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Quantitative Research Designs: Descriptive non-experimental, Quasi-experimental or Experimental?


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Quantitative research methods participation in the information

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Quantitative Studies of Water and Sanitation Utilities: A Literature Survey

Black Report 6 Explanation of Health Inequalities. 6.1 Standardised death rates in present day Europe have probably reached their lowest point in the entire history of human society. Quantitative Research Paper. The twentieth century has witnessed a dramatic decline in the rate of infectious disease, as well as the introduction of powerful therapies for its treatment. Common causes of death which have thus greatly diminished, such as TB and diphtheria were often linked to for the teacher, poverty and material deprivation. They have been replaced by new diseases, some of which seem instead to quantitative, be linked with affluence and bfa creative writing material abundance. On that account inequalities in health might have been expected to diminish.

The evidence which we have presented in earlier chapters suggests that this has not been the case. We must now address ourselves to the question of why social class should continue to exert so significant an influence on health in quantitative Britain, 6.2 There are a number of approaches to explanation of the goede essays, relationship between social class and health, or at least some aspect of research paper, it, in the present day. In our view none of these approaches provides a wholly satisfactory explanation of the relationship, or one that can account for life cycle differences in the influence of social class on the risk of premature death. Indeed the duality essay, variable of social class is in itself multi-faceted and its influence probably varies according to age or stage in the life cycle and according to the development sequence of quantitative, a disease episode itself.

6.3 At the most fundamental level, theoretical explanations of the relationship between health and inequality might be roughly divided into spi publisher services 4 categories:- i. artefact explanations; ii. theories of natural or social selection. iii. materialist explanations; and. iv. cultural/behavioural explanations. In some partial respect each one of quantitative research paper, these explanatory forms sheds some light on the observed relationships between class and health in present day Britain. We will first describe and cover for the post of primary teacher discuss in general terms the four approaches and then go on, by reference to the problems of different age-groups, to show that a satisfactory explanation must build essentially on the ideas of the cumulative dispositions and experience of the whole life-time, and quantitative research paper of multiple causation. 6.4 In this approach to the analysis of the relationship between health and social class, emphasis is placed on the “artificial” nature of the correlated variables. Both health and letter for career change into human resources class are artefacts of the quantitative paper, measurement process and it is implied that their observed relationship may itself be an artefact of little casual significance. Hence the suggestion that continuities in the pattern of for the post, health inequality in research paper the twentieth century may be more a reflection of duality essay, changing trends in quantitative paper the occupational structure of British society than of a causal link between material welfare and health (see OPCS, 1978). Shifts in the occupational structure have led to the decline of certain “traditional” partly skilled and unskilled manual occupations (Registrar General’s Social Classes IV and V). Those men and women who continue to follow such trades tend therefore to be older on average than the rest of the active labour force because fresh entrants have been attracted to new job opportunities or they may be in ‘residual” occupations which have always had a poor health record. (This evolution in the social structure has of course been accompanied by some change in spi publisher services ethnic composition of the quantitative research, population.) 6.5 Thus the failure of health inequalities to diminish is believed to be explained to essay, a greater or lesser extent by quantitative paper, the reduction of the letter post of primary, proportional the population in the poorest occupational classes (the implication being that the upwardly mobile either had better health than those who remained and that therefore the research, health of spi publisher services, some of the latter could even have since improved; or that the health of the research, upwardly mobile subsequently improved).

6.6 One of the problems here is that because of services, changes in occupational classification the change in recent decades in the distribution of quantitative, population between the classes, and especially the “decline” in the proportion in class V, has been believed to be larger than in fact it has been (see Table 3.16 above). Table 6.1 gives estimates by age as well as class of the distribution in 1951, 1961 and 1971. For men aged 25 and over the percentage in class V declined from 11 to 8 and in class IV from 27 to 18 in the 20 years 1951 to 1971 (Most of the corresponding increase taking place in class II, but also class I). However, the rate of change slowed down in 1961-1971 and it can be seen that between a fifth and a quarter of those in the youngest age-groups continued to be found in classes IV and V. Overall, substantially more than a quarter of economically active men remained in classes IV and V in duality essay 1971. Table 6.1 Percentage of men aged 25 and over in research paper five occupational classes in 1951, 1961 and 1971 (England and Wales) according to 1960 (and 1970) classification of occupations. 6.7 Second, there are theoretical models which emphasise natural or social processes of selection.

In this approach, social class is relegated to the status of dependent variable while health itself acquires the greater degree of causal significance. The occupational class structure is seen as a filter or sorter of human beings and one of the major bases of selection is health, ie. physical strength, vigour or agility. It is inferred that the letter for the, Registrar General’s class I has the lowest rate of premature mortality because it is made up of the strongest and most robust men and women in the population. Class V by contrast contains the weakest and most frail people. Put another way, this explanation suggests that physical weakness or poor health carries low social worth as well as low economic reward, but that these factors play no causal role in the event of high mortality. Their relationship is strictly reflective. Paper. Those men and women who by virtue of innate physical characteristics are destined to live the shortest lives also reap the most meagre rewards. This type of explanation has been invoked to explain the preponderance of individuals with severe mental disorders in social class V (a thesis which was reviewed critically in, for example, Goldberg and Morrison 1963). It is assumed that affected people inevitably drift to goede schrijven, the bottom rung of the Registrar General’s occupational scale. Similar selective processes are thought to quantitative, occur with other forms of disease even though the extent of drift may not be so great.

6 .8 Another problem to which this mode of reasoning has been applied is the distinct regional pattern exhibited by mortality rates. In this ease, the essay verse, national economy is conceptualised as a mechanism of selection. Those parts of the UK with low rates of age-specific mortality and, by implication, apparently more fit populations are also believed to be regions where the economy is in a relatively healthy state and where job opportunities are better. This regional imbalance in economic vitality is associated with a trend in migration which systematically drains the depressed industrialised regions of their fittest men and women. The net result is believed to be reflected in the differential regional pattern of quantitative research paper, age specific mortality. Processes of selection may also influence the distribution of mortality between occupations.

In certain types of manual work, the level of physical strength and stamina required may in letter for career human itself act as a means of selecting or rejecting individuals. As a consequence although a given occupation might carry obvious hazards to the physical welfare of a worker, its tendency to attract and keep only the physically robust may disguise these inherent dangers (cf Fox and Collier, 1976). Thus it may be misleading to infer, on the basis of paper, death rates, the level of health risk attached to different occupations; to do so is to assume that the pattern of recruitment is bible random rather than systematically exclusive. 3. Research Paper. Materialist or structural explanations. 6.9 The third general type of explanation of the relationship between class and health emphasises the role of letter change into resources, economic and associated socio-structural factors in distribution of health and research well-being. There are many separate strands of reasoning within its explanatory rubric which can be more or less ordered according to the extent to which the primary causal significance is assigned directly or indirectly to the role of economic deprivation. Amongst explanations which focus on the direct influence of poverty or economic deprivation in the production of variation in services rates of mortality is Marx’s radical critique. This theory of political economy provides a theory of history linked to an explanatory account of the quantitative, contemporary form and letter of primary inevitability of economic exploitation.

6.10 Those associated with such a radical approach see health or the physical welfare of workers as a key dependent variable determined by the system of paper, production which also gives a particular character to the culture and cover of primary the ideology of society. Not all follow Marx and those who do risk interpreting modern problems in a way which he would not necessarily have approved. Crudely expressed in its original form, the argument was as follows. Capitalism is in essence a system of economic organisation which depends on the exploitation of human labour. The accumulation of profit, the research paper, guiding principle not only of the economic system, but of the whole form of capitalist social organisation, is the storing up in duality essay tangible form of the human effort and resources expended by individual workers over and above what they either require or have been allowed, to maintain their bodies in a fit and healthy condition. Marx did not use the modern concept of quantitative research, health in his analysis and was primarily concerned with the material welfare of human beings. This is reflected in his theory of “immiserisation” which assumes a minimum subsistence level which capitalist social organisation systematically violates through its greed for profit. In the process of bfa creative ateneo, immiseration the worker experiences economic deprivation on an ever increasing scale until finally he is quantitative research paper left with insufficient resources to maintain bodily health.

6.11 Placed in its historical context Marx’s analysis can be seen, at least in essay part, as a counter critique to Malthusian theory which saw the relationship between death, disease and poverty as a natural phenomenon: the quantitative research paper, demographic safety valve of the fixed relationship between population size and the natural level of material wealth in the world. Marx’s antidote to this “naturalistic” theory of duality essay, social inequality stressed the potential elasticity of material production under the capitalist mode of quantitative, production, while at the same time drawing attention to its dependency on an unequal distribution of resources as well as its inherent tendency to promote material inequality in health as well as property between human beings. 6.12 Most modern proponents of Marxist theory do not interpret the process of material exploitation in terms of human bodily resources, and tend to verse, measure surplus value in terms of wealth or property, the factors into quantitative research paper which human labour is transposed. With the benefit of a century’s hind-sight the for career change into human, validity of quantitative research paper, much of this nineteenth century theory of the for the, relationship between health and material inequality has been accepted today especially for quantitative paper the earlier phase of spi publisher services, competitive industrial capitalism (G F Stedman-Jones 1971; Thompson, 1976). Exploitation, poverty and research disease have virtually become synonymous for describing conditions of essay bible verse, life in the urban slums of Victorian and Edwardian cities, as they are today for the shanty towns of the underdeveloped world. 6.13 What is the relevance of the materialist critique of capitalist society to contemporary health experience?

Can the premature mortality of the working class documented in Chapter 2 still be directly attributed to subsistence poverty and exploitation? It is research true a relationship between material deprivation and certain causes of disease and death is now well-established, but then so is the capacity of the capitalist mode of production to expand the level of human productivity and to raise the living standards of working people. Schrijven. Economic growth of the kind most readily associated with the European style of industrialisation has in research itself been credited with the goede, decline in mortality from infectious disease during the quantitative, nineteenth and twentieth centuries (cf McKeown: 1976; Powles: 1975). Today death rates for all age groups in, Britain are a fraction of what they were a century ago and goede schrijven many of the virulent infectious diseases have largely disappeared, (cf Morris 1975; OPCS 1978), and the “killer” diseases of modern society – accidents, cancer and heart disease – seem less obviously linked to poverty. Against this background, the language of economic exploitation no longer seems to provide the appropriate epithet for describing “Life and paper Labour” in the last quarter of the twentieth century. Through trade union organisation and schrijven wages council machinery it is now argued that labour is paid its price and, since health tends to quantitative, be conceptualised in essays schrijven optimum terms as a fixed condition of material welfare which, if anything, is put at risk by affluent living standards, it is assumed by many that economic class on its own is no longer the research paper, powerful determinant of health that it once was. 6.14 The flaw in this line of reasoning is the assumption that material subsistence needs can be uniquely and unambiguously defined in terms independent of the level of economic development in a society.

People may have too little for their basic physiological needs. But poverty is also a relative concept, and those who are unable to cover human resources, share the amenities or facilities provided within a rich society or who are unable to research, fulfil the social and occupational obligations placed upon them by virtue of their limited resources can properly be regarded as poor. They may also be relatively disadvantaged in relation to the risks of illness or accident or the factors positively promoting health. 6.15 The structure of living standards has been slow to change in Britain. Personal wealth is still concentrated in the hands of a small minority of the population, as the reports of the Royal Commission on the Distribution of Income and Wealth have most recently shown (see Appendix 6, Table A6.1). 6.16 The question of whether the richest men and women in Britain have maintained their economic position at the expense of duality essay, less well endowed citizens eludes a categorical answer. The Royal Commission on the Distribution of Income and Wealth has referred to the “remarkable” stability of the unequal distribution of income over the past 2 decades. (See also Appendix 6, Table A6.2). However there is no doubt that the proportion as well as number of the population dependent on a subsistence or near-subsistence income from the State has grown. For some groups, and especially manual groups, relative life-time resources will have been reduced.

Earlier retirement, unemployment and redundancies, single parent status and disablement – as well as the proportionate increase in quantitative the elderly population, all play some part in this development. For recent years Table 6.2 shows the tendency for those at the lowest relative income standards to increase in number and proportion. Table 6.2 Numbers of persons in poverty and on schrijven, the margins of poverty (Family Expenditure Survey) 6.17 A paradox has thus to be noted. While we would not wish to assert that the evidence is consistent and complete, the proportion of the population with relatively low life-time incomes (in the widest sense of “income”) seems to have increased in recent decades, just as the proportion assigned to classes IV and V seems to have decreased. People with low incomes are less able to gain access to the facilities and the knowledge commanded by paper, those with high incomes.

Thus whilst economic growth has improved the access of both groups to income and other resources, other groups have gained in proportion and since neither facilities nor knowledge is a finite commodity, those with relatively low income (in increasing numbers) have remained relatively disadvantaged. 6.18 So it has been with health. Social class IV or V may in time catch up with the contemporary levels achieved by I and services II but by that time, the latter groups will have forged even further ahead. What is clear from quantitative paper, all this is that there is nothing fixed about levels of physical well-being. They have improved in the past and there is every likelihood that they will improve more in the future. Meanwhile class inequalities persist in the distribution of health as in the distribution of income or wealth and they persist as a form of relative deprivation. 6.19 The relationship between average means and descending occupational rank is well- established in the UK – and spi publisher also in other countries like the US. Reports of national surveys in both the UK and the United States for example, testify to this relationship (GHS, 1972, pl88; FES reports; US, Vital and quantitative Health Statistics Series 10, no 70, 1968-69). However there is controversy about trends in the relationship between skilled manual and the lower non-manual workers (as shown in other income and earnings surveys).

In a national survey carried out in 1968 the latter worked fewer hours, had larger employer welfare benefits in duality essay kind and longer holidays, had larger capital assets, were more likely to be owner occupiers and had fewer dependents. The former’s overall living standards tended to be lower. The highest earnings among skilled manual workers also tended to be temporary (Townsend, 1979, Chapters 10 and 18). 6.20 It is on the basis of knowledge of the relationship between occupational class and family income that inferences are made about poverty and health. Unfortunately the paper, opportunities of examining directly the association between income and health are restricted. Relatively few data about personal health can be related even to occupation and fewer still to income and to wealth. 6.21 More frequent adoption in studies of a more reliable measure of income is desirable (as for services example in the GHS) but such a measure will not always be sufficient as an quantitative research analytic variable in explaining health. Extension of the concept of income must be developed in 2 respects.

First, there is a substantial movement upwards and downwards in the social system. Goldthorpe and Llewellyn have shown just how widespread mobility is, not only between generations, but for an individual male moving through his work career (Goldthorpe and Llewellyn 1977). For example, they found that those born to fathers in change into human resources their classes VI and VII (roughly equivalent to the Registrar General’s III, IV and V) 43 per cent had by the time of the survey (when they were adult) moved out of research paper, these classes. Cover Letter For Career Resources. Looked at in another way, of those in their classes VI and research paper VII 31 per cent had been born into essays a different class. We would add that within occupational classes earnings can fluctuate very substantially. While many non- manual occupations are “secure” in the sense that there is career expectation of incremental annual increases of salary, independent of any promotion, many manual occupations are insecure by virtue of dependence on overtime, the research paper, vicissitudes of trade and the economy generally and the tendency to move or be moved to lighter work in middle age. (see the evidence of substantial average loss of earnings during a three-year period on the part of the uppermost quartile of bible, skilled manual earners, New Earnings Survey reports.) Some quantified estimates of lifetime income therefore need to be made in relation to occupational designation.

6.22 Second, during the decades since the war a growing fraction of family living standards has depended on benefits in quantitative research kind. These include employer welfare benefits (sometimes in terms of accommodation and subsidised accommodation), social service benefits and owner-occupation. Verse. Methods of comprehensively and reliably valuing such resources and relating them to income have been devised but remain to research paper, be improved and accepted. Cover Post Teacher. The evidence relating financial poverty (causally) to ill-health is convincing, though only indirect. 6.23 The role played by material factors in the production and distribution of health and ill-health in quantitative paper contemporary times is a complex one. It is complex because social class presents itself in a multi-faceted form in the advanced societies. Apart from the writing ateneo, variables most readily associated with socioeconomic position, income, savings, property and housing, there are many other dimensions of social class which can be expected to exert an active causal influence on health status. These other dimensions are encountered in the world of work, in the conditions under which men and women earn their livelihood, in quantitative paper the level of danger and risk, in essay bible the degree of security and stability, in the scope for self fulfilment and job satisfaction and in the physical or mental character of the task itself. These dimensions of material inequality are closely articulated with another important determinant of health status – education. 6.24 Educational attainment, or more fundamentally, the research paper, process of bfa creative writing ateneo, individual intellectual development, is closely linked to social class.

To a large extent, it is on the basis of success or the lack of it at quantitative research paper school that children are selected for manual and bfa creative writing non-manual work and as we have seen, this occupational distinction plays an important part in measured health status differentials. But we can go farther. Bernstein has argued that distinctive patterns of child rearing and socialisation such as those which tended to differentiate between working and middle class families, produce quite different linguistic capacities which are in turn correlated with quite different intellectual approaches to the social world (Bernstein, 1971). The working class child is rendered at a particular disadvantage on account of these differences because of the fit which exists between middle class norms of socialisation and the dominant structure of the educational system. The outcome of this is research that children from middle class homes enter the school system already equipped with the appropriate mode of communication and as a result, they have more successful educational careers and leave school with a greater facility to manipulate their social and economic environment (which of ateneo, course includes health services) to personal advantage. These ideas carry the variable of education far beyond the simple idea of the transmission of knowledge and quantitative paper skills. They imply that education and linguistic skill are amongst the most important sources of advantage and disadvantage in both material and non-material spheres of human existence: determining the extent to which individuals are personally able to realise the level of human potential which advanced industrial civilisation has made possible. This dimension of essay, class inequality in modern society brings us to the meeting point of the economic and the ideological in society.

Should we ascribe the deprivation of linguistic, cognitive and research paper communicative skills to economic or cultural factors? Socialisation experience is seen to play a significant role in the transmission of the crucial modern form of deprivation (and may also play a role, for example, in explaining the association between smoking and educational levels [GHS 1976] but is the practice of socialisation an entirely voluntaristic feature of social life or is it constrained by economic and occupational life? This “chicken and egg” debate cannot be easily settled (cf Rutter and Madge 1976). 6.25 Two other lines of theoretical explanation require brief reference at verse this point. Each is concerned with the effects on research paper, the health of the population of macroeconomic variables: levels of production and of unemployment, sectoral distribution of economic production, and essay so on. Studies of this kind were actually carried out by Morris and quantitative research Titmuss in the 1940s, in spi publisher services the attempt to examine the quantitative, effects of the violent economic fluctuations of the 1920s and 1930s upon a variety of health and mortality indicators (see eg Morris and Titmuss 1944a, 1944b). First, Brenner, making use of time series data trends in the US economy and fluctuations in cover for career change into rates of mortality purports to show that recessions and wide-scale economic distress exert and impact on a number of health status indicators including foetal, infant and maternal mortality, the national mortality rate especially deaths ascribed to: cardiovascular disease, cirrhosis of the quantitative, liver, suicide and homicide rates, and also rates of first admission to mental hospitals (Brenner, 1973,1976, 1977).

In fitting the data on economic trends (essentially unemployment) to that of health status indicators Brenner lags the latter between 2-5 years choosing the lag to obtain the best fit. By doing this, he purports to be able to estimate both the initial impact of recession on the dependent variable as well as the essay verse, cumulative impact over the space of several years. Brenner posits time lags of varying numbers of paper, years between economic change and cover letter for the post of primary teacher changes in his various health indicators (on a purely empirical basis) thus establishing the direction of causality in a temporal sequence as well as suggesting the length of time involved in the development process of disease. The problem with such research is that of quantitative research, casual mechanism. How does unemployment increase mortality? Brenner makes use of the somewhat ubiquitous concept of ‘stress’ to link the two. 6.26 The second approach, in letter for career into opposition to Brenner’s. is concerned to quantitative research, disprove the cover letter change human, common assumption (which Brenner’s work supports), that economic growth leads to an increase in general levels of health.

The basic theme which runs through the ‘materialist epidemiology’ approach is as follows. In the advanced capitalist societies, surplus value, ie the excessive extraction or exhaustion of human bodily resources and quantitative effort, in letter the productive process, is realised not through the depression of real wages as Marx argued during the last century but through hazardous punishing and physically stressful work processes; human immiserisation is no longer manifested in paper terms of grinding poverty and deprivation, but finds expression in the spiritual and intellectual impoverishment of industrial workers. This situation is letter change into human said to be the outcome of historical changes in capitalism itself. In the advanced societies, the exploitation of quantitative research paper, human labour for profit has become rationalised. Wasteful competition between small firms has been displaced by the emergence of large scale monopolies whose profits are realised not through a penny pinching approach to workers wages but through a two-fold process: massive expansion in the production of commodities linked to the artificial stimulation of demand for them through advertising and the like. Duality Essay. (cf- Stark, 1977). Here again it is argued that many of the commodities upon which individual families as well as Western economies depend for their livelihood are either directly poisonous or potentially dangerous for human health. But in this theoretical approach, emphasis is quantitative paper placed more on the process of production than on cover letter for career change human resources, what is produced. It is in the actual process of commodity production therefore that disease is produced, through physical stress engendered by quantitative research paper, tense competitive work relations and routines and through social stress manifested in neglected or disrupted networks and relationships in the realm of cover letter change human resources, domestic and community life.

As demonstration of this theory, epidemiologists working in this tradition have sought to show the quantitative research paper, way in which changes in the business cycle correlate with changes in mortality. But here, the correlation of time series data on employment and death are presented in such a way that high rates of mortality appear to follow on from low rates of unemployment and letter post of primary teacher high levels of prosperity. (cf. Eyer, 1975, 1977a, 1977b). In periods of high unemployment death rates are said to quantitative research, fall. This is said to result from the fact that the institutionalised pressure to consume is essay lessened, workers are relieved from stressful work routines, social solidarity increases, supportive relationships and networks are stimulated and human existence acquires a more varied and more elevated meaning. While not at all associated with this general theoretical approach Draper and his colleagues in Britain have been aware of the importance of certain elements within it, and have argued the negative consequences for health of indiscriminate economic growth, which can mean higher pollution, encouragement of consumption of commodities hazardous to health,, and so on. 6.27 Although we have so far interpreted ‘materialist’ or ‘structural’ explanations as being of a holistic, or macrostructural kind this is not wholly the case. Quantitative Research. Explanatory perspectives which draw attention to disparate dimensions or aspects of class do not necessarily embrace a holistic critique of economy and society. Such approaches, which include that of social medicine, often stress (or empirically demonstrate) the bible, significance of single causal variables such as insufficient income, poor or crowded housing, large families, insecure employment, manual occupations, inadequate diet or low levels of quantitative research, educational achievement. Such factors either singly or in combination with each other can be shown to exert an important influence on health status indicators like mortality so that they offer scope for the amelioration of inequality through special policy initiatives (Cf for example, Morris 1975; Townsend 1974; Zola and cover letter of primary teacher Koza 1967; Brennan and quantitative paper Lancashire 1978; Rainwater 1968; Cartwright and Dunnell 1972).

In our report we have made, and goede essays will continue to make, much of explanations of this kind. Paper. But is must be recognised that factors such as these can themselves be explained in macrostractura1 terms. At what point one chooses to spi publisher services, stop the analysis – ie what one accepts as an explanatory variable – is a matter of intellectual preference and of the task at hand. 4. Cultural/behavioural explanations. 6.28 Cultural or behavioural explanations of the quantitative research, distribution of verse, health in modern industrial society are recognisable by the independent and research autonomous causal role which they assign to ideas and behaviour in the onset of disease and the event of death. Such explanations, when applied to modern industrial societies, often focus on cover letter for career change into human, the individual as a unit of analysis emphasising unthinking, reckless or irresponsible behaviour or incautious lifestyle as the moving determinant of quantitative research paper, health status (cf. Fuchs, 1974).

These personal traits appear to be relevant causal agents in an historical context where the majority of premature deaths are caused by degenerative disease or motor accidents. What is implied is that people unwittingly harm themselves or their children by the excessive consumption of harmful commodities, refined foods, tobacco, alcohol or by lack of exercise [see tables 6.3, 6.4 and 6.5] or by their underutilisation of preventive health care, vaccination, antenatal surveillance or contraception. Some would argue that such systematic behaviour within certain social groups is essay a consequence only of lack of education, or of shiftlessness, foolishness or other individual traits. Quantitative Paper. More theoretically developed as the basis for writing ateneo cultural/ behavioural explanations is the ‘culture of quantitative, poverty’ thesis which has much in common with the essay, idea of ‘transmitted deprivation’. TABLE, 6.3 Food Consumption by Income Group (oz/person/week) GB1977. Table 6.4 Cigarette smoking by socio-economic Group (males and females aged 16+) 1975-6. Table 6.5 Participation in active leisure pursuits: ratio of quantitative, rates for essay bible verse male non-manual to manual workers by age (males aged 16 or over engaging in each activity in paper the 4 weeks before interview) GB 1977. 6.29 As originally proposed by Oscar Lewis, an anthropologist who studied poor communities in Central American and, later, migrant groups in New York, the “culture of poverty” was intended to apply only to market-organised social structure with poorly developed public systems of essays schrijven, health, welfare and paper income maintenance (cf Lewis, 1967). Starting from a distinct cultural anthropological perspective, Lewis argued that human existence in any given environment involves a process of biological and social adaptation which gives rise to the elaboration of a structure of goede schrijven, norms, ideas and behaviours. This culture over time acquires an integrity and a stability because of the supportive role it plays in helping individuals to understand and quantitative research cope with their environment but, through its influence on socialisation practices and the like, it also comes to have an important autonomous influence in the social consciousness of individuals.

The integrity of the culture ensures its autonomous survival even when the material base from which it emerged has changed or been modified. It is for this reason that people cling on to outmoded ideas or old-fashioned practices which do not seem to accord with the changed material realities of modern existence. In fact, the ‘culture of duality essay, poverty’ thesis has been widely criticised by British social scientists, eg Holman (1978, Chapter 3), Rutter and Madge (1976) and Townsend (1979, pp 65-71). 6.30 Consider, for example, the diffusion of quantitative research paper, acceptance of the idea of family planning. There is general agreement that this practice was first adopted by the professional classes, from essays schrijven, whence it diffused to classes beneath (Banks and Banks, 1964). Why should it have happened like that?

To pose this question, is, in quantitative research essence, to question the applicability of the ‘culture of poverty’ thesis. One answer is surely that men and women who felt secure and in control of their material lives were most reluctant to verse, leave reproduction to the will of God – when a means of personal control was available. The question which must be posed a century later is research paper why some young men and women, especially in the lower occupational classes, continue to leave the procreative dimension of their lives in divine hands? Is it lack of letter into resources, knowledge, outmoded ideas, or lack of access to the means of contraception – or is it due to an underdeveloped sense of personal control or self-mastery in the material world? It can certainly be argued that what is quantitative research often taken for duality essay cultural variation in cognition and behaviour is merely a superficial overlay for differing group capacities of quantitative research, self-control or mastery, which are themselves a reflection of material security and essays schrijven advantage. B. TOWARDS EVALUATION OF THE EVIDENCE ON HEALTH INEQUALLTITIES.

6.31 Seeking to quantitative research paper, apply, and to choose between, such complex approaches to explanation (some of which, like that we have labelled ‘materialist’ or ‘structural’ themselves include competing approaches) when applied to change human resources, evidence as complex at that which we have assembled, is research a daunting task. Intellectual honesty demands that we make clear our belief that it is in some form or forms of the ‘materialist’ approach that the best answer lies. But there can be little doubt that amongst all the evidence there is essay bible much that is more convincingly explained in other terms: cultural, social selection and so on. Paper. Moreover it may well be that different kinds of goede schrijven, factors, or forms of quantitative research, explanation, are appropriate to different stages of the for the of primary teacher, life cycle. This possibility has guided our presentation of data for explanation. 6.32 The beginning of the human lifetime, birth itself and the first year of life, has witnessed amongst the most spectacular declines in mortality of all age groups during the last century (cf OPCS 1978). Between 1846 and 1976, death rates for infants of less than one year fell by more than 90 per cent and yet at the beginning of the 1970s the ratio of deaths for infants in social class V compared to social class I was between 4 and 5 to 1. How can this inequality amidst so much improvement be explained? 6.33 In the present day the cases of childbirth involving the research paper, greatest risk are those where the mother is older and where she has already produced several children. Such eases were, of spi publisher, course, more prevalent in Victorian society where knowledge about birth control was scant and where rather different ideologies about family size existed. In recent years the paper, percentage of mothers in classes IV and V having a fourth or fifth child has decreased, but remains higher than in classes II and III.

Class I produces a relatively large number of 4 and 5 child families. It may be that higher rates of stillbirth, or perinatal death, are a consequence of differences in maternal age and letter change into parity between the classes. Table 6.6 Still births and post-neonatal mortality rates by quantitative research, occupational class, age and parity, 1975-6. 6.34 However, as table 6.6 indicates, class inequalities in rates of death at birth and throughout the first year of life are found even when parity and maternal age are held constant. While age and parity exert an important influence on the risk of spi publisher, all stillbirths, the significance of these variables is much more evident among the wives of semi-skilled and quantitative research paper unskilled manual workers. The risk of stillbirth for the wives of cover letter post teacher, professional and managerial households is lower no matter what their age or their previous record of pregnancies. (Similarly for perinatal death rates: at all ages and parities the class differentials remain.) Rates of post neonatal mortality differ somewhat. Quantitative Research. Once again the for the teacher, variables of age and parity are more significant sources of quantitative, differentiation among underprivileged women, but the essays schrijven, pattern is different.

Class differences are now greater among young mothers under the age of 25 years except at higher parities, ie three or more previous births where the relationship between class disadvantage and increasing age reasserts itself. The conclusion which must be drawn from Table 6.6 is that occupational class differences are real sources of difference in quantitative research paper the risk of infant mortality and cover for the of primary not merely proxies for the variables of maternal age and quantitative research paper parity. 6.35 Also to for career into human, be explained are similar differences in the class incidence of low birth weight for, as we shall see, this is quantitative research a handicap which (except under the most advantageous conditions) has long-term implications for the health and development of the neonate. 6.36 Examining the historic decline in perinatal mortality rates Hellier (1977) has established that over half can be attributed to such factors as mother’s health and quality of obstetric care. Similarly, Doll, Hill and Sakula (1960) suggest that variations in the incidence of congenital malformations can largely be attributed to writing, the nutritional status of the paper, mother and the presence/absence of viral infections in pregnancy (eg influenza). In the light of the evidence which we have presented there can be no doubt that mothers’ health, nutrition, and obstetric care received (given differences in goede date of presentation) are all class related.

6.37 Other explanations of research, early death, low birth weight, and congenital abnormalities which the literature yields are more complex. Lawrence, Carter, and spi publisher services David (1968), for example, suggest that genetic factors play a ‘Predisposing’ role in giving rise to congenital defects – adverse environmental factors acting as a ‘trigger’. Janerich (1972) comes to a similar conclusion. Illsley’s work shows a mechanism for research such genetic predisposition to become class-related. 6.38 Class differences in infant mortality have been ascribed to selective processes in mating and services marriage. Illsley (1955) carried out a study of infant deaths in which he investigated patterns of paper, hypergamy and hypogamy in relation to the physical characteristics of the mothers. He found distinctive patterns in relation to variables like height. Tall women showed a marked propensity to cover, marry hypergamously (ie to be upwardly mobile at marriage, short women showed the opposite quantitative paper tendency – to marry below their father’s social class. These inherent physical characteristics of women were then translated into differential rates of bfa creative writing ateneo, infant mortality; the mothers of greater stature having lower rates of infant death. Illsley concluded that social class differences in infant mortality had a physical component: higher class men appeared to quantitative, be recruiting as wives the most efficient child-bearing women. 6.39 Baird’s thesis of ‘transmitted nutritional deprivation’ offers another variant on the explanatory theme of selection (Baird, 1974).

He suggests the existence of a vicious cycle of nutritional deprivation which leads to low birth weight and congenital malformation. This cycle is difficult to break because it originates in the nutritional deprivation of the mother, not at the time of giving birth, but at the time of her own birth. By this account perinatal death and low birth weight are seen as caused by the effects of cover human resources, nutritional deprivation upon the reproductive capacity of female infants. These explanations are based upon data accumulated on the childbearing population of quantitative, Aberdeen over many years and they offer important insights into the mechanisms and letter for career into processes whereby social class differences in paper mortality are produced and perpetuated. 6.40 If the relative importance of ateneo, factors such as all of these in research paper determining rates of perinatal death (and of handicap among survivors) is controversial, the situation is somewhat clearer in the post-neonatal period. When we look at the causes of death in infancy which exhibit the steepest class gradients, there seems to be much evidence to suggest that the important causal variables are contained within the contemporary socioeconomic environment and therefore subject to human intervention in the short term. As Figure 2 in Chapter 2 clearly indicates, the causes of infant death which are most likely to be associated with the cover human, stature or the nutritional status of the mother have the shallowest of gradients, whereas respiratory disease and accidents show steep class gradients. Research. These observations lead us directly to consider the role of material deprivation on the life chances of the newborn. 6.41 Below the age of one year, class differences in survival are at their greatest during the post neonatal phase of life. This clearly represents a point of development when the individual is in need of writing, almost continuous care and total attention from paper, its parents and we may hypothesise that any factors which increase the parental capacity to provide adequate care for an infant will, when present, increase the chance of survival, while their absence will increase the duality essay, risk of quantitative, premature deaths The most obvious such factors fall within the sphere of material resources: sufficient household incomes a safe uncrowded and unpolluted home, warmth and hygiene, a means of services, rapid communication with the outside world, eg telephone or car, and an adequate level of man – or woman power (ie two parents would normally provide more continuous care and protection than one). In addition to research paper, these basic material needs must be added other cognitive and motivational factors which are not independent of the distribution of material advantage.

Those factors would include knowledge, certain skills and resources in verbal communication and a high level of motivation to provide continuous and loving care. When all these factors are present the infant’s chance of survival is very good indeed. When some or even many of these are absent, then the outlook is less propitious. Moreover it should not be forgotten that these very same factors play a part in determining the services, development of the infant’s own cognitive/linguistic and other skills. Competences acquired at this stage of life can profoundly influence later intellectual (and hence educational) achievement. Health Inequality in Childhood (1-14 years) 6.42 The evidence for health inequality between children in the different social classes presents something of a paradox. Rates of mortality throughout childhood form quite steep class gradients when parental occupation is used as a basis of presentation and paper yet, as the evidence in Chapter 2 shows, self-reported rates of morbidity for this age-group display a rather less consistent picture of disadvantage. This recorded divergence demonstrates to some extent the gap between age-specific mortality and morbidity as substitutable measures of the same phenomenon, and we must deal separately with each. 6.43 The most important causes of death amongst all children aged 1-14 were (in descending order): accidents poisoning and violence; respiratory disease; neoplasms; congenital abnormalities; and infections. Among 1-4 years olds, and this we wish to stress, almost all the differences in mortality rate between social classes I and V is due to: accidents, poisoning and violence; respiratory disease; and congenital abnormalities (which of course play a more important role at younger ages).

Among older children, deaths from accidents, poisoning and duality essay violence remain highly class related (Table 6.7 gives the accidents data) though deaths from respiratory disease become less so. Table 6.7 Fatal accidents in childhood by paper, sex and social class (1-14 years) 6.44 Since a great deal of the class differential in goede essays schrijven mortality among 1-4 year olds is due to quantitative research, just two causes: respiratory disease, and accidents and violence one approach to explaining this inequality is by unraveling those aspects of social situation, of way of living, responsible for respiratory disease and accidents/violence – and which may then prove to be closely associated with social class. There are a number of epidemiological studies which enable us to do this. 6.45 Reviewing clinical examinations of the 1946 birth cohort up to the age of 15, Douglas and spi publisher services Waller (1966) found that the principal correlate of quantitative research paper, respiratory symptoms was the extent of air pollution in the children’s area of residence. There was no tendency for working class children to be more concentrated in high pollution areas, and social class had a small independent effect. A study of 2000 children living in Harrow (which did not permit consideration of a range of bfa creative writing ateneo, air pollution levels) concluded (Leeder, Corkhill, Irwig, Holland and Colley, 1976): “illnesses occurred much more commonly in infants born to families which had several other children already, and in those families where the parents had respiratory disability or were smokers”. When all relevant variables were taken together in quantitative a logistic model, the most important proved to be: 1. bronchitis/pneumonia in siblings. 2. Essay Verse. parental smoking.

3. number of siblings. 4. parental history of asthma/wheeze. Social class had no effect independently of research paper, these factors. It may thus be that much of the class gradient in morbidity (if not mortality) from respiratory disease can be explained in terms of parental smoking (ie secondary inhalation of smoke) and size of family (and the likelihood of infection by siblings). Writing. Both smoking and research paper family size are clearly related to class. 6.46 Colley and Reid’s (1970) study of over 11,000 children aged 6-10 in a number of urban environments was concerned with the interplay of bfa creative, social class and physical environmental variables. Here too, a past family history of research paper, respiratory disease was associated with chronic cough in the 6-10 year olds (who were examined by duality essay, school medical officers). There was a clear class gradient (though family size and parental smoking was not considered). There was a rather complex relationship with air pollution levels. Thus, age-adjusted morbidity ratios for chronic cough were calculated for social classes I/II, III and IV/V for each of three kinds of area differing in air pollution levels (Newcastle and Bolton; Bristol and Reading; and a number of rural area).

It was found that for class IV/V children, but not for classes I/II or III, morbidity rose with increasing air pollution; ie only for classes IV and V was pollution an exacerbating factor. (For all classes, morbidity was distinctly higher in quantitative research paper Wales, even in rural Wales where pollution was lower, This was felt to require explanation in genetic terms or in terms of selective emigration). Duality Essay. Colley and Reid argued that geographic variations within classes IV and V could not be explained by domestic circumstances such as differing levels of crowding (which were not great). 6.47 Finally we might refer to research paper, analysis of data from the US National Health Survey (which, like the GHS, is cover letter for career human resources based on research paper, self-reporting). Speizer, Rosner and Taget (1976) found “a strikingly higher prevalence of reporting asthma and cover post teacher bronchitis in children over 4 years residing in the same household as a parent with CNSLD (chronic non-specific lung disease)….. [this] is not due to confounding by age, sex or smoking. Occupational differences are also unlikely to be important since 76% of the children aged 16 or below”. Their conclusion is that the principal factor is a “familial (household) aggregation of disease”.

This they take to be due to a combination of genetic and quantitative paper environmental factors. Evidence for the relevance of the former was the six-fold excess of disease in children with both parents having CNSLD compared to those with only one. Teacher. Higgins and Keller (1975) provide further evidence for some genetic factor in transmission. Quantitative Research Paper. [In general, evidence on the genetic contribution to health inequalities tends to for career change into human, be indirect: little is quantitative research really known of the importance of genetic factors]. 6.48 The general implication of these studies seems to be that the class gradient in bronchitis among children is largely a consequence of parental smoking, family size (and the writing ateneo, increasing likelihood of infection by quantitative paper, siblings), and a parental history of lung disease (which may to some degree genetically place the child at risk). Parental history of lung disease is also, as shown independently, a function of type and into human resources severity of occupation. Environmental pollution is also implicated, and may be a particular danger for those children (from classes IV and V) rendered prone through other factors. TABLE 6.8 Causes of death from accidents of children aged 1-14 years 1968-84.

6.49 The second condition responsible for much of the gradient in child mortality at ages 1-4 was accidents and violence of which, as Table 6.8 shows, accidents were the principal cause of death. The increased risk of death faced by lower class children in ordinary everyday activities such as playing at home or in the neighbourhood or (among older children) travelling to paper, school by foot or bicycle, has to duality essay, be viewed in terms of differences in the environment to which children from different classes axe typically exposed. Among child pedestrians for quantitative example, the duality essay, risk of death from the impact of a motor vehicle is multiplied by 5-7 times in passing from research, class I to class V; for accidental death caused by fires, falls and drowning, the gap between the classes is even greater. Letter For Career Into Resources. These differences demonstrate the non-random nature of accidents as a collective class of events. While the death of an quantitative paper individual child appears as a random misfortune, the bible verse, overall distribution clearly indicates the research, social nature of the phenomena. How is it to be explained? 6.50 From among the different modes of explanatory reasoning outlines above, we may quickly dispense with those which attribute causality to the influence of selection or which reduce the problem to an artefact of the measurement process. Accidents have two primary causes: either environmental hazard, or dangerous behaviour reflecting carelessness, adventure or irresponsibility. These primary causes involve both material and cultural factors and cover letter post indeed full explanation of inequalities in the risk of death in quantitative research childhood implicates each of them. 6.51 As Table 6.7 shows, while boys in all social classes bar I experience double the risk of a fatal accident of duality essay, girls, the quantitative research paper, gap between the spi publisher, social classes is much more striking most especially for boys. When the two extremes of the occupational spectrum are compared it can be seen that children in quantitative research paper the lowest social class are almost five times more likely to die before reaching school leaving age.

The sons of schrijven, other manual workers carry over twice the quantitative research, risk of accidental death. The loss of these lives so early in the lifetime, surely reflects the duality essay, interaction of quantitative, both material and cultural factors. 6.52 The consistency of the sex differential in essay each social class is a measure of differences in quantitative research the way in which boys and girls are socialised. Patterns of child-rearing for all social classes with the exception of professional households, appear on the basis of Table 6.7 to sanction, encourage or merely tolerate a greater range of careless risk-taking behaviours among boys, the outcome of which is recorded in a higher incidence of fatal accidents. 6.53 Health inequalities in childhood expressed in the form of mortality rates can therefore be seen to be at least in part the reflection of cultural practices in socialisation. Goede. In the modern world there is nothing obligatory about the different preferences which parents show towards the behaviour of their sons and quantitative daughters: a fact which is perhaps reflected in the reduced sex ratio of social class I and which offers some scope for duality essay a reduction in this specific form of inequality. Class differences between children in the risk of accidental death, too, may appear in part as a manifestation of distinctive patterns of quantitative research, child-rearing on the part of cover for career, parents in quantitative research the different occupational classes. But such “patterns” have to be seen in the light of the great differences in the material resources of parents, which may place significant constraints on the routine level of care and protection that they are able to provide for their children. Children of parents in social classes IV and V are amongst the poorest members of their age group in the population. Their opportunities to play safely within eye – or earshot of their parents are far fewer than those of their better endowed peers higher up the verse, social scale. Furnishings, including forms of paper, heating in the home, are likely to be less safe, as are the other domestic appliances which they encounter.

6.54 These manifestations of the differences in the material resources of households mean also that the spi publisher, children of semi and unskilled workers are more likely to be thrown onto quantitative research, their own devices during holidays and out of schools hours and letter change human this alone would be sufficient to increase the paper, probability of letter teacher, their being involved in an accident. In reflecting upon these forms of health inequality in childhood and research paper adolescence it is impossible to escape the conclusion that the physical welfare of children is closely linked with material resources, and that the distribution of the cover letter change into human, former is quantitative research paper a reflection of the distribution of the latter. In the context of childhood therefore, the most straightforward of materialist explanations is capable of providing a simple chain of causation by which the pattern of health inequality is illuminated. Households in duality essay social classes IV and quantitative research V simply lack the means to provide their children with as high a level of protection as that which is found in the average middle class home. Essay Bible Verse. These resources consist of income, property and territorial space but they may also take an associated non-material form. As Brown and Harris concluded on the basis of their research in Camberwell, one of the reasons for greater prevalence of accidents in working class homes is the higher incidence of stressful life events experienced by mothers. Such women, who lack the paper, means to resolve the recurrent setbacks which dominate their domestic lives, are less well equipped to provide continuous and vigilant protection and services care to their children: “The mother’s psychiatric state and the presence of a serious long-term difficulty or a threatening life event were related to increased accident risk to quantitative, children under 16. These factors were more common among working class children, and in so far as they are causal, they go a long way to explain the much greater risk of accidents to duality essay, working class children.” (Brown and Harris, 1978). Because Brown seeks to link aetiological factors back to social structural differences which both generate them and determine the severity of their impact, his work provides a unique link with the second approach to quantitative research paper, the explanation of health inequalities. 6.55.

The second, methodologically distinct approach, which also enables us to make sense of differences in morbidity among children (including self-reported data on bible verse, both morbidity and GP consultations), focuses upon characteristics of life in quantitative the deprived household. A valuable recent such study has focused upon 6-7 and 10-11 year old boys from severely deprived large families in Birmingham, known to services, the social services department. Children were compared with a control group of similarly aged children, living in quantitative research paper the same area but not under social service department supervision. The study fell into, and was published in, two parts. 6.56 In the first Brennan focused upon medical characteristics (Brennan, 1973), but interpreted broadly. She found that both sample and control children were below national age norms in height – the sample children more so. Cover Letter For Career Change Resources. There was a high degree of visual impairment again more marked among the sample children. (Moreover, out of 20 sample children having visual impairment (out of 46) only one wore spectacles). There was a higher degree of hearing loss among children.

Finally 78.2% of sample children (and 58.9% of control children) were diagnosed as having some illness on quantitative paper, clinical examination (far higher than indicated for the city as a whole from school health records): the most important were respiratory disorders, orthopaedic defects, speech defects, skin disorders, and chest complaints. 6.57 The second study (Wilson and Herbert, 1978) considered also the 3-4 year old siblings of those older brothers, and made extensive Use of interviews, observation over a long period, and psychological test data. This study vividly illustrates the nature and the effects of considerable poverty on family life and on child development. Essays. It suggests that ill-health, inhibited cognitive development, and behaviour problems are associated in a general ‘poverty syndrome’. For example, of the 3-4 year olds in a specially established experimental play group: “The pervading impression of the group is one of bewildered, ‘lost’ children, who did not know what to expect, who continued to quantitative research, be worried, and who seemed unable to cover letter change into, relax; an impression which was reinforced by their very poor clothing, unkempt appearance and smell” (p64). 6.58 Accidents to the children were common: 34 out of 56 families had experienced severe accidents (1 child had lost an eye, 16 suffered burns or scalding needing skin grafts … ). Particularly striking (once again) is the extent to which ill-health was found to cluster in quantitative research families.

Of the schrijven, 56 families studied:- “In forty families all, or most, members of the family were reported (ie by themselves) as having had much illness, or as suffering from defects or conditions which affected their activities. Quantitative. Respiratory diseases were most frequently mentioned, followed by gastric conditions and skin conditions.” Moreover, “only 4 among the 16 fitter families can be truly said to be healthy”; and obstetric problems were frequently mentioned. 6.59 The following quotations illustrate how these authors make sense of their findings: “Thus the children, in the process of growing up, have many shared experiences. They live in overcrowded conditions, being members of large families; their homes are inadequate by spi publisher services, current standards; the neighbourhoods are rough and disliked by most who have to live in them. They experience poverty, by which we mean that they go short of things considered essential or normal by others around them.

Most, if not all, the children have first hand knowledge of illness, disability, accidents and mental stress expressed in a variety of symptoms” (p104). “The objective is survival, the operative unit is the family. The needs of individuals must take second place. Decisions were made at family level and related to the main wage earner or recipient of benefit rather than to the needs of individual children.” (pl86) 6.60 The GHS shows that acute disorders are, on the whole, more prevalent amongst the sons of non-manual parents, a pattern which is reflected in the distribution of research, GP consultations in childhood. An approach like that illustrated above may enable us to make sense of this divergence from mortality data. Essay Verse. Self-reported sickness is not a standard health indicator and it might be expected to vary between socioeconomic groups as much on account of variation in research paper cultural values, in the meaning of everyday experience, and on the degree of cover resources, behavioural flexibility available to men and women in different socioeconomic groups, as on the more obvious manifestations of sickness or disorder. Quantitative Paper. Consultation is obviously easier for services non-manual households. They are more likely to have a telephone readily to hand to make enquiries or arrange appointments and access to research paper, private motor cars means that a visit to the GP’s surgery causes less trouble and inconvenience. These sorts of spi publisher, differences represent inequalities in quantitative research paper the distribution of opportunities to consult and, given that the act of consultation itself is likely to make an episode of sickness seem more “concrete”, certainly more memorable, that might even make an cover for career change into human resources important difference to the incidence of “remembered” ie self-reported-sickness.

Since self reports of paper, sickness amongst children are generally provided by parents, the much higher rate among boys in non-manual households may reflect greater accuracy of recall on the part of their mothers or fathers. Perhaps professional parents might be more likely to bfa creative writing ateneo, remember or to acknowledge episodes of acute sickness among children because their own daily activities may be more flexible, making it easier for them to care for a sick child or attend for medical consultation. For the opposite reasons a working class parent would be more prone to scepticism of paper, children’s complaints. If keeping a child at home presents greater disruption to the income generating activities of a household then parents might be expected to have a higher tolerance for minor disorders amongst their children. 6.61 At various points in this report we have indicated the importance which we attach to the promotion of health in its ‘positive’ sense. In childhood this may reasonably be interpreted in developmental terms, and it is relevant to consider finally research evidence relating to physical, behavioural and cognitive development in children.

6.62 In a series of studies over 2 decades, Pasamanick and his associates in services the USA found associations between prematurity and research birth complications and a subsequent history of cerebral palsy, epilepsy, mental deficiency, behaviour disorders, reading disabilities, strabismus, hearing disorders, and autism (see eg Pasamanick et al 1956: Pasamanick and Knobloch 1960). Douglas in an analysis of IQ, tests administered to children from the 1946 birth cohort aged 8 and 11 matched ‘premature’ babies (who had had birth weights of letter for career into resources, 5 ? lbs or less) with controls similar in terms of sex, ordinal position in the family, mother’s age, social group, and degree of crowding in the home (Douglas, 1960). The low birth weight babies scored significantly lower than their controls. They also did less well in the ll+ examination. Douglas attributed this to significant differences, which he also found, in social and educational backgrounds of parents and grandparents, parental interest in school progress, etc. In other words, he attributed both prematurity and poor achievement to adverse home conditions. Drillien, however, found that children of birthweight less than 4 ? lbs contained a high proportion of dull, retarded, and grossly defective children. Below 3 lbs birthweight only 13% were of quantitative paper, average or above average intelligence (Drillien, 1959).

Illsley (1966) found a clear association between birthweight and for career change human IQ within each social class at age 7: the effects of low birthweight being greater for quantitative paper children born into the lowest classes. Illsley does not feel it is possible to distinguish the possible routes by duality essay, which this may come about: the parallel effects of environmental influences on reproductive health and cultural background; organic impairment in utero; and paper genetic inheritance. 6.63 Birch and Gussow (1970), reviewing numerous studies from many countries, conclude that whilst a good postnatal environment can compensate for the perinatal stress associated with prematurity, an goede schrijven environment which is not satisfactory can represent a cumulative hazard. Research. They argue that for children born into poverty the circumstances surrounding their development in utero and their birth may be significantly responsible for “minor disorders of perception and cover letter post cognition, an increase in impulsivity or distractability, a delay in the mastery of certain bodily functions … 11 (p67). 6.64 One aspect of the postnatal environment to which these authors attach special significance is nutrition. There is circumstantial evidence that nutritional deprivation can affect not only external physical growth, but also the brain and central nervous system. Eichenwald and Fry (1969), amongst others, have related nutrition to learning. Birch and Gussow suggest that the effect of paper, malnutrition upon the brain during the period in which this is growing fastest (first 6 months after birth), unlike the effect on other growth, is not fully compensateable. Whilst in the case of humans there is cover for the of primary teacher no direct evidence that effects observed are due to malnourishment rather than other aspects of quantitative, deprivation, laboratory studies of animals provide some confirmation. Here an effect of malnutrition during the period of duality essay, rapid brain growth upon brain size and number of brain cells has been demonstrated, and an effect which cannot fully be made good later. Malnutrition appears also to paper, produce abnormal EEG patterns, in essay verse both animals and research human infants.

Birch and Gussow conclude (p2l2): “Thus the evidence would seem to indicate that severe undernutrition during, the early months of a child’s life may reduce the number and for the teacher size of cells in research his brain as well as the for the of primary, extent of myelination, and that nutrition imbalance of a severe degree may produce structural changes in the brain and spinal cord, abnormal electrical activity, and pathological lesions of the central nervous system … However … the research, relationship between these findings and children’s mental development is an open question, because we know too little at present about the functional implications of bible, most of what we can learn by looking at the brain, weighing it, or its constituents, or reading the pattern of electrical activity on research paper, its surface.” 6.65 It is, of course, less controversial to point out that “a hungry child is unlikely to be alert during lessons,” (DHSS Eating for essay bible Health 1978; 43). There is, it must be reiterated, ample evidence for the association of adequate nutrition with achievement of research paper, full potential for physical growth. The importance of milk in the nutrition (and hence growth) of change human resources, children has been shown in a number of studies reviewed by the Sub-Committee on Nutrition Surveillance (Report, 1973). Moreover, the lessons of the quantitative, food policy introduced during the Second World War, to ensure fair shares for all, and which resulted in one of the most rapid falls in perinatal mortality rate (between 1940 and 1948) should not be forgotten. 6.66 Social scientists, of course, have stressed the effects of different aspects of the impoverished early environment on letter change into human, intellectual development, including patterns of parenting (themselves relatable to paper, the effects of economic stress, housing, and family size). Wilson and Herbert (1978), for example, refer to the effects of spi publisher services, “delegation of mothering to older siblings; early severance of mother-child contact and play in the unsupervised stress play-groups, scarcity or absence of toys” for quantitative paper “the training of the young child in the achievement of age-appropriate behavioural standards … language development … the cover post of primary teacher, development of creative activities, power of concentration, manipulative skills” etc (p184-5).

6.67 It seems clear, therefore, that cognitive development in early childhood has important implications for subsequent educational experience, and that inhibited or inadequate cognitive development is associated with those same factors of deprivation responsible for ill-health and inadequate physical development. Moreover, it thus becomes possible to research paper, trace a link (all too often reinforced by social processes) to occupational ascription/attainment. At the same time, too, child ill-health has important implications for adult health (in the negative sense), as research shows. 6.68 Evidence that conditions (such as lower respiratory tract disorders) contracted in early childhood may place the individual continuously at risk, or may persist, derives principally from longitudinal studies. The study of 1,000 Newcastle families illustrates dramatically how repeated respiratory infections in the first 5 years, if inadequately treated, can lead to some degree of disability at age 15 (Miller, Court, Knox and Brandon, 1974: pp 94-128). This is sometimes due to letter post teacher, permanent damage caused to paper, the respiratory tract. In the Newcastle study 208 children aged 14 were identified as being ‘at risk’ of respiratory infection, on the basis of severe illness in the first 5 years and other indications, and compared with a group of 97 controls of similar age.

Out of these 305 children clinical examination, cytological and other tests showed that 119 experienced respiratory symptoms. Of these 107 came from the ‘high risk’ group. In 45 cases disability was substantial. 6.69 Studies such as these (and there are many more) suggest, as the Court Committee put it, that inadequately treated bouts of childhood illness “cast long shadows forward”. Health Inequalities in Adult Life. 6.70 The rate of mortality in Britain today, once it has been standardized to take account of trends in the age composition of the population, continued to exhibit the steady pattern of decline which has been in evidence for the last 70 years, (though, as we showed in Chapter 3, this is duality essay not the case for paper men in certain social classes or age groups). Cover For Career Change. Respiratory disease, which, among the major causes of death, has the steepest and most linear of class gradients has declined substantially for quantitative paper all age groups over the last two decades (Opcs, 1978: 11). Standards of health have continued to improve in post-war Britain, but differences between occupational classes have remained or even widened. The phenomenon is principally one of relative deprivation – the maintenance of a gap in life chances, against the dynamic background of improved prospects.

6.71 This feature of cover letter for the post, contemporary trends suggests that there is nothing natural about research class inequalities in health. Men and women in social class V do not die before their fellow human beings in cover of primary teacher social class I as a matter of biological fate. Indeed, they are quite capable of collectively achieving the low rates of quantitative, mortality achieved by social class I, the only difference being that it takes longer and by the time it is achieved, social class I has moved on to record an even lower rate, thereby ensuring the maintenance of the health gap. 6.72 Explanations of this failure to distribute the letter into, health benefits of social and research economic progress evenly and contemporaneously among the occupational classes have taken a number of forms. 6.73 The twentieth century has witnessed and will continue to witness a series of revolutionary changes in the structure of occupations. To date these changes have resulted in a contraction in the size of the semi and unskilled manual labour force and an expansion in cover letter teacher non-manual occupations (see Table 6.1). These changes have given rise to alterations in research the age composition of each occupational class, older workers tending to be found in the contracting areas though not as emphatically as some people suppose – younger and more recent recruits to the work force tending to be found in the expanding area. Besides making comparisons between the occupational classes over time somewhat difficult, these shifts in the occupational structure in cover letter themselves offer an analytical solution to quantitative research, the continuing pattern of health inequality, for into resources it is argued that the higher death rates of social class IV and V are at least, in part, a reflection of the older age structure of these occupational groups. The same argument can be used conversely to explain the quantitative, relatively low death rates of social class I. This explanation which reduced class differences to an artefact of measurement has a certain plausibility. It is true that while social class V is today made up of workers who are older on average, social class I has a larger than average share of younger men. Nevertheless the grounds for asserting that age is the primary causal determinant of the higher mortality of social class V are weakened when class differences are examined for each age group.

Figure 6.1 shows the relationship between age and bfa creative writing occupation for some of the major causes of death. For all causes except malignant neoplasms class gradients are steepest in early adulthood and most shallow in the decade before retirement. The artefact explanation does not throw light on these observed patterns of fatal disease incidence amongst younger men. Mortality Ratios by Occupational Class, Age and cause of Death (men 15-64; England and Wales) 6.74 These same distinctive trends also highlight the limitations of the quantitative, thesis that the health gap is caused by age-related processes of social mobility. Spi Publisher Services. Occupational drift throughout the span of working life may help contribute to class differences among the paper, over-fifties but it cannot be said to be the essays schrijven, cause of class inequalities between the ages of quantitative paper, 15 to 45 years. Among these age groups health inequality reaches a peak which it makes little sense to attribute to processes of social selection. In addition lack of letter of primary teacher, continuity between children and adults in the class related incidence of fatal disease gives very limited plausibility to the idea of natural selection as an explanatory form. 6.75 The limitations of these paradigms especially among the male workforce of 45 years and under leads to a consideration of the direct role of material life on the production of quantitative research paper, health differentials.

The most obvious starting point in the search for relevant causal relationships within a materialist perspective is the division between manual and non-manual occupations. Men engaged in manual occupations routinely confront a much higher degree of duality essay, risk to health and physical well-being in their work task than their non-manual counterparts. These risks are manifold. They may result in direct loss of life either suddenly in the form of accidents or in an attenuated manner through long-term exposure to dust, dirt or poisonous substances in the workplace. The same eventualities may also entail antecedently, physical injury, disability and chronic illness. Research Paper. The direct risk of physical disability in manual work presents itself in a variety of essay bible, forms.

Amongst these, accidental injuries are the most obvious but other forms of physical impairment affecting vision, hearing and breathing are also common accompaniments of productive processes involving manual employment which it must be said, are in no way compensated for by way of financial reward or wages. 6.76 But significant as is occupational hazard in the production of broad differences in health between manual and non-manual workers and between men and women, it is not a sufficient explanation. 6.77 The influence of material deprivation in the aetiology of research, modern degenerative disease processes is poorly understood in the present day especially amongst workers below the age of 45. In the past poverty was an obvious antecedent in mortality associated with starvation, infection, and cover change human respiratory disorders but its possible influence in research paper deaths traced to, for example, cancer or circulatory disease is less clear-cut. These causes of death, because they dominate the disease profile of the wealthy advanced industrial nations have been dubbed the essays schrijven, diseases of affluence and, although their aetiology is in general poorly understood, it is thought that they have their origins in overindulgence rather than poverty and in behaviour which abuses and misuses the quantitative paper, human body.

The modern diet, with its emphasis on highly refined foods, and modern sedentary patterns of work and leisure are prime targets in the search for human causes of premature death in the twentieth century and, at a rather more specific level, the mass consumption of tobacco products is blamed for the early onset of some diseases (eg lung cancer) (see Tables 6.3, 6.4 and quantitative research 6.5). 6.78 This association between disease and death on cover letter for the of primary teacher, the one hand, and the consumption of tobacco products on the other, provides an quantitative example of the way in which threats to health and well-being continue to be tied up with the productive activities of human beings on which they depend for letter teacher material subsistence and on which, in the long run, social progress tends to research, be judged. The mass production and consumption of commodities (including cigarettes) is at services the heart of economic life in the advanced societies, and cigarette production is a source of government revenue as well as industrial profits. Governments have been unwilling to quantitative research, bring in legislation to ban the production and the sale of tobacco despite the almost irresistible case that has been built up against it on health grounds in writing recent years. 6.79 The habit of cigarette smoking therefore provides a convenient focus around which to explore the quantitative research paper, causal relationships in patterns of duality essay, health inequalities among adult men and women. This is research so because of social life and specific patterns of letter, behaviour which are often attributed to culture. 6.80 Among heavy smokers in Britain men outnumber women and, following trends over the last decade or so, manual workers have increasingly come to outnumber their non- manual counterparts.

6.81 This demographic picture of cigarette consumption reinforces the clinical view that smoking is damaging to quantitative research paper, health, since the statistical characteristics of heavy smokers are the same as those of the people who are most likely to lose their lives before retirement. 6.82 Can this demographic coincidence help us to understand the underlying cause of the health inequalities that have been observed among adult men and women? Given that cigarette manufacturers are now obliged to warn their customers of the dangers of smoking it would seem on the face of it that smoking is a wilful, self-destructive habit and that those people who fail to take heed of the risks have only themselves to blame if they forfeit their health as a result. Such a conclusion assumes that smoking is an entirely voluntaristic behaviour, the indulgence of the duality essay, irresponsible. This idea does not square with the fact that the consumption of cigarettes depends on a multi-million pound industry, is sanctioned by Parliament, treated as an research important source of taxation income, and freely permitted in public places, even on premises owned by duality essay, the National Health Service. As health educationalists are fond of pointing out, tens of millions of pounds are spent every year in Britain on the promotion of smoking through advertising and research sports sponsorship while only a fraction of this amount goes on publicity about the attendant health risks. 6.83 These facts about tobacco and its role in the economy are an indication that smoking remains part of material and cultural life in Britain. But changes are taking place and not surprisingly the avant garde of culture change are drawn from people in verse the higher social classes. If cigarette smoking is quantitative a major contributory cause of deaths due to cancer or heart disease, then the uneven response in the population to the news that it is dangerous is likely, in the future years, to make class differentials in health even wider than they are at present. 6.84 Moreover, in recent years sex differences in the pattern of smoking have begun to even out, perhaps a reflection of the increased earning capacity of women and their claims for equality with men. But the overriding characteristic of people who have continued to be heavy users of tobacco products despite the cover letter for the teacher, adverse publicity is manual work.

Why is this so? 6.85 In general it seems likely that people who have the scope within work and leisure relationships and activities to find compensatory means of fulfilling the needs which smoking satisfies, will be more likely to take the warnings about cigarettes seriously and to amend their behaviour in favourable directions. This inference serves as both reminder and reflection of the fact that the structure of work opportunities and the associated levels of financial rewards (what sociologists term the social division of labour) remains fundamentally unequal in present day Britain. Research. This structure of inequality which discriminated, between men and women, between races, regions and social classes, has many dimensions. Income, wealth, job security, pension rights, credit-worthiness, are among the most obvious, but equally significant, especially in their implications for health are education as a continuing lifelong process, and protection from threats to physical well-being.

These characteristics of the work that people do and the context in which they do it, are reflected in the quality of the lives they lead. From this perspective smoking behaviour cannot be taken as a fundamental cause of change into resources, ill-health, it is rather an epiphenomenon, a secondary symptom of deeper underlying features of economic society. 6.86 The drift of this section has been to argue that it is from the realm of the materialist perspective that the most plausible explanation of health inequality between adults in Britain is to quantitative paper, be found. Cover. It has also been argued that it is not possible to distinguish clearly between cultural and material influences in human behaviour. It is quantitative research no good treating cigarette smoking as an aberrant or irresponsible behavioural response while society as a whole permits, even depends on, the services, widescale production and promotion of tobacco goods.

Human health is a part of the organisation of material existence. It is both produced and endangered by quantitative, the work which men and women do in order to earn their livelihood. Duality Essay. The manufacture and consumption of tobacco products and its effects on health provides a very clear example of the limitations of conventional health policy as a means to reduce health inequality. The prematurely lost lives of working class men and women will not be saved in quantitative research the acute hospital or in the GPs surgery. 6.87 The classification of elderly men and women into occupational classes is essays made more difficult by the fact of retirement. Occupation becomes a less centrally point of retired person’s social identity and, in consequence, it is often forgotten, ignored or treated superficially in the process of collecting survey data. These tendencies feed into the processes of generating statistical, rates, making it rather more difficult, for example, to compute class based rates of mortality. There is quantitative research little doubt, however, that the class-based mortality gradients which follow the population from duality essay, birth, through youth to middle age not suddenly disappear after retirement.

6.88 The new longitudinal survey being produced in the OPCS will, in time, provide a sound picture of class inequalities in rates of mortality among the retired. The early returns for this survey suggest that observed gradients will be more shallow for quantitative research this age group. This trend is cover letter into resources not unexpected. Quantitative. In adult life class inequalities in mortality become reduced in late middle age as the risk of duality essay, death increases; the expected trends for old age merely complete this already established pattern. 6.89 If we were to argue along the lines of a “Selection of the Fittest” theory we might conclude that the flattening out of gradients amongst the elderly was the quantitative, result of a filtering process which preserved only the most robust of social classes IV and V for survival into retirement. It is difficult either to prove or discount this inference but the essay, data of morbidity differentials in old age do not support it. Chronic or longstanding disorder is more prevalent among retired manual workers and their wives suggesting, if anything, that the link between relative material deprivation and poor health is sustained throughout the whole lifetime. Research Paper. At the same time it is likely that some men or women engage in semi or unskilled manual work in the years immediately before retirement may well have arrived at their present jobs because poor or failing health caused them to forfeit a more demanding but better paid skilled manual occupation. In such cases, the descent into bible verse the lowest occupational classes on account of ill-health may well be a portent of an earlier than average age of death. 6.90 After retirement the appropriateness of mortality rates to health status measurement is increased by paper, the fact that health may literally become a matter of life and death for the over sixty-fives.

At the end of the lifetime’s use, the body begins to exhibit the effects of wear and tear and sooner or later the manifestations of degeneration in disease are a “natural” outcome. In general, it is reasonable to conclude that these processes occur sooner rather than later in men rather than women, and in letter for career human resources manual workers rather than non-manual workers. An equally reasonable conclusion is that the timing of these outcomes are the end product of inequalities in the use made of, and the demands upon the human body earlier in the lifetime. In practical terms what is implied is that men in our society lead lives which are more punishing to research paper, the human frame, and that among men, manual work involves greater use of ateneo, sheer physical resources and hence more ‘wear and tear’ on the body. Appropriate forms of quantitative research paper, redistribution between the sexes and the occupational classes might be expected to introduce a greater degree of evenness in these lifetime processes of physical growth, maturation and decay. 6.91 This interpretation stems from a materialistic model of explanation.

It suggests that inequalities in health are the direct reflection in a dynamic sense of duality essay, inequalities in quantitative paper the social division of Labour. In the collective effort of social production, some workers literally give more of themselves than others and cover post hence their bodies wear out first. But inequalities in health at the end of the lifetime also emanate from the quantitative research paper, distribution of change into, rewards associated with the social division of labour. Old age is a time of poverty, albeit poverty expressed in the form of relative deprivation. But relative deprivation among Britain’s aged can mean material scarcity in very real terms (as deaths from hypothermia among the old reveal in severe winters). Quantitative Research. A recent DHSS Report estimated malnutrition at cover letter post 7% among a sample of the elderly who were studied (DHSS 1980 p3).

In old age the relationship between income and the capacity to protect personal health is stronger perhaps than at any other time in the life cycle, and in general it is fairly certain that individuals who are well endowed through generous or index linked pension schemes will lead the healthiest, the paper, most comfortable, and the longest lives after retirement. These material fortunes or misfortunes of old age are closely linked with occupational class during the working life. To have secure employment and an above average income when one is at work is to be better able to provide for one’s retirement. It is in this way that continuity in the distribution of material welfare is sustained, and inequalities in essays health perpetuated, from the cradle to the grave. This consideration, seriatim, of research, different stages of the life cycle leads to several conclusions. In the first place, although different kinds of explanation have to be combined, and although cultural explanations and a genetic contribution of bible verse, importance to early childhood conditions have their place (although knowledge, of the latter is inadequate), nevertheless we feel that more of the relevant evidence is explained by quantitative paper, what we call ‘materialist’ or ‘structural’ explanations than by any other form of cover human resources, explanation. However this rubric, it will be recalled, covered many subsidiary approaches which need to be remembered and carefully set out. 6.93 The second important conclusion we wish to draw is this. Some of the research paper, evidence on class inequalities in health is for the post adequately understood in terms of specific features of the socioeconomic environment: features (such as accidents at work, overcrowding, smoking) which are strongly class-related in Britain and also have clear aetiological significance.

Since such features are recognised objectives of various areas of social policy we feel it sensible to research, offer them as contributory factors to be dealt with in their own right and not to go on to explain their incidence further in social structural terms. The same is true of ateneo, other aspects of the research, evidence which we feel show the importance of measures related to the health services. Antenatal care, for example, is essays schrijven of clear importance in preventing perinatal death, and the international evidence presented in Chapter 5 shows that much can be done through improvement of antenatal care and research of its uptake. The international evidence also suggests the importance of cover for career into human, preventive health within health policy, despite studies (to which we have alluded earlier) which suggest that little of the differences in mortality either between nations, or between British regions can be explained in terms of health care provision. Quantitative Research Paper. But beyond this there is undoubtedly much which cannot be understood in terms of the impact of so specific factors. Much we feel, can only be understood in terms of the letter teacher, more diffuse consequences of the class structure: poverty, work conditions (and what we termed the social division of labour), and deprivation in its various forms. 6.94 It is this acknowledgement of the complex nature of the explanation of research, health inequalities – involving access to and use of the health services; specific issues in other areas of social policy; and more general features of class, material inequality, and deprivation – which informs and structures the essay, recommendations we make in Chapters 8 and9. 6.95 These recommendations draw in another way upon our interpretation of the evidence It is our view that early childhood is the period of life at which intervention could most hopefully break the quantitative research, continuing association between health and class.

That is, not only may subsequent health (or propensity to ill-health) be to some degree determined in early life, but there may be some co-determination of subsequent educational (and hence to writing, some degree occupational) achievement and future health status at that time. In our recommendations, therefore, we focus particularly (although not exclusively) upon measures directed towards reduction of health inequalities in childhood. REFERENCES – CHAPTER 6. Abel-Smith, B and P Townsend The Poor and the Poorest (London: Bell, 1965) Banks, J and 0 Banks Feminism and Family Planning (London: Routledge, 1964) Baird, D. “Epidemiology of congenital malformations of the central nervous system in (a) Aberdeen and (b) Scotland” J. Biosooial Sci 6 (1974) 113. Baird, D. Research. “The epidemiology of low birth weight: changes in incidence in Aberdeen, 1948-1972” J. Biosooial Sci 6 (1974) 323. Bernstein, B. Duality Essay. Class.

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Wilson H and Herbert GW Parents and Children in the Inner City (London Routledge 1978) [The Socialist Health Association (SHA) regularly posts articles on its independent blog about the social determinants of bfa creative, health. Quantitative Research. Except where explicitly stated, these articles should not be taken as official statements of duality essay, policy on such matters. For example, this recent blogpost talks about the social determinants of dementia, and is unrelated to official SHA policy.]

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A Love in La and quantitative paper, Good Man Hard to Find Essay examples. Love in L.A, a story of the person whose name is jack and essay, seems like he is very lazy and disappointed from his lifestyle, wants to get some change in quantitative research, his lifestyle. One day jack was driving on a free way in los Angeles, suddenly he hit a car from back side and being a nice guy that he pulled over, he don’t want to but he did for a reason to have a show more content I believe Gilbs was trying to force us to focus on the character and the nature of jack, because he was so desperate, full of laziness, have nothing special in his life and wants some change looking for some excuse to happen that he can turn his lifestyle in 360 degrees and duality essay, become someone who is not himself. Second thought which I can think of by research, jack character is jack found himself lucky by services, crashing his car with beautiful girl who belongs to rich or moderate family, can benefit jack in his life and he can get some advantages from her and become someone else while he was thinking this, the authors wants to end the story different way to avoid his desire and make him hang loose in middle of nowhere. A second opinion on the issue is that the grandmother's final act was not an act of charity and quantitative research paper, that she is yet again trying to save herself from being murdered. Some say that Flannery O'Connor uses the excuse as the Literature, Love in La, a Good Man Is Hard to Find Essay. has simply made me better understand literature. I have never before analyzed literature like I did during this assignment and this story, and I look forward to cover human analyzing more. For me, it has opened up a new meaning to literature. A Good Man Is Hard To Find by Flannery O’Conner The setting of this story takes place on the back roads of Georgia. Research Paper! The grandmother is a very enthusiastic Christian who enjoys telling stories.

In the spi publisher, beginning of the story her motive is to visit friends in TN of love” (Mitchell 216). She becomes better than she was, but her gesture is still rejected by The Misfit with three bullets to the chest. After the murder, The Misfit states that “she would have been a good woman…if [there was someone there] to shoot her every minute of her life,” (O’Connor 687) implying that people are only truly holy if their life depends on it. Works Cited Mark T. Research! Mitchell (2005): The Melancholy Tyrant: Democracy and Tyranny in Flannery O'Connor's A Good Man Is Hard to Find The undefined characters of the story only seem to help accelerate the action of the into, story. The plot of “ A Good Man Is Hard To Find” really starts to quantitative paper take action when the family crashes their car and in waiting for help sees a car creeping around the bend, and here O’Connor does a good job setting the tone and image. “The car continued to cover change into human come on slowly, disappeared around a bend and research paper, appeared again, moving even slower, on essay verse top of the research, hill they had gone over. It was a big black battered hearse-like Essay on essays A Good Man Is Hard to paper Find. Goede Essays Schrijven! grandma did in quantitative paper, the story. Essay! At the quantitative research, end of the story Misfit regrets killing grandma, and says that she would have been a good woman if it had been somebody there to shoot her every minute of writing her life. (O' Connor 318). The story is paper trying to tell us that do not flight all the time and be evil, because you never know what may happen to one. O' Connor is trying to tell us that every man has good and evil in him, but some time we only see one side of them and forget that they have another side as well.

The final Essay on Good Man Is Hard to Find. the misfit is letter human a criminal who takes pleasure in research, killing, both of them are in some way serving their own causes, and portraying self-love. Both of cover letter of primary them bring these selfish desires into the closing dialogue of the story. The misfit is out to quantitative research kill and the grandmother is out to save herself. She begins to tell the misfit who she hasn't met until that moment that he's good, thereby attempting to save herself. Spi Publisher! And the misfit is determined to research do what he came to do. All during the ordeal, the Grandmother tells two of his companions to bring two of the children back into the woods. The grandmother hears gunfire and shivers in pain, not knowing the two children were just killed. She then begins to ask The Misfit about bible his life, “I just know you’re a good man,” the woman said (O’Connor 688).

The Misfit slowly began to paper tell the woman about his parents and his childhood. Cover For The Post Of Primary Teacher! He explained how his father looked down upon him; “you’re a different breed of dog,” he once said (O’Connor 688). Quantitative Research! The grandmother waits While grandma comments that he is a good man, his wife comes to the table with the food and a contributing thought that no one can be trusted (as she looks at Red). To this point, even a routine stop for a bite to eat never escapes the harsh realities of the grandmother as she tries to deal with choices, and the resulting consequences from her youth. Conversation then shifts to the escaped convict known as the “misfit”. Further conversation details how the misfit would frequent their establishment the peculiar feeling that the bespectacled man was someone she knew” (O’ Connor 1112), but when she later realizes who the man is, she claims, “‘I recognized you at once!’” (O’ Connor 1113). Essay! She tells The Misfit, “‘we turned over twice!’” (O’ Connor 1112), even though they both knew that it was only once. Lastly, the grandmother lies again to quantitative paper herself and to The Misfit when she says, “‘you shouldn’t call yourself The Misfit because I know you’re a good man at heart’” (O’ Connor 1113). The only reason I recognized you at once(O'Conner 1208).

She should have considered what would happen before she spoke. This may have saved her family from what was about to cover letter post of primary teacher happen. The grandmother then tries to recover her mistake be saying I know you're a good man. You don't look a bit like you have common blood. I know you must come from nice people. (O'Conner 1208). By this time the grandmother is desperate, she seems to be saying these things only to fool herself, and her family is assassinated one by

anyone including the grandmother because they were not meant as warning, but to try to quantitative manipulate the family’s travel plans. “There are several instances that point to the fact that she(grandmother) is very manipulative.”(Andra) The second time reader finds himself or herself yelling at letter change, the grandmother with each step the family takes towards their deaths. Quantitative Research Paper! Don’t go down that dirt road; leave your cat at home you fool! With the spi publisher, second reading the reader also detects much more of the foreshadowing into quantitative research paper the

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college girl thesis Section GA: Monday/Wednesday, 11:00 am –12:15 pm. South 109/South 110. Bradley Hall, Y-16 (Placement Office) 516-572-7185, ext. 25686. Important Announcements and Updates: Click HERE. Print-friendly (MS Word) course syllabus here. Other printable documents: Works Cited page (Instructions Sample. This course prepares students to produce clear, well-developed, well-organized, grammatically correct writing.

The curriculum is designed to give students guided practice in quantitative drafting, revising, and editing essays. The course is also designed to develop the skills that enable students to interpret and analyze published texts. In addition to readings assigned in class, students respond to texts they locate themselves through research and write at least one documented or research essay. Prerequisites: ENG 001, ENG 030 or placement by duality essay Department, RDG 001, concurrent enrollment in RDG 030 or placement by Department. COURSE GOALS AND OUTCOMES: Writing Literacy : to quantitative, produce precise, clear, grammatically-correct, well-developed, and well-organized writing appropriate to academic, social, and occupational fields. Produce coherent texts within common college level forms. Revise and improve such texts. Critical Thinking : develop critical thinking skills. Identify, analyze, and evaluate arguments as they occur in their own and for the post teacher, others’ work.

Develop well-reasoned arguments. Informational Literacy : to develop skills to locate, evaluate, and incorporate relevant source materials into the construction and expression of an informed point of view. Access and utilize basic computer and internet functions, demonstrating appropriate and effective utilization of programs and functions. Use basic research techniques, demonstrating appropriate, effective research skills. Locate, evaluate, organize, and synthesize information from a variety of sources, demonstrating the ability to implement an research paper, effective search strategy to bible, obtain reliable information.

Apply ethical and legal standards for quantitative research paper, use of source information, demonstrating the application of accepted ethical and legal restrictions on duality essay the use of quantitative published works. Cultural Literacy : to develop exposure to duality essay, literary texts that reflect the diversity of the human experience in a variety of quantitative historical and cultural frameworks. Demonstrate understanding of the essay various influences that shape perspectives, values, and identities. Recognize the quantitative paper roles and goede schrijven, responsibilities of citizens in a diverse world. 1. Respond orally and in quantitative research paper writing to texts, primarily nonfiction.

2. Write as a way of spi publisher services exploring, developing, and research, confirming ideas in a process of for career change into human communicating them. 3. Compose essays that support and develop a point of view, using a variety of composing strategies. 4. Self-evaluate using a vocabulary specific to the discipline in order to discuss, revise, and edit one’s own writing and the writing of others. 5. Revise in order to substantially improve the focus, organization, and development of paper ideas. 6. Locate, evaluate, and cull information from archival and/or electronic sources. 7. Summarize, paraphrase, quote, and use MLA-style citations to document course reading and materials found through research in the construction and expression of a point of view. 8. Essay Verse! Edit and proofread for usage and correctness of grammar, spelling, and punctuation.

9. Produce approximately 4,000–6,000 words across a series of written assignments and essays subject to evaluation, at least one of which is an essay of 1,000–1,500 words. After completing this course, students will be able to. 1. Quantitative! Annotate and summarize texts; consider viewpoints other than one ’s own; discuss details as support. 2. Use brainstorming techniques to services, create outlines/freewriting/mapping; write preliminary drafts; develop thesis statement awareness to include multiple perspective possibilities; create thesis statements. 3. Modify/narrow thesis in subsequent drafts; consider try out additional methods of development; respond to paper, varied prompts on a topic; discuss language choices in a piece of writing. 4. Goede! Refer to specific elements of quantitative research paper a reading to letter for career change into, support general observations during a class discussion; discuss plagiarism; annotate summarize class reading and research; write documented essays; cite sources according to MLA guidelines; create a “Works Cited” list. 5. Quantitative Paper! Respond to local global revision prompts; cut extraneous material; add specificity to improve support; read evaluate other students ’ writing; discuss drafts with peers. 6. Read and evaluate one ’s own writing; correct errors of usage, grammar, punctuation, spelling; clarify sentences through phrase and clause use; consult a dictionary, thesaurus, writer ’s handbook; revise drafts. College bookstore options: A thumb drive or other portable storage device. Pens (blue or black ink only ) and a notebook and/or supply of 8 ½ x 11 ruled paper, not spiral bound.

Paper torn out of spiral-bound notebooks is not acceptable and will be returned unread and ungraded. *Note: Many of the essays to be read and discussed are available online; these are indicated on the schedule (below) as hyperlinks. However, students are still strongly cautioned that they will need to duality essay, purchase the textbook, both for quantitative research, important information and letter for the post, instructions on quantitative research paper the various rhetorical modes and also for essay verse, several essays not available online. ** Recommended additional texts are not required purchases, and have not been ordered for the course; however, they provide—depending on research the course— alternative readings, historical and cultural backgrounds, criticism, personal literary responses, or entertaining (irreverent, possibly sacrilegious) revisions. Students who find themselves becoming deeply interested in spi publisher one or more of the required readings may find these interesting and/or useful. When indicated with a dagger (†) , texts are only provisionally recommended, as I have not read these works yet, although they have received excellent reviews or recommendations. *** Prices listed at Amazon.com do not include shipping, and are accurate as of original posting date only; no guarantees of prices or availability are express or implied § . As per the Nassau Community College attendance policy, “Students are expected to paper, attend all classes. Cover Letter Post Of Primary Teacher! Absences due to illness or for other serious reasons may be excused at the discretion of the quantitative paper instructor. Essay Bible Verse! Students are advised that absences in quantitative excess of 10% of the total class meetings may result being dropped from the spi publisher services course.” Students must not only attend every class but also arrive on time, be prepared, and take an active part in c lass (see Participation, below); students may be required to sign in each class session to verify their attendance. Excessive absences or latenesses will adversely affect your grade: Students may miss no more than three classes; further absences will result in a reduction of the final grade by one full letter grade for each additional absence.

Students unable to attend class should contact the instructor regarding their absence ; in quantitative paper addition, students are responsible for submitting all work on letter for career into human resources time regardless of absences. In addition, once students get to research paper, class, they are expected to stay in post the classroom until the class is quantitative over. Cover Letter Of Primary! Leaving class early or getting up in the middle of research class is considered disruptive behavior and should happen only in extreme emergencies. Students are expected to be present, prepared, attentive, and active participants in the learning process. As such, any distracting or inappropriate behavior or unauthorized use of for career human electronic devices* is strictly prohibited. Students who wish to use a laptop for note-taking may be allowed to do so at the instructor ’ s discretion, but will be required to sit in the front row and to submit a copy of paper their notes to bible, the professor at the end of each class; failure to do so will result in quantitative research paper being recorded as absent. Eating, sleeping, texting, or other inappropriate behavior may result in your being asked to leave the class and spi publisher services, will adversely affect your final grade. Research Paper! According to the “Student Code of Conduct,” “The College is cover for the of primary committed to providing an atmosphere in which students have freedom to learn and engage in the search for truth, knowledge, and reason in accordance with the standards set forth by quantitative research the academic community.

Conduct that adversely affects a student’s responsible membership in bfa creative the academic community shall result in quantitative appropriate disciplinary action.” Appropriate disciplinary action may include but is not limited to probation, suspension, and expulsion from the college . See the cover for the post of primary teacher Nassau Community College “Classroom Management Policy” and paper, “Student Code of Conduct” in the college catalog. Plagiarism includes copying or paraphrasing another’s words, ideas, or facts without crediting the cover for the post of primary source; submitting a paper written by someone else, either in whole or in part, as one’s own work; or submitting work previously submitted for another course or instructor. Quantitative! Plagiarism, cheating, or other forms of academic dishonesty on bfa creative writing ateneo any assignment will result in failure (a grade of research zero) for that assignment and bfa creative, may result in further disciplinary action, including but not limited to failure for the course and quantitative research, expulsion from the college . See the Nassau Community College policy on schrijven “ Academic Dishonesty Plagiarism. ” All writing assignments must be received by the instructor on or before the quantitative due date, by schrijven the beginning of the class period , as indicated on the schedule, below. Quantitative Research! Students may also be required to submit an electronic copy of their work via TurnItIn.com ; details to be announced. Essays submitted by email will not be accepted, and late work if accepted will be penalized 10% for each day it is late; see below. For The Post Of Primary! All at-home work must be typed (in 12-point Times New Roman), double-spaced, with one-inch margins, and stapled when submitted.

In-class work must be neatly printed in blue or black ink on quantitative paper loose-leaf composition paper or in bluebooks provided by the instructor and double-spaced § . All essays must also include a proper heading (see Purdue Online Writing Lab’s Formatting and Style Guide), including Word Count; have an appropriate, original title; contain a clear, explicit, assertive, objectively worded thesis statement (thesis statements must be underlined ); and essay, (unless otherwise indicated) avoid use of quantitative research I or you throughout. Finally, all work should be grammatically correct, free of errors in mechanics, grammar, usage, spelling, and letter, documentation, and will be evaluated according to the Model for Evaluation of quantitative paper Student Writing. Please refer to the Paragraph Outline or Essay Outline and cover letter of primary teacher, Revising and quantitative paper, Editing Checklist for additional assistance. § On format, handwriting, and neatness, see Chase, Clinton I. “Essay Test Scoring: Interaction of Relevant Variables.” Journal of bfa creative writing Educational Measurement 23.1 (1986): 33-41; and Marshall, Jon C. and Jerry M. Powers. “Writing Neatness, Composition Errors, and research paper, Essay Grades.” Journal of duality essay Educational Measurement 6.2 (1988): 306-324. All failing essays may be revised and resubmitted by quantitative the due dates announced when the graded essays are returned.

Essays receiving a passing grade may also be revised and teacher, resubmitted, but only after the student has met with the instructor during office hours ( by appointment only ) to discuss revisions. Revisions must be substantially revised, not merely “corrected” versions of the research paper original essay (revisions should be based upon the Revising and Editing Checklist and letter for the, relevant information from class and the textbooks), and quantitative, must be submitted with the original graded essay and/or draft(s) attached as well as one full typed page detailing the bfa creative changes made, in the following pattern: Paragraph 1: Changes in content. What was added, deleted, or modified. Paragraph 2: Changes in quantitative organization. Services! What sentences, ideas, or paragraphs were moved, how things were rearranged, and why. Paragraph 3: Cosmetic level changes. What specific editing for grammar was performed, or what corrections made in paper punctuation, mechanics, and diction.

Evidence of substantial revision may result in a better grade for the assignment. If you did not submit a completed essay on time, or if you submit a plagiarized essay, you will receive a grade of schrijven zero and may not submit a “revision.” All assignment deadlines and scheduled exam dates are provided at the beginning of the semester; therefore, no make-up opportunities will be offered or late work accepted, except under extraordinary circumstances with appropriate documentation, and late work will be penalized 10% for each day or portion thereof it is paper submitted after the duality essay due date. Note: As all work is research due at spi publisher the beginning of the class period, this includes work submitted after class has begun on the due date . Excuses such as “crashed computers,” “lost flash drives,” or “empty printer ink cartridges” will not be accepted. All essays or work should be saved both on your computer’s hard drive and again on removable storage device as well as uploaded to cloud storage. Quantitative Paper! (OneDrive, et cetera ) Students should also keep backup copies of all work submitted. Disabilities and Accommodations : If you have a physical, psychological, medical, or learning disability that may impact on your ability to carry out the assigned coursework, I urge you to contact the goede essays schrijven staff at the Center for quantitative research paper, Students with Disabilities (CSD), Building U (516 572-7241), TTY (516) 572-7617. Duality Essay! The counselors at CSD will review your concerns and determine to quantitative research paper, what reasonable accommodations you are entitled as covered by the Americans with Disabilities Act and bfa creative, Section 504 of the Rehabilitation Act of 1973. All information and documentation pertaining to personal disabilities will be kept confidential.

Students should avail themselves of the Writing Center and Help Centers available in research the English and Reading/BEP departments, located at Bradley and North Halls and the Library, as part of duality essay this course. Quantitative Research! These services can be considered an services, integral part of the course work and will help the student to research paper, master the bible verse necessary knowledge and quantitative, skills for goede schrijven, Composition I. As this class will combine both lecture and discussion, students are expected both to attend every session and to take an active part in c lass—joining in discussions and raising questions. Discussion is one of the quantitative research paper best ways to clarify your understandings and to duality essay, test your conclusions. Research! Open discussion always involves personal exposure, and thus the taking of risks: your ideas may not be the same as your fellow students’ or even the instructor’s. Yet as long as your points are honest and supportable, they will be respected. Questions, discussion, disagreement, and laughter are all encouraged. Taking an services, active part also means being prepared: students should bring pens, a notebook and/or loose-leaf paper, and the textbook to every class. In addition, all reading or writing assignments must be completed in advance, according to the schedule (below). Diagnostic Essay (ungraded):

Students will complete an in-class Diagnostic Essay at the beginning of the semester on quantitative research paper a topic provided; this essay will be read and duality essay, returned, but will not receive a grade, nor will it affect your final average. Students should retain this and all other essays until the end of the quantitative research semester. With the exception of the first week, class may begin with a short (five-minute) quiz on cover change resources the readings for the day, at the instructor’s discretion. Quizzes cannot be made up; if you miss a quiz due to research paper, absence or lateness, that grade will be regarded as a zero. Essay Verse! At the end of the paper semester, the lowest quiz grade will be dropped. Exercises reviewing essential grammar and/or writing skills will also be assigned, to be completed in services class, or to be done online as homework and submitted electronically. Total number of quizzes and exercises during the semester will determine the point value of each; that is, if 11 assignments are assigned (lowest quiz grade will be dropped), each is worth up to one-half point. Students will also complete various shorter in-class writing assignments during the semester, including short summaries, mini-essays, and response papers. Total number of research paper assignments during the semester will determine the point value of each; that is, if 10 assignments are required, each is services worth up to one full point. Essays (2 @ 10 %, 2 @ 15%): Students will complete four essays during the semester in quantitative a variety of rhetorical modes, including Narration/Description (combined), Process, Comparison/Contrast (Midterm), and Persuasion/Argumentation . T opics must be selected from the services list of suggestions provided (see Essay Topics) or developed in consultation with the instructor.

Essays must be at research paper least three to four (3-4) pages (750 to 1000 words, minimum ) and correctly formatted; see above. Research Essay (25%): Students will also complete an argumentative (persuasive) Research Essay of at least five to spi publisher services, seven pages (at least 1250-1500 words), using a minimum of three to five primary or secondary sources ( sources must be reliable : scholarly criticism or analysis, not summaries, reviews, or “analysis” from sites such as e-Notes , SparkNotes , Wikipedia *, 123HelpMe , or Gradesaver.com ) , correctly documented utilizing MLA format , with a cover page and Works Cited page ( cover page and Works Cited do not count toward the research paper six-page requirement). Duality Essay! The final draft of the research paper must be submitted in a folder, including copies of all sources used. Extra Credit (possibly various opportunities, at 1–2 points each): Note: As a general rule, extra credit only helps if you have already completed all of the assigned work, and will not make up for quantitative paper, missing an essay (or two, or three).

Extra credit opportunities will be announced in class, and they will also be posted here as well as on the class Announcements page , so do not ask at the end of the semester for services, “ extra credit ” to bring your average up. Extra credit opportunities to date: Introduction to Blackboard. The Office of paper Distance Education is bible holding on-campus open. demonstrations for paper, students in G Building, Room 149: Thursday, January 19, 2:30 – 3:45 pm.

Friday, January 20, 2:00 – 3:15 pm. Monday, January 23, 3:30 – 4:45 pm. Tuesday, January 24, 11:30 am – 12:45 pm. No sign-up needed! First-come-first-serve basis! For questions, please call the Office of letter change resources Distance Education. Sentence Building and Avoiding Run-ons, Comma Splices, and quantitative research, Fragments. Using Correct Punctuation: Commas, Semicolons, and Colons. Subject-Verb Agreement, Verb Formation, Tense Usage.

Tuesday/Thursday Club Hour Series: 11:30 am to 12:45 pm. Thursday, March 2. Building Compound Sentences. Building Complex Sentences. Building Compound Sentences. Building Complex Sentences. Understanding and Using Verb Tense. Using Correct Punctuation. The Verb Phrase. Wednesday Afternoon Series: 2:00 pm to duality essay, 3:15 pm , Bradley Hall Ballroom. Wednesday, March 1.

Building Compound Sentences. Wednesday, March 8. Building Complex Sentences. Wednesday, March 15. Wednesday, March 22. The Verb Phrase. Tuesday Evening Series. Building Compound Sentences. Building Complex Sentences. Tuesday, March 21.

Using Correct Punctuation. Tuesday, March 28. Using Correct Punctuation. The Writing Centers are located in research paper Bradley Hall (Bldg. Y) and on the second floor of the Library, room L233. 572-7195 or 572-3595. Topics include: Locating and Evaluating Sources. Integrating Sources into an Essay.

Creating and Formatting a Works Cited List. Wednesday, April 5. Tuesday, April 18. G Building (Room TBA) Evening Activity Hour* Thursday, April 20. 11:30 am – to 12:45 pm. Thursday , April 27.

11:30 am – 12:45 pm. 11:30 am – 12:45 pm. Wednesday, May 3. 11:00 am – 12:15 pm. *Evening Activity Hour (Classes are canceled; check with your instructor.) Seating is limited! Sign up now by calling or visiting the for the post of primary Writing Center . The Writing Centers are located in Bradley Hall (Bldg. Y) and on research the second floor of the Library, room L233. 572-7195 or 572-3595. It's “About Time”: Managing Time, Self, College.

February 7, 11:30am - 12:45pm - M206. February 14, 11:30am - 12:45pm - M206. Being Successful in an Online Class. March 23, 11:30am -12:45pm - G149. Learning Skills Workshops.

( It is recommended that students attend all four of the cover post following) March 7, 11:30am - 12:45pm Bldg. M206. Studying and research paper, Organizing For Classes. March 14, 11:30am - 12:45pm Bldg. M206. Reading College Textbooks. March 21, 11:30am - 12:45pm Bldg. M206. March 28, 11:30am - 12:45pm Bldg.

M206. Managing Test Anxiety. April 18, 11:30am - 12:45pm Bldg. Cover For The Post Of Primary! M206. April 25, 11:30am - 12:45pm Bldg. M20. For questions, call 516-572-7141. will be added to the final total.

Final average will determine the grade received for the course, as follows: Note: Percentages ending in .5 or greater are rounded up. Research! Therefore, 79.5 rounds to 80, a B, but 79.4 rounds to 79, a C+. important dates: SPRING 2017 SEMESTER. 1st half semester classes last day drop without a W grade. Evening Activity Hour: 7:00 p.m. class will not meet; all other classes follow a regular schedule.

Evening classes extended by 5 minutes for final exams. Evening classes end. NOTE: All dates subject to change. Note: All readings below are required, and must be completed by the session indicated; the duality essay only exceptions are those indicated with an asterisk (*), which are recommended additional readings or resources. Readings from The Norton Field Guide to Writing (Bullock) are identified below by page number or by author and title as well as page numbers, e.g., “Arguing a Position” (Bullock 156-161) or Foer, “My Life as a Dog” (Bullock 245-248). Readings from the Norton Online Handbook are identified below by paper title and bfa creative writing ateneo, section number; e.g., “Sentence Fragments” ( Norton S-2). Research! Additional readings, including handouts or online texts, will also be assigned. Red text indicates due dates or links to assignments; Blue text indicates links to assignments, resources, or online versions of texts. Cover For The Post Of Primary! ( Note : While every effort is made to verify the accuracy and usefulness of paper these links and their contents, no guarantees are made.

Please notify me of any broken or outdated links at Brian.Murphy@NCC.edu.) Note: This schedule is bfa creative ateneo subject to revision according to research paper, the instructor’s discretion, the academic calendar for services, the semester, school closings due to quantitative, inclement weather or other reasons, and the progress of the letter into human class. Paper! Additions or changes will be announced in class, and bible verse, they will also be posted here as well as on the class Announcements page . “Generating Ideas and Text,” “Drafting” (Bullock 289-300) In-class assignment: The Writing Process. “Reading in Academic Contexts” (Bullock 10-32), “Analyzing Texts” (Bullock 94-128); “Beginning and Ending” (Bullock 331-343); “Complete Sentences” ( Norton S-1), “Fragments” ( Norton S-2), “Comma Splices and Fused Sentences” ( Norton S-3 ) “Subject-Verb Agreement” ( Norton S-5), “Pronoun-Antecedent Agreement” ( Norton S-6a) “Adjectives and Adverbs” ( Norton W-5) Revising and Editing: “Assessing Your Own Writing,” “Getting Response and Revising,” “Editing and Proofreading” (Bullock 301-317) Comparison and Contrast Writing: “Comparing and Contrasting” (Bullock 380-387); Arthur Asa Berger, “How to Analyze an Advertisement” ( from the Center for Media Literacy)

Scott A. Lukas, “How to Read Ads” ( from the Gender Ads Project) Six different versions of the story: Jakob and Wilhelm Grimm, “Ashputtle” (a slightly edited version) and, some responses to fairy tales in popular culture: Jane Yolen, “America's 'Cinderella.'” ( Children's Literature in Education 8.1 (1970): 21-29.) ( here in .pdf) In-class writing: Compare-Contrast.

“Audience,” “Genre” (Bullock 57-63); “Words” ( Norton W), especially “Appropriate Words” (W-1), “Precise Words” (W-2), and “Unnecessary Words” (W-4) *See also, Questions on Suzanne Britt, here. Note: As previously announced, class will meet in quantitative Y-A/B, the computer lab in essays the Writing Center, Bradley Hall. Using Words Effectively: “Audience,” “Genre” (Bullock 57-63); “Words” (Norton W), especially “Appropriate Words” (W-1), “Precise Words” (W-2), and research paper, “Unnecessary Words” (W-4) See additional required form, here. Additional, optional exercises: “Arguing a Position” (Bullock 156-182); “Arguing” (Bullock 355-375) “Punctuation” and “Mechanics” ( Norton P-1 through P-11 ) Note: For online text, scroll down.

See additional required form, here. “Doing Research” continued: “Documentation” and “MLA Style” (Bullock 496-548), “MLA format” One paragraph each (typed, 12-point Times New Roman, double spaced) evaluating DHMO.org and cover letter for the of primary teacher, MartinLutherKing.org. In addition, complete the Information Literacy Tutorial on the NCC Library page, then print out and submit the paper last page with your results. “Doing Research” continued: “Quoting, Paraphrasing, and Summarizing,” “Acknowledging Sources, Avoiding Plagiarism” (Bullock 478-495) Homework/In-class Writing: Bring one of the sources from the Bibliography due on Monday, April 17. This should be a compete printout or photocopy of the sources, including complete bibliographical information. Model Research Essay: Shankar, “ The Case of the Missing Kidney: An Analysis of Rumor ” (Handout)

Note : No longer available online. Annotated Bibliography (2) Due. Course wrap-up, Final conferences. For each of the post teacher assigned essays and quantitative research paper, projects, a topic or list of verse topic choices will be provided. Your work must be on one of the assigned topics for that assignment or developed in consultation with the quantitative research instructor, or it will receive a grade of “F”. Bfa Creative Ateneo! All work must be submitted on quantitative research paper or before the due date, by cover for career resources the beginning of the research paper class period; late work will not be accepted (see above).

Failure to bring the required essay will result in a zero for the assignment, without opportunity for revisions. For each of the essays, select one of the topics to discuss in a well-developed, coherent, and bible, thoughtful essay. Research Paper! Be sure to focus carefully on the topic, and remember that these are formal essays: they must have an appropriate, original title; contain an introduction, body, and conclusion; have a clear, explicit, assertive, objectively worded thesis statement (thesis statements must be underlined ); and (unless otherwise indicated) avoid use of for career change into I or you throughout. Be sure to use appropriate topic sentences and transitions to paper, guide the reader. Remember that you are not summarizing the spi publisher works, but responding to them in quantitative a critical manner. Be sure to include evidence or examples from the specific text(s) that you are writing about, but do not retell the story, and do not copy directly from the textbook except when quoting. Remember to incorporate sources correctly, whether quoting, paraphrasing, or summarizing: use signal phrases and document with parenthetical citations and a Work (or Works) Cited page.

Diagnostic Essay: In-class essay, Session 2 (Mon. Duality Essay! 23 Jan.) Select one of the quantitative research paper following topics, and compose a formal essay. Your essay will not receive a grade, nor will it affect your final average; this is for evaluative purposes only. You will have approximately one hour to complete this essay. (Use of “ I ” is spi publisher allowed for all three choices.) 1. What is your favorite text— however you may define the term “text ” (novel, short story, graphic novel, and research, so on)—or who is your favorite author, and why? Defend your choice with specific examples. 2. The late Steve Jobs, former CEO of Apple, once notably claimed that “ people don’t read anymore” (see “ The Passion of Steve Jobs”). Was he correct?

Consider: With radio, television, cable, personal computers, smart phones, web-books, and tablets, we are living in a post-literate world, one in which people merely skim, browse, or surf rather than engaging in deep, meaningful reading for any prolonged periods of time. That is, sustained, concentrated reading * —for pleasure or for knowledge—is no longer necessary or important. Cover Letter Post Of Primary Teacher! Do you agree or disagree? Why or why not? 3. Why are you here?

That is, what is your objective or goal? How do you anticipate achieving it, and how will this class, or your education at Nassau Community College, help you to achieve this goal? *On reading, see also: Note : Due to quantitative paper, the nature of this assignment, use of I is appropriate for any of the three topic choices. Due Monday, February 13; Revisions due Monday, Feb. Spi Publisher Services! 27. After reading “Narrating” (Bullock 419-427), “Describing” (Bullock 399-407 ), and research, the assigned descriptive and narrative essays, select one of the following topics and compose a narrative essay.

Your essay should tell a clear, chronological story that shows or demonstrates a specific point; in addition, use description to make your narrative vivid. Your reader should be able to goede schrijven, visualize clearly the objects/settings/people involved in your story. Essays must have an appropriate, original title; contain an quantitative research paper, introduction (with an explicit, assertive thesis, underlined ), several body paragraphs supporting the thesis, and an appropriate concluding paragraph; and avoid use of you throughout. Be sure to use appropriate topic sentences and transitions to guide the reader. Your essay will be evaluated in bfa creative writing ateneo terms of Main Idea, Organization, Support, and Mechanics (Words and Sentences).

Therefore, make certain your essay is quantitative not only well organized and developed, but also grammatically correct, free of errors in mechanics, grammar, usage, and spelling. Note: This is not a research essay. While you may use secondary sources to duality essay, provide a hook or to enhance your introduction or conclusion, unnecessary or excessive use of secondary sources should be avoided. 1.) Write a narrative account of a time you enjoyed a “moment of glory” other than completing high school or your GED, getting your driver’s license, or participating in paper a sports- or competition-related event. Explain what happened, how you reacted, and why you reacted the way that you did. Be sure to explain both the duality essay immediate and the long-term significance of this event, and use specific, detailed descriptions. 2.) Write a narrative account of research a time you experienced a “life-changing event” (as above, other than high school graduation, earning a GED, getting your license, or winning some sports event).

This may be something you only later came to realize had significantly changed your life, or one that you immediately recognized as life-changing when it happened. Again, explain what happened, how you reacted, and why you reacted the way that you did, as well as both the immediate and the long-term significance of this event, and be descriptive. 3.) Select an goede essays, important personal item or treasured object that you own, and quantitative paper, explain the object, its significance to you, and duality essay, how you came to acquire it. You may also explain how it has affected your life since acquiring it. As above, do not focus on the obvious, such as your diploma, license, or trophy; instead, consider the love letters your great-grandmother kept, the stuffed animal you have had since your were four, a coin you have carried as a good luck charm since middle school, and so on. Be sure to paper, both describe the object and to tell its story.

Note : Due to the nature of this assignment, use of I is appropriate for duality essay, any of the quantitative paper three topic choices. Essay 2: Process, “Draft” I n-class essay , Wed. 27 February; Final Essay due Wed. 8 March. After reading “Explaining a Process” (Bullock 414-418 ) and the assigned process analysis essays, select one of the goede essays schrijven following topics and quantitative paper, compose a clear, well-written directive process analysis. Your reader should be able to understand and schrijven, complete the research process successfully by cover for the of primary following your instructions. Research Paper! While use of the second person (“you”) may be appropriate in goede essays your introduction and/or conclusion, use the indefinite pronoun (“Next, one should make sure that. Quantitative Paper! ”) or the imperative mood (“Next, close the door. ”) in the body of your essay, and essay, be consistent: do not switch back and forth between “one” and “you,” either explicit or implied.

Note : your essay should have a title, ideally one more creative or original than “How to Do X.,” In addition, you must assert something significant about the subjects, that it is important or even pleasurable to learn this process, and use appropriate topic sentences. For example, Thesis: An assertion concerning the process being explained, indicating the importance or benefit of the process, and the major steps necessary to complete the process. For example: Although [process] may seem intimidating to the beginner, one can save time and money by [step 1], [step 2], and [step 3]. Topic sentence 1: A sentence utilizing an appropriate chronological transition (time marker), indicating the first major step (your first major division), and research, emphasizing the main idea from your thesis (the process and its importance, ease, interest, or value). For example: The first step in [process] is to [name and define Step 1]. Topic sentence 2: A sentence utilizing an appropriate chronological transition, indicating the next major step, and emphasizing the main idea from your thesis. For example: Next, to [process], be sure to duality essay, [Step 2]

Topic sentence 3: A sentence with an quantitative research paper, appropriate transition, indicating what the goede schrijven step is, et cetera. For example: After that, [Step 3]. Topic sentence 4 (if necessary): and so on. You may include individual phrases or substeps in research outline form under each topic sentence, but this is duality essay recommended, not required. 1.) How to perform a specific process associated with an unusual hobby or interest: for example, how to groom a horse, evaluate the worth of a baseball card, stretch and prep a canvas, et cetera . Paper! Do not attempt to cover change into resources, explain an entire hobby, however; focus on just one process.

Additionally, t his should be an unusual hobby, not something like playing videogames or soccer. 2.) How to cope with a specific, unusual emergency situation: not how to administer CPR or how to administer first aid to someone badly cut, but what to do if pursued by an alligator or if your car goes off the research Whitestone or George Washington Bridge, for cover, example. 3.) How to master one specific important academic survival skill: taking notes, finding materials in quantitative paper the college library, registering for classes, and cover letter change into, so on, but not how to study, write an essay, or read critically. Quantitative Research Paper! Be sure to include your own, specific ideas, and be sure that your process analysis is written in such a way that it is genuinely useful to a new student. The version due in class on March 8, a finished, typed revision, must be submitted with the duality essay “draft” attached, even if you have changed your original topic. Essay 3, Comparison–Contrast: Midterm Essay Exam, Wed. 15 March. After reading “Comparing and Contrasting” (Bullock 380-387) and the assigned comparison-contrast essays, compose a persuasive contrast essay. Note : your essay should have a title, ideally one more creative or original than “A vs. B.” In addition, you must assert something about the subjects , indicating the specific significant difference between the two. Be sure not to state merely that one “is better than” or “superior to” the other; rather, define a specific, significant difference, one that all of your details support.

So, for quantitative, example, “ A is services funnier than B because. ” or “ A is both simpler and research paper, more economical than B because. ” . Services! For example: Thesis: An assertion concerning the two subjects chosen for quantitative research paper, your essay, indicating the specific significant difference between the two and the major divisions of your essay. For example: Although A and duality essay, B are (similar in some way or ways), A (is in some particular way different than or superior to) B because of (major criteria: the quantitative paper divisions of your essay). Topic sentence 1: An assertion about how one single criterion, your first major division, distinguishes the two subjects. For example: The first way in spi publisher services which A (is superior in some way to) B is (first major criterion). Note : Alternatively, your first body paragraph may sum up the similarities between the two, if necessary, followed by several paragraphs enumerating differences. For example: Obviously, both Superman and Batman are costumed superheroes fighting crime and confronting a variety of enemies in their respective cities, Metropolis and Gotham City, while maintaining secret identities as “normal” humans. Topic sentence 2: An assertion about how one single criterion, your second major division, distinguishes the two subjects. For example: In addition, A (is superior in some way to) B because (second major criterion). Topic sentence 3: An assertion about research paper, how one single criterion, your third major division, distinguishes the two subjects.

For example: More importantly, A is also (superior in third major criterion to) B. Essays must be at cover for career into human least three to research paper, four (3-4) pages (750 to 1000 words, minimum ) and correctly formatted. Goede Essays! Be sure to focus carefully on quantitative research the topic, and remember that these are formal essays: they must have an appropriate, original title; contain an introduction, body, and letter for career change into, conclusion; have a clear, explicit, assertive, objectively worded thesis statement (thesis statements must be underlined ); and quantitative research, (unless otherwise indicated) avoid use of I or you throughout. Be sure to use appropriate topic sentences and transitions to guide the reader. Remember that these are not research essays; use of secondary sources, whether credited or not, will be considered grounds for failure. 1.) Two similar television shows ; for example, two specific situation comedies, two news broadcasts, two police procedurals, and so on. You may not use The Simpsons or Family Guy , or television programs about duality essay, superheroes, nor should you focus on just a single character or figure from each show.

2.) The print and movie versions of the same story. (The print version of the story can be a novel, graphic novel, short story, play, and so on). How does the research paper movie adapt, revise, or alter the services story, what is changed or left out, and why? How do all of quantitative research these individual changes contribute to a different interpretation of the text; that is, what is the significant difference between the versions? 3.) Two different versions of the same film , but be careful not to confuse reboots with remakes . That is, something like Rise of the cover post Planet of the Apes (2011) is quantitative paper not another version of cover letter for career change human Planet of the Apes (1968, 2001), nor is Batman Begins (2005) or The Dark Knight Rises (2012) the same story as Batman (1989). As above, h ow does each version adapt, revise, or alter the story? What is changed or left out, and why? 4.) Two ads for similar products that were published (or broadcast) between 25–75 years apart. Paper! (Some research required.) Consider shifts in cultural attitudes toward gender, race, romance, politics, consumerism, “success” (whatever that means), et cetera . Cover Letter Change Into Resources! Your assertion should refer to the significant changes or shifts in appeal, effectiveness, audience, and so on. Note : You may use the prewriting done in class previously, as well as a dictionary and/or thesaurus, but no other materials, either print or online. Essay 3 revisions must be at research paper least three to four (3-4) pages (750 to 1000 words, minimum ), typed (in 12-point Times New Roman), double-spaced, with one-inch margins and cover letter for the, the proper heading, and stapled when submitted, just like all essays completed at home. You must also submit the original essay, the prewriting, and research, a one-page explanation of duality essay your changes. In addition, you must complete and submit an additional form this time, here.

Incomplete revision submissions will not be read, nor will the original grade received be changed. You must establish a clear thesis before you can begin to put together a focused, well-organized, and quantitative, purposeful argument essay. Therefore, as your first step in the assignment, you must develop and submit a clear, well-written, one-page explanation of the topic you have chosen, your reason for the selection, your focus and opinion, and duality essay, a clear, well-written, explicit, and assertive preliminary thesis. Note : Choose your topic carefully . You will not be allowed to quantitative research, change your topic once you have made your selection, although you may modify your position on the particular issue and will, presumably, revise your thesis during the process of writing. Your work should take the following form: Topic: the services topic selected from the list provided.

Rationale: why you have chosen to research and write about quantitative paper, this particular topic. Focus: a narrowed form of the subject, and the issue or debate involved. Opinion: your subjective opinion on writing the debate or issue. Thesis: your opinion, worded objectively . Topic: Assisted Suicide and research, Euthanasia ( Note: this is not a real topic choice!) Rationale: I selected this topic because I work in a critical care facility with many permanently disabled and even comatose patients. Many of the patients’ families have to confront this issue regularly, like whether to “pull the plug” as it were, and ateneo, I am not sure how I feel about paper, it myself..

Focus: Should physician-assisted suicide be legalized for terminally ill patients? Opinion: I think that assisted suicide should be okay, if the person is already dying anyhow. Thesis: Voluntary physician-assisted suicide should be a legal option for terminally ill patients, to alleviate prolonged physical and bfa creative writing ateneo, emotional suffering and to avoid unnecessary expense. Select one of the paper following broad topics. These topics need to be further restricted, so narrow and focus the topic yourself, but be sure that your topic is both narrow and debatable , not merely informative. Then, compose your assertive thesis statement, as above. Education reform ( one specific proposal, for example. Cover Letter For Career Into Human Resources! improving readings scores on standardized tests in K-12, increasing student retention rates in college, streamlining remedial coursework, and so on) Election reform ( one specific proposal, for example, abolishing the Electoral College, restricting PAC funding, and so on) Immigration reform ( one specific proposal, for example, building a wall, “extreme vetting, ” and so on) Tax reform ( one specific proposal, for research, example, replacing income taxes with a consumption tax, implementing a flat tax rate, and so on) OR any topic appearing in a New York Times editorial published Wednesday, March 29 through Tuesday, April 4 (for example, The Supreme Court, Brexit, NC's transgender restroom law, and so on).

You must attach a copy of the editorial to your assignment. Utilizing the library databases , specifically Academic Search Complete, find a minimum of three to five scholarly or professional sources on the topic you have selected for cover letter for the teacher, your Argument Topic . Then, after reading the articles, create an Annotated Bibliography including a correct citation for quantitative paper, each source along with a one-paragraph description or summary of the spi publisher services source, at least two to three sentences each. After reading “Arguing” ( Bullock 355-375 ), “Arguing a Position” ( Bullock 156-182 ) , and the assigned persuasive essays, compose a formal, final persuasive thesis statement and at least three to five topic sentences for the body of your argument. Your thesis should be argumentative (making a claim), rather than purely informative. Be sure to include in quantitative your topic sentences appropriate evidence, examples, data, or other support for your assertion; remember, however, that these are not research essays . As always, your “draft” should be correctly formatted and correct, free of errors in mechanics, grammar, usage, and bfa creative writing ateneo, spelling. Quantitative Research! In addition, you should have an appropriate title, ideally one more creative or original than “Argument Essay,” and underline your thesis. Your submission must be typed, 12-point Times new Roman, double-spaced, and adhere to the following format: Thesis statement: A formal, specific, clear, and assertive statement on the actual debate or issue, adopting one side or favoring a single proposal. It must include your topic, the claim or assertion, and letter for career change resources, the major divisions of your essay.

Topic sentence 1: The first major point or argument in favor of your claim. Topic sentence 2: The second point supporting your argument. Thesis statement: Voluntary physician-assisted suicide should be a legal option for terminally ill patients, to alleviate prolonged physical and emotional suffering and to avoid unnecessary expense. Topic sentence 1: Many terminally ill patients suffer excruciating, untreatable pain, which could be alleviated were voluntary euthanasia legalized. Topic sentence 2: In addition to quantitative paper, physical suffering, emotional suffering takes a toll on both the duality essay patient and his or her family. Topic sentence 3: Perhaps most important, the quantitative research paper financial cost of long-term health care for the terminally ill could be greatly reduced were these patients allowed to terminate their lives legally. Your “revision” should be a completed essay of at least three to four (3-4) pages (750 to 1000 words) based upon your “draft” previously submitted: Add an introductory device (a “hook”) and transitional sentence, if necessary, to expand your thesis statement into goede essays, a proper introduction. Add support for each of research your topic sentences; inclu de appropriate evidence, examples, data, or other support for your assertion.

Remember, however, that these are not research essays: use only common knowledge or what you already know about the topic. In the body of your essay, be sure to anticipate and refute opposing viewpoints or possible objections to your position. Add an appropriate conclusion. You must include with your essay the “draft” and pre-writing previously submitted. As always, your essays should be correctly formatted, and services, should be grammatically correct, free of errors in mechanics, grammar, usage, spelling, and documentation. In addition, your essay should have an research, appropriate title, ideally one more creative or original than “Argument Essay”! And underline your thesis! You must include with your essay the essay verse “draft” and pre-writing previously submitted.

As always, your essays should be correctly formatted, and should be grammatically correct, free of research paper errors in mechanics, grammar, usage, spelling, and documentation. Goede Essays! In addition, your essay should have an appropriate title, ideally one more creative or original than “Argument Essay”! And underline your thesis! Note : If you did not write on one of the approved topics, wrote on a topic from a news article in the Times instead of an editorial, failed to include a copy of the research paper editorial with your submission, or chose a topic of your own without prior permission for your topic selection, annotated bibliography, or argument “draft,” Topics to services, be announced. Utilizing the library databases as before, specifically Academic Search Complete or appropriate subject-specific databases, find a minimum of three to five additional scholarly or professional sources on the topic you have selected for your Argument Topic . These sources must be opposed to quantitative, the view you presented in your argument essay, contradicting or attempting to spi publisher, disprove your assertions. Research Paper! Then, after reading the articles, create an Annotated Bibliography of at least seven to ten sources (including both your original three to five and the new three to five) , correctly documented in MLA format, along with a one-paragraph description or summary of the source, at letter post least two to three sentences each. You might also find the following additional resources useful:

MLA format (Purdue university’s Online Writing Lab) A finished, typed draft of the completed research essay must be brought to class for peer review, evaluation, and quantitative research paper, comments. This should be a complete draft of your research essay, using a minimum of services three to quantitative, five secondary sources, five to seven pages, and including both a cover page and Works Cited page. This draft is worth 5% of your final grade; f ailure to bring the required essay will result in a zero for the assignment. Your research essay should take the following form: Introduction: Establish significance of topic, the issue or debate involved, and writing ateneo, the opposing sides. Arguments: Summary of research paper each source, with critique, organized according to side.

For example, three to duality essay, five sources opposing physician-assisted suicide, then three to five sources supporting physician-assisted suicide. Conclusion: A thoughtful analysis of the quantitative paper relative merits of each side of the debate, according to the positions presented in your sources, followed by essay a logical conclusion. You must include at least one short quotation, one long—block—quotation, and quantitative, one paraphrase, and these sources must be properly documented (utilizing MLA format), and integrated into your writing smoothly and correctly. Note : You do not need to submit the folder containing copies of your sources at cover for the teacher this time. The final research paper must be submitted in a research folder, including your Preliminary Draft and copies of all sources used. Be sure to print out or photocopy all secondary sources, and highlight all relevant passages, whether quoted, paraphrased, or summarized. Failure to submit a complete research essay in a folder according to these instructions will be grounds for failure on quantitative paper the assignment.

In addition, plagiarism, either in whole or in part, will result in verse automatic failure (a grade of zero) for quantitative research paper, the assignment, just as for any essay, and therefore likely failure for the course as well. Please refer to the following as well: Class Plagiarism Policy (on syllabus), as well as the Nassau Community College Policy on schrijven Academic Dishonesty and quantitative paper, Plagiarism (in the college catalog). You might also find the following additional resources useful: MLA format (Purdue university’s Online Writing Lab) * Note : Students must obtain prior approval for independent topics; speak to services, me before or after class or email me to set up an appointment during my office hours. Grammar, Writing, and Research Papers:

Links to sites for textbook purchase or rental are provided for students seeking textbook options; no guarantees or recommendations concerning these services are intended, either express or implied.

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An Outline for Quantitative Research Papers

Intrathoracic pulsion diverticulum in a horse. This is a report of a 12-year-old Swedish Warmblood gelding with a ruptured esophageal pulsion diverticulum associated with atypical clinical signs of colic and septic peritonitis on presentation. The location of this diverticulum at the hiatus was unique and was most likely responsible for the unusual presentation of quantitative research, this horse. Diverticule de Zenker intrathoracique chez un cheval. Ceci est un rapport d#x02019;un hongre de race Swedish Warmblood #x000e2;g#x000e9; de 12 ans pr#x000e9;sentant un diverticule de Zenker perfor#x000e9; associ#x000e9; #x000e0; des signes cliniques atypiques de coliques et de p#x000e9;ritonite septique #x000e0; la pr#x000e9;sentation. L#x02019;emplacement de ce diverticule au hiatus #x000e9;tait unique et fort probablement responsable de la pr#x000e9;sentation inhabituelle de ce cheval.

(Traduit par Isabelle Valli#x000e8;res) A 12-year-old Swedish Warmblood gelding was presented to the William R. Pritchard Veterinary Medical Teaching Hospital, University of California #x02014; Davis, with a 1-day history of inappetence and signs of colic. On presentation, the horse seemed dull but the ateneo, results of research paper, physical examination were within normal limits except for decreased auscultable gut sounds. Abdominal examination per rectum failed to detect any abnormalities. It was difficult to advance a nasogastric tube beyond the level of the gastric cardia, despite addition of lidocaine via the writing, nasogastric tube.

This was later also noted by paper the referring veterinarian when recalling the initial examination of the goede essays, horse. A gastric impaction was suspected; however, when the nasogastric tube finally entered the stomach, no excessive feed or gastric reflux was obtained. Results of abdominal radiograph examination and quantitative research paper thoracic and abdominal ultrasound examinations were unremarkable. Duality Essay? A complete blood (cell) count (CBC) identified a normal leukocyte count with lymphopenia [white blood cells (WBC) = 6610/#x003bc;L, reference interval (RI): 5000 to 11600/#x003bc;L; lymphocytes = 999/#x003bc;L, RI: 1600 to 5800/#x003bc;L], and an immature (band) neutrophilia (1190/#x003bc;L) with cytologic evidence of slight to moderate toxicity. Quantitative Research Paper? Abdominocentesis revealed a turbid orange-tinged fluid and further analysis identified increased total protein concentration (34 g/L; reference value: #x0003c; 20 g/L), total WBC (86 860/#x003bc;L; reference value: #x0003c; 5000/#x003bc;L), and non-degenerate neutrophils (90% of total). Rare bacterial rods and cocci were noted intracellularly. Due to services, the presence of variable intracellular bacteria noted on cytology, the probability of a primary septic peritonitis was considered low and suspicion of secondary septic peritonitis due to bacterial translocation from compromised or perforated bowel was suspected. Systemic peri-operative antibiotics and anti-inflammatory medications were initiated; these included penicillin (PenOnePro; VetOne Pharmaceuticals, Meridian, Idaho, USA), 22 000 U/kg body weight (BW), IM, q12h, gentamicin sulfate (GentaVed 100; VEDCO, St. Joseph, Missouri, USA), 6.6 mg/kg BW, IV, q24h, and flunixin meglumine (Banamine; Schering Plough Animal Health, Union, New Jersey, USA), 1.1 mg/kg BW, IV. Tetanus toxoid (Tetanus Toxoid; Fort Dodge, Iowa, USA), 1 mL, IM was also administered.

Exploratory celiotomy was performed to identify a source of the peritonitis. Quantitative Research Paper? During surgical exploration no compromised or punctured bowel was located and letter for the the source of the peritonitis could not be identified. There was no gross evidence of enteritis or colitis and no fibrin accumulation around the abdominal viscera. Quantitative Research? A large amount of duality essay, turbid, yellow peritoneal fluid was present. Quantitative? The bowel was thoroughly lavaged with sterile saline and duality essay returned to quantitative paper, the abdominal cavity.

A closed negative suction drainage system (Snyder Hemovac 800 mL Wound Drainage Device; Zimmer, Dover, Ohio, USA) was placed to cover for the post, allow repeated abdominal lavages (1). Quantitative Research? The gelding recovered uneventfully from anesthesia and was treated with Plasma-lyte A (Baxter, Deerfield, Illinois, USA) crystalloids (4 mL/kg BW per hour, IV) and lidocaine (Lidocaine HCL 2%, Hospira, Lake Forest, Illinois, USA) continuous rate infusion (CRI) (1.3 mg/kg BW bolus, 0.05 mg/kg BW per minute CRI). The gelding was also continued on flunixin meglumine (0.7 mg/kg BW, IV q8h), penicillin (22 000 U/kg BW, IM q12h), gentamicin sulfate (6.6 mg/kg BW, IV, q8h), polymyxin B (Polymyxin B; X-Gen Pharmaceutical, Northport, New York, USA), 3000 U/kg BW, diluted in 1 L of saline IV, q12h. Abdominal lavage (10 L of warmed lactated Ringers solution; Lactated Ringer#x02019;s Injection, Baxter Healthcare Corporation, Deerfield, Illinois, USA) was performed twice a day. The horse became febrile (38.4#x000b0;C to 39.1#x000b0;C) 12 h after surgery and experienced acute intermittent episodes of discomfort that included pawing and bruxism. The horse also continued to have a dull demeanor with an letter into inconsistent appetite.

Metronidazole (Metronidazole; Teva Pharmaceuticals, Selleville, Pennsylvania, USA), 20 mg/kg BW, per quantitative research paper rectum, TID was added to the antibiotic regimen. The horse was also started on oral ranitidine (Ranitidine tablets; Amneal Pharmaceuticals, Glasgow, Kentucky, USA), 6.6 mg/kg BW, PO, TID and omeprazole (Gastrogard; M#x000e9;rial LLC, Duluth, Georgia, USA), 1 mg/kg BW, PO, once a day as treatment for possible ulcers. Fecal output was decreased after surgery and the passage of bible, a nasogastric tube was again difficult beyond the level of the cardia but was eventually successful and the horse was given mineral oil via the research paper, tube. Rectal palpation detected no abnormalities. The horse continued to spike intermittent fevers (up to 40#x000b0;C) but his appetite improved. Thoracic auscultation was unremarkable and the intravenous catheter and abdominal incision showed no signs of infection.

Two days after surgery, a CBC identified marked leucopenia (2700/#x003bc;L, RI: 5000 to 11600/#x003bc;L) with slight toxic band neutrophils. A respiratory panel on goede, nasal swab was negative for equine herpesvirus-1 and #x02212;4, Streptococcus equi, influenza and equine arteritis viruses. An enteric panel for Salmonella and clostridia was negative. Three days after surgery a gastroscopy was performed to quantitative research, exclude gastric ulcers as a source of the peritonitis and to assess the esophagus. The endoscopic examination was unremarkable. An abdominal fluid sample was obtained and showed marked improvement in the white blood cell count (14 000 cells/#x003bc;L) with 70% non-degenerate neutrophils and improved total protein concentration (26 g/L; reference value: #x0003c; 20 g/L). Glucose concentration was normal and no bacteria were present on direct smear. Lactate concentration was markedly elevated (1.22 mmol/L, reference value: #x0003c; 0.22 mmol/L). The horse had an abdominal ultrasound examination the next morning; the bfa creative, results of the ultrasound examination were unremarkable except that the visualized lung field was considered to research, be abnormal. Of Primary Teacher? A repeat ultrasonographic examination of the thorax revealed bilateral pleuropneumonia with moderate fibrinous pleural effusion and consolidation of the cranio-ventral lung bilaterally. Careful auscultation of the thorax revealed friction rubs dorsally on the left with occasional crackles and absent lung sounds cranioventrally.

Increased bronchial sounds could be ausculted dorsally on the right hemithorax, with absent lung sounds cranioventrally. The pleural fluid was drained from the right thorax and was grossly orange-tinged and opaque. A chest drain (24 French) was placed in research paper the right hemithorax and the abdominal lavage system was removed. Services? A total of quantitative, 3 L of fluid were drained from the writing ateneo, right hemithorax and 2 L were drained from the left side using a teat cannula. Quantitative Research? The fluid was submitted for of primary cytology and aerobic and anaerobic bacterial culture that included methods for detection of Mycoplasma. A coagulation panel was submitted and was unremarkable. A transtracheal wash was also performed and submitted for research paper bacterial culture. The pleural fluid cytology identified a total nucleated cell count of 58 240/#x003bc;L and 76% degenerative neutrophils that contained short bacterial rods and cocci and confirmed a septic pleuropneumonia.

The development of bilateral pleuropnuemonia despite a reasonably strong broad-spectrum antibiotic regime lead to cover letter post, the decision to promptly change the antibiotics prior to quantitative research paper, bacterial culture and letter of primary sensitivity results: penicillin was discontinued and ceftiofur (Naxcel; Pfizer, New York, New York, USA), 2.2 mg/kg BW, IV, q12h was initiated. Gentamicin was increased to the maximum dose of 8.8 mg/kg BW, IV, q24h to account for the expanded extracellular fluid compartment in a horse with pleuropenumonia (2). Metronidazole concentration and frequency were increased (25 mg/kg BW, per rectum, q8h). The gelding was continued on quantitative research paper, intravenous flunixin meglumine (1.1 mg/kg BW, IV q12h). Gentamicin was replaced with amikacin (Amikacin Sulfate Injection; Teva Parenteral Medicines, Irvine, California, USA), 21 mg/kg BW, IV q24h after 24 h of diagnosis of writing, pleuropneumonia because the culture results showed growth of quantitative paper, Escherichia coli. Although susceptibility results were still pending, a higher percentage of spi publisher services, equine E. coli isolates have been shown to be more susceptible to amikacin than gentamicin (3).

On the following day repeat thoracic ultrasonography revealed marked accumulation of effusion in the left hemithorax; therefore, a chest drain (24 French) was placed, which released 12 L of serosanguinous and malodorous pleural fluid. Aerobic and anaerobic bacterial cultures of the pleural cavity further identified small numbers of Enterococcus faecalis and paper Enterobacter sakazakii. Transtracheal wash also revealed Enterbacter sakazakii. Antibiotic sensitivity tests showed both species to be markedly resistant to antibiotics. The horse was treated for 3 d with ceftiofur, metronidazole, and amikacin along with pleural drainage. The gelding continued to spike fevers (38.6#x000b0;C to cover letter for the post teacher, 40.3#x000b0;C), and had a persistently elevated heart rate (60 beats/min). Due to the susceptibility pattern of the quantitative, cultured bacteria, ceftiofur was discontinued and replaced by ampicillin (Ampicilllin for Injection; Sandoz, Princeton, New Jersey, USA), 20 mg/kg BW, IV, q8h. Metronidazole (25 mg/kg BW) was instilled into the chest cavity through the left intra-thoracic drain.

The gelding continued to be febrile (39#x000b0;C), with an spi publisher increased heart rate of 80 beats/min. Quantitative Research? Four days post diagnosis of pleuritis, 50 mL of malodorous, purulent fluid containing a moderate amount of plant material was collected from the for career into, left indwelling thoracic tube. Research Paper? A ruptured esophagus was suspected and, due to poor prognosis, the horse was euthanized. On necropsy, pleuropneumonia, pleuritis, and pericarditis were identified. Approximately 7 cm cranial to the gastro-esophageal junction, a 6 cm #x000d7; 1 cm linear, full-thickness defect through the esophageal mucosa was identified that had smooth edges and goede essays schrijven communicated with a large multi-chambered diverticulum filled with green to grey malodorous feed material ( Figure 1 ). Research Paper? The diverticulum was lined by a 0.1 cm layer of pale yellow material (fibrin) overlying a layer of bfa creative ateneo, dense connective tissue. Quantitative Research? One pocket of the diverticulum extended cranially from the mucosal defect along the ventral aspect of the esophagus. This pocket was ruptured just to the left of the midline, leaking feed material into letter for the post the dorsal aspect of the left thoracic cavity. The largest chamber of the diverticulum extended caudally from the mucosal defect, measured approximately 20 cm in quantitative research diameter, and essay verse was located at the esophageal hiatus along the left side. Quantitative? It dissected between and was adhered to the muscles of the diaphragm and essay bible verse the gastric serosa adjacent to the diaphragm. Multiple abscesses were noted within the wall of the diverticulum. Paper? There was moderate hypertrophy of the muscle layer of the distal third of the esophagus.

This horse was unusual in spi publisher its atypical clinical presentation of an quantitative paper esophageal diverticulum (4,5). Esophageal diverticula can either be traction or pulsion. A traction diverticulum usually arises as an acquired lesion after healing of an espophageal wound and usually has a shallow body and wide opening. Traction diverticula are still able to transmit normal peristalsis; the spi publisher, wide neck rarely entraps feed and therefore seldom causes clinical signs. A pulsion diverticulum results from protrusion of the esophageal mucosa through a defect in the wall and usually has a flask-like body and a narrow opening predisposing it to impaction and subsequent rupture. Paper? Horses with esophageal diverticula typically show dysphagia, a history of intermittent esophageal obstruction, weight loss, saliva dripping from the nostrils, and diffuse swelling of the ventral aspect of neck.

The diverticulum is bfa creative, usually located in the cervical esophageal region. A skin fistula or evidence of a wound over that area may also be present (5,6). An intrathoracic pulsion diverticulum was described in a 7-month-old colt that was presented after intermittent, chronic esophageal obstruction (7). The diverticulum was speculated to be congenital (7). The horse in our study was 12 years old with no history of quantitative research, prior esophageal obstruction, making a congenital abnormality very unlikely.

Alternatively trauma, potentially from previous nasogastric intubations or esophageal obstruction, could have caused the formation of the diverticulum in bible this horse. In human medicine, a diverticulum similar to the case presented here would be referred to as an epiphrenic diverticulum, a pulsion diverticulum located in quantitative paper the distal 10 cm of the bfa creative writing ateneo, esophagus (8). Recently, and quantitative paper with the use of ambulatory manometry, epiphrenic diverticula have been more likely to be attributed to essay, concurrent esophageal motor dysfunction (5,9). A barium swallow is used to assess the size of the quantitative research, diverticulum and goede of its neck, its location, and the distance from the research, gastroesphoageal junction (8). This type of diverticulum can be an incidental finding in patients, with 37% (10) to 65% (11) showing clinical signs of dysphagia and regurgitation as an indication for surgery. Verse? The main indication for surgical treatment in humans is aspiration pneumonia and therefore other clinical symptoms of respiratory disease such as night coughing, laryngitis, or pneumonia are also indications for surgery (8,12). Due to the pathophysiology of motor dysfunction, a myotomy along with the diverticulectomy is performed by a thoracoscopic approach (9). In this horse, no history of dysphagia or respiratory dysfunction was present. The esophageal lining at endoscopy and necropsy showed no evidence of ulcerations to suggest a history of regurgitation. The diverticulum seemed to paper, have expanded, however, to the point of for the post of primary teacher, rupture. Abscessation of the diverticulum was probably due to the disruption of the mucosal lining of the diverticulum.

Septic peritonitis likely developed due to the location of the diverticulum between the pleural and peritoneal cavities. It is also possible that one of the abscesses leaked into the peritoneal cavity. It is less likely, but possible, that peritonitis developed secondary to septic pleuritis due to a communication between the peritoneal and pleural cavities. In the latter case, septic pleuritis with translocation of bacteria through a compromised wall of the quantitative, esophageal diverticulum would have had to be present initially. However, the goede schrijven, gelding had performed well under general anesthesia and showed unremarkable thoracic auscultation and ultrasound examination findings on presentation to the hospital. A diagnosis of quantitative research paper, diverticulum can be made with contrast radiography and endoscopy (5,13). In this case, endoscopic examination of the esophagus and stomach was performed 3 d post-presentation and essay the diverticulum was not detected.

It is possible that the research, diverticulum was empty of feed and spi publisher services small enough that it escaped detection on quantitative paper, endoscopy or that the pulsion diverticulum opening was missed due to its size. In addition, in essay verse retrospect and in research re-evaluation of the abdominal radiographs, images of the distal esophagus did not show any evidence of bfa creative, a diverticulum. Endoscopy of the esophagus and stomach was performed on day 3 of hospitalization to rule out perforating esophageal or gastric ulcers as a cause of the septic body cavities. The horse had been on broad-spectrum antibiotics since presentation, yet the pleuropneumonia continued to progress. Dechant et al (14) published a report of quantitative, a horse that was presented for acute onset of pleuritis and was diagnosed at postmortem with a ruptured esophagus secondary to services, esophageal ulceration. The horse showed none of the typical antemortem signs of esophageal ulcers. The horse was similarly treated for quantitative a severe and peracute pleuro-pneumonia, but had no historical risk factors associated with pleuropneumonia. The authors of that study emphasized the importance of investigating internal sources of infection in spi publisher services persistent non-responsive pleuritis cases where there is no evidence of quantitative paper, external trauma (14). We believe that the atypical history and spi publisher clinical presentation of quantitative research, this horse contributed to advancement of an undiagnosed esophageal pulsion diverticulum to cover change resources, the point of its rupture. A contrast radiographic study to assess size and location of the quantitative research, diverticulum and possible diverticulectomy by essays thoracotomy or thoracoscopy would have been a possibility if an research paper esophageal diverticulum had been suspected earlier on. To the authors#x02019; knowledge, this is one of the essay bible verse, first reports to describe an intrathoracic pulsion diverticulum in an adult horse.

A ruptured esophagus, although rare, has been described as a cause for paper persistent, acute, and severe pleuritis. Essay Bible Verse? In the present case, however, a compromised esophagus was associated with signs of colic and paper septic peritonitis as the presenting clinical signs. The location of this diverticulum at the hiatus was unique and letter for career change into resources was most likely responsible for the unusual presentation of this horse. CVJ.