Friday, December 27, 2019
Educating Volunteer With The Elderly - 1744 Words
In my home town they have started two very well known organizations that were designed to help the children in the community. These two organizations are known as Kids First and WeCare. The heads of these organizations hold silent auctions, radio auctions, and clothes and food drives to donate to families within the community who are not able to afford to purchase these items on their own budgets. There are to girls who decided that they wanted to help the lower income families within our community and within their own school systems. These two girls, who happen to be sisters, started a coat and blanket drive to host at their school which they hold every year. They simply ask the other students to bring in their old coats that they have†¦show more content†¦Goodwill is an organization in which people donate unwanted items for other people to buy at a lower cost than brand new items from a store. Not only can people help by donating but they can also help by buying items from the stores too. According to the organization’s Website, Goodwill is a non-profit organization that spends about eighty-three cents on every dollar they make on programs and services for those in need (â€Å"Think Before You Donate,†2015, para. ). Goodwill not only benefits the community in which they are located in, but also on a national level all around the nation. Another nation-wide organization that several people participate in is Operation Christmas Child. This is one organization that is simple, not too costly, and still extremely effective for those who receive it. For those donating, it’s as simple as filling a shoebox with items for either a boy or a girl, marking it for a specific age group and dropping it off at a specified location. This organization mainly targets children whose parents cannot afford to give them presents or sometimes the necessities they need. These shoe boxes may be the only thing that a child receives around Christmas time. Taking a small amount of time out of the day and buying the items to fill the shoebox is just a small price to pay to help someone in need. Another nation wide organization that is simple to participate in is the Angel Tree Program. This program is usually highlyShow MoreRelatedHealth Partners Free Clinic Is An Agency That Can Help These Individuals948 Words  | 4 PagesPeople are living longer and the elderly population is gowing by leaps and bounds. In the years to come, this age group will face chronic illnesses. These individuals will need teaching on how to self-manage the sickness. Diabetes medications can cost a person up to $1,379 which is a lot of money for someone on a limited income. Twenty percent of people age 65 and older conveyed taking less prescriptions over the past couple of years (Bennett Flaherty-Robb, 2013). Health Partners Free ClinicRead MoreThe Greater Cleveland Food Bank828 Words  | 4 Pagesprofit food distribution organization that serves No rtheastern Ohio and was founded in 1979. The organization seeks to bring nutritious meals those that are most affected by hunger and poor nutrition in the region, such as low income families and elderly. The organization is headquartered on the eastern side of Cleveland, OH. 1 Statement of need, purpose, rationale Nutrition plays an important role in one’s health, an unhealthy diet can be a contributing factor for overall poor health. In fact, itRead MoreWorking With The Elderly Population1475 Words  | 6 Pagesyears in my life I knew that I had a passion to care for the elderly (aging) population. From this passion, it ignited a fire so strong that I pursue my certified nursing assistant certification to gain a better understanding of working with the elderly population. By doing so, it has been a great benefit to my life; aging is an inevitable experience that we all will go through during our life. It is important to ensure that our elderly individuals are still able to enjoy the best quality of lifeRead MoreWhy Voter Education Is Important1187 Words  | 5 Pagesits sources remain unclear because it lacks inline citations. Please improve this article by introducing more precise citations. (May 2009) | Libraries are useful resources for adult learners. Adult education is the practice of teaching and educating adults. Adult education takes place in the workplace, through extension school (e.g. Harvard Extension) or school of continuing education (Columbia School of Continuing Education). Other learning places include community colleges, folk high schoolsRead MorePersonal Project Is Much More Than A Project783 Words  | 4 Pagesterm and long-term care facilities. Inquiring into the psychological connection between animals and people through animal therapy was a way to combine my interests in psychology and medicine with my new puppy. It was also personal because I have elderly grandparents who enjoy spending time with their pets and from personal experience I know how spending time with my dog can be a remedy for stress. Animal therapy is an ingenuitive way for animal owners to share the joy of pets with residents of facilitiesRead MoreSocial Work in Canada Essay1229 Words  | 5 Pagesfact. Educating the two groups on the value of the other is a great place to start. Once the awareness process is begun, many other useful tools can also be implemented. The â€Å"have†community is made up of a large proportion of retired people. This can be seen as a potential resource for volunteer labour. The retirement community in Canada makes up most of our volunteer hours and saves the tax payers millions of dollars in social programming (MacLean, M., 2002, SW 416 –Aging) Elderly personsRead MoreMy Career Goal Of Advance Practice Registered Nurse1615 Words  | 7 Pageseducation and conducting meetings with clients as needed to assist with self-management. Interacting with Medical Directors on Challenging cases, making referrals to outside sources and coordinating services as needed for home health, DME, etc. Educating members on disease processes and encouraging members to make healthy lifestyle changes according to Healthy People 2020 Objectives Grady Health System, Atlanta, GA Senior Charge RN, Nurse Manager and Educator (11/1991-12/2009) Highlights of Contributions:Read MoreThe Career Goal Of Advance Practice Registered Nurse1614 Words  | 7 Pageseducation and conducting meetings with clients as needed to assist with self-management. Interacting with Medical Directors on Challenging cases, making referrals to outside sources and coordinating services as needed for home health, DME, etc. Educating members on disease processes and encouraging members to make healthy lifestyle changes according to Healthy People 2020 Objectives Grady Health System, Atlanta, GA Senior Charge RN, Nurse Manager and Educator (11/1991-12/2009) Highlights of Contributions:Read MoreMy Life Of A Doctor925 Words  | 4 Pagesaffected my medical aspirations the most in this regard was shadowing doctors at the University of Minnesota hospital the summer after my freshman year of college. I went on rounds and talked through cases with physicians who were very supportive educating me on how the hospital as well as the illnesses operated. I enjoyed learning how doctors deliberate and decide to treat patients based on a wide range of information from test scores and CT scans to talking with the patients one-on-one. Through thisRead MoreCommunity Service By Robert Coles884 Words  | 4 Pagesjunior tutors in the ghetto, he teaches the children that there is a better life outside of the world they are currently living in, provided they study hard and receive a good education. The junior has a remarkable sense on what community service is, educating the youth as they are our future in society. The college junior doesn’t th ink people are completely aware of what some children go through by the time they’re thirteen or fourteen. He believes trying to teach them that furthering their education
Thursday, December 19, 2019
12 Angry Men-Social Psych Review - 1437 Words
One Belligerent Room There are few examples of group dynamics as complete and realistic as the film Twelve Angry Men. Recently I was required to view this film and had at first great reservations about its value as an educational tool, but soon after the opening credits rolled by and the deliberations began to take place I was caught up in the story. This film was not only entertaining, but it also serves as a great example of many of the theories and aspects of social psychology. Including too many concepts to name, the film touched on several very important theories: process loss in group decisions, groupthink, the fatal attribution error (FAE), normative social influence, and social norms. One of the first concepts to be seen in†¦show more content†¦Even if the evidence does not necessarily add up the man is still a liar and his type does not deserve to be free. Only a few jurors fight this error of judgment and remind the others that his rough upbringing may have had something to do with his past convictions and that this situation did not necessarily warrant violence toward his father. Another aspect of social psychology that is demonstrated by the characters in the film is that of social roles and the need to follow them. Social norms are rules that explain how persons are expected to behave in certain situations; if a social norm is rebelled against the results are often extreme. This is seen incredibly easily in how well the words of the jurors mirror the actions of participants in a 1951 study by Schacter. In the psychological study on norm breaking, a confederate consistently went against the group in a discussion on the possible sentencing of an imaginary juvenile delinquent. The group first tried to bring the deviant back to the group norm and after no success proceeded to ignore and then punish him for his dissenting belief. The very same things happen to the characters who fail to conform to the norm; when Mr. Davis is the lone d issenter one of the other jurors asks that he tell the group where he was mixed up so they could try to straighten (him) out. Another example of this same sort of behavior occurs when one of the last three jurors standing for conviction begins speaking passionatelyShow MoreRelatedâ€Å"Vulgarized Filipino Identity: Development of Filipino Profanity†5036 Words  | 21 PagesSchool of Languages, Humanities and Social Sciences Mapà ºa Institute of Technology A Research Draft on â€Å"Vulgarized Filipino Identity: Development of Filipino Profanity†Introduction Vulgarity of Language Humans express their feelings in many different ways physically, mentally or verbally. Vulgar words, also known as swearing or cursing exists in all human languages that perform certain functions. One study found that swearing is not merely a common reaction to pain; it actually functionsRead MoreBehaviorism and Classical Conditioning Essay3350 Words  | 14 Pages Watson, there have been many variations of the behaviorist view that have surfaced over the years. In this paper I will attempt to give a detailed description of the history of behaviorism including information about some of the most influential men associated with this movement. I will also explain the methodologies associated with behaviorism such as classical conditioning, operant conditioning, and other controversial theories and views. Behaviorism The atmosphere surrounding the psychologicalRead MoreNeo Personality Inventory Revised ( Neo Pi R )4227 Words  | 17 Pages NEO Personality Inventory-Revised (NEO PI-R) Linda Laiton Dominguez Salem College Psych 220, Spring 2017 Dr. Mary Jacobsen April 18, 2017 Psychological tests or psychological assessments are an important asset in the field of psychology. These tests are designed toRead MoreUse Of Traditional Chinese Medicine During The Treatment Of Schizophrenia Essay7976 Words  | 32 Pagesto be one of the top ten causes of long-term disability worldwide. Late adolescence and early adulthood are periods for the onset of schizophrenia. In 40% of men and 23% of women diagnosed with schizophrenia, the condition manifested before the age of 19 (Addington, Cadenhead, Cannon, 2007).These are critical years in a young adult’s social and vocational development. The term schizophrenia was first used in 1908 by Eugen Bleuler, a Swiss psychiatrist, and was meant to describe the disunity ofRead MoreFundamentals of Hrm263904 Words  | 1056 PagesLise Johnson Sarah Vernon Amy Scholz Laura Finley Dorothy Sinclair Sandra Dumas Susan McLaughlin Kevin Murphy Laura Ierardi Allison Morris Hilary Newman mb editorial services David Levy  ©Michael Eudenbach/Getty Images, Inc. This book was set in 10/12 ITC Legacy Serif Book by Aptaracorp, Inc. and printed and bound by Courier/Kendallville. The cover was printed by Courier/Kendallville. This book is printed on acid free paper. Copyright  © 2010, 2007, 2005, 2002 John Wiley Sons, Inc. All rights reservedRead MoreLogical Reasoning189930 Words  | 760 Pages....................................................................................................... 5 Examples of Good Reasoning............................................................................................................. 14 Review of Major Points ....................................................................................................................... 17 Glossary .................................................................................................
Wednesday, December 11, 2019
Whats the matter with tax exemption Essay Example For Students
Whats the matter with tax exemption? Essay Not-for-profit institutions are making out like bandits, the Philadelphia Inquirer told readers in a blistering series of news articles and editorials last spring. Although it did not single out arts organizations, the newspaper questioned the charitable merits of nonprofits ranging from hospitals, universities, foundations and museums to country clubs, trade groups and professional surfers. Added up, their tax exemptions deprived the Treasury of $36.5 billion in 1992, according to the Inquirer, and that figure excludes local property taxes, state and city sales taxes and taxes waived for churches and religious groups. Flawed assumptions and oversimplifications aside, the energetic crusade struck a resonant chord in Congress. With a gaping deficit to worry about, not-for-profit tax breaks must look to lawmakers a lot like Charlie Chaplin to his starving companion in The Gold Rush. Mighty tempting. With direct support slashed almost to the bone, legislators have already begun chipping away at special postal rates and other indirect subsidies. Seizing this hot issue, Rep. J.J. Pickle (D-Tex.) convened the House Ways and Means Oversight Subcommittee in June to review whether not-for-profit entities are complying with the spirit of the tax code. In opening remarks, Pickle charged that widespread abuses are cheating the federal government of tax revenues. He put not-for-profit institutions on notice to expect a full reappraisal. Change is needed and long overdue, he declared. No one is predicting yet a wholesale sack of the not-for-profit community, but congressional prodding and media broadsides are likely to trigger a great deal of soul-searching in the theatre community and some legal steps to safeguard tax benefits. It means profound change possibly, profound reexamination certainly, warns Judith Golub, executive director of the American Arts Alliance. For now, theatres face added time and costs for compliance with existing legislation. Farther down the road, everything is up for grabs. We dont know what is in Mr. Pickles head, Golub says. But theatres may have reason to fear legislators scalpels. Because theatre is the only performing art with both nonprofit and commercial wings, theatres must be especially vigilant or they could face added scrutiny, cautions Peter Zeisler, executive director of the Theatre Communications Group. Acting to preserve its tax exempt status while fostering co-operation with commercial producers, the Manhattan Theatre Club recently established a wholly owned, for-profit subsidiary. We took a conservative position, says managing director Barry Grove, because our tax status is important to us. Meantime, the Inquirer is expected to repackage its reporting in book form that should gain even wider attention. To be sure, some of the grievances are well founded. The newspaper documented the nonprofit sectors size and extraordinary growth, the slack requirements for exemption and a few egregious cases of overcompensation and other abuses, especially among well-heeled hospitals, universities and religious institutions. No one in the bona fide not-for-profit world doubts that some abuses exist witness the scandal at United Way that sent its richly paid executive director packingor questions the need to punish organizations that commit fraud in not-for-profit guises. In its zeal to justify headlines, however, the Inquirer overlooked reasons why some institutions received tax benefits in the first place. By defining the not-for-profit mission in its narrowest sense as charitable services provided free to the poor by volunteers and poorly paid staffers the reporting glosses over social benefits of medical, educational, human resources and cultural activities that cannot survive on a commercial basis. Although the Internal Revenue Service lists 25 separate not-for-profit categories, the Inquirer lumps them together with scant distinctions. By setting such a narrow guideline that few not-for-profit institutions can or should satisfy, the series impugns thousands of institutions that try honestly and at considerable expense to abide by the letter and spirit of the law. The festival that Ashland built EssayBut Grove also takes the high ground on principle. The virtual absence of dramatic plays developed in the commercial theatre and the long list of Broadway failures, should supply proof that producing straight drama is, by nature, a nonprofit venture. It is not quite as easy to make a similar case for musicals, he concedes, given their wider commercial success and lucrative payoff (not to say that there havent been plenty of failures). But Grove stresses that most of the musicals on Broadway this season are revivals or else began in England supported by heavy subsidies. There he rests a case for allowing nonprofit theatres to develop musicals in partnership with commercial producers. It is a case that may soon be tested, now that British super-producer Cameron Mackintosh has promised $1.5 million over the next five years to three New York theatres, the Manhattan Theatre Club, Playwrights Horizons and Lincoln Center Theater. But straight play or musical, Grove is adamant that the length of a run should have no bearing on tax status. Museums, for example, routinely rely on permanent exhibitions. Dance companies keep works in their repertoires for years. And A Chorus Lines 10-year run never threatened the New York Shakespeare Festival with a loss of its exemption. In the end, Grove declares, theatre is an art form that needs support. Cherished assumptions like Groves may be due for reevaluation, however. Even foundations, the final bastions of institutional support for the arts, are taking a harder look at whether the recipients of their largesse really deserve it. I am convinced that somewhere at the bottom of all this is a need to reexamine the meaning of not-for-profit organizational culture, says Rachel Bellow, an arts funder with the Mellon Foundation. It has to move beyond the traditional and not very illuminating distinction that not-for-profit is for the public good and for-profit works for private gain. That doesnt tell you anything. No rising wave It is well and good to talk about social benefits, but federal, state and municipal funds for the arts are depleted and wont come back. Its not like hunkering down and waiting for the wave to rise. Its not going to, Bellow says. Withdrawal of public support could quite easily extend to curtailing tax benefits. Corporate donations, too, have passed their peak for the foreseeable future. Bellow blasts the hue and cry over lost corporate dollars, which by her lights are back to the level where they always have been but for a fillip in the 80s. Whatever comes of the tempest touched off by the Inquirer, perhaps the series erred most in not considering thousands of men and women who elect to work in the nonprofit sector. In the theatre, certainly, hours are often longer and the work as demanding, if not more demanding, than equivalent management positions in the corporate world. With very few exceptions, their salaries and benefits are modest if not downright abysmal compared to the private sector, and there are no stock options or bonuses. Nor can they hide beneath layers Of bureaucracy; results of their efforts are visible with every new production.
Tuesday, December 3, 2019
Risk factors for Bronchial Asthma among primary school children of two different regions in Saudi Arabia Essay Example
Risk factors for Bronchial Asthma among primary school children of two different regions in Saudi Arabia Paper 1.        Introduction (from World Health Organization [11]) 1.1      Asthma: Definition Asthma attacks all age groups but often starts in childhood. It is a disease characterized by recurrent attacks of breathlessness and wheezing, which vary in severity and frequency from person to person. In an individual, they may occur from hour to hour and day to day. This condition is due to inflammation of the air passages in the lungs and affects the sensitivity of the nerve endings in the airways so they become easily irritated. In an attack, the lining of the passages swell causing the airways to narrow and reducing the flow of air in and out of the lungs. We will write a custom essay sample on Risk factors for Bronchial Asthma among primary school children of two different regions in Saudi Arabia specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Risk factors for Bronchial Asthma among primary school children of two different regions in Saudi Arabia specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Risk factors for Bronchial Asthma among primary school children of two different regions in Saudi Arabia specifically for you FOR ONLY $16.38 $13.9/page Hire Writer 1.2      Asthma: Scope Between 100 and 150 million people around the globe roughly the equivalent of the population of the Russian Federation suffer from asthma and this number is rising. World-wide, deaths from this condition have reached over 180,000 annually. Around 8% of the Swiss population suffers from asthma as against only 2% some 25-30 years ago. In Germany, there are an estimated 4 million asthmatics. In Western Europe as a whole, asthma has doubled in ten years, according to the UCB Institute of Allergy in Belgium. In the United States, the number of asthmatics has leapt by over 60% since the early 1980s and deaths have doubled to 5,000 a year. There are about 3 million asthmatics in Japan of whom 7% have severe and 30% have moderate asthma. In Australia, one child in six under the age of 16 is affected. Asthma is not just a public health problem for developed countries. In developing countries, however, the incidence of the disease varies greatly. India has an estimated 15-20 million asthmatics. In the Western Pacific Region of WHO, the incidence varies from over 50% among children in the Caroline Islands to virtually zero in Papua New Guinea. In Brazil, Costa Rica, Panama, Peru and Uruguay, prevalence of asthma symptoms in children varies from 20% to 30%. In Kenya, it approaches 20%. In India, rough estimates indicate a prevalence of between 10% and 15% in 5-11 year old children. 1.3      Asthma: Causes Asthma cannot be cured, but could be controlled. The strongest risk factors for developing asthma are exposure, especially in infancy, to indoor allergens (such as domestic mites in bedding, carpets and stuffed furniture, cats and cockroaches) and a family history of asthma or allergy. A study in the South Atlantic Island of Tristan da Cunha, where one in three of the 300 inhabitants has asthma, found children with asthmatic parents were much more likely to develop the condition. Exposure to tobacco smoke and exposure to chemical irritants in the workplace are additional risk factors. Other risk factors include certain drugs (aspirin and other non-steroid anti-inflammatory drugs), low birth weight and respiratory infection. The weather (cold air), extreme emotional expression and physical exercise can exacerbate asthma. Urbanization appears to be correlated with an increase in asthma. The nature of the risk is unclear because studies have not taken into account indoor allergens although these have been identified as significant risk factors. Experts are struggling to understand why rates world-wide are, on average, rising by 50% every decade. And they are baffled by isolated incidents involving hundreds of people in a city, who suffer from allergies such as hay fever but who had never had asthma, suddenly being struck down by asthma attacks so severe they needed emergency hospital treatment. 1.4      Bronchial asthma Asthma is a chronic lung condition characterized by difficulty in breathing. People with asthma have extra sensitive or hyper responsive airways. The airways react by narrowing or obstructing when they become irritated. This makes it difficult for the air to move in and out. This narrowing or obstruction can cause one or a combination of symptoms such as wheezing, coughing, shortness of breath and chest tightness. 1.5      Asthma: Management Because asthma is a chronic condition, it usually requires continuous medical care. Patients with moderate to severe asthma have to take long-term medication daily (for example, anti-inflammatory drugs) to control the underlying inflammation and prevent symptoms and attacks. If symptoms occur, short-term medications (inhaled short-acting beta2-agonists) are used to relieve them. Medication is not the only way to control asthma. It is also important to avoid asthma triggers stimuli that irritate and inflame the airways. Each person must learn what triggers he or she should avoid. Although asthma does not kill on the scale of chronic obstructive pulmonary diseases (COPD), failure to use appropriate drugs or comply with treatment, coupled with an under-recognition of the severity of the problem, can lead to unnecessary deaths, most of which occur outside hospital. 2.        Objectives of study The objective of the study involves finding out about the incidence of bronchial asthma among children of 6-12 years in two different regions in Saudi Arabia. It also endeavors to investigate the level of awareness that the parents possess about the disease, its prevention and management. A comparative study between the socio-economic levels, and the subsequent health care facilities/awareness shall also be disused. 2.1      Importance to Saudi Arabia This study shall be of significant value to the Ministry of Health in the Kingdom. Firstly, only a scant amount of work has been done in the same realm. But more importantly, it will give an ideation into the incidence, trends and awareness of this condition in Saudi Arabia. This will help the Government to establish working patterns and future strategies into the disease that is still a potent challenge even n the developed world. Special significance would be the condition of the children, and the subsequent response of the parents to their condition. This would also give a psycho-sociological impression into the differences that two different regions in the Saudi Arabia have towards the importance that parents give towards their children. It would also help the Ministry in disseminating more information about the disease among the masses, through pamphlets as given in Appendix C. 2.2      Background Literature review Over the years and over the regions, a lot has been written and published in asthma. Interestingly, much of the work done is characteristically similar to each other, unlike some other disease of an international domain. A very brief discourse of some of the relevant works shall be mentioned hereunder, in reference in to the study in question. These are just the tip of the iceberg as far as work on asthma all over the world is concerned. However, what is most important is the fact that the facts, figures and incidence will keep changing with every region of the world. Therefore, if specified care packages are to be prepared for Saudi Arabia, ten exclusive studies of this sort must be conducted so that specialized data is made available, and subsequent strategies may be adopted. 2.2.1   Adult Asthma It has also been highlighted that â€Å"exposure to ammonia gas in the workplace is significantly associated with increase in respiratory symptoms and bronchial asthma.†[2]. To add, it is also considered that â€Å"educational programs based on self – learning in small peer groups, seem to be effective in improving asthma management†[5]. Furthermore, â€Å"the prevalence of asthma has increased in most countries since the 1970s. Levels may have plateaued in developed countries but as prevalence is associated with urbanization and a western lifestyle the problem worldwide is likely to increase over the next two decades†[17]. In a nutshell, â€Å"the prevalence of asthma in adults has increased more than twofold in 20 years, largely in association with trends in atopy, as measured indirectly by the prevalence of hay fever†[20]. 2.2.2   Child Asthma â€Å"Asthmatic school children have a higher mean period of school absenteeism compared to their non asthmatic classmates. The risk of suffering the impacts of this disease is shown to be particularly increased among questionnaire-diagnosed asthma belonging to less socio-economically advantaged families†[1]. The diagnosis age is of prime importance. â€Å"Repeated viral infections other than lower respiratory tract infections early in life may reduce the risk of developing asthma up to school age†[16]. Taking some facts of Great Britain, it can be seen that â€Å"prevalence of self reported symptoms, diagnosis, and treatment of asthma was high among 12-14 year olds throughout Great Britain with little geographical or urban-rural variation. Under diagnosis and under treatment were substantial†[14]. â€Å"The burden of self reported asthma and other allergic diseases among adolescents has changed substantially for the better in recent years throughout the British Isles. These trends correspond to those seen in the 10-14 year age group in hospital admissions, consultations with general practitioners, and parentally reported symptoms in the health survey for England†[12]. Overall, it is considered that â€Å"factors directly or indirectly related to the heating systems used in rural Bavarian homes decrease the susceptibility of children to becoming atopic and to developing bronchial hyper responsiveness†[15]. Further evidence surfaces when it is declared that â€Å"asthma, as defined by combined symptoms and test criteria, was seriously under diagnosed among adolescents. Under diagnosis was most prevalent among girls and was associated with a low tendency to report symptoms and with several independent risk factors that may help identification of previously undiagnosed asthmatic patients†[18]. But as far as the purposes of this particular study goes, the primary factor is that â€Å"a considerable proportion of children presenting to a district general hospital with pneumonia either already have unrecognized asthma or subsequently develop asthma. The high cumulative prevalence of asthma suggests that careful follow up of such children is worth while†[19]. 2.2.3   Comparison between Adult and Child Asthma While making a comparison among adults and children, some other facts come in view. â€Å"Another issue is that in both children and adults, wide variations in the prevalence of current asthma symptoms are often observed between centers within the same country. This indicates that the asthma symptom prevalence rate reported for each country is dependent to some extent on the number of centers studied†[3]. Then, there also seems to be a link among the family members. â€Å"The prevalence may actually be higher since a significant number of subjects with symptoms suggestive of asthma reported themselves as non-asthmatic subjects. As expected, positive family history was forthcoming in subjects with asthma symptoms. Most asthmatic subjects have not experienced a significant improvement in their quality of life, which could indicate sub-optimal management†[4]. Furthermore, â€Å"the parents of the asthmatic children scored significantly higher in DSSI/sAD compared to parents of the controls. Maternal anxiety reached the level of clinical disease. Maternal anxiety and left-handedness of the child were associated with asthmatic attacks 1 year later†[6]. However, â€Å"the major differences between populations found in the International Study of Asthma and Allergies in Childhood Phase One are likely to be due to environmental factors†[13].            3.        Methodology The methodology for the study entails a simple yet sequential process. Primarily, it is a comparative, cross-sectional study between two different regions in Saudi Arabia, to find out the incidence and awareness of Bronchial Asthma. It is questionnaire-based study, which shall give us demographic as well as technical data into the subject. 3.1      Study design It is a cross sectional study, which means that it shall have a sample that is representative of varying segments of the society. It is not merely a study of one group, one community or one class within Saudi Arabia. The subjects for this study shall be in two categories. Firstly, there would be children from 6-12 years from two different places; Madinah Munawara and Yanbu as industrial and non industrial city respectively. Then, the parents of the same children would also be administered with questionnaires. Questionnaires shall be devised that shall be specific for the two tiers, and would attempt to find out varying information on the subject. As the questionnaires would primarily have objective and closed-ended items, thus the statistical analyses at the end would involve item and questionnaire analysis. 3.2      Sampling frame The children would of course be from primary and lower grades. They would be belonging to two different cities, and hence would represent different living, climatic and socio-economic conditions. Similarly, their parents would possess the same difference in primary characteristics that would be taken as variables in case individual factor analysis needs to be considered at any point in time. 3.3      Sample size determination A sample of 2000 students in each city (a total of 4000), is considered as suitable to make a reasonable comparison for the sake of the study. These would be a fair enough sample of a population, to establish a trend of the incidence of Bronchial asthma among the two cities. Further, it would help in establishing the trend analysis for the disease, including its incidence and management. 3.4      Study Setting The study would be set at the schools in the two cities mentioned. Prior permission would be taken firstly from the school administration, and then from the parents. A consent form for participation of the parent and the child shall be made available before the actual questionnaires shall be administered. For ethical and secrecy reasons, the parents shall be confirmed on the consent form that no information about them or their children’s identity shall be disclosed at any point in the study. It is important to consider this, as parents may not like to share any information about their child’s health if they believe that he/she may be labeled in the future for any types of special and/or biased treatment. 3.5      Study plan Firstly, data would be collected from the population. For that purpose, personal presence would be mandatory at the institution. The parents may like to take the questionnaires home and return them the next day duly completed if physical presence is not possible. After the data is collected, then subsequent information would be tabulated and analyzed for the consequent discussion upon the study. 3.6      Questionnaire Survey There are three different types of questionnaires that have been made available. Firstly, there is the form for the parents that will seek information about their child, his life style, and incidence of asthma (Appendix A). Secondly, there is also another questionnaire that would be available to be filled by the medical health care professionals, based on the guidelines of the Medical Research Council. (Appendix B). 3.7      Data handling and statistics Once the objective data is made available through the questionnaires, then the data shall be fed to the computer software SPSS, and subsequent evaluation shall be done. Special areas of interest as far as the results are concerned shall include the incidence of asthma, the awareness about it, and the knowledge of the parents about the same. Finally, a comparison would be done on these three parameters among the two cities mentioned. 4.                 Conclusion Despite the advances made in the medical world today, bronchial asthma still possess to be a potent threat to life and living all around the world. This means that proactive steps need to be taken so that all prevention can come before cure. However, all of this can only be possible once we know what exactly the nature of the enemy is. Therefore, the epidemiology of the disease must be established in specific region so that it can be adequately tackled. Saudi Arabia is no alien to this disease, and it also needs to establish its working parameters so that it can provide its inhabitants a healthier life style. Studies like this are imperative to the cause of health care all over. It is extremely important, for the purposes of appropriate distribution of resources, and proper development of medical facilities that the true nature of the problem is found out. For that, the incidence, awareness, and management needs to develop ever more so that the people can breathe an air with the technical and administrative problems that asthma may like to offer. Parents Questionnaire (Adapted from ISAAC [9] and Asthma.org.uk [10])             Appendix A Demographic Information a)        Age of Child             _______ b)        Year of schooling      _______ c)        No. of siblings                       _______         Brothers         _______         Sisters _______ d)       Number of Child in Birth order        _______ e)        Average monthly income of parents(s) and/or other bread earners (in Riyals):            0 – 2000 ___             2000 – 5000 ___       5000 – 8000 ___       8000 + ___ f)        Any other medical condition or history of disease for the child            _____________________________________________________________________ g)        History of Bronchial Asthma in Family            _____________________________________________________________________ h)        Birth place of child (city/country)    _______________________________________ i)         Different cities/countries in which the child has lived for over 3 months till now            _____________________________________________________________________ Questions 1. Has your child ever had wheezing or whistling in the chest at any time in the past?            Yes _____                 No _____ 2. Has your child had wheezing or whistling in the chest in the last 12 months?            Yes _____                 No _____ 3. How many attacks of wheezing has your child had in the last 12 months?            Never _____  Monthly ______    Fortnightly _______ Weekly _______ Daily _____ 4. In the last 12 months, how often, on average, has your childs sleep been disturbed due to wheezing?            Never _____  Monthly ______    Fortnightly _______ Weekly _______ Daily _____ 5. In the last 12 months, has wheezing ever been severe enough to limit your childs speech to one or two words at a time between breaths?            Never _____  Monthly ______    Fortnightly _______ Weekly _______ Daily _____ 6. Has your child ever had asthma?            Yes _____                 No _____ 7. In the last 12 months, has your childs chest sounded wheezy during or after exercise?            Never _____  Monthly ______    Fortnightly _______ Weekly _______ Daily _____ 8. In the last 12 months, has your child had a dry cough at night, apart from a cough associated with a cold or chest infection?            Never _____  Monthly ______    Fortnightly _______ Weekly _______ Daily _____ Adapted from Medical Research Council [8]                Appendix B Bronchial Asthma (BA) Research Strategy Questionnaire Q1      About you 1.1      Please mark the boxes next to the categories that apply to you (you may need to mark more than one) I am a†¦ person with BA                                                        researcher person who has recovered from BA                         researcher specializing in BA carer                                                                          clinician with BA patients charity representative                                               GP or nurse                                                                                          clinical specialist other (please specify)†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 1.2 Name†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ Address†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ Email†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ (This part can be left blank if you prefer) Based on your knowledge and experience, please give your opinion to the following questions:- Q2      Understanding BA 2.1      What is your understanding of the term Asthma? 2.2      What is your understanding of the term Bronchial Asthma? 2.3      In your opinion, is BA                a) a single disorder with a wide range of symptoms? OR                        b) are there distinct differences, ie subgroups or entities? 2.4      If you think that b) is true and there is a basis for subdividing it, how would you advise that it be done? 2.5      In your opinion, how could improvements in health of people with BA be measured? Q3      Research now 3.1      Which areas of research currently provide the strongest research evidence base for understanding BA? 3.2      Where are the gaps in research evidence? 3.3      Why do you think this is? 3.4      If there are obstacles to closing the gaps, how can they be overcome? Q4      Research for the future and your vision for a research strategy NB A research strategy includes assessing current national and international knowledge and gaps in knowledge in a given disease/disorder. It helps to decide what further areas of research are needed and how this might be achieved. 4.1      What do you see as the most important areas for research that will increase our understanding of BA? Please list them in order of priority. 4.2      Why are they important? 4.3     What do you want a research strategy to achieve in the short term (3 years)? 4.4     What do you want a research strategy to deliver in the longer term (more than five years)? 4.5      What would make the strategy work? 4.6     If you were asked, how could you or your organization contribute to the strategy? 4.7     What do you think the barriers could be to implementing the strategy? 4.8      Is there any other advice or comment that you would like to give to MRC that will help it produce its strategy? Thank you for completing the questionnaire. Information Pamphlet (from HealthNet [7])                   Appendix C Bronchial Asthma in Saudi Arabia Although the incidence of asthma is increasing world widely, there is many voices many specialists say that asthma tends to be under diagnosed and under treated. Yet, the Bronchial Asthma (B.A.) affects 5 – 10 % of world population†¦ including Saudi Arabia. What is B.A.? This disease is defined as a reversible obstinction of large and small airways due to hyper-responsiveness to various Immunologic and non-imunologic stimuli. It is a chronic inflammatory disorder of the airway in which many cells play role in particular mast cells, eosinophils and T.lymphocytes. What are the major symptoms of B.A.? The main symptoms of this disease are: wheezing, cough, dyspnea, tachypnea and chest pain. Post tussive emesis and cough following cold air exposure or with laughter are suggestive of asthma. In susceptible individuals this inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough, particularly at night and early morning. To what extent has this disease spread in the Kingdom? In Saudi Arabia, the increased use of artificial irrigation, greenery, pollution and change of lifestyle have been cited as some of the factors that are responsible for the growing incidence of bronchial asthma. The prevalence of asthma among school children in Riyadh, for example, to be about 10%, and that range in the entire Kingdom is between 4% and 23% in different areas all over Saudi Arabia. What are the reasons behind these increased prevalence of B.A. in the Kingdom? The high and rapidly increasing in prevalence is attributed to environmental and social changes. Rapid increasing prevalence with increased exposure to indoor allergens and occupational exposure as well as indoor and outdoor pollutants are just some of the reason that tell us why prevalence and morbidity have increased. Regarding society and patient knowledge, it is notable that some patients, depending on their backgrounds, may have various misconceptions about asthma that may interfere with asthma management. These include ideas that asthma is infectious because it runs in families or affect more than a family member at a time. How can we protect our children from B.A.? To avoid asthma triggering factors one should follow certain procedures: One must avoid both active and passive smoking. Wood smoke, incense, strong perfumes, household sprays and cooking oil should be avoided. Ozone, nitrogen dioxide, and acidic aerosol might aggravate the problem. House dust mites, specially in humid areas like Jeddah and Dammam, are bad for asthma patient. Hence, one should encase mattresses and box pillows, wash blankets and beds once a week, remove carpet from time to time, and avoid stuffed toys. Animals should be removed from the home. Insects must be controlled and killed immediately. References 1.        Al-Dawood, K. Schoolboys with bronchial asthma in Al-Khobar City, Saudi Arabia: are they at increased risk of school absenteeism? Journal of Asthma. 2002 Aug; 39(5):413-20. 2.        Ballal SG, Ali BA, Albar AA, Ahmed HO, al-Hasan AY. Bronchial asthma in two chemical fertilizer producing factories in eastern Saudi Arabia. International Journal of Tuberculosis and Lung Disorders. 1998 Apr; 2(4):330-5. 3.        Clark, T. Global Initiative for Asthma. Saudi Medical Journal. 1992; 13: 521-4. 4.        Khan S, Roy A, Christopher DJ, Cherian AM. Prevalence of bronchial asthma among bank employees of Vellore using questionnaire-based data. Journal of Indian Medical Association. 2002 Nov; 100(11):643-4, 655. 5.        Veninga CC, Lagerlov P, Wahlstrom R, Muskova M, Denig P, Berkhof J, Kochen MM, Haaijer-Ruskamp FM: Evaluating an Educational Intervention to improve the treatment of Asthma in four European Countries. Au. J Respir Crit. Care Med. 1999, 160:1254-1262. 6.        Krommydas, G. et al. Left-handedness and Parental Psychopathology in the Course of Bronchial Asthma in Childhood. Pediatric Asthma, Allergy Immunology. 2002. Jun, Vol. 15, No. 3: 145-152. 7.        HealthNet. Bronchial Asthma in Saudi Arabia. 2002. 14 April, 2006. http://www.health.net.sa/english/section/full_story.cfm?catid=11type=aid=24. 8.        Medical Research Council. 2006. 14 April, 2006. http://www.mrc.ac.uk/. 9.        Ponsonby, P. et al. Exercise-induced bronchial hyperresponsiveness and parental ISAAC questionnaire responses. European Respiratory Journal. 1996, 9, 1356–1362. 10.      Asthmauk. 60-second-test. 14 April, 2006. http://www.asthma.org.uk/index.html. 11.      World Health Organization. Bronchial Asthma. 15 April, 2006. http://www.who.int/respiratory/asthma/en/. 12.      Anderson, R. et al. Trends in prevalence of symptoms of asthma, hay fever, and eczema in 12-14 year olds in the British Isles, 1995-2002: questionnaire survey. BMJ 2004;328:1052-1053. 13.      European Respiration Journal. Worldwide variations in the prevalence of asthma symptoms: the International Study of Asthma and Allergies in Childhood (ISAAC). 1998; 12: 315-335 14.      Kaur, B. et al. Prevalence of asthma symptoms, diagnosis, and treatment in 12-14 year old children across Great Britain (international study of asthma and allergies in childhood, ISAAC UK). BMJ 1998;316:118-124. 15.      Mutius, E. et al. Relation of indoor heating with asthma, allergic sensitisation, and bronchial responsiveness: survey of children in South Bavaria. BMJ 1996;312:1448-1450. 16.      Illi, S. et al. Early childhood infectious diseases and the development of asthma up to school age: a birth cohort study. BMJ 2001;322:390-395. 17.      Rees, J. Asthma control in adults. BMJ 2006;332:767-771. 18.      Siersted, H. et al. Population based study of risk factors for under diagnosis of asthma in adolescence: Odense schoolchild study. BMJ 1998;316:651-657. 19.      Clark. C. et al. Asthma after childhood pneumonia: six year follow up study. BMJ 2000;320:1514-1516. 20.      Upton, M. et al. Intergenerational 20 year trends in the prevalence of asthma and hay fever in adults: the Midspan family study surveys of parents and offspring. BMJ 2000;321:88-92.
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