and sweat AED might not be very effective. So In order to get defibrillations effectiveness use the piece of cloth which is kept in the AED kit to dry the chest Moving vehicle Using AED devise needs special care especially during the transportation of the patient. In case of using moving vehicle it may affect AEDs analyzing the heart rhythm which can lead to wrong analysis. Flammable materials Try to avoid using any flammable materials like alcohol and stop any flammable gases like oxygen .using these flammable materials can make fire due to the expected spark from the shock. Chest patches Be close to the patient and scan for any nitroglycerine patches and remove it right away before attaching the AEDs paddles. These patches can make burn to the patients chest. Metal surface Avoid using the metal or any electric conductive surface because the ability of transmitting the shock to the rescuers or any persons nearby. Pacemaker The rescuer should look to the patients chest closely and identify if this patient using pacemaker especially if its implanted one. Try to attach the paddles one to one and have inches distance from the pacemaker to avoid destroying the pacemakers batteries. Age consideration AED is not recommended to be used in children under age of 8 especially in unadjusted energy AEDs. Hands off The users during analyzing the heart rhythm must be hands off to avoid analyzing disturbance. Furthermore the users and any person nearby must be clear before delivering the shock avoiding the transmission of the shock to them. Wireless devices The nearby people they must not use their wireless devices like cell phone and especially during the analyzing heart rhythm and delivering shock process. These devices can cause trouble made by waves interference which may influence the analysis. Education in a clinical setting Education can be defined as a learning opportunity which is planned by an individual or a committee to reach a related objective (Rogers, 2002). One of the main differences between nurse education and education of children in school is, that nurse education is based upon the theory and practice of adult learning. Furthermore, there are different teaching strategies, some of these teaching strategies like; lectures method, (lecturers) are the main instrument in this method. Experiential learning depends on learning result from experience. Last method is pairs exercise in this method the group members are asked to from pairs then work together (Quinn Hughes, 2007). The coordinators and teachers must chose the best teaching strategy accordingly and provide good learning environment to achieve teaching program goals (Quinn Hughes, 2007). McEwen Willss, (2007) have referred to one of the grand theory which is Henderson theory. The Henderson theory is focusing on the important of education for medical team, patient and families that translate to practice and experience to improve the quality of care. If this research has been done in a clinical setting it can enhance the education. Categorization of learning theories McEwen Willss, (2007) have mentioned, that sometime it will come to the nurses mind a question why is it very important to be aware of about the process of learning and to understand learning theories. The importance of understanding learning theories is to describe the process used to get about changes in the way individuals understand information and skills or tasks. Moreover, Bigge Shermis (1999) categorized the learning theories to two categories which are; Behavioral learning theories Behavioral learning theories which depend on behavior response and ignore the feeling, thoughts and cognitive processes of the student. In addition, behavioral learning theories were the first widely used in education and these types of learning theories includes the work of Pavlov, Skinner and others. Furthermore, these types of learning theories persistent in the American educational system in 1959s and 1960s, as well as behavioral learning theories enhance the American educational system in 20th century (McEwen Willss, 2007). Cognitive learning theories Cognitive learning theories which based on the mental processes and activities which go within the student. These type of theories start to get wide thrust in 1960s. Moreover, Jean Piaget is the most important theorists in cognitive science which developed main components of his theory in 1920s (McEwen Willss, 2007). Teaching approach Teaching can be defined most of the time as the facilitation of learning and is passing on to intentional act of communicating information (Bastable, 2003). To achieve this, the teachers must know the learning methods and the individual needs and connect them to instruction (Forrest, 2004). Skill and knowledge Skill is defined as a goal-directed, well organized behavior that is acquired through practice and performed with economy of effort (Proctor Dutta, 1995, p.18). Knowledge can be defined, as set of organized statements of facts or ideas, presenting a reasoned judgment or an experimental result, which is transmitted to others through some communication medium in some systematic form (Bell, 1976, p.175). Up to date, there are a lot of research articles regarding cardiopulmonary resuscitation education and use of an automated external defibrillation. Therefore it is important to identify teaching approaches and critically evaluate the effect of the education on skills and knowledge. The effect of Cardiopulmonary resuscitation education on nurses skill and knowledge Kardong ,Oermann,Odom,Ha (2010) conclude in their article if the nurses used manikin with voice advisory they will be more competent than the nurses how used normal manikin without voice advisory. Furthermore the median number of chest compression before Basic Life Support course was three and so fast, but after BLS training increased to 13 as stated by (Mellor Woollard, 2010). In addition, Madden (2010) found in his study that, the nurses are more confidant and competent in case of cardiac emergency situation after CPR training. AIM The aim of this literature review was to describe teaching approaches for cardiopulmonary resuscitation education in relation to acquired skills and knowledge in the use of an automated external defibrillation in a cardiac arrest situation in a clinical setting. Research questions Which teaching approaches are used for cardiopulmonary resuscitation education when nurses use an automated external defibrillation in a cardiac arrest situation in a clinical setting? What effect has the cardiopulmonary resuscitation education on nurses` skills in their use of an automated external defibrillation in a cardiac arrest situation in a clinical setting? What effect has the cardiopulmonary resuscitation education on nurses` knowledge when an automated external defibrillation is used in a cardiac arrest situation in a clinical setting? METHOD The method chosen for this study is a literature review with a systematic approach. A literature review is a critical summary of research on a topic of interest, often prepared to put a research problem in context (Polit Beck, 2008, p.757). Literature search The literature search was carried out in PubMed which is a data base that anyone, anywhere in the world with internet access can search for journal articles and permanent resource regardless of your institutional affiliation (Polit Beck, 2008, p.757). MeSH terms are created by the National Center for Biotechnology Information (NCBI). PubMed, works through searching in National Library of Medicine (NLMs) Web site, it helps the researchers to get full text of the articles from biomedical literature and helps to access further links to selected life sciences journals not in MEDLINE (National Center for Biotechnology Information, 2010). The search strategies were made by combining MeSH terms in PubMed and the result of this database search are shown in Table 1. In order to get relevant original articles to this literature review the authors have used Mesh term and limited the research which published in the last 10 years between 2001-2011, English human and any age. Table 1. Database search in Pubmed. Database Key word Identified articles (hits) Abstracts reviewed Articles examined Articles Included Date for search Pubmed 22032011 (Cardiopulmonary Resuscitation[Mesh]) AND Education, Nursing, Continuing[Mesh] 41 41 23 4 Pubmed 22032011 Cardiopulmonary Resuscitation[Mesh] nursing skill 22 21 21 4 Pubmed 22032011 (education [Subheading]) AND Cardiopulmonary Resuscitation[Mesh] 725 500 30 11 Key words In this literature review the authors completed this research with the following key words; (Cardiopulmonary Resuscitation AND Education, Nursing, Continuing[Mesh], Cardiopulmonary Resuscitation[Mesh] nursing skill and (Education [Subheading]) AND Cardiopulmonary Resuscitation[Mesh]. Identified original articles had to be published in peer-reviewed journals with an available abstract and had to focus on cardiopulmonary resuscitation education in relation to the use of an automated external defibrillation in a cardiac arrest situation in a clinical setting. Furthermore studies on adult, children eight years and older, SVT-VT patients and nurses were included. Non medical people and younger children (less than eight years), patients with pacemaker and refusal of informed consent were excluded, as were studies that did not involve health-care professionals in clinical settings. The primary search yielded 19 original articles of interest. In addition bibliographic searches revealed X articles. The articles are presented in the matrix (Appendix 1). The selected articles were assessed independently by the authors using Appendix 1Sophiahemmet University College classification guide of academic articles and studies regarding quality in both quantitative and qualitative research (Appendix 2). The studies were classified as Randomised controlled trial (RCT), Clinical controlled trial (CCT), Non- controlled study (P), Retrospective study (R) or Qualitative study (Q). Scientific quality of the studies was assessed on a three-grade scale:  high- (I), moderate- (II) or low- (III) quality. The authors` intended to work systematically by highlighting the similar words in the articles e.g., AED, clinical setting, skills and knowledge and discuss on regular basis to compare and discuss responses to the research questions. This literature review content the cardiopulmonary resuscitation education in relation to acquired skills and knowledge in the use of an automated external defibrillation in resuscitation situation in hospitals for most of the medical professionals like; doctors, technicians and nursing staff, but the authors will focus on nursing staff avoiding the vagueness of this literature review. Manual search can be defined as finding an original article which has been used in literature review (Polit Beck, 2008). ETHICAL CONSIDERATIONS The ethical consideration which are so important in this literature review, include the authors must check who is the sponsor of the study because it includes the use of technology Furthermore the authors must assess if the participants in the reviewed studies were informed and consented before they participated, especially in case of patients are involved. Finally, the authors must clarify if these studies have got approval from the ethical committees (Spouse, 2003). RESULTS 19 primary published articles have been reviewed by the authors` in this study which have focused on Teaching approaches used for cardiopulmonary resuscitation education when nurses use an automated external defibrillation in a cardiac arrest situation in a clinical setting and the Effect of cardiopulmonary resuscitation education on nurses` skills knowledge in their use of an automated external defibrillation in a cardiac arrest situation in a clinical setting. Results from the studies are chosen which are relevant to this study`s aim and research questions The selected results from the primary published articles have been categorized under the following headings; Teaching approaches used for cardiopulmonary resuscitation education when nurses use an automated external defibrillation in a cardiac arrest situation in a clinical setting Perkins, Hulme, Bion, (2002) stated in their article that , peer tuition is the one type of teaching approach which depends on peer of tutors with exceptional teaching background and experience by lecture-led CPR training. However, it pointed out that, in spite of cardiopulmonary resuscitation and AED skills performance enhance with peer tuition, knowledge remained the same over the participants. The quality of performance can be improved with audible feedback system (Noordergraaf, et al.2006). Furthermore, if audible feedback system has been used there is significant improvement in skill acquisition and skill retention has been reported that is available in automated external defibrillation (Handley Handley, 2003) Szà ¶gedi , Zrà ­nyi , Betlehem, Ujvà ¡rinà © Tà ³th(2010) defined problem-based learning as one of learning methods which organize the knowledge in clinical setting ,strengthens to motivate the students to learn, enhances clinical reasoning skills, and improve self-directed and continues education. Furthermore they concluded this method is better and more efficient method form the traditional method which is class room during cardiopulmonary education. Moreover this method can enhance and improve the outcome of cardiopulmonary education which can lead to better understanding and skill demonstrating during resuscitation in clinical setting. The other teaching approach which has been emphasized by Bjà ¸rshol, Lindner, Sà ¸reide , Moen Sunde(2009) is manikin and 24-min video instruction during cardiopulmonary resuscitation training. They made a study on hospital employees by distributing 5118 personal manikins.3466 responded to the first questionnaire the result can be seen in table 2 Table 2. Questionnaire administered to all hospital employees before receiving their personal resuscitation manikin. Question Answer Number of replies What is your age? 43 ( ±11) years 3445 What is your gender? Female: 87% 3298 Male: 13% How long ago did you have training in basic life support (BLS)? 15 (8-60) months 3295 Never: 296 How well do you feel that you are trained in BLS (1-5, 1  =  very bad and 5  =  very good)? 3.1 ( ±1.0) 3412 Have you been in a situation where you needed skills in BLS, whether at work or not? Yes, at work: 1121 (33%) 3425 Yes, outside work: 363 (11%) No: 2071 (60%) Altogether 908 replied to second questionnaire which they attended the classroom training the result can seen in table 2 Table 2. Questionnaire to all hospital employees nine months after receiving their personal resuscitation manikin. Question Answer Number of replies Where did you perform the BLS training with your MiniAnne manikin? Hospital meeting room: 908 (65%) 1397 Own dept.: 366 (26%) At home: 73 (5%) Did not participate: 120 (9%) How long ago did you train with your MiniAnne manikin? 39 (26-48) weeks 1184 How well do you feel that you are trained in BLS (1-5, 1  =  very bad and 5  =  very good)? 3.8 ( ±0.8) 1333 How many persons, in addition to yourself, have trained on BLS with your MiniAnne manikin/self-instruction movie? 1 (0-3) 1165 Have you experienced any discomfort using the manikin? Yes: 49 (4%) 1272 No: 1223 (96%) After receiving the participants their personal manikin by six month the result is displayed in table 3 Table 3. Number of study subjects performing different BLS tasks before and six months after BLS training with a personal resuscitation manikin and video instruction (percentages in brackets). The number of correct chest compressions and mouth-to-mouth ventilations are measured for 2  min after initiation of BLS (interquartile range in brackets). Before BLS training, n  =  59 Six months after BLS training, n  =  39 P value Assessed responsiveness 42 (71) 34 (87) 0.02 Opened airways before assessing respiration 10 (17) 17 (44) 0.01 Assessed respiration 42 (71) 28 (72) 0.73 Pulse check 34 (58) 13 (33) 0.02 Called for help before starting BLS 45 (76) 32 (82) 0.61 Correct telephone number for EMS activation 56 (98) 39 (100) Ns Correct compression :ventilation (C:V) ratio 32 (54) 36 (98) Number of correct chest compressions 60 (5-102) 119 (75-150) Number of correct mouth-to-mouth ventilations 3 (0-8) 4 (0-7) 0.23 After finalizing the result by Bjà ¸rshol , Lindner , Sà ¸reide , Moen Sunde(2009) they came to that cardiopulmonary resuscitation training with manikin and video instruction benefit and improve the staff self-confidence and clinical basic life support skill. In other hands using assessment of cardiopulmonary resuscitation defibrillation (CPR-D) nursing skills and informing the leaders is necessary to give information for kind of education they need seems to improve resuscitation performance (Mà ¤kinen, et al.2007). Spearpoint, Gruber Brett (2009) mentioned in their article that permanent cardiopulmonary education as one of the teaching approaches. Moreover they stated that , The simplicity, continuous and quality of the education on basic life support program are affected on CPR performance and hospitals cardiac arrest through increasing patient discharge and decrease the cardiac arrest. There was study done by Moule , Albarran , Bessant , Brownfield Pollock (2008) in united kingdom comparing two teaching met

Abortion: A Religious Issue Essays -- essays research papers fc

Abortion: A Religious Issue   Ã‚  Ã‚  Ã‚  Ã‚  One of the toughest issues to debate in our world today is abortion. Abortion is the induced termination of pregnancy before the fetus can survive. Nowadays, abortion affects all people, not just the mother and the baby. There are moral, ethical, health-related, political, and religious aspects that affect how people feel towards abortion. By looking at religion and its views, one can see just how hard it would be to argue in the pro-choice position of this debate.   Ã‚  Ã‚  Ã‚  Ã‚  First of all, I must start with the truth†¦the Bible does not directly say anything about abortion. The actual word is not mentioned at all. During biblical times, abortion was an unthinkable act and â€Å"there was no need to mention it in the criminal code† (Anderson 1). â€Å"Children were viewed as a gift or heritage from the Lord†¦ the Scriptures state†¦that God opens and closes the womb and is sovereign over conception† (Anderson 1). In this sense, â€Å"childlessness was seen as a curse† (Anderson 1). Passages taken from the Bible are used as supporting details because they state indirectly how God feels towards the issue. Before Christ was born, however, opinions differed towards abortion. Unwanted children were destroyed through abortion and infanticide because the Romans and Greeks thought human life was neither sacred nor inviolate (Ayd 48). In fact, Aristole claimed â€Å"that all babies beyond a legally defined quota should be sentenced to death by exposure† (Ayd 48). However, there were some people who objected this inhumanity. â€Å"Hippocrates declared that physicians should not perform or enable a women to procure an abortion† (Ayd 48). Even though there were laws against the act, people ignored them and continued to perform the procedure as if it was nothing.   Ã‚  Ã‚  Ã‚  Ã‚  Then God became man, and man was created in God’s image. The Bible says that man is not the owner of his life and body, and the uses he can make of these are limited and governed by divine law (Ayd 48). The entire will of God is for man to come to know Him in a personal relationship so that he may spend eternity in Heaven. This is why there is life on Earth. If one can go through the trials and temptations of life and stay on the side of the Lord, then he is deemed worthy to go to Heaven. By following through with an abortion, the u... ...holic Churches will continue to teach that the Bible and God are against abortion. There will also be many people who will oppose this teaching because of their own opinions and beliefs. No matter how people feel towards the issue of abortion, we must remember that the entire procedure is between the mother and the fetus. Both need to be taken into consideration when making a decision, and it is not hard to see where one might be led once reading the Bible.   Ã‚  Ã‚  Ã‚  Ã‚  There is just one thing I do not understand. Whatever happened to the Golden Rule: Do unto others as you would have them do unto you? As Dr. Irvine Page says, â€Å" Life has a way of taking revenge on those who destroy it† (Ayd 51). Works Cited Anderson, Kerby. â€Å"Arguments Against Abortion.† 2000: 19 February 2001 . Ayd, Frank J., M.D. â€Å"Abortion: The Catholic Viewpoint.† Abortion: Changing Views And Practice. Ed. R. Bruce Sloane, M.D. New York: Grune and Stratton, Inc, 1971. 48-52. Bible- New International Version Scwarz, Stephen D. The Moral Question of Abortion. Chicago: Loyola University Press,   Ã‚  Ã‚  Ã‚  Ã‚  1990.

Assessing teachers by the quality of results they attain

Judging teacher quality on test marking is a extremely debated issue. Teachers are frequently assessed by the quality of consequences in which they attain. Policies and statute law in educational methods have changed dramatically throughout the 19th and 20th century. This is down to altering political parties being in power and their positions on how instruction should be taught, besides due to the economic alterations over the old ages. As new ideas and old pattern has been examined alterations have necessarily been made. Exam marking is a method which has been used for over a hundred old ages to judge teacher quality. However the inquiry which I intend to present is whether that is adequate to find how ‘good ‘ a instructor truly is. Should opinions on this be changed, have they started to alter and is it possible to alter the peoples view after a life-time of test mark being figure one? These are the inquiries that I intend to see through looking at old and current poli cies, international positions and policies and besides whether the course of study has a bearing on this position. History The method of tests and measuring kids was ab initio introduced in the 1870 Forster Act. This was besides when the authorities started to supply free instruction for all kids, nevertheless, with free instruction for all came the authorities saw that there needed to be a manner to turn out to the people of England that there money was being spent sagely: hence methods of proving the kids was instigated to demo that the kids were larning in schools. The manner in which kids were tested was via Her Majesty ‘s Inspectors, they would see schools in order to oppugn the category on how much they had learnt in their categories. The authorities besides gave instructors incentive to do certain that the kids could reply these inquiries as they were being judged every bit much as the kids. The better a category did in these reviews the more respectable the teacher wage would be. However this chalk and speak method was non without issue, as the kids were assessed merely on the inquiries tha t the inspector asked, which could be said to be an unjust proving method. Therefore schools jumped directly in with instruction to prove instead than learning to larn. ( Ward and Eden, 2009:87-88 ) Changes were brought approximately in 1902 with the Balfour Education Act, instructors were given more freedom to make their ain teaching method. The Early Old ages sector in peculiar was get downing to have more freedom within their instruction. There are many influences which supported this ideal. Possibly one of the earliest was Aristotle, his position that cognition came through experience was noted every bit early as 366BC ( Pound, 2008b ) . Followed on by Jean-Jacques Rousseau who believed that kids should believe otherwise about instruction, he believed in liberating up the kid ‘s head, promoting people to seek out new thoughts. ( Pound, 2008a:7 ) Maria Montessori believed that kids learned throughout their lives from the minute they are born. Montessori was another truster, like Rousseau, that observation was the key to a kid ‘s learning experience, besides she believed that kids should non be pushed to larn but excessively allow them larn at their ain gait. There fore from my position Rousseau and Montessori are opposing the thought of standardized testing as this is an impossible technique to verify good instruction if kids learn at different ages and phases. They believe in steering the kid in their acquisition instead than ‘teaching a kid ‘ what they need to cognize to complete scrutinies. Once once more the instruction system was changed dramatically ; the 1944 Education Act introduced the tripartite system, which in bend brought about the 11 plus scrutiny, one time once more proving the kids at certain age/stages to find what they have learnt. The 11-plus test aimed to find the intelligence of all 10s to eleven twelvemonth old kids, to set up which school they should go to, those kids that scored the highest would go to the grammar schools ; to learn extremely academic topics, where as the kids which scored the lower consequences would travel to either the secondary proficient schools ; for mechanical and scientific minded pupil or the secondary modern schools ; for kids taking for low skilled occupations and homecare. The kids that attended the grammar schools were seen to be the most intelligent ; the grammar schools brought in the better instructors therefore the kids that were in front were seen to be given the chance to acquire farther in front. Although, the in structor quality of the ‘best ‘ instructors should besides be up for argument, the instructor deemed the ‘best ‘ were merely so as they scored the highest on their tests. These tests did non integrate the aggregation of any cognition of the individual taking them. The testing does non enlist critical instructor quality issues such as whether the instructor has a good resonance with kids, nor does it prove if the instructor is considerate, sort or creative. Therefore it can be said that these kids are non truly accessing the ‘best ‘ instructors but simply being taught by an older coevals of in-between category people who has entree to the stuffs to win in tests. The 11 plus exam argument has many angles, it could be seen as carnival in some ways as the kids were tested on certain cognition, each kid was given the same trial with no exclusions, nevertheless did each kid have the entree to the same stuffs and the same chances to successfully take such tests? Social category is a large issue which should be taken into consideration when discoursing whether the test standards were a just proving method. Children from in-between category households ; kids of canvassers and physicians were more accustomed to the countries of involvement within the tests. Such things as anagrams would be tested seting some in-between category kids at an advantage as their parents are more likely to hold done things such as crosswords therefore the kids are more likely to hold come across this before, whereas the working category kids are much less likely to hold this experience. Reasoning that the authorities of the clip were still really much thought of doing the rich richer and the hapless poorer hence further spliting the societal categories. The 1967 Plowden Report one time once more changed the educational doctrines. The Plowden Report recommended that primary instruction became more like early old ages instruction, they called for more active scholars, kids should be larning through drama. The Plowden study besides called for the abolition of cyclosis, conveying about subject based larning for primary instruction instead than subject based acquisition. This was possible due to the abolition of the eleven-plus test therefore a broader course of study was possible, instead than the instructor to prove method. ( Ward and Eden, 2009:67/68 ) Parents protested the recommended alterations as they wanted kids to be taught specific lessons such as reading and authorship, the thought of kids traveling to school and playing was seen as unequal instruction. This position was one of which the parents were familiar, their instruction was one of command and work sheets, hence this is what the parents knew. This contention around the parent ‘s protests resulted in the authorities commissioning more research in the 1970 ‘s and 1980 ‘s. Even so, this testing was one time once more based upon exam tonss. Neville Bennett ( 1976 ) tested kids at the start and terminal of the academic twelvemonth. Bennett ‘s consequences found that the ‘traditional ‘ instructors produced better test consequences ; nevertheless Bennett ‘s consequences have been criticised as he merely tested the kids on the nucleus topic ‘s maths and English. Another unfavorable judgment of Bennett ‘s survey was his deficiency of detecting categories that he was researching. The bases of these consequences were strictly on the consequences they produced. This resulted in instructor quality once more being judged entirely on the consequences that they can bring forth. ( Ward and Eden, 2009:92 ) Course of study In 1988, the National Curriculum was introduced, it was at first really traditional but became more flexible with the debut of vocational topics. The national course of study was implemented with no authorities intercession in learning methods or teaching method, giving instructor ‘s freedom to make their ain teaching method and utilize their ain methods of learning. However the national course of study was to standardize school instruction to do testing and appraisal easier. Key Stage appraisals were implemented at ages seven, eleven and 16. These standardized trials have been used to categorize kids into ability groups. Ball ( 2003 ) claimed that the National course of study favoured in-between category groups, it has been said that it was besides bias against different cultural groups. For Example History lessons were based entirely on British history and the school twenty-four hours was covered in Christian traditions ; such as supplications before go forthing school and in school assemblies. The course of study has one time once more had a proposed alteration with the publication of the White paper 2010, this will be discussed subsequently on. Standards non Structures New Labour leader Tony Blair in concurrence with the educational curate Barry Gardiner recognised the demand to assist working category kids achieve. Blair believed in ‘standards non constructions ‘ . Rather than underscoring on grammar schools and school pick, Blair found it more of import to underscore acquiring good criterions out of all schools. Compulsory numeracy and literacy hours were introduced to do certain that all kids were ab initio being taught to read and compose decently, which in bend would foster their accomplishments in the hereafter. â€Å" Education should be about happening success in every kid. When I talk about elevation criterions, I do non merely intend what gets measured in external scrutinies. We have to be much more concerned about the quality and relevancy of instruction our immature people receive and with the scope of chances to let them to win in the universe of work in the twenty-first Century. † ( Gardiner, 2004 ) Standards non constructions is where kids are what affair, it is said that seting kids on the right way to lifelong acquisition is where they will see true success. Gardiner recognised that the procedure, in which the kid acquires these womb-to-tomb acquisition accomplishments, is much less of import than the devising certain the kid does achieve these accomplishments. Gardiner aimed for a more holistic attack to acquisition, besides a demand for more vocational topics in schools. Although the course of study was to be more holistic the kids ‘s accomplishments were scored on trial. ( Gardiner, 2004 ) International attacks In the United States, the 2001 No Child Left Behind Act stated that all instructors by 2005-2006 had to be extremely qualified, be a certified instructor and major in their specific capable therefore obtaining a certification. Thus the Centre of Assessment and Evaluation ( CAEL ) in pupil acquisition in America, noted in Tennessee, where there was an attack pioneered called the ‘value added ‘ attack. This was intended to measure the value teachers add to the pupils larning. Students are compared to their ain acquisition: pupil ‘s trial tonss are compared with their ain old tonss instead than being compared to other pupil ‘s tonss, therefore category or household income is non an issue. The instructors were judged on how the pupils they had had improved, besides they defined the instructors of best quality gained greater accomplishment from the lower achieving pupils, instead than the higher achieving pupils in which it is normally assessed. However it was stat ed that there ought to hold been some observation in schoolrooms to truly assess the pupil ‘s betterment. ( CAESL, 2004 ) In Wales conference tabular arraies were abolished in 2001, harmonizing to research workers at Bristol University this has severely affected the public presentation of pupils in Wales. In conformity to their research, this attack has decreased public presentation as there is no force per unit area for the pupils to better. GCSE consequences have been compared with England by comparing similar schools from each state ; this research showed that Welsh schools were acquiring up to two GSCE classs lower than the schools in England. Naming and shaming schools through conference tabular arraies in England is seen to hike overall classs due to the force per unit area to maintain league place. ( Loveys, 2010 ) However the NAS/UWT instructors brotherhood has clearly opposed this place in mentioning that Wales ‘s school public presentation is bettering twelvemonth on twelvemonth. ( BBC, 2010 ) â€Å" It handily fails to foreground the fact that overall school public presentation in schools in Wales additions during the period covered by the study. † ( BBC, 2010 ) These teacher Unions promote the abolition of League tabular arraies saying that schools are offering easier classs to better their conference place. Parents Choice It has been said that parents are non taking schools based on the school conference tabular arraies but are more interested in location for easiness of handiness, little category sizes and the attention that is given to the kids. John Bangs, the caput of instruction at the National Union of Teachers stated in an interview for The Times that parents choose schools for their ain grounds, he believes they would be better aided by a full position of school accomplishment instead than merely consequences of trials, public presentation tabular arraies and Ofsted reviews which merely focus on a few cardinal opinions. ( Sugden, 2010 ) The Departments for Schools has clearly set out to relieve this job, as a statement a interpreter at the Department for Schools has said in The Times interview, that they are presenting a new strategy which will present a new school study card, this aims to give a more clear and full position of the school including more than simply academic accomplishment. How ever, it is besides said that no apology will be made for seting a strong influence over academic consequences, as we have more good and outstanding schools than of all time before, giving parents a existent pick and the option to weigh out other factors. ( Sugden, 2010 ) Current ideals and statute law The alliance has brought about new ideals on instruction. Prosecuting new positions and combined positions of the conservativists and broad Democrats. OFSTED has upped criterions and the new authorities has publicised new thoughts of personality testing. First observing the recent OFSTED studies, that has stated that they are upping their criterions and have judged many schools as inadequate. This is due to the coming ideals that schools need now to be judged non merely on informations, as it was seen that OFSTED could merely phone in their consequences. ( Shepherd, 2010 ) It has been found that instructors are non good plenty equipped to learn pupils, their exanimate effort at learning pupils is go forthing pupils bored and unwilling or being inspired to larn. OFSTED have concluded that the hapless instructors that are fighting to hold on the pupil ‘s imaginativeness and are neglecting to animate the kids that they are learning, hence kids are being giving mundane undertakings, harmonizing to OFSTED ‘s main inspector Christine Gilbert. â€Å" There is excessively much instruction that is dull and uninspiring. This means that excessively many immature people are non equipped good plenty to do the best of their lives. † ( Gilbert, 2010 ) In correlativity with this the alliance has proposed alterations to the educational system. The White paper that has been published on the 24th of November is naming for more in-school preparation for instructors. The White Paper will besides get rid of clip bounds on the sum of clip schools are allowed to supervise schoolrooms, hence making more flexibleness, taking to make better instructors. ( Vasager, 2010 ) â€Å" The remarks came as the Coalition prepared to print a White Paper today that will toughen up tests, overhaul the national course of study, reform instructor preparation and give staff more power to train students. All schools will be forced to run into tough new marks or face being taken over. † ( Paton, 2010a ) Besides the White Paper has besides proposed that all manque instructors ‘ under-go personality showing and aptitude trials which all instructors must go through before modification, this method is already in usage in Finland. The national course of study is to be tightened up to halt forcing the ‘easier ‘ classs. The purpose of the new tightened up course of study is besides to set forward a more specific nucleus cognition, this go forthing more free clip for such things as humanistic disciplines, athletics and civilization. ( Paton, 2010b ) League tabular arraies are excessively be focused on the nucleus topics such as maths, English and Science so that schools can no longer acquire to the top of the tabular arraies by forcing pupils into the softer or easier topics, which are non found valuable by future employers. The focal point of future instructors will be that they have great capable cognition, and a love of learning and their maestro topic. ( Paton, 2010b ) Besides Broad Democrat leader Nick Clegg proposed the system of ‘Like-versus-like ‘ which the Tories have said to be unfastened excessively. This system will suggest that school conference tabular arraies will be compared to those in similar state of affairss for illustration hapless with hapless, in-between category with in-between category. ( Asthana & A ; Helm, 2010 ) Teacher quality is a construct which is difficult to specify, many factors such as observation, trial marking, personality testing and kid inspiring is needed in correlativity with each other to find if a instructor is truly a ‘good ‘ instructor. The history of instruction has evolved over the century, traveling back and Forth between ideals depending on the political party in power and the economic sciences of the clip. From the first oncoming of scrutinies, get downing from oppugning from Her Royal Highness ‘ Inspectors, to standardised proving. The eleven-plus tests were extremely respected in their clip, but as research continued it was found that these trials could be seen as favoring in-between category kids. The research has continually been extended until current thoughts that pupils need to be tested against pupils of similar backgrounds, which in bend provided more accurate histories of betterment and accomplishment. Through research of international ideal s of instruction, parts have begun to go intertwined within the English instruction system. International ‘failures ‘ ( harmonizing to some ) such as the Welsh schools get rid ofing conference tabular arraies has besides been taken into consideration. This research had the opposite consequence by turn outing the authorities with ground non to take on this attack. In decision throughout the last century instructor quality has basically been based upon scrutiny tonss, observation or kid inspiring yet none have put them all together, which could so give a better definition of the ‘good ‘ instructor. Quality of learning demands to be a holistic position, much like the instruction is taking towards.

The Problem Of Becoming Homeless Essay - 1485 Words

â€Å"On a single night in January 2015, there were 564,708 people experiencing homelessness in the United States. Sixty-nine percent of those who were homeless were in sheltered locations and 31 percent were found in unsheltered locations† (Facts). People living in poverty are most likely have a high risk becoming homeless. Many other reasons why becoming homeless is due to economic conditions such as unemployment and increasing housing costs (Why). In addition, with all the new economic rules they are at higher risk of losing what they have already. In certain areas, homeless people are families, single mothers, and children are major in homelessness. However, the number of homeless is families who has children had increased more over the past decade or so. It is the fastest growing division of the homeless population. The problem of homelessness in America is growing dramatically. It is an issue that can strike at anymore in given moment and when you least expect it. 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