Sexual Abuse in Institutions of Learning Disabled

Sexual Abuse in Institutions of Learning Disabled Literature review that critically analyses the sexual abuse of people with learning disabilities in institutions There are a great many facets to the problem of sexual abuse of people with learning disabilities in institutions. The wide variety of learning disabilities, the wide scope for different types of sexual abuse and indeed the huge variety in the institutions themselves, means that there is not any unified standpoint or all-encompassing view that can be taken on the subject. (Ryan J et al 1987). This review will therefore consider each of these aspects in turn together with the literature associated with them and then attempt to draw conclusions from a critical evaluation of each The term learning disability is applied to cover a wide range of different clinical entities. Differing impairments due to differing aetiologies are typically â€Å"lumped together â€Å" under this one term. In the context of this review, differentiation of the various types of learning disability is largely irrelevant and the only discriminating factor that may be relevant is the degree of disability or impairment. For that reason alone we shall consider all causes of learning disability and the conclusions reached will therefore largely be generalisations in the area. Approximately 2% of the UK population are currently classified as having a learning disability and this proportion has been slowly rising over time. In their comprehensive review of the subject, Xenitidis suggests that the reasons for this growth are manifold and complex. (Xenitidis K et al 2000). Part of the reasons given are that the definitions and criteria for the diagnosis of a learning disability are progressively changing as our knowledge of the area expands together with the fact that other relevant factors are changing such as the socio-economic conditions together with the fact that pre-term neonates who would previously been expected to die are now helped to survive but with an increased risk of cognitive impairment and learning disability (Aspray TJ et al. 1999). The McGrother study suggests that over a 35yr period from 1960 the prevalence of learning disability has increased at an average rate of 1.2% per year (McGrother C et al. 2001). One of the difficulties encountered in the context of sexual abuse is the problems that there are in discovering it. The typical person with a learning disability may have differing perceptions of â€Å"right and wrong† and therefore may not be in a position to make a judgement about what is happening. Other factors are that they have a greater difficulty in accessing professional help. (Wilson D et al 1999).Clearly this is less of a problem if we consider the group who are in institutions rather then those who live in the community, but against this is the argument that those in institutions generally tend to be those with the greatest disability and therefore would intuitively be less able to draw attention to a potential problem. (Patja K. 2000) The literature in this area is not particularly extensive but there are a few high quality papers that stand out. The first is by Sequeira (Sequeira H et al 2003) which was a case controlled study (a rare construction in this particular area) which set out to consider any correlation between sexual abuse, mental health and behavioural problems in people with learning disabilities. The authors suggest that this is the first study to seek such a connection. They matched a surprisingly large entry cohort of 54 adults with learning disability in a residential setting who had suffered from sexual abuse with a similar cohort who had not been abused. The actual study was both carefully constructed and meticulously carried out. In broad terms the findings of the study were that there was a statistically significant correlation between sexual abuse and mental illness and behavioural problems together with symptoms of post-traumatic stress. Reassuringly, the authors found that the reactions to abuse were essentially the same as in the general population which suggests that when recognised, the symptoms were evident to observers, but equally this implies that a significant amount of abuse is undetected. (Thompson D et al 1997). With the group with learning disabilities, the authors concluded that in addition, the study group tended to exhibit stereotypical behaviour patterns and that there was a positive correlation between the degree of abuse and the severity of the symptoms reported. We can confidently conclude therefore that there is a positive association between sexual abuse and both psychiatric and behavioural abnormalities in people who have learning disabilities. How does the design and architecture of institutions foster abuse? It has to be observed that an extensive literature search reveals no specific studies on the issues of institution structure and opportunities for abuse. There are a number of papers that refer tangentially to the issue however, and we shall assimilate the points raised in them. Brown, (1999) and Manthorpe (et al, 1999), both observe that institutions, both large and small, are not specifically immune from sexual abuse of their residents. They point to working practices that allow professionals a degree of privacy when dealing with residents in vulnerable situations. (Burke K 1999). It would be unlikely that anyone would disturb a nurse giving a patient a bath or a doctor conducting an interview or examination of a patient. In this respect, it is not the actual architecture of the institution, it is the structuring of the working practice that fosters the possibility of abuse in this area. (Churchill J 1998). Some institutions have mixed sex dormitories and areas which can be difficult for nursing staff to monitor. Inter-resident abuse can therefore take place in areas which may be less easy to detect than the open plan structure of many wards in general hospitals (Brown H et al 1997) Who are the perpetrators of abuse against people with learning disabilities? This is clearly a difficult area in which to be dogmatic, as one can cite evidence from various enquiries which have examined the issue and have implicated virtually every category of professional from medical staff, (COI 1969), through nurses (COI 1971), to care assistants and sub-contracted employees (DOH 2000). Equally, to be balanced, one has to also examine the recent spate of prosecutions form residential care home workers that have been overturned in the appeal court where allegations of abuse have been found to be vindictive or fraudulent. (also COI 1978) What impact does power imbalance between carer and service user have over occurrence of abuse? Abuse, almost by definition, implies an abuse of power.(Northway R 1998).There is automatically an imbalance between those with learning disabilities and those in the general population as, by the very nature of their disability, the majority of those with a learning disability are dependent on other carers for their own protection and safety. (Pillemer K et al. 1993).This power imbalance is taken to a greater extreme when those (healthcare professionals) who are employed to care for their patients, and thereby are generally invested with a degree of trust give instructions to those who are more vulnerable. As Rogers points out, (Rogers AC 1997) the moment a nurse puts on a uniform or the doctor a white coat, they are invested with an automatic degree of authority and respect by the general population and possibly all the more so by those with learning disability, who may well have learned to be more deferential or respectful because these healthcare professionals are effectively the gatekeepers to their own security and well-being. (Sines D 1995) What can be done to reduce abuse in institutions? It is clearly important to be able to restore confidence in the residential settings for the care of those with learning disabilities. One of the prime mechanisms of reduction is to place professional emphasis on detection of abuse together with implementation of management procedures that will minimise the potential for abuse. The recent Government White Paper â€Å"No Secrets† (DOH 2000) has gone a long way into implementing such measures, and this, together with provincial measures in other parts of the UK (NAW 2000), presents guidelines which will help to prevent sexual abuse and also facilitate the investigation of such abuse when it is alleged. Professional bodies have publicly proclaimed a policy of Zero tolerance in this area and have encouraged the philosophy of â€Å"whistle blowing† (NMC 2002 a) it should be noted however, that a study commissioned by the same group, The Nursing and Midwifery council (NMC 2000 b) suggested that despite the guidance and directives given there is clear evidence that nurses, in particular, do not have sufficient knowledge or have received sufficient training in the area of prevention of sexual abuse to effect the recommendations in the Government White Papers. References Aspray TJ, Francis RM, Tyrer SP, and Quilliam SJ 1999 Patients with learning disability in the community BMJ, Feb 1999; 318: 476 – 477 Brown H Stein J 1997.  Sexual abuse perpetrated by men with intellectual disabilities: a comparative study.  Journal of Intellectual Disability Research 41 (3) 215-224. Brown H 1999,  Abuse of people with learning disabilities. In: N Stanley J Manthorpe r B Penhale (Eds) Institutional Abuse: Perspectives Across the Life Coarse. London: Routledge. 1999 Burke K 1999,  Nurses told to avoid close relationships with their patients.  Nursing Standard 13 (49) 4. Churchill J 1998,  It doesnt happen here! In:  T Thompson P Mathias (Eds)  London: Sage/Open University Press. 1998 COI 1969,  Committee of Inquiry (1969) Report of the Committee of Inquiry into Allegations of Ill-treatment of Patients and Other Irregularities at the Ely Hospital, Cardiff. Cmd 3975. London: HMSO. COI 1971,  Committee of Inquiry into Farleigh Hospital (1971) Report of the Committee of Inquiry into Farleigh Hospital.  London: HMSO. 1971,   COI 1978,  Committee of Inquiry into Normansfield Hospital (1978) Report of the Committee of Inquiry into Normansfield Hospital. Cmd 7357.  London: HMSO.1978 DOH 2000,  Department of Health (2000),  No Secrets: Guidance on Developing and Implementing Mula-agency Policies and Procedures to Protect Vulnerable Adults from Abuse.  London: The Stationery Office. 2000 Manthorpe J Stanley N 1999,  Shifting the focus: from bad apples to users rights. In: N Stanley J Manthorpe r B Penhale (Eds) Institutional Abuse: Perspectives Across the Life Course.  London: Routledge 1999 McGrother C, Thorp C, Taub N, Machado O. 2001,  Prevalence, disability and need in adults with severe learning disability.  Tiz Learn Dis Rev 2001;6: 4-13 NAW 2000,  National Assembly for Wales (2000) In Safe Hands: Protection of Vulnerable Adults in Wales.  Cardiff: Social Services Inspectorate for Wales. NMC (2002 a),  Code of Professional Conduct.  London: Nursing and Midwifery Council. NMC (2002 b),  Practitioner-Client Relationships and the Prevention of Abuse.  London: Nursing and Midwifery Council. Northway R 1998,  Oppression in the Lives of People with Learning Difficulties: A Participatory Study. PhD Thesis.  Bristol: University of Bristol. Patja K. 2000,  Life expectancy of people with intellectual disability: a 35-year follow-up study. J Intellect Disabil Res 2000;44: 590-9. Pillemer K Hudson B 1993,  A model abuse prevention programme for nursing assistants.  Gerentologist 33 (1) 128-131. Rogers AC 1997,  Vulnerability health and healthcare.  Journal of Advanced Nursing 26 65-72. Ryan J Thomas F 1987,  The Politics of Mental Handicap.  London: Free Association Books. Sequeira H, Howlin P, Hollins S 2003,  Psychological disturbance associated with sexual abuse in people with learning disabilities,  The British Journal of Psychiatry (2003) 183: 451-456 Sines D 1995,  Impaired autonomy: the challenge of caring.  Journal of Clinical Nursing 4 (2) 109-115. Thompson D, Clare I Brown H 1997,  Not such an ordinary relationship: the role of women support staff in relation to men with learning disabilities who have difficult sexual behaviour.  Disability and Society 12 (4) 573-592. Wilson D, Haire A. 1999,  Health care screening for people with mental handicap living in the community.,  BMJ 1999;301: 1379-81 Xenitidis K. Thornicroft G. Leese M. Slade M. Fotiadou M. Philp H. Sayer J. Harris E. McGee D. Murphy DG. 2000,  Reliability and validity of the CANDID-a needs assessment instrument for adults with learning disabilities and mental health problems.  British Journal of Psychiatry. 176:473-8, 2000 May ############################################################# 29.3.06 PDG Word count 2,071

Cell Biology Meiosis and Mitosis

Cell Biology (CP8121) Experiment 2: Observing Mitosis and Meiosis on cell specimens (Formal report) Name: Wong Chung An Class: DMLS/FT/1B/02 Admin number: P1138687 Summary This experiment aims to observe mitosis and meiosis on cell specimens. It involves the modelling of the stages of meiosis and also the staining procedures to identify mitosis in onion root tip. There are two parts to the procedure of the experiment whereby the first is staining and observing mitosis in onion root tips and the second being observing and comparing mitosis between whitefish blastula and onion root tip. The results are that the five stages of mitosis have been observed and sketched, together with a comparison of telophase in plant and animal cells. The difference between the two types of cell division mitosis and meiosis has also been recorded. The conclusion is that all the objectives of the experiment have been met and it is recommended that the mitotic spindle be stained for a more complete picture of the various stages of mitosis. 1) Introduction It is important that the experiment is carried out so as to differentiate between the two types of nuclear division, mitosis and meiosis. Mitosis is a process mainly for the growth and replacement of somatic cells and it involves the replication of chromosomes which results in having two daughter cells each same as the parent nucleus. On the contrary, meiosis is for the production of gametes which is essential for an organism’s reproduction and it comprises of two successive nuclear divisions which results in the production of four haploid cells. Mitosis: A process which replicates chromosomes exactly so that each of the daughter cells contains identical information. The process of mitosis involves five stages. The five stages are: Interphase, Prophase, Metaphase, Anaphase and Telophase respectively. Meiosis: A process whereby two successive nuclear divisions will produce four haploid cells. There are two rounds of cell division in meiosis, mainly meiosis I and meiosis II. Meiosis I is identical to that of mitosis whereas meiosis II is a round of reductional division. The process of meiosis has allowed for an escalation of genetic variations because of the crossing over of the genes. This process is crucial as it produces half the number of chromosomes as per the human sex cells. For humans, every gamete contains 23 chromosomes and fertilisation of an egg by a sperm will restitute the diploid number of 46 chromosomes 2) Objectives * Learn a staining procedure to identify mitosis using onion root tip. * Compare and contrast mitosis in plants and animals. * Compare and contrast stages of mitosis and meiosis * Model stages of meiosis. 3) Procedures (a) Preparation and observation of onion root tip slide ) An onion root tip was obtained and the first 1-3mm of its root tip was cut off using a scalpel. The root tip was then placed at the centre of a clean slide using a forceps. 2) Then, the root tip was covered with 2-3 drops of 1N HCL solution and then placed over the hot plate for 3-5 seconds using a slide holder. 3) Without touching the root tip, the excess acid was then blotted off using a paper towel. 4) After which, the root tip was then covered once again, this time in 3-4 drops of 0. 5% Toluidine Blue solution. 5) The excess stain was blotted off and a cover slip was added. ) To spread out the stained root tip for visualisation, the slide was placed in the middle of a folded paper towel and applied pressure upon by placing the thumb directly above the cover slip and having it gently pressed on against a lab bench. 7) The slide was examined on low power on the microscope and embryonic cells which are square-like were looked for. 8) Once the mitotic figures were found, the microscope was switched to a higher power. 9) The phases that were seen were sketched on the datasheet. (b) Observation of prepared slides: Mitosis in Onion root tip & Whitefish blastula ) The prepared slides provided were reviewed by using a low power (10x) to locate the cells and high power (40x) to change the focus. 2) This time, instead of sketching the different phases of mitosis in onion root tip, the differences in mitosis between the plant and animal cells were re corded. 4) Results and Discussion *For the results, refer to the datasheet archived under appendix at the end of the report. 5. 1 Explanation and reasons for results The results of the datasheet have shown that all the five main phases of mitosis can be observed. This can because of several reasons such as the choice of use of onion root tips, flattening of the onion root tips, addition of hydrochloric acid and 0. 5% Toluidine Blue solution. Onion root tips are easy to grow in large numbers and the cells at its tips are actively dividing, thus many of its cells will be in different stages of mitosis. The reason for using the last 1-3mm of the root tip is because it is where the region of cell division (meristem) is located. This is the region whereby cells are dividing but not significantly increasing in size. The flattening of the onion root tips allows the chromosomes of each individual cell to be observed. The hydrochloric acid added, plays a part in fragmenting the root tissues by weakening and removing the bonds between cells so that each cell will not be attached to the other cell, obstructing the observation. Toluidine Blue solution acts as a colorant, giving a blue colour to the chromosomes and so that it is more easily spotted and examined. 5. 2 Evaluation of the results achieved Interphase: The interphase is the phase in which the cell is involved in metabolic activity and fulfilling its role as part of a tissue in the body. During this phase, the DNA duplicates as it is preparing for mitosis and the chromosomes are cannot be easily distinguished. However, the nucleolus, a dark spot may be visible instead. Prophase: During the prophase, the chromatin within the nucleus will begin to condense and become visible in the microscope as chromosomes. Then the nuclear membrane will dissolve, signalling the start of Prometaphase. After which, proteins would then attach to the centromeres, creating kinetochores in which the microtubules will attached to. The chromosomes would then start moving. Metaphase: The chromosomes would then be aligned by the spindle fibres at the equator of the spindle. This alignment helps to ensure that in the anaphase, when the chromosomes are separated, each of the new nucleuses will receive a copy of each of the chromosomes. Anaphase: In the anaphase, the two sister chromatids of each chromosome at the centromeres would start to separate. This movement is due to the shortening of the kinetochore microtubules. Telophase: The two sets of daughter chromosomes would arrive at the two poles and the mitotic spindle would disappear. A nuclear envelope would start to form around each set of daughter chromosomes at both ends of the poles. Cytokinesis may have also begun during this phase depending on each individual cell. 5. 3 Descriptions of problems encountered The problem that we have encountered during this experiment was during the preparation of the first slide of onion root tip. The amount of toluidine blue solution may not be enough as only a few of the cell nucleus have been stained. This makes it difficult for us trace the various stages of mitosis. This problem is resolved however by making a new set of the onion root tip slide. 5) Conclusions and Recommendations In conclusion, the experiment was a success and all of the objectives of the experiments were met. All five stages of mitosis have been observed and a comparison of mitosis between plant and animal cells has been made. Although we did not get to observe the stages of meiosis, we have modelled the stages of meiosis and acquired knowledge of it. In my opinion, I would recommend that the mitotic spindles of the onion root tip cells be stained as well. This would allow a more in depth observation of mitosis and instead of solely looking at the movement of the chromosomes and the nucleus, we could observe the reason behind the movement of the chromosomes. 6) Appendix http://www. marietta. edu/~biol/introlab/Onion%20root%20mitosis. pdf Clark, D. C. and P. M. Mathis. (2000). Modeling mitosis and meiosis: a problem-solving activity. The American Biology Teacher Mickle, J. E. 1990. A model for teaching mitosis and meiosis. The American Biology Teacher Carmen Chan Yuen Man (2011). Cell Biology lecture notes (CP8121). Singapore Polytechnic.

Discursive Essay

Compare the advantages and disadvantages of three of the following as media for communicating information. State which you consider to be the most effective. †¢ comics †¢ books †¢ radio †¢ television †¢ film †¢ theatre The role of media is no longer able to be separated from information. As it is a very important element in the information delivery, there are various kinds of media existed nowadays. Among those media, television, radio, and film are mostly favorite choices of people around the world. Radio is a media which has been used for decades but still keep its uniqueness as its greatest power.People love hearing news from radio because they could get it for free. Plus, they can do it everywhere they are. They can do it at home, in the office or on the way to certain place. However, radio has some weaknesses. One of them is give people a limitation in seeing the visual. In many cases, the importance of need to see the visual of the information give n is very high. Film is also considered as a favorite media for people because it is able to give a lot of information in a very interactive ways.We can even learn history which is considered boring for some people by watching movie. Nevertheless, the number of film that people can watch is very limited because it takes a quite long time to enjoy one full movie. The last media that influence alot in human’s life is television. There will always a television existed in a house. Not only one, sometimes there are more than two or three televisions in a house. It makes the use of this media can’t be monitored by adults regularly. This condition can be harmful for children as they can access it freely.Moreover, unlike any other media, there is nothing can be done to prevent them to get access to some inappropriate shows for children under age. Besides, there is a high tendency for someone to get addicted to it. It could happen to children, or even adults. When it happens to someone, it will definitely give him or her some disadvantages. They will not be able to give full focus on things that they currently do as they are bothered with this problem. Further, television is a media with a very high number of advertisements.There are thousands of advertisements showed up in television every day. These advertisements take a big role in changing someone’s shopping habit. It has a great power to influence the audience to be very consumptive in life. The audience might get high impulse to buy things that they even really need. On the other hand, television is proved as a great companion in every house. Television could be a great media to take away stress that the owner might get after working all day long. The show can be accessed for free, so someone does not have to spend some amount of money to have it.Besides, the owner does not have to get out of his or her house to enjoy the show. They just need to turn their television on and sit calmly. Moreov er, television provides thousands of information from its shows. It provides news that is updated regularly. As a plus, the audience could also get the visualization of the updated events happened. It seems that television has erased distance gap among countries all over the world so we could get current news from other countries in a very short time.Plus, television gives a lot of job opportunities for many people. They can work as newscaster, reporter, script writer, producers, and other jobs by the existence of television. It can be categorized as a big business as well, so it needs a lot of personnel to support. It means that more people could get work from it. In conclusion, I think television has brought more influence on human’s life because it provides more benefits for our life compared to other media such as radio Discursive Essay Compare the advantages and disadvantages of three of the following as media for communicating information. State which you consider to be the most effective. †¢ comics †¢ books †¢ radio †¢ television †¢ film †¢ theatre The role of media is no longer able to be separated from information. As it is a very important element in the information delivery, there are various kinds of media existed nowadays. Among those media, television, radio, and film are mostly favorite choices of people around the world. Radio is a media which has been used for decades but still keep its uniqueness as its greatest power.People love hearing news from radio because they could get it for free. Plus, they can do it everywhere they are. They can do it at home, in the office or on the way to certain place. However, radio has some weaknesses. One of them is give people a limitation in seeing the visual. In many cases, the importance of need to see the visual of the information give n is very high. Film is also considered as a favorite media for people because it is able to give a lot of information in a very interactive ways.We can even learn history which is considered boring for some people by watching movie. Nevertheless, the number of film that people can watch is very limited because it takes a quite long time to enjoy one full movie. The last media that influence alot in human’s life is television. There will always a television existed in a house. Not only one, sometimes there are more than two or three televisions in a house. It makes the use of this media can’t be monitored by adults regularly. This condition can be harmful for children as they can access it freely.Moreover, unlike any other media, there is nothing can be done to prevent them to get access to some inappropriate shows for children under age. Besides, there is a high tendency for someone to get addicted to it. It could happen to children, or even adults. When it happens to someone, it will definitely give him or her some disadvantages. They will not be able to give full focus on things that they currently do as they are bothered with this problem. Further, television is a media with a very high number of advertisements.There are thousands of advertisements showed up in television every day. These advertisements take a big role in changing someone’s shopping habit. It has a great power to influence the audience to be very consumptive in life. The audience might get high impulse to buy things that they even really need. On the other hand, television is proved as a great companion in every house. Television could be a great media to take away stress that the owner might get after working all day long. The show can be accessed for free, so someone does not have to spend some amount of money to have it.Besides, the owner does not have to get out of his or her house to enjoy the show. They just need to turn their television on and sit calmly. Moreov er, television provides thousands of information from its shows. It provides news that is updated regularly. As a plus, the audience could also get the visualization of the updated events happened. It seems that television has erased distance gap among countries all over the world so we could get current news from other countries in a very short time.Plus, television gives a lot of job opportunities for many people. They can work as newscaster, reporter, script writer, producers, and other jobs by the existence of television. It can be categorized as a big business as well, so it needs a lot of personnel to support. It means that more people could get work from it. In conclusion, I think television has brought more influence on human’s life because it provides more benefits for our life compared to other media such as radio

Early Adulthood The Period Between The Ages Of 20 And 40...

Early adulthood is the period between the ages of 20 and 40 years characterized by a peak in physical and intellectual performance. During early adulthood, individuals are concerned with expanding the capability to share intimacy, find the right career pathway, and intimate love. Although in the past decades, all those events happened during late teens and early twenties, the trend nowadays is to postpone them into the thirties. Due to better nutrition and more efficient methods employed towards combating and preventing disease, the life expectancy in the US was of 79 years in 2014, compared to 70 years in the 1960s (World Bank, 2014). Worldwide, longevity, economic, and social factors contributed to a delay in the commencement of certain life events that used to occur during the first part of early adulthood, the twenties, to mid or even late thirties. In addition to those factors, the media has been promoting this new tendency without many regards towards the physical and mental changes that happen during the thirties. Meg Jay, a clinical psychologist, talks about the beginning of her career, when her very first patient, Alex, 26 years old, dealt with â€Å"guy problems†. Young and inexperienced, Meg Jay did not try to push her patient towards ending a relationship with no future until encouraged by her supervisor. As many adults her age, Alex did not seek to marry the guy she was dating at the time, and she was more likely â€Å"killing time† until the â€Å"right† person came along.Show MoreRelatedLifespan Development and Personality Paper1456 Words   |  6 Pages Development does not end with adolescence. Adults, too, go through modifications and experience physical, cognitive, and social changes. 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