Childcare - Orientation Package Essay Example for Free

Childcare Orientation Package Essay INTRODUCTION One of the goals of the Ministry of Children and Youth Services is to help support social and economic development in Ontario by investing in and supporting an affordable, accessible and accountable child care system which helps benefit children, their parents and caregivers, and the broader community. The early learning and child care system in Ontario should: †¢ be accessible, affordable and inclusive †¢ care for children in a safe, nurturing environment †¢ foster early childhood development †¢ help support early learning and readiness for school †¢ be flexible and provide choice †¢ support children and their families †¢ provide appropriate standards of child care †¢ provide supports for parents in financial need, who are employed, in training, or involved in other employment activities †¢ support economic growth, and †¢ work in partnership with others involved in Ontario’s. early learning and child care system. This Orientation Package has been designed to provide individuals who are interested in obtaining a licence to operate either a day nursery (also known as child care centres) or a private-home day care agency in the Province of Ontario, with practical information and advice. The following information is included in this package: †¢ the process for obtaining a licence †¢ a summary of the licensing requirements to operate a day nursery or a private-home day care agency under the Day Nurseries Act †¢ a glossary of terms (Appendix 1) †¢ information to assist you in considering your decision to apply for a licence to operate either a day nursery or a private-home day care agency (Appendix 2) †¢ a list of the Regional Offices of the Ministry of Children and Youth Services (Appendix 3), and †¢ a list of the Child Care Service System Managers responsible for planning and managing the delivery of child care services throughout Ontario (Appendix 4). 4 CHILD CARE IN ONTARIO The child care system in Ontario consists of a range of services for families and their children, including licensed day nurseries and private-home day care which provide supports to children and their families. The Day Nurseries Act requires any premise that receives more than five children under the age of 10 years, not of common parentage (children who have different parents), for temporary care and guidance, to be licensed as a day nursery. A person may provide informal child care to five children or less under the age of 10 years who are not of common parentage (children who have different parents), in addition to his/her own children, without a licence. This number may not be exceeded, regardless of the number of adults present or on site. When a person provides in-home child care at more than one location or co-ordinates the provision of care at more than one site, a licence to operate a private-home day care agency is required. It is an offence to establish, operate or maintain a day nursery or private-home day care agency without a licence. On conviction, the fine is up to $2,000 for each day the offence continues, or imprisonment for a term of not more than one year, or both. Ministry staff have the responsibility to follow-up on all complaints about child care being provided without a licence. CHILD CARE LICENSING IN ONTARIO The Ministry of Children and Youth Services is responsible for the Day Nurseries Act and issues licences to operators of child care programs. There are two types of licensed child care programs: day nurseries and private-home day care agencies. In the Day Nurseries Act and in this package, child care centres are referred to as day nurseries. Day nurseries may include nursery schools, full day care, extended day care, and before and after school programs. Private-home day care agencies arrange or offer home day care at more than one home. Care is provided to five children or less, under 10 years of age in a private residence other than the home of the parent/guardian of the child. Homes are monitored by the agency. Role of the Operator Operators have responsibility for the operation and management of each day nursery or private-home day care agency, including the program, financial and personnel administration of the program. Operators of licensed day nurseries and private-home day care agencies are required to achieve and maintain compliance with the standards set out in Ontario Regulation 262 under the Day Nurseries Act at all times. The Day Nurseries Act and Ontario Regulation 262 are available through: Publication Services 777 Bay Street, Market Level, Toronto, Ontario M5G 2C8 416-585-7485 or 1-800-668-9938 The Day Nurseries Act is available on the ministry’s website at: http://www. elaws. gov. on. ca/html/statutes/english/elaws_statutes_90d02_e. htm. Ontario Regulation 262 under the Day Nurseries Act is available online at: http://www. elaws. gov. on. ca/html/regs/english/elaws_regs_900262_e. htm#37. (1). The Director under the Day Nurseries Act Child care licences are issued by a â€Å"Director† who is an employee of the Ministry of Children and Youth Services, appointed by the Minister for the purpose of the Day Nurseries Act. The Director reviews all documents required for licensing, approves and signs the licence. The Director has the authority to refuse to issue a new licence if: †¢ the applicant or any of the officers, directors or employees of the applicant are not competent to operate a day nursery or privatehome day care agency in a responsible manner in accordance with the Day Nurseries Act 6 †¢ the past conduct of the applicant affords reasonable grounds for the belief that a day nursery or private-home day care agency will not be operated in accordance with the Day Nurseries Act, or the building in which the applicant proposes to operate the day nursery or provide private-home day care does not comply with the requirements of the Day Nurseries Act. †¢ In addition, if there are grounds, the Director may refuse to renew or revoke an existing licence. The Director may also issue a direction and temporarily suspend a licence if there is an immediate threat to the health, safety or well-being of the children. An applicant or licensee is entitled to a hearing before the Licence Appeal Tribunal. Role of Program Advisors Program Advisors, Ministry of Children and Youth Services staff designated under Section 16 of the Day Nurseries Act, are responsible for inspecting day nurseries and private-home day care agencies to enforce licensing requirements. In some regional offices, this position is referred to as Licensing Specialist. Program Advisors are responsible for assessing whether the operator has met the licensing requirements before an initial licence is issued. Unannounced inspections are conducted by Program Advisors for licence renewals on an annual basis or more frequently for a shorter term licences. In addition, Program Advisors conduct unannounced inspections in response to complaints related to licensed child care programs and to monitor operators who have difficulty maintaining compliance with licensing standards. The Ministry of Children and Youth Services also responds to complaints from the public pertaining to persons who are alleged to be operating without a licence (i. e. caring for more than five children under 10 years of age, not of common parentage, without a licence). The Application Process An individual or corporation can apply for a licence to operate a day nursery or a private-home day care agency. (Licences cannot be issued to partnerships. ) Types of operators include: †¢ an individual †¢ corporations (non-profit and for-profit) †¢ municipalities †¢ community colleges †¢ churches, or †¢ Bands and Councils of the Band. The prospective operator contacts the local Regional Office (see Appendix 3) to request an application package and confirm the information required before proceeding with the next steps in the licensing process. Prior to requesting an initial site inspection for a day nursery (a visit to determine if the space is appropriate), the operator submits the completed application form to the Regional Office, as well as: †¢ †¢ †¢ written verification from the zoning authority confirming the location is approved for use as a child care centre detailed floor plans, and detailed site plans of the proposed location. These plans must include room measurements, window measurements (actual glass area), location of fixed cabinets (counters and storage areas) and fenced outdoor playground space dimensions (if required). Please note that effective July 1, 2005, as part of regulatory changes to the Ontario Building Code, all building or renovation plans for a day nursery must be reviewed and approved by the Ministry of Children and Youth Services prior to a municipality issuing a building permit. It is the operator’s responsibility to determine whether the location will meet zoning, building, fire and health requirements. Written verification must be submitted to the regional office confirming that these requirements have been met prior to a licence being issued. The fee for a new licence is $15; the renewal fee is $10. If a licence renewal is submitted to the ministry after the licence expiry date, the late fee is $25. 8 Planning and Design Guidelines for Child Care Centres This guide provides information about the planning, design and renovation of licensed child care centres. It is intended to be used by persons involved in the site selection, design, and operation of a child care centre in the province of Ontario. This guide is available through the local MCYS Regional office and on the ministry’s website at http://www. children. gov. on. ca/mcys/english/resources/publications/be ststart-planning. asp. (Alternately, from the ministry’s home page at. http://www. children. gov. on.ca, you can follow the links to Best Start, then Best Start resources, then Planning and Design Guidelines for Child Care Centres. ) Obtaining a Licence To obtain a licence, applicants must demonstrate compliance with the requirements set out in Regulation 262 of the Day Nurseries Act in a number of areas including: confirmation of compliance with municipal zoning, building, fire and health requirements; the suitability of the building; availability of equipment and furnishings; conformity with space requirements and playground standards; maintenance of staff/child ratios for various age groups; staff qualifications; nutrition; appropriate behaviour management; programming and insurance. Private-home day care agencies must demonstrate compliance with the requirements set out in Regulation 262 of the Day Nurseries Act in a number of areas including: staffing and training; policies and procedures; records of inspections of providers’ homes; availability of equipment and furnishings; appropriate behaviour management and insurance. The Program Advisor makes a recommendation to the Director under the Day Nurseries Act about the issuance of a licence based on their assessment of compliance with the requirements of the Day Nurseries Act and ministry policy. The Director decides whether to issue a licence and the type and term of licence to be issued. The Director may add terms and conditions to the licence. The operator is required to comply with the terms and conditions of the licence as well as the requirements of the Day Nurseries Act and ministry policy. Operators must apply for a licence renewal prior to the expiry date of the current licence. Licences may be issued for a period of up to one year if all licensing requirements are met. Health Canada – Product Safety Program Health Canada helps protect the Canadian public by researching, assessing and collaborating in the management of the health risks and safety hazards associated with the many consumer products, including children’s equipment, toys and furnishings, that Canadians use everyday. Through their Product Safety Program, Health Canada communicates information about juvenile product hazards and recalls to protect children from avoidable risks. Advisories and warnings, juvenile product recall notices, food recalls and allergy alerts are posted on the Health Canada website. The Consumer Product Recalls webpage can be accessed at http://209. 217. 71. 106/PR/list-liste-e. jsp. Health Canada offers an electronic newsletter so that the public can receive updates when consumer advisories and warnings, juvenile product recalls, and consultation documents regarding consumer product safety are posted on the Health Canada Web site. As a prospective operator, you are encouraged to register on line for this service at: http://www. hc-sc. gc. ca/cps-spc/advisories-avis/_subscribeabonnement/index_e. html. Duration of Initial Licensing Process It may take up to 6 to 12 months to open a new day nursery or private-home day care agency depending on a number of factors, including the extent of the renovations, the incorporation of a corporation, the purchasing of equipment, the hiring of a supervisor or home visitors, the recruitment of staff, the development of policies and obtaining all required approvals. Types of Licences †¢ Regular licence – may be issued for up to 1 year if the operator was in compliance with licensing requirements when last inspected. 10 †¢ Regular short-term licence – issued at the discretion of the Director routinely issued to new licensees (generally for a period of up to six months) or when more frequent licensing visits are appropriate to support ongoing compliance. Regular licence with terms and conditions terms and conditions are requirements prescribed by a Director and are additional to the requirements of the Day Nurseries Act. They may reflect circumstances specific to the operation, such as half day or 10 month service. They may also be in place to minimize the recurrence of a non-compliance, such as incomplete staff medical records. Provisional licence – When Day Nurseries Act requirements have not been met and the operator requires time to meet requirements, a provisional licence (generally for a period up to three months) may be issued. This licence gives the operator a period of time to meet licensing requirements. Copies of a letter indicating that a provisional licence has been issued and a summary of the non-compliances are sent to the centre for distribution to parents. The summary of non-compliances will also appear on the Child Care Licensing Website. †¢ †¢ Child Care Licensing Website MCYS has launched the Child Care Licensing Website to provide parents with information about licensed child care in Ontario. The site is accessible at http://www. ontario. ca/ONT/portal51/licensedchildcare. A search tool allows parents to search for child care by city, postal code, type of program, age group, program name, operator name and language of service delivery. The site also provides the status of the licence and the terms and conditions of the licence for any licensed program parents might be considering or about which they might be concerned. Once a licence is issued, the information appearing on the licence of the program will be available on the website. Child Care Service System Managers The child care system is managed at the municipal level by fortyseven Consolidated Municipal Service Managers (CMSMs) /District 11 Social Services Administration Boards (DSSABs). Each service system manager has responsibility for planning and managing a broad range of child care services, including fee subsidy, wage subsidy, family resource centres and special needs resourcing. Prospective operators should contact their local child care service system manager (see Appendix 4) to discuss the need for child care in the area being considered and for information about funding and fee subsidy. 12 DAY NURSERIES ACT SUMMARY OF LICENSING REQUIREMENTS FOR DAY NURSERIES Day nurseries are centre-based programs and can include nursery schools, full day child care, extended day and before and after school programs. Organization and Management The operator of the day nursery is responsible for maintaining compliance with the Day Nurseries Act and ministry policy. This includes responsibility for the operation and management of the program and financial and personnel administration. A qualified supervisor who directs the program and oversees the staff is required for each child care centre. This person must have a diploma in Early Childhood Education, or other academic qualifications which are considered equivalent, and have at least two years experience in Early Childhood Education. The supervisor must also be approved by the Director under the Day Nurseries Act. Staff Qualifications †¢ The supervisor must have a diploma in Early Childhood Education or equivalent qualifications, with two years experience and must be approved by the Director under the Day Nurseries Act. †¢ One staff with a diploma in Early Childhood Education or equivalent qualifications must be hired for each group of children. Health Assessments and Immunization †¢ Staff immunization/health assessment, as required by the local medical officer of health, must be completed before commencing employment. 13. Number and Group Size Number of Staff required for a Day Nursery Other than a Day Nursery for Children with Disabilities Ratio of Employees to Children 3 to 10 1 to 5 Maximum Number of Children in a Group 10 15 Group Age of Children in Group Infant Toddler Under 18 months of age 18 months of age and over up to and including 30 months of age more than 30 months of age up to and including 5 years of age 44 months of age or over and up to and including 67 months of age as of August 31 of the year 56 months of age or over and up to and including 67 months of age as of August 31 of the year 68 months of age or over as of August 31 of the year and up to and including 12 years of age Preschool 1 to 8 16 Junior Kindergarten 1 to 10 20 Senior Kindergarten 1 to 12 24 School age. 1 to 15 30 †¢ All children must be supervised by an adult at all times. †¢ Ratios are not permitted to be reduced at any time for children under 18 months of age. †¢ Ratios are not to be reduced on the playground. 14 †¢ Where there are six or more children over 18 months of age or four or more children under 18 months of age in attendance, there must be at least two adults on the premises. †¢ Staff/child ratios may be reduced to 2/3 of the required ratios during the periods of arrival and departure of children and during the rest period, with the following exceptions: †¢ †¢ when children are under 18 months of age on the playground with any age group. †¢ In a full day program operating six or more hours in a day, for the purposes of staffing, the period of arrival is not to exceed two hours after the opening and the period of departure is not to exceed two hours before the closing of the day nursery. †¢ In half day nursery school programs and school age programs, the period of arrival is not to exceed 30 minutes after the opening and the period of departure is not to exceed 30 minutes before the closing of the day nursery. Criminal Reference Checks Individuals and directors of a corporation applying for new licences will be required to submit a criminal reference check to their local Ministry of Children and Youth Services Regional Office as part of the licence application. In preparation for the initial licensing visit, the operator of the day nursery is required to develop a criminal reference check policy for all full and part time staff working with the children, as well as for volunteers. Additional information about the Ministry of Children and Youth Services criminal reference check policy is available from Regional Offices. Building and Accommodation Each day nursery must: †¢ comply with the requirements of applicable local authorities i. e. zoning and building department, medical officer of health and fire department †¢ comply with the requirements of the Safe Drinking Water Act, 2002, O. Reg. 170/03, where applicable. These provisions only apply to designated facilities with drinking water systems where 15 the water is not provided through service connections with a municipal residential water system. The requirements of this regulation are available from the Ministry of the Environment’s website at http://www. ene. gov. on. ca/envision/gp/5361e. pdf †¢ comply with the requirements for lead flushing and water sample testing (where applicable) under the Safe Drinking Water Act, 2002, O. Reg. 243/07. The requirements of this regulation are available from the Ministry of the Environment’s website at http://www. ontario. ca/ONT/portal51/drinkingwater/General? docId= 177450lang=en †¢ comply with the requirements of the Smoke-Free Ontario Act. †¢ have designated spaces for washing, toileting and separate storage areas for toys, play materials and equipment †¢ have designated space for eating and resting, preparation of food if prepared on premises or a food service area if food is catered (prepared off premises by a food catering company and delivered to the centre), a fenced playground (see page 15), storage for beds, a staff rest area and an office area if the program operates for six or more hours †¢ have play space of at least 2. 8 square metres (30 square feet) Of unobstructed floor space for each child, based on the licensed capacity †¢ have separate play activity rooms for each age grouping. A separate sleep area for infants is also required †¢ have rooms on or below the second floor where the rooms are for children under six years of age †¢ have a clear window glass area equivalent to 10% of the available floor area for each play activity room for a program that operates for six or more hours in a day. 16 Equipment and Furnishings Each day nursery must have: †¢ an adequate number of toys, equipment and furnishings for the licensed capacity. The toys, equipment and furnishings must be age appropriate and include sufficient numbers for rotation as well as for gross-motor activity in the playground area †¢ infant and toddler diapering areas that are adjacent to a sink †¢ cribs or cradles that meet the requirements of the Hazardous Products Act, for infants, and cots for older children †¢ equipment and furnishings which are maintained in a safe and clean condition and kept in a good state of repair †¢ a telephone or an alternative means of obtaining emergency assistance that is approved by the Director. †¢ Where children are transported in a day nursery vehicle, child seating and restraint systems are used that meet the requirements of the Highway Traffic Act, O. Reg. 613. Policies and Procedures Every operator must develop the following policies and procedures: †¢ Fire evacuation procedures †¢ Sanitary practices †¢ Serious occurrence policy, including child abuse reporting procedures †¢ Criminal reference check policy †¢ Medication policy †¢ Behaviour management policy, including monitoring procedures and contravention policies 17. †¢ Program statement/parent handbook †¢ Playground safety policy †¢ Anaphylactic policy, including an individual plan for each child with a severe allergy and the emergency procedures to be followed. Playground Requirements †¢ Programs operating six or more hours in a day require outdoor play space equivalent to 5. 6 square metres (60 square feet) per child, based on licensed capacity. †¢ The playground must be: †¢ sub-divided if licensed capacity is over 64 children †¢ at ground level and adjacent to the premise †¢ designed so that staff can maintain constant supervision. †¢ If used by children under 44 months of age as of August 31 of the year, the playground must be fenced to a minimum height of 1. 2m (4 feet) and furnished with one or more gates that can be securely closed at all times. †¢ If used by children 44 months of age and up to an including 67 month of age as of August 31 of the year (children eligible to attend junior and senior kindergarten), the playground is fenced to a minimum height of 1. 2 metres and the fence is furnished with one or more gates that are securely closed at all times, unless otherwise approved by the Director. †¢ Fixed playground structures (i. e. climbing equipment, slides) are not required by the Day Nurseries Act; however, if the operator intends to install fixed play structures, the structures and safety surfacing must meet current Canadian Standards Association standards. †¢ The current Canadian Standards Association’s (CSA) Standard applies to new and newly renovated playground equipment, and 18 safety surfacing. The CSA Standards also set out the requirements for routine maintenance and inspections. †¢ Playground plans indicating the type and location of fixed structures as well as the type and area of safety surfacing must be approved by the ministry before installation. †¢ Once play structures and surfacing are installed, compliance with the CSA standards must be verified in writing by an independent certified playground inspector before the structures can be used by the children. Inspections †¢ Copies of fire and health inspections are to be sent to the Ministry of Children and Youth Services program advisor and kept on file at the day nursery. Insurance Requirements †¢ The operator must have comprehensive general liability coverage and personal injury coverage for all staff and volunteers. †¢ All vehicles owned by the operator and used for transportation of staff and children must have motor vehicle insurance. Fire Safety and Emergency Information †¢ A fire safety plan must be approved by the local fire department. †¢ A written evacuation procedure, approved by the fire department, must be posted in each room. †¢ Staff are to be instructed on their responsibilities in the event of fire. †¢ Monthly fire drills must be conducted and written records of drills maintained. †¢ Tests of the fire alarm system and fire protection equipment (as required under the Ontario Fire Code) must be conducted and written records of test results maintained. †¢ There must be a designated place of emergency shelter. †¢ An up-to-date list of emergency telephone numbers including the fire department, hospital, ambulance service, poison control centre, police department and a taxi service must be posted where they can be easily accessed. †¢ Medical and emergency contact information for each child must be accessible. Health and Medical Supervision †¢ A daily written log that includes health and safety incidents is required. †¢ Any instructions or recommendations made by the fire department, public health department or other regulatory bodies must be implemented and recorded. †¢ Sanitary practices and procedures must be approved by Ministry. †¢ Children must be immunized according to the requirements of the local medical officer of health, unless a fully authorized exemption is on file. †¢ Before each child begins to play with others, a daily observation of the child’s health is required. †¢ An ill child must be separated from others and arrangements made for the child to be taken home or for immediate medical attention, if required. †¢ Serious occurrence procedures must be in place and the Ministry of Children and Youth Services notified of any occurrence. A serious occurrence includes such things as the death of a child, a serious injury, alleged abuse/mistreatment of a child, a missing child, a disaster on the premises (e. g. fire) or a serious complaint. 20 †¢ A written anaphylactic policy is in place that includes: †¢ A strategy to reduce the risk of exposure to anaphylactic causative agents †¢ A communication plan for the provision of information on lifethreatening allergies, including anaphylactic allergies †¢ An individual plan for each child with an anaphylactic allergy that includes emergency procedures in respect of the child †¢ Staff, students and volunteers have received training on procedures to be followed if a child has an anaphylactic reaction. †¢ A first aid kit and manual must be readily available. †¢ A written procedure approved by a qualified medical practitioner regarding the giving and recording of medication is required. The procedure should include the storage of medication (e. g. medication must be stored in a locked container). †¢ If a child has or may have a reportable disease or is or may be infected with a communicable disease, this is reported to the medical officer of health as soon as possible. †¢ Cats and dogs on the premises must be inoculated against rabies. Nutrition †¢ Infants are to be fed according to written parental instructions. †¢ Food and drink from home must be labelled with the child’s name. †¢ All food and drink must be stored to maintain maximum nutritive value. †¢ Meals and snacks must meet the requirements of the Day Nurseries Act. Canadas Food Guide provides useful information about nutrition. 21 †¢ Meals are to be provided where a day nursery operates for 6 or more hours each day or where the daily program operates less than 6 hours each day and operates over the meal time. This generally refers to the provision of lunch as the mid-day meal. In day nurseries that offer care over extended hours, this may mean that breakfast and/or dinner are also provided. †¢ With the approval of a ministry Director, children 44 months of age or over as of August 31 of the year may bring bag lunches. Written policies and procedures with guidelines for bag lunches should be both posted and provided to parents. †¢ Menus must be posted with substitutions noted. †¢ Children’s food allergies must be posted in the kitchen and in all rooms where food is served. †¢ Special dietary arrangements for individual children are to be carried out according to written instructions of parents. Behaviour Management †¢ Corporal punishment is not allowed under any circumstances. †¢ The following are not permitted: †¢ deliberate harsh or degrading measures that would humiliate or undermine a childs self respect †¢ deprivation of food, shelter, clothing or bedding †¢ confining a child in a locked room †¢ exits locked for the purpose of confinement. †¢ Written behaviour management policies and procedures which guide centre staff in managing children’s behaviour are to be reviewed annually by the operator. The operator is required to review the policies and procedures with employees and volunteers or students before they begin working, and annually thereafter. These policies must set out permitted and prohibited behaviour 22 management practices and measures to deal with any contraventions of the policy. †¢ There must be: †¢ a signed, written record of all reviews, and †¢ a written procedure for monitoring behaviour management practices of employees, students and volunteers, and a record kept of this monitoring. Enrolment Records †¢ Up to date enrolment records for all children in attendance must be on site at all times and be available to the Ministry of Children and Youth Services. These records include, in part, an application, immunization records, emergency information, names of persons to whom the child may be released, parental instructions regarding rest, diet or exercise. †¢ Daily attendance records that indicate a child’s arrival, departure and absence from the program are required. †¢ The medical officer of health or designate such as the public health nurse is permitted to inspect children’s records to ensure that all required immunizations are up to date. Program In order to ensure that the program offered is age and developmentally appropriate for the age of the children being served, the following is required: †¢ a written program philosophy statement which is reviewed annually by the operator and with parents prior to enrolling their child †¢ a program statement which includes: Services, age range, times when the services are offered, holidays, fees, admission and discharge policies, program philosophy, program development, personal and health care, nutrition, parental involvement and 23  behaviour management, specialized services and activities off the premises †¢ varied, flexible and age appropriate programs that include quiet and active play, individual and group activities which are designed to promote gross and fine motor skills, language and cognitive skills, and social and emotional development, and †¢ a daily program plan posted and available to parents with any variations to the program recorded in the daily log. In addition: †¢ Any infants not able to walk are to be separated from other children during active indoor and outdoor play periods †¢ Children under 30 months of age are to be separated from older children during active indoor and outdoor play periods †¢ Children who attend for six or more hours in a day and are over 30 months of age shall have at least two hours of outdoor play, weather permitting †¢ Children who attend for.

Perspective on Religion Herman Melvilles Moby-Dick Essay example -- M

Perspective on Religion Herman Melville's Moby-Dick A cornerstone of the philosophical and narrative substructure of Herman Melville's Moby-Dick is point of view, or perspective. The textually primary point of view in the novel is Ishmael's, since he is the narrator of the story. However, Ishmael relates his story in such a way that one can easily detect numerous other "voices," or other perspectives, in the story, which often oppose the narrator's voice. These other, non-primary perspectives function both to establish Moby-Dick as a novel with numerous points of view and to clarify Ishmael's own particular point of view on certain subjects. For instance, in "The Ramadan" Ishmael attempts to convince Queequeg of the ridiculous and impractical nature of Queequeg's religion. Ishmael quickly perceives that his attempt is ineffective. He writes, "I do not think that my remarks about religion made much impression upon Queequeg. Because he somehow seemed dull of hearing on that important subject, unless considered from his own point of view " (88). In this passage and its, context are two important implications. First, in blatantly noting that Queequeg must see from "his own point of view," Ishmael states and accepts that he and Queequeg view religion from different perspectives. Second, in stating in the context of this quotation his criticisms of Queequeg's religion--that it is impractical, unhealthy, and without benefit to the soul - Ishmael reveals something of his own perspective on religion (87-88). Religion, or in the case of Moby-Dick, one's perspective on religion, is a substantial theme in the novel. Of this "important subject," as Ishmael describes it, numerous voices in the narrative speak. The orthodox Christian v... ... of the omnipresence of God. He believes that religion should be practical and healthy. Ishmael believes that history is cyclical, not linear, and he believes in reincarnation. Ishmael believes that humans are the products of their interplay between chance, necessity, and free will. Ishmael argues for all these beliefs not on the basis of canonical revelation or discursive reasons, but on the basis of intuition and mystical insight. This is Ishmael's religious perspective. But whose perspective is right? Is Ishmael's correct? Is Ahab's? Queequeg's? Is the orthodox Christian perspective correct? Moby-Dick does not answer these questions. Ishmael tells the reader that the "pulpit leads to the world" (46). Ishmael shows the reader that who is in the pulpit makes all the difference. Work Cited Melville, Herman. Moby-Dick. New York, NY: Bantam Books, 1981.

The Epidemic Of Heroin Health And Social Care Essay

Because of the huge handiness of drugs and its impact on many aspects of health care and the economic system, it is imperative that wellness attention suppliers and policy shapers understand what drugs are being abused, who uses these drugs, where the drugs come from, and the wellness and economic load on the United States. It is going extremely of import for those straight involved with substance maltreaters to understand the physiological effects, psychosocial effects and backdown effects of drugs. Opiates and opiate derived functions in peculiar, whether illicit ( such as diacetylmorphine ) or prescription ( such as Oxycontin ) are being to a great extent abused across the state. These drugs can hold serious wellness deductions during usage and during disconnected surcease ( detoxification or backdown ) . This paper will show a reappraisal of the literature on the epidemic of diacetylmorphine and prescription opiate maltreatment. Through a critical reappraisal, constructs such as the prevalence of the job, the physiologic effects of maltreatment, the current tendencies in direction of the job and deductions for nursing and health care will be explored.BackgroundBefore proceeding, it is of import to briefly discourse the basic pharmacological medicine of opiate drugs. Opiates, otherwise known as narcotics, include the drugs diacetylmorphine, morphia, codeine, oxycontin, hydrocodone, dolophine hydrochloride and other chemically-related derived functions. All opiates are considered dispensable merely by prescription in the United States with the exclusion of diacetylmorphine, which is illegal in all fortunes. Opiates wield their effects by triping pleasance centres in the encephalon. The neurobiochemical theoretical account of dependence suggests that over clip, the encephalon ‘s c hemical science alterations so that it yearns for the substance when it is non at that place and can bring forth physiologic effects of backdown when stopped. Heroin for illustration, which is chemically-related to morphine ( the chemical name for diacetylmorphine is diamorphine ) readily crosses the blood-brain barrier to do a rapid spilling of Dopastat into the dopaminergic receptors of the encephalon ‘s nerve cells. For this ground, the drug is easy habit-forming and absence of the drug causes a esthesis of hungering and can do feelings of unwellness, such as sickness and diarrhoea, when stopped suddenly. .Prevalence of the ProblemSeveral research workers in the nursing, allied wellness and economic sciences subjects have explored and discussed the prevalence of prescription opiate maltreatment and hypotheses of the beginning of the job. However, there is a big spread in the literature related to the prevalence of illicit drug maltreatment ( diacetylmorphine ) among differe nt populations. The prevalence informations for diacetylmorphine maltreatment in the US is mostly reported by national study tendencies, such as the National Institute of Drug Abuse ( portion of the National Institutes of Health ) Survey on Drug Use and Health ( NSDUH ) . Even so, the monolithic study papers pays small attending to the job of diacetylmorphine maltreatment and studies merely two per centum of the 67,500 study respondents utilizing diacetylmorphine in the month predating the study ( National Survey on Drug Use and Health, 2009 ) . The etiology of prescription drug abuse and maltreatment is discussed more to a great extent in the literature than is heroin maltreatment. Harmonizing to the NSDUH, in 2009 4.8 % of the study respondents aged 12 and older reported utilizing prescription opiates for non-medical grounds. Of those, over 55 % reported obtaining the drug for free from a friend or comparative, and 4.8 % reported buying the drug from a trader on the streets ( National Survey on Drug Use and Health, 2009 ) . Research workers at Columbia University surveyed striplings aged 12 to 17 in 2005 and found that 9.3 % reported the abuse of prescription opiates over the past month. In researching the striplings ‘ motivations for maltreatment, the research workers found that the most normally reported motivations were easiness of attainment and affordability. Among immature grownup college pupils, prevalence of non-medical prescription opiate maltreatment has been reported between seven and nine per centum in the past month to twelve to fourteen per centum life-time prevalence. One of the most at-risk groups for abuse of and dependence to prescription opiates is the chronic hurting population. When used suitably, opiate hurting medicines are a gilded criterion of attention for serious pain-related conditions ( such as post-operative hurting, neuropathic hurting and so on ) . In an attempt to better manage hurting, the figure of prescriptions for opiate medicines increased 154 % in the ten-year period from 1992 to 2002, even though the population of the United States increased by merely 13 % . Although prescription opiates have been used to handle hurting and better the quality of life among acute and chronic hurting patients, the coming of the drugs ‘ abuse has led to a broad organic structure of literature on normative patterns and monitoring of opiate drugs. There delicate balance between pull offing hurting adequately and the hazard for abuse, dependence and recreation has been discussed in the literature late, mostly among the adolescent/young grownup and chronic hurting populations. Although there is a general deficiency in the literature of the figure of people prescribed opiates for chronic hurting. There is a big organic structure of literature which suggests that the increased figure of prescription opiates for chronic hurting patients has contributed significantly to the drug maltreatment job. In surveies to look into the usage of prescription opiates for chronic hurting, it has been found that hurting intervention programs are thin, good certification on the patient ‘s wellness history and history of substance maltreatment is rare, and opiates are sometimes improperly utilised or non indicated at all.Health Consequences of Opiate AbuseBoth prescription and illicit opiates have the possible to exercise a myriad of ague and chronic negative wellness effects for the user. Neurological diminution, vision alterations, cardiac abnormalcies, vascular complications, pneumonic upsets and mortality have been studied and reported. In a survey of over 500 opiate nuts, electrocardiographic alterations were documented in 61 % of the sample. These ECG alterations included ST-segment lift, which may bespeak ischaemic bosom harm ( or deficiency of oxygen-rich blood to the myocardium ) and QTc protraction ( seen largely with dolophine hydrochloride nuts ) . Prolonged QTc intervals may take to inappropriate triggering of the ventricles and may take to potentially deadly ventricular tachycardia. The usage of diacetylmorphine and other drugs by injection with non-sterile or reused acerate leafs may bring forth powerful toxins in the blood stream taking to endocarditis, left ventricular bleeding and decease. Research workers in Ireland reviewed the autopsy findings from eight instances of diacetylmorphine users and found rapid fatal unwellness caused by the endotoxin Clostridium novyi which caused fatal subendocardial bleeding, spleen expansion and pneumonic hydrops in all of the topics studied. Heroin can do important acute peripheral and cardinal nervous system complications such as neuropathy and hearing loss. In a survey six of endovenous and intranasal diacetylmorphine users admitted to the infirmary for acute unwellness, five had documented rhabdomyolysis between three and 36 hours after disposal of the drug. In each of the five instances, there was no documented injury. Typically rhabdomyolysis occurs after a traumatic, compression-type hurt where enzymes slop into the muscular structure and cause rapid neurological diminution, loss of musculus tone and coma. In each of the topics studied, no injury or compaction hurt occurred. In a group of patients with a reported history of â€Å" speedballing † ( or blending diacetylmorphine and cocaine ) , 2 of the 16 studied experient sudden, bilateral sensorineural hearing loss four hours after â€Å" speedballing † which resolved within three yearss. One extra participant experienced sudden hearing loss after â⠂¬Å" speedballing † but one-sidedly. The mechanism by which the hearing loss occurred was described as a possible cochlear toxicity or autoimmune reaction related straight to the drugs. Injection of drugs of any type can do vascular complications, tegument and soft tissue infections and infective diseases such as hepatitis and HIV. In the most terrible instances, opiate maltreatment may take to decease, by and large from overdose. Heroin has been related to 1.65 deceases per 100,000 people in the Florida population entirely over the last decennary and in Alabama between 1986 and 2003, a reappraisal of medical tester ‘s studies revealed those who ‘s cause of sudden decease was undermined were 5.3 times more likely to hold a history of drug maltreatment. Research workers in the United Kingdom have farther investigated heroin deceases and concluded that overdose related to heroin seldom occurs after the usage of heroin alone- in 50 % of the instances they reviewed, intoxicant was besides involved. Although surveies have been published on the wellness effects of maltreatment itself, a reappraisal of nursing, medical and allied wellness literature shows a important deficiency of surveies on the wellness effects of backdown ( disconnected surcease ) of opiate drugs. Several surveies have been found associating to the usage of pharmacotherapy to handle opiate dependence ( such as dolophine hydrochloride and similar plans ) but no surveies have explored the physiologic effects of backdown without medicine aid. Searching on-line databases for relevant articles on opiate backdown does non give any surveies other than those utilizing medication-assisted backdown therapies ( such as dolophine hydrochloride and buprenorphine ) . This is of import to populations such as inmates in a correctional installation where pharmacotherapy is non by and large used during detoxification and requires farther attending. In amount, the possible health-related effects of opiate maltreatment can negatively impact a myriad of organic structure systems. The hazard of potentially fatal infective disease, neurological and cardiovascular complications and decease by overdose creates a public wellness job that demands attending. Health attention suppliers in all spheres must be able to quickly and suitably place those at hazard.Deductions for Advanced Nursing PracticeNurse practicians are allowed normative authorization in about any province across the state. Depending on the pattern scene, they may order opiates to handle hurting. Opiates are the gilded criterion for handling moderate to severe hurting in both ague and chronic hurting syndromes. There has been some discourse in the literature on the quandary to handle or non to handle hurting with opiates. On the one manus, effectual hurting direction is non merely ethical but besides opiates are effectual for many patients for hurting direction – an d on the other manus there is a fright of abuse, dependance and dependence issues. The ability for advanced pattern nurses to place drug-seeking behaviour, issues with dependence and possible recreation of opiates is important to the job of opiate maltreatment. As it has been documented in the literature, recreation of prescription opiates by and large occurs with the patient merchandising, trading or giving away the medicine to another. Harmonizing to Annie Gerhardt, exigency room nurse practician, â€Å" drug searchers become victims of their ain disease † , going involved in a tangled web of dependence, drug-seeking, drug recreation and condemnable behaviour that escalates over clip with increased drug usage. Gerhardt ( 2004 ) suggests supervising patients treated with opiates for replenishing Master of Educations before their follow up assignments, patient studies of â€Å" losing † medicines, trying to see different suppliers for hurting medicines ( which can norm ally be identified by pharmaceuticss ) , and â€Å" scamming † suppliers for more medicines by congratulating the supplier or the office staff or displaying increased degrees of hurting in order to secure more medicine. When ordering opiates to handle hurting in patients already known to hold dependence issues, utilizing sustained-released preparations may cut down dependence while adequately handling hurting. Sustained-release preparations normally have a reduced street value and are less likely to be sold and diverted, and the backdown from sustained-release opiates is typically non as terrible. In footings of advanced pattern nursing, prescribers have the alone ability to screen for possible dependence issues, monitor those who are prescribed habit-forming medicines and potentially control recreation of those medicines to others for whom they are non prescribed. Ultimately, the cognition of drugs of maltreatment and health-related effects is of import for nurses at all degrees to possess.Deductions for ResearchTo further add to the organic structure of literature on the topic of opiate drug maltreatment, dependence and backdown, several countries still need to be explored. First, forms of drug usage in single populations and communities should be investigated. The types of drugs most normally used, the paths of disposal of these drugs and their negative health-related effects should be studied in a assortment of communities, both urban and rural, to derive a better apprehension of the forms of usage across the state. More research is needed beyond simple prevalence surveies on the figure of people who use to spread out on the existent forms of maltreatment. Similarly, the psychosocial effect of drug usage across different populations needs farther probe in order to joint the negative impact on persons and communities. Because the disconnected surcease of opiate drugs without medicine aid occurs often in specific scenes, more research needs to be done on the physiological effects of non-assisted detoxification. The forms of symptoms of backdown and negative wellness effects among populations such as the incarcerated and the hospitalized demand to be explored. The potency for the development of evidence-based protocols for the direction of maltreatment and backdown in these scenes can happen one time the forms of symptoms and wellness effects are documented.DecisionIn amount, the job of drug maltreatment ( which extends far beyond even opiate drugs ) has been reported in multiple beginnings, and prevalence surveies seem rampant in the literature. However, much more work demands to be done on the effects of drug maltreatment from a health care position across a assortment of populations in different scenes to get down to understand the impact of drugs on communities.

The Attrition Problem in Colleges and Universities

INTRODUCTION Intense competition has made student attrition a concern for colleges and universities. Attrition is costly and generates considerable concerns for educational institutions (Tinto, 1993). This is especially true for small schools that do not have huge endowments, and must depend upon tuition and fees to support programming. The loss of students has a detrimental impact upon budgeting as the costs involved in recruiting new students is definitely higher than the cost to retain existing students (Braunstein, Lesser, Pescatrice, 2006). Small colleges and universities are looking for ways to differentiate from the competition by offering creative programs that will meet the needs and wants of students. These schools then†¦show more content†¦Further studies suggest that students must take control of the college experience by getting involved in career planning, joining campus organizations, developing internships, and providing service to the community (Letcher Neves, 2010). The authors go on to suggest that instructors need to help students gain self- confidence as well as providing a valuable educational experience and a solid learning environment. Giese and Cote (2000) have found that there is no single definition of customer satisfaction, and suggest that satisfaction can be explained best as a response to an evaluation process. The authors further suggest that problems occur when selecting a definition and comparing results when â€Å"operationalizing† the definition. Therefore, organizations must use care tailoring the survey specifically to the type of customer satisfaction questions which can be customized for particular needs. Other studies suggest there is a relationship between variables relating to the students goal achievement and social integration into academic life (Wetzel, O’Toole, Peterson, 1999). Academic and social factors appeared to be the most important reason for persisting to graduation. 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