Friday, January 31, 2020

Infant and Child Development Essay Example for Free

Infant and Child Development Essay This assignment will critically review Howlett, Kirk and Pine’s (2011) study, which aims to investigate whether attendance of gesturing classes affects parental stress. Howlett et al. , (2011) attempt to examine claims, advertised by commercial products, that believe attending gesturing classes can improve child-parent communications, thus reducing parental stress. Participants gave demographic information and completed a Parenting Stress Index (PSI) questionnaire. ANCOVA was used to look at whether attending gesturing classes affected parental stress, mothers attending a gesture group and mothers attending a non gesture group were compared; with ‘sibling status’ and ‘birth order’ controlled. Researchers found that mothers who attended infant gesture classes had higher stress scores than mothers who had attended non-gesturing classes. From these findings the following claims are made: that mothers in the gesture group had higher pre-existing stress than in the non gesture group, * that mothers attended gesturing classes in an attempt to alleviate their pre-existing stress, * that gesturing classes may cause mothers to view their child negatively. This critique will firstly provide an overall evaluation of the article with reference to strengths and weaknesses found. Flaws will also be highlighted with suggestion to how these could be rectified. Points of detail in the evaluation will then be expanded and conclusions discussed. Overall evaluation First and foremost, the overall presentation of the article appears to lack in structure and organisation; this results in a lack of flow and clarity. In the introduction, the research question and key definitions of interest (i. e. ‘gesture, ‘non gesture’ and ‘stress’) are not discussed at the beginning. Characteristics of non gesturing mothers are instead firstly mentioned in the discussion section. The outline of categories in the background demographic questionnaire should have been made aware to readers in the methodology. Furthermore, in the results, findings from the study should have been stated in the opening paragraph. A fundamental flaw consistent throughout the article regards its lack of sufficient detail in ensuring strength of argument. In the introduction and discussion more research is needed in relation to how and why parental stresses occur to support findings. Furthermore unjustified claims are used to sustain argument which questions the validity of the research. The lack of detail regarding the direction of study also instigates ambiguity. More information is also needed about the procedure of the study so as to allow for replication. Further details as to how these flaws can be rectified are discussed later. Fundamental flaws are apparent regarding the non-random sample used and the lack of baseline stress measures. As no baseline pre-test has been conducted authors’ claims, as stated previously, can only be based on speculation. More information is provided on these flaws in the latter section. Strengths highlighted in the article include the demographic information provided. This information is useful as it allows for generalisation of results by ensuring groups are appropriately matched and offers useful information for future research in the region. (Keith, 2010). Furthermore the PSI questionnaire used, is well validated (Colver, 2006); using a creditable measuring instrument like this increases the reliability of the study. Moreover, the correct statistical test has been used, ANCOVA, and results are also provided with appropriate information. Abstract and Introduction The abstract fails to provide a rationale for the study; as this is unclear, readers may misjudge the subject matter. There is also no description of the stimuli used; the meaning of ‘gesturing’ is unexplained. Authors should elaborate upon what they mean by ‘gesturing’ so as to avoid misinterpretation. However, principal findings and design measures used in the study are stated. The introduction appears to lack in structure and organisation. No initial description of research question with reference to what it attempts to demonstrate is present; this is firstly mentioned in the third paragraph. Furthermore, authors first provide a definition of ‘gesturing’ in midpoint of this section. Considering this topic is the phenomenon of the study it would have been more appropriate to be stated at the beginning, rather than after the discussion of the benefits of gesturing; this may prevent misinterpretation. Although an explanation of ‘non-gesturing’ is provided in the discussion section, it would also be helpful for readers if it were included in the introduction; this enables differentiation between the two conditions. Similarly, a definition of the authors’ interpretation of ‘stress’ could have been stated at the start in ensuring readers’ clarity of terms. There is also no statement of hypothesis. nd authors do not provide a rationale or historical backdrop, therefore it lacks in significance and does not substantially contribute to the literature. Moreover, research discussed appears to be framed as a general review of literature and set out in list form with a lack of evaluation. For example, research has been described in relation to a study that has found no relationship between gesturing and linguistic benefits in infants (Kirk, Howlett, Pine and Fletcher), however it has not been evaluated or linked to the aims of the study. Furthermore, there are limited findings provided relating to the negative aspects of gesturing. Considering the paper is directed towards whether these classes affect parental stress, more research should be discussed in relation to the disapproval of gesturing classes, to support findings in the article. In addition, the article has included different research examples to support their view that parental stress can inhibit parent-child relationships, however there is no development in argument of how or why these stresses occur. To rectify, in ensuring clarity, more detail should be provided whereby these examples should be put in context with direct reference to the research question. Moreover, unjustified claims have been used in an attempt to sustain argument; for example, Howlett et al. , (2011) highlight ‘‘advertising claims that baby sign will reduce parental frustration and stress have little empirical foundation’. As this statement is not explained, it may seem misleading and as an ineffective use of argument. There is also no valid reference provided. In improving the structure and validity of their argument, authors should use evidence from influential papers to provide further detail in supporting their claims. The direction of study also appears ambiguous as authors switch between terms when stating the aim of the research. It is unclear whether authors are focusing on gesturing affecting stress or gesturing reducing stress. Howlett et al. , (2011) firstly state, ‘there are valid reasons to suggest that gesturing with an infant could reduce parental stress, this paper evaluates that claim’, (p. 438) they continue by stating, ‘this research investigates whether gesturing with an infant affects parenting stress’ (p438). One clear statement of what is being intended to measure needs to be used throughout the article so as to avoid confusion. The final paragraph includes a vague definition of variables whereby readers are left to determine their own assumptions. For example, it is stated that the frequency and duration of gesture use was used to measure the relationship between gesture use and stress, however it is unclear at this stage whether authors are implying ‘gesturing’ in terms of when mothers’ attended gesturing classes or their general use of gesturing; in and out of classes. The PSI is outlined, however researchers have not explained its benefits or why it have been use; this may leave readers questioning its credibility. Furthermore, it is important for researchers to include a statement of predictions, however this is not present. Methodology The authors recruited 178 participants (mothers) from the south-east of England; the sample size represents regional bias as mothers’ solely attending gesturing classes in this region is not representative of the whole country. Age range of infants used in the study is firstly mention in this section. It is stated infants ranged between 3 and 36months; however research discussed in the introduction only refers to the importance of gesturing from 9 months. Therefore authors have not justified the relevance of focusing on infants younger than 9 months; in certifying readers understanding, this could have been mentioned in the introduction. Authors have stated the measuring instruments used in the study. A strength regards the sufficient detail provided about the PSI booklet; examples of typical features such as the subscales of both the child and parent domains have been described. However no further details are provided about the background demographics questionnaire; categories are presented in the results section, however, it would be helpful for readers if details were included in this section. The potential confounding effects of using self-report questionnaires should also be noted. Social desirability bias may be apparent whereby participants may respond in a favourable light; mothers may not want to admit they are experiencing difficulties and respond untruthfully. Furthermore, as questionnaires are standardised, ambiguous questions cannot be explained; this may lead participants to misinterpret questions. Motivation for parents to complete questionnaires may also be scarce, resulting in superficial responses. In helping overcome these difficulties, authors could have stated whether participants were informed about why the information was collected and how the results will be beneficial; if participants knew the importance of their responses and were informed that negative responses were equally as helpful as positive, it may have made them want to answer more honestly. A fundamental flaw in methodology regards the fact that authors have not measured parental stress levels before conducting study. As there is no baseline stress measures prior to class attendance, there is no way of knowing if gesturing classes caused an increase in stress or what would have happened regardless of the implementation of the program; to rectify, researchers should use a pre-test methodology. Furthermore, another weakness in the methodology regards the fact that no ethic considerations are discussed. For example, authors could have included whether participant confidentiality was taken into account and whether de-briefing was offered subsequent to the study to respondents who may have expressed signs of upset. Description of procedures appears to lack in detail whereby there is no sequential pattern to how the research was carried out. There is also no precision in relation to what is investigated, to whom, and under what conditions. For example, Howlett et al. , (2011) state ‘contact was made with the infant groups’ (p. 39); more information should be provided such as how and when participants were contacted. Furthermore, no information is provided on how many classes parents had attended before the study or when the questionnaires took place; more sufficient detail is needed so as to allow replication and in ensuring consistency. There are also issues surrounding the amount of time participants were given to complete the PSI; it is stated the questionnaire takes approximately 30 minutes to complete, however, the procedure of collection differed between participants. Some gave completed questionnaires to a group leader, others were returned by post; the same conditions should be applied to all participants in ensuring standardisation. In addition, authors have not provided details of data collection or analysis undergone in the study; to avoid ambiguity it is important to include where the scores used in the analyses have derived from. An apparent fundamental flaw in the procedure relates to the fact that participants were not randomly allocated to the two groups in the study; randomisation is important as it eliminates sources of bias and ensures unpredictability. To rectify, random selection of mothers from a population could participate in the study. Results The beginning paragraph of the results is too vague; the hypothesis is not stated and no information on what statistical tests were used is provided. Furthermore, what the study found has not been not stated; it is firstly mentioned half way through this section. However, a strength in the article regards the demographic information provided for the two groups of mothers. Hours a week mothers’ work, maternal education, family income and siblings were included. It also highlights the similarities and equivalence between the two groups, making the interpretation of results valid. Another strength to this study regards the fact that researchers have applied the correct statistical tests. Two analyses of ANCOVA were conducted to measure the differences between the gesturing and non gesturing groups’ PSI scores. ANCOVA is appropriate to use as it allows to compare one variable (PSI stress scores) in two or more groups (gesture group and non gesture group) ith consideration for variability of other variables; covariates (‘sibling status’ was used as a covariate in the first ANCOVA and ‘birth order’; in the second). Controlling ‘sibling status’ and ‘birth order’ stops these conditions being confounding variables and ensures validity. As ‘sibling status’ and ‘birth control’ covariates have been controlled, it may have been more beneficial for readers if authors ma de aware of these strategies used prior to the results section as there is no discussion relating to siblings until this point. Results found from ANCOVA also confirm to readers exactly what the researchers were intending to measure; after confusion from the introduction, uncertainties are clarified and findings explain that the focus is upon whether attending gesturing classes affects parental stress. Results are also provided with adequate information whereby the obtained F value, df and level of significance have been stated. Furthermore researchers are correct in using a Pearson’s r correlation in confirming results which is used to see if there is a correlation between at two continuous variables. By doing so, it was found that there was no relationship between how long or often gesture groups mothers had been gesturing with their infant, and the mothers’ total stress scores. Therefore mothers stress levels were unrelated to frequency and duration. Furthermore, in this section descriptive statistics have been provided in two separate tables. In ‘Table One’, which shows the ‘mean (S. D) stress scores for each item on the PSI by group’, data does not seem to be explained in full. The scale used is unclear and readers have not been informed on the system used whereby there is confusion as to what the numbers mean. Tables 2 which shows the ‘summary of two ANCOVA results’, is more coherent as a brief description is displayed underneath describing the covariates. Discussion In this section, yet again, the aim of the research remains unclear; it is stated ‘the aim of the study was to investigate the impact of gesturing with an infant upon parental stress’ (p442), authors need to be more specific in their interpretation of ‘gesturing’, whether they are referring to attendance of gesturing classes or general use of gesturing is uncertain. Possible explanations for findings have been discussed, such as the view that there may have been a difference between gesturing and non gesturing mothers due to gesturing mothers feeling more stressed prior to the study. Authors continue by suggesting these mothers chose to attend gesturing classes because of these feelings of stress in hope that they would help. However, authors’ claims can only be seen as speculation as no baseline measurement was used. It should be noted that researchers have evaluated their findings and acknowledged that as baseline measures are not present, no assumptions can be made as to why mothers who attended gesturing classes had increased stress levels compared to non gesturing mothers or whether they were more stressed before attending the classes. Due to the lack of solid findings, like in the introduction, groundless claims have been used in an effort to uphold argument in explaining mothers’ cause of stress. For example, it is stated ‘mothers have high aspirations for their child and the parenting industry may, albeit unwittingly, foster maternal insecurities’(p443); no justification has been provided for this claim. Moreover, additional research is needed to support the authors’ concluding claims that attending gesturing classes may be detrimental and effect mothers’ perception of their infant in a negative light. Only Hyson’s (1991) study relating to mothers who induced academically focused activities on preschool children has been used as evidence to back up this claim, this does not justify the authors’ inflated claims. To conclude, even though this article has used creditable measuring instruments and appropriate statistical tests, Howlett et al’s claims can only be seen as speculation as no pre-test baseline is used. No findings can be validated without measuring the stress levels of mothers prior to class attendance, whether increase in stress has occurred due to attending gesturing classes in unknown. For future recommendations, authors could use a baseline measures to test mothers’ stress scores prior to the study.

Thursday, January 23, 2020

Slavery in Shakespeares The Tempest :: Tempest essays

Slavery in The Tempest  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Slavery occurs on a widespread basis in The Tempest. Occurrence of slavery to many of the characters, all in different ways, helps to provide the atmosphere for the play. The obvious slaves are not the only slaves, as Prospero has basically got everybody entranced when he wants, to do whatever he wants with them. He can also control the way that they think.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The first and most obvious slave is ariel. Ariel is an airy spirit who is promised his freedom by Prospero if his job is done well. His job was to entrance the visitors to the island under Prospero's control. "What Ariel! My industrious servant, Ariel!" That is what Prospero said in act 4, scene 1, line 33. He was talking to his slave, Ariel, who entranced the visitors to the island.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Another example could be Alonso, the king of Naples. Since he is not in Naples, but on Prospero's island, and under his control, he is a slave in a way. In act 3, scene 3, lines 95-102, Alonso admits complete and utter loss of control. "O, it is monstrous, monstrous! Methought the billows spoke and told me of it; The winds did sing it to me; and the thunder, that deep and dreadful organ pipe, pronounced the name of Prosper; it did bass my trespass. Therefore my son i' th' ooze is bedded; and I'll seek him deeper than e'er plummet sounded and with him there lie mudded." He is telling us that Prospero is in control of him.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Prospero, Trinculo, and Stephano are in control of Caliban, the deformed son of Sycorax, and therefore Caliban is their slave. "Monster lay-to your fingers; help to bear this away where my hogstead of wine is, or I'll turn you out of my kingdom. Go to, carry this. In act 4, scene 1, lines 250-253, Stephano told Caliban to carry something for him, or he would be out of his kingdom. He treats Caliban like dirt because he is their slave.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In act 4, scene 1, lines 262-265, Prospero is describing how all of his former friends are now pretty much under his control, even though they don't know it, and enslaved to Prospero. "At this hour lies at my mercy all mine enemies. Shortly shall my labors end, and thou shalt have the air at freedom."   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In act 5, scene 1, lines 7-10, it states "Confined together in the same fashion as you gave in charge, just as you left them-all prisoners, sir, in the line grove which weather-fends your cell.

Wednesday, January 15, 2020

Master Patient Index and Primary Keys

HSIS FALA09 Master Patient Index and Primary Keys The Master Patient Index (MPI) is an electronic medical record system for every patient registered in a health care organization. The MPI is stored in a database and contains a unique identifier, known as the Primary Key (PK). The PK is unique and identifies each record in the database. The MPI is considered the most important resource in a healthcare facility (AHIMA). The MPI will contain the core elements about a patient such as name, address, phone number, date of birth, gender, race, social security number, and the unique patient identification number (Merida). The MPI identifies all patients that have been treated in a facility or healthcare organization. The PK is the unique identification number associated with the patient. The PK allows a patient to be cross-referenced between different facilities within a healthcare system (AHIMA). Each time a patient visits a facility within the healthcare organization the registration system within the facility will look to the MPI for the patient information. If no record exists then one will be created at registration. Services obtained by the patient at each facility will now be linked to the MPI record using the PK (AHIMA). The MPI allows historical data about a patient’s care to be stored and later obtained. The MPI also allows access to information from any clinic, physician, laboratory, radiologist, medications, known allergies, referrals, billing, and accounts receivable with the use of the PK. The MPI allows for quick and accurate storage of a patient’s care. Quick access to a patient’s full medical history by a physician allows for better patient care (AHIMA). The MPI enables the health care organization to improve patient care through the integration of patient records and ensuring that all historical care information on each patient resides in one record. It also helps the health care organization to decrease costs through improved operational efficiency. Improved patient care, decreased costs, and improved operational efficiency make the Master Patient Index one of the most important resources in a healthcare facility. References American Health Information Management Association (AHIMA). (Dec. 2, 2009) Retrieved from http://www. ahima. org/ Johns, Merida L. , (2002). Concepts of Health Information Management. In S. Anderson (Eds. ), The _Health Information Management _Series (pp. 20-49). New York: Delmar.

Tuesday, January 7, 2020

The Water Resources Management Accepts Application For...

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