Quality Health Care Essay

Quality health care is defined as â€Å"the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge†. The Institute of Medicine’s 2001 article, To Err Is Human released the statement that medical errors were responsible for between 44,000 and 98,000 deaths annually in the United States (McEwen and Willis, 2014). An immediate demand for accountability and quality in the health care system requested and many quality improvement/management initiatives were undertaken that directly impacted the discipline of nursing. A recent announcement was made that The Agency for Healthcare Research and Quality estimated 1.3 million fewer patients (a 17% reduction) were harmed in U.S. hospitals from 2010 to 2013. The estimate of 34,530 deaths prevented in 2013 was nearly 10 times greater than the reduction estimated in 2011. The cumulative cost savings during the period analyzed was nearly $12 billion. Healthcare quality and safety experts call the reductions impressive, but they also emphasize that there is still a long way to go to improve the safety of the nation’s hospitals (Rice, 2014). The majority of these medical errors result from faulty systems and processes, not individuals. Because errors are caused by system or process failures it is important to adopt various process-improvement techniques to identify inefficiencies, ineffective care, and preventable errors to then influence changes associated with systems. Each of these techniques involves assessing performance and using findings to inform change (McNally, Page, and Sunderland, 1997). Our textbook and this class provide us with the insight on specific theories, models, and framework applicable to nursing administration and management. Quality management (QM) is responsible greatly for the work done on the reduction of medical errors. We will discuss components to leadership in a QM environment and essential roles and responsibilities of these leaders. We will also learn that quality improvement and evidence-based practice are cornerstones of a successful and high performing health care organization. McEwen, M., & Wills, E. M. (2014). Theoretical basis for nursing (4th ed.). Philadelphia: Lippincott. ISBN: 978-1-4511-9031-1 McNally M., Page M., and Sunderland V. (1997). Failure mode and effects analysis in improving a drug distribution system. American Journal of Health System Pharmacy. (54) 17-7.  Rice, S., (2014). 1.3 million adverse events prevented in U.S. hospitals since 2010, feds say. Retrieved December 4, 2014 from: http://www.modernhealthcare.com/article/20141202/NEWS/312029936.

Classroom Assessment Essay

The primary distinction between internal and external assessment are the teachers. Teachers are expected to use classroom assessment as part of the job. There are a variety of ways teachers assess students in order to monitor progress, to grade performance and to modify instruction. But the manner in which teachers choose to assess students has a significant impact on the students’ classroom experience. In many ways, the format and content of repeated quizzes and tests defines a students’ experience of school and influences their view of the discipline. Classroom assessment is a nonstandardized, localized process idiosyncratic to teachers’ beliefs, knowledge and experience. The manner in which classroom assessment is constructed, enacted and utilized is teacher dependent. Classroom assessment requires teachers to make regular decisions and judgments about student learning on an ongoing basis. Assessment is the process of identifying, observing and interpreting cognition in order to designing and implementing classroom assessments. Teachers’ conceptions of how students learn influence not only how they interpret students’ work, but also the content and nature of feedback they provide (Delaware Professional Teaching Standard #8: Assessment). Prior to assessment design, teachers’ should gather information through interviews, observation and testing. It is also important to create an environment in which students are encourage sharing their thoughts with their peers and are willing to be sensitive to the social fabric of the classroom (Delaware Professional Teaching Standard #5: Learning Environment). External assessments also influence schools and classrooms, especially schools that serve students of poverty and other at-risk populations. School administrators and teachers should be familiar with the benefits and risks of external assessments. The practical reality is that the push for educational accountability, coupled with limited resources, will result in external assessments that cannot be replicating in classroom practices (Delaware Professional Teaching Standard #9: Professional Growth). External assessment will motivate teachers to prepare students for a successful testing rather than learning, restricting student involvement and enjoyment. The question for those interested in improving formative assessment is not whether there are effects, but to what degree can these effects be minimized or leveraged to support student learning. Collaboration with other educators is critical to expanding teachers’ assessment practices. Teacher collaboration can offer a safe environment for teachers to share and discuss their challenges and concerns and to discover solutions to assessment problems (Delaware Professional Teaching Standard #9: Professional Growth). Classroom assessment is based on the teacher’s methods of observation and judgments. Internal assessment is further influenced by local contexts and classroom environments, and occurs in classrooms on an ongoing basis. It is important to explore ways in which teachers can bring about positive changes in assessment and provide a vision for effective assessment practices, while promoting good learning and grading. Personal Reflection: I intend to use assessment as a bridge between practical experience and formal teacher training, in order to develop better teaching techniques. By assessing what students know about the realistic world around them, I will be able to develop lesson plans that help incorporate subject areas they are lacking, such as knowledge of local history or developing business plans. I will develop qualitative assessments through objective questioning and eliciting a student’s subjective interpretation of information, as well as standard techniques such as tests and quizzes.

Republic Polytechnic Case Study Assignment Example | Topics and Well Written Essays - 2750 words

Republic Polytechnic Case Study - Assignment Example Implementation of an ERP in any organization involves a life cycle from the decision to adopt it to successful roll out, with discernible implementation phases as characterized by the key stakeholders, typical activities, associated challenges and outcomes. Four broad phases can be discerned based on this framework. They are planning, configuration, testing and actual implementation (Kumar, Maheshwari and Kumar 2003, pp. 795). Other authors present the phases as involving planning, implementation, stabilization and improvement (Markus and Tanis 2000, pp.173-207: Shanks et al. 2000, pp. 2). In the case of Republic Polytechnic’s ERP, the latter framework is seen in action thus forming this paper’s line of discussion.The first stage that was undertaken in RP’s implementation of the ERP is planning. RP needed an Enterprise System that was able to support two considerations. These include their problem-based learning pedagogy and their commitment to an IT strategy tha t would render the campus paperless for faster, efficient and cost-effective processes. RP set out on an outsourcing path for the vendor of an enterprise-wide e-learning management system that would provide a package which could suit RP’s mission and strategic direction. All relevant stakeholders were involved in finding such a vendor, flexible enough to allow for the heavy customization that was necessary for RP’s strategy, to be rolled out dubbed LEO (Learning Environment Online). This step involved two representatives from RP.... o allow for the heavy customization that was necessary for RP’s strategy, finally leading to settling on Wizlearn Pte Limited and their Academic Version 7 package. Post-purchase tailoring was the next step aimed at customizing the vendor’s product to RP’s needs in the system to be rolled out dubbed LEO (Learning Environment Online). This step involved two representatives from RP. These are OAA (Officer of Academic Affairs) and OIS (Officer of Information Systems) and an external IS team from the vendor all of whom liaised together and held discussions that finally resulted in a heavily customized product plan ready to be rolled out. The next phase after the planning part was actual implementation of the settled upon system, done a few weeks before the opening of the school term. The system that was rolled out provided an optimum system for RP and her staff although it was not exactly like they had envisioned as it had not accommodated all their views. Stabilizati on was the next phase for the system. Although the roll out had determined that there would be no need for training of RP staff, it was still necessary to provide basic training on the core features of the LEO. In a similar fashion, the students were trained on a basic general IT course and then given a few lessons on the core features of the LEO by the facilitators. The last phase of RP’s implementation of their ERP was improvement. This involved addition of the features that had been suggested in the planning stage but had been left out in implementation. More improvements on the ERP were based on suggestions from three sources; the top management, the facilitators and the development team itself, with additional suggestions being drawn from the students. The LEO manager determined which improvements

The Role of the Mother Tongue in Second Language Learning Essay

The Role of the Mother Tongue in Second Language Learning - Essay Example The impact of the first language on the second language can bring problems especially in intercultural communication where the speakers use a lingua franca such as English or another language, hence causing misunderstandings and problems in communication. This research argues that contemporary linguistic theory demonstrates that primary language interference necessitates that second language instructor increasingly explore bilingual instructional strategies for teaching second language acquisition. The second language is any language that a person learns in addition to his/her first language. The term can also be used to refer to learning a third, fourth and subsequent languages. Second language acquisition is, therefore, the process by which people or learners study that language. The majority of linguists agree that errors made by second language learners originate from the speech of their first language. This occurs as a result of the influence of language transfer from the first language. The errors are mostly lexical or phonological. Still, the traditional approach to second language instruction has rigidly kept first and second languages rigidly separate. While instruction methods may be appropriate to keep a separate area for each language, linguistic theory demonstrates that bilingual instruction strategies are necessary. Rather than language learning existing in a vacuum, the learners’ mother tongue influences the way the second language vocabulary is learned and recalled for use. Learners at their disposal compensate their lack of knowledge by constructing difficult lexical items that are characterized by errors emanating from their first language. How the mother tongue helps or hinders learning is dependent on language distance, that is, the learners’ knowledge of the second language. Of course, there are also external aspects to language acquisition. Breen (135) and Prabhu (158) note that language is a social phenomenon. Most people seek to learn a language  to dialogue with the target language speakers and participate in their institutions.

Total Quality Management Essay Example | Topics and Well Written Essays - 1250 words

Total Quality Management - Essay Example In quality improvement teams, employees from the same department, division, or team of the organisation brainstorm to identify a list of problems to resolve. The advantage of this approach is that the employees characteristically have the best view of their work environment and associated problems and can develop ideas to improve efficiency and effectiveness. The drawback to this is that the problems chosen by the group may or may not contribute to the Axact Inc. overall goals. Axact Inc. with a focused success paradigm can multiply the return on its investment for its quality efforts over an organisation without a clear vision. With the myriad of problems any given group can identify, it is important that resources be allocated for problem solving that can contribute positively to the successful implementation of Axact Inc. strategy. Based on such considerations, it is evident that the need for specific criteria and models to verify the quality fit between the Axact Inc. and the business atmosphere in that it operates, and to effectively and efficiently manages the relationships among the actors within the network. Such relationships, in fact, are characterised by many-to-many connections instead of more traditional one-to-one. For that reason, a deep revision of current managerial techniques is dramatically requested. Regardless of huge number of works on this subject, (Harland et al., 2001; Lamming et al., 2000), reliable criteria for the analysis and the evaluation of Axact Inc. networks, based on the relationships among economic actors interconnected through Internet, are not yet available. Accordingly, managers usually operate according to empirical methodologies that often do not assure optimal quality performances. In order to contribute towards the solution of such a problem, preliminarily examined facto rs that mostly affect the Axact Inc. quality performances. It may be assumed that effectiveness and efficiency of Axact Inc. depend on the coherence between the characteristics of the atmosphere in that the embedded actors operate and the way in that relationships among embedded actors are managed. The management of such relationships, consecutively, is based on the following three factors (Cucchiella et al., 2002): The structures adopted to organise the relationships among the actors of the network (Axact Inc. organisational structures). The criteria adopted to manage such relationships (managerial criteria); and The activities to be done for coordinating the relationships (critical activities). With respect to the Axact Inc. organisational structures, Tapscott et al. (2000) define five types of b-web adopted to manage relationships among embedded actors based on the level of product-service value integration (high vs. low) and control type: Agora, Aggregation, Value chain, Alliance, and Distributive network. According to Nkkentved (2000), the managerial criteria may be instead, defined on the basis of two variables, the market fragmentation and the product/process complexity. Consequently, six types of criteria may be identified: Auction house; Independent trading exchanges; Vendor trading

Fundamentals of Mass Communication Essay Example | Topics and Well Written Essays - 1750 words

Fundamentals of Mass Communication - Essay Example The films Terminator and Robocop mirrored the â€Å"dehumanizing potential of technology† that was an issue in America during the reign of President Reagan (16) with the concept of male heroes and female damsel in distress to make the story alive and exciting. However, some films were created simply to be entertaining without much connection to a particular social and political state of affairs. I chose to deconstruct The Matrix film episode due to the meanings attached to its symbols and due to its popularity. The symbolism and gender stereotyping in film can be an effective tool in conveying messages to mankind’s socio-political issues. The film The Matrix was first shown in public in 1999 but due to its huge success it became a trilogy with The Matrix Reloaded episode in May 2003, and The Matrix Revolutions shown in November of the same year. The film appeals to both male and female audiences from teenagers to late twenties basically because it is the age group who are interested in virtual games and martial arts stunts. The film is heavily loaded with gravity defying martial arts stunts and its story is based on computer generated technology which is of interest to the aforementioned audiences. The romance between the lead characters of Neo and Trinity as well as Trinity’s own persona in the film makes it generally appealing to female audiences. Major Characters and its Symbols. In the hit science fiction film The Matrix, the major characters Neo, Trinity, Morpheus, the Oracle, and Agent Smith embodies the archetypes described by Carl Jung. These archetypes along with the other symbols were used to support the entirety of the film and the message it wanted to convey to its audiences. It is worth noting though that the film is heavily loaded with male characters playing both the protagonists and antagonists roles. In the trilogy, there are four women who played important roles:

Should polygamy be made legal in the United States Essay

Should polygamy be made legal in the United States - Essay Example This enabled a division of labor. It also relieves the difficulty of child bearing. Few women in Zimbabwe desired to be a single wife in a marriage because of the numerous responsibilities customs and the larger society would give her (Zeitzen 2008). In contrast, Western societies has championed two conflicting principles of marriage’s purpose, one rooted in collective or joint principles, and the other rooted in personal satisfaction and companionship (Gordon 2002). This fusion of principles has generated laws that rigidly control sexual behavior in accordance to a monogamous definition of marriage. The United States, as such, bans polygamy (Zeitzen 2008). In my opinion, it should remain to be so. The success of polygamy depends on the culture which hosts it. For instance, as shown in the above discussion, in largely agricultural or labor-intensive societies such as Zimbabwe polygamy is more favorable than monogamy. But in a society like the United States, which is highly ind ustrialized or mechanized, monogamy is more acceptable than polygamy. Polygamy, in my opinion, should not be legalized. According to my research, some of the most compelling reasons for the prohibition of polygamy are the following: (1) Legalizing polygamy will further deprive women of some basic rights.

Drawing on current academic theory and debate, critically evaluate the Essay

Drawing on current academic theory and debate, critically evaluate the contribution of the Human Resource Management function to the management of employee reward practices - Essay Example Throughout the whole XX century and even earlier both practitioners and scholars attempted to design the theories explaining human behaviour at work and the ways to raise its effectiveness. A good insight into the value of HR related programs is provided by Schuler (1990: 52-54). He emphasizes that the HR function had an opportunity to shift from being an â€Å"employee advocate† (associated with personnel management) to a â€Å"member of the management team†. Schuler’s (1990) view was that this required HR professionals to be concerned with the profits, organizational effectiveness and business survival. In other words, human resource issues should be addressed as business issues. Storey (2001: 18-34) believes that emergence of HRM contributed greatly to an ever-greatest since industrial revolution shift in the principles of management. HRM encouraged both managers and employees to get rid of traditional patterns of interaction, outdated ideas of motivation, stereotypes, assessment and appraisal. Managers ceased to be mere mentors and executioners and turned to be the members of business teams. Introduction of HRM principle has made modern companies more competitive, dynamic and people-friendly that consequently influenced their efficiency and marketability. Therefore, many believe that HRM caused what was later called â€Å"a new managerialism† – a new look on organization, the ways it functions and succeeds and the way its employees work (Storey, 2001, p. 18). At the same time, HRM is not just a set of principles; it is rather an organizational science that helps to implement company’s general strategy in a most effective way. Thus, according to the most conventional definitions HRM is defined as a â€Å"system that is tailored to the demands of the business strategy† (Miles and Snow, 1984, p. 36-37); or â€Å"the pattern of planned activities intended to enable an organization to achieve its goals† (Wright and McMahan, 1992, pp. 343-345).

Madonna and child Research Paper Example | Topics and Well Written Essays - 250 words

Madonna and child - Research Paper Example hild Jesus – the main characters in â€Å"Madonna and Child.† Except for Jesus, son of God the Father by Christian faith, there are no other gods and goddesses in the image. The scenery of Madonna, which translates to ‘Our Lady’, and her Christ Child provides relation to Catholic worship of Mary as a Virgin Mother or a woman handpicked by the Divine to conceive for a Holy Child, out of purity. Each of the persons in this biblical theme of Duccio’s work – identified as Mary and Jesus, are dressed in what appears to be a black silken garment and a customary tunic in peach and brown, respectively. Mary and Jesus are in a position where Mary, looking out as though to make contact with audience’s point of sight in calm sacred radiance, holds Jesus close to her bosom while Jesus warmly and innocently gazes at her with an iconic holy sign in the fingers of his right hand. The Metropolitan Museum of Art. â€Å"Madonna and Child – Duccio di Buoninsegna.† The Collection Online. 2000 – 2014. Web. 10 Nov 2014.

Health Care Issues in Ireland Research Paper Example | Topics and Well Written Essays - 1250 words

Health Care Issues in Ireland - Research Paper Example Firstly, there is a large gap between the quality of services for the private health owners and the public health coverage. Secondly, due to the two tiered health care system there are a lot of issues with the medical practitioners as they discriminate between those who pay for health care and those who don`t. Thirdly, Ireland also has a lot of cultural issues with health care which needs to be addressed with some serious consideration. Ireland ranks 22nd on the health care ranking for the developed world, where only US lies behind this state in this context1. This reflects the widespread difference between the quality of coverage provided by the public health care and the private health care. This is indicative of the basic flaw in the system, where there are separate health packages for those who belong to the lower income group and those who fall high in the average income spectrum. In other words, Ireland follows the system where a medical card is issued to those who belong to a lower income group which makes them eligible for a free health care service (Noan & Nolan 2004). However, those who don`t need welfare fund to run their homes, and can afford to pay for health care are required to pay a fees to be eligible for the health care process. This system creates various issues for the entire health care structure operational in Ireland. Firstly, those who avail the free services via their medical cards have to go through extended waiting lines to get themselves checked. In the peak season, for instance when the winter flu breaks, there are cases when people have to wait for three consecutive days for their turn. The quality of service in the public hospitals is so pathetic that the emergency wards, even the lobbies of crowded with patient beds (Noan & Nolan 2004). Though prescriptions are also free for medical card owners, but the quality is quite low. At the same time, those who opt for the private health care are better off as they get treated on the spot and quality services are availed by these patients who have purchased a health care or pay the required fees for the medical checkups2. Secondly, other issues also related with the two tiered system prevalent in Ireland for instance the issue with the medical practitioners discriminating against the patients who avail the medical card for free services. Basically, the flaw lies in the way health care functions in Ireland. Those who are covered under a health care plan are treated in the same public hospitals where other citizens, even those with the medical cards are treated. The system would have worked fine if the doctors were to be paid the same amount of salary by the government regardless of the types of patients they`re dealing with. In fact, it`s the other way round i.e. the medical practitioners are being paid their due amount of salary by the government to treat the patients with the medical cards (Noan & Nolan 2004). However, when it comes to the treatment of those who ar en’t relying on the medical card, for their treatment the practitioners are paid on a fee per service basis. This above system mentioned above where practitioners are paid a higher amount for dealing with the private health care patients is the root cause of the health care issues prevailing in Ireland. The practitioners take it more like a business as they have a higher self interest in treating the

Community and Population Health Essay Example for Free

Community and Population Health Essay Introduction I currently reside in Denver County, Colorado. I have chosen to assess and analyze this community for this assignment. Denver, Colorado is located east of the Eastern Foothills of the Rocky Mountains. Denver County is centrally located within the city of Denver, Colorado and includes the Denver International Airport located north-east of the city. The elevation of this county is 5,277 feet and therefore is nicknamed the â€Å"Mile-High City†. Denver County contains 154.9 square miles of land with a large amount of parks and rivers, of which 1. 4 miles is water. (City and County of Denver, 2011). Population Economic Status According to the 2010 census, Denver County has a population of 600,158 people with a median age of 33.7 years old (U.S. Census Bureau, 2010a). Denver County’s population is approximately 50% male and 50% female (U.S. Census Bureau, 2010a). The ethnicity of Denver County is predominately White (52.2%), with Hispanic (31.8%) and Black (9.8%) ethnic groups comprising the next largest population groups (U.S. Census Bureau, 2010a). The median household income in Denver County from 2008-2012 was is $49,091; compared to $58,244 for the entire state of Colorado (U.S. Census Bureau, 2010b). From2008-2012, 18.9% of households were at or below poverty; compared to an average of 12.9% for the entire state of Colorado (U.S. Census Bureau, 2010b). The average reported unemployment rate for persons ages 16 + in Denver County was 8.6% (with a +/- 0.4% margin of error) (U.S. Census Bureau, 2010a). Denver County has a high percentage of educated workforce. In 2008-2012, 36.7% of the population age 25 + had obtained their Bachelor’s Degree, or a higher level of education; compared 28.5% for the entire US (U.S. Census  Bureau, 2010b). Although Denver County has a large percentage of educated residents, it also has a high number of homeless residents. In a survey taken in January 2013, an estimated 11,167 people were homeless in Denver (including employed homeless) (Metro Denver Homeless Initiative, 2013). Of those individuals, 43% were women and 62% were adults with children (Metro Denver Homeless Initiative, 2013). The birth rate in Denver County in 2012 was 9,236 (Colorado Department of Public Health and Environment, 2012). This was average compared to the previous two years – in 2011 there were 9,431 births compared to 2010 where there were 9,584 births (Colorado Department of Public Health and Environment, 2012). Denver County’s death rate in 2012 was 4,220 (Colorado Department of Public Health and Environment, 2012). This number was average compared to the previous two years as well – in 2011 there were 4,156 deaths and in 2010 there were 4,210 deaths. The number one cause of death in Denver County from 2010 – 2012 was cardiovascular disease (Colorado Department of Public Health and Environment, 2012). The majority of deaths related to population was individuals age 85+ (Colorado Department of Public Health and Environment, 2012). Denver County offers two primary basic food assistance programs. These programs are called SNAP (Supplemental Nutrition Assistance Program) and WIC (Women, Infants, and Children). For the fiscal year of 2013, Colorado had an average of 47,636,090 persons from a total of 23,052,396 households were signed up for SNAP benefits (USDA, 2014a). This number had increased by approximately 1,027,016 persons from 2012 fiscal year (USDA, 2014a). For the fiscal year of 2013, Colorado had an average of 8,662,591 persons (including women, infants, and children) were receiving supplemental nutrition from the WIC program (USDA, 2014b). This number decreased by 245,249 persons from 2012 fiscal year (USDA, 2014b). Cultural Assessment The population size and sex of the cultural group I interviewed was of twenty white women. Out of the twenty women I interviewed, ten women were between the ages of 20-29 years old and ten women were between the ages of  30-49 years old. All twenty women are currently registered nurses on the internal medicine/oncology floor at the hospital I am currently employed at. The amount of nursing experience these individuals have ranges from two years to 29 years of experience. All twenty individuals interviewed have health insurance. The attitudes toward age and aging of the twenty individuals surveyed varied with a similar goal of staying healthy to prevent the onset of diseases. The younger group interviewed felt it was important to eat healthy and exercise to promote internal health and longevity of life in general. The older group interviewed were more specific with their answers and felt it was important to maintain low stress lifestyles to promote good mental and physical health, to exercise to promote strong bones/balance, to perform mental exercises to help prevent the onset of dementia, and to regularly attend appointments. Both groups agreed that positive vs. negative attitudes directly affect physical health and one’s quality of life. When I asked both groups of their opinions regarding what age adolescents are considered adults, I received drastically different answers. The younger group felt as if ages 18-19 years old are considered adults related to society’s description of an adult, the independency promoted with high school graduation, and the onset of college. The older group felt as if ages 22-23 years old are considered adults primarily related to maturity, life experiences, and the beginning of an entry level career after completion of a college degree. Both groups felt as if college education was an expectation. All of the individuals interviewed currently have their degree in nursing with an active nursing license. Approximately one-third of those interviewed have their Bachelor’s Degree in Nursing and several of those interviewed possess recognizable specialty healthcare certifications. As an entirety, the group interviewed is healthy. Over half of those interviewed have no prior diagnoses regarding their state physical of health. The most obvious physical characteristic that both groups share is being overweight with eleven out of the twenty women interviewed currently being overweight according to their projected BMI. The entire population interviewed shared the mental challenge of overcoming the stress presented at work regarding difficult/challenging patients and all women interviewed believed they have compromised their safety while caring for a patient at one time or another in their career. When I asked this group what the usual sources of stress are, work was number one for all twenty women interviewed. The younger population interviewed stated that children/family and educational goals are some of their secondary sources of stress. The older population interviewed stated that aging/retirement and the health of other family members are their secondary sources of stress. Both groups primarily use the mountains/nature and outdoor activities, such as skiing and hiking, to cope with stress. Five of the individuals drive nearly sixty miles to work (one-way) daily, related to owning a home in the mountains to escape the â€Å"rush and chaos† of the city and helping to find a â€Å"balance in life†. Out of all twenty individuals interviewed, over 3/4 of the woman are married and/or have a significant other. When asked what their number one priority in life was, family was consistently number one. Most all other interests and goals were related to benefiting or bettering the family. Some of the answers named were continuing educational goals, buying a new home, having a baby, planning retirement, and helping their parents with activities of daily life. Of the cultural group identified, all of them share a team attitude while still exhibiting individualist perspectives unique to personal preferences and opinions. Neighborhood/Community Safety Denver is divided into about 80 different official neighborhoods within Denver County (City and County of Denver, 2011). Those 80 different neighborhoods have been divided into seven police and fire districts; including Denver International Airport with has its own district (Denver Police Department, 2014; Denver Fire Department, 2014). The average response time for the Denver Police Department varied in 2013 from 14.9 minutes to respond to urgent, emergency calls (from the time a 911 call was received to the time an officer arrived on the scene) to 16.9 minutes for an officer to respond to a non-emergency call (Maass, 2013). According to Lt. Matt Murray from the Denver Police Department, these slow response times  have been directly correlated with a lack of officers (Maass, 2013). According to Murray, the Denver Police Department can have as many as 1,426 officers and as of October 3, 2013, the Denver Police Department had only 1,350 officers (Maass, 2013). A new class of 70 recr uits are currently in training in hopes to decrease the department’s response times in 2014 (Maass, 2013). The Denver Fire Department maintains 34 different fire stations that are strategically split into seven districts (Denver Fire Department, 2014). Firefighter’s each work an average of three 24-hour shift with an average of 180 firefighter’s on-duty per shift (Denver Fire Department, 2014). The Denver Fire Department responds to a variety of calls including Fire Suppression, Rescue Operations, Hazardous Materials Response, Technical Rescue, Urban Search and Rescue, Water and Ice Rescue, High Angle Rope Rescue, Confined Space and Trench Rescue, Wildland Firefighting, and Emergency Medical Services. They also perform thousands of building inspections annually, daily training and certifications, public and community education, school fire drills, and organize other special events (Denver Fire Department, 2014). According to the Denver Fire Department 2012 Annual Report, there were a total of 101,531 alarms/calls made in 2012 that required the response of the fire department team (Maass, 2013). Out of those 101,531 calls made to the fire department, 54,350 were for medical calls, 8,103 were for auto accidents, 2,248 were for fires, and approximately 37,000 calls required other services or rescues (Maass, 2013). Denver County has a significant amount of violence, crime, and gang activity within the community. In January/February 2014 there were a total of 7,268 crimes captured by the National Incident-Based Reporting System (NIBRS) (Denver Police Department, 2014). According to this reporting system, the crimes are broken down into four categories; (1) crimes against persons, (2) crimes against property, (3) crimes against society, and (4) all other offenses (Denver Police Department, 2014). The top two offenses in Denver County per category included (1) simple assault and aggravated assault, (2) larceny and criminal mischief/damaged property, (3) drug/narcotic violations and prostitution, and (4) disorderly conduct/disturbing the peace and  criminal trespassing (Denver Police Department, 2014). These figures are slightly elevated from a total of 6,822 crimes in January/February 2013 (Denver Police Department, 2014). There is a variety of different gang activity in Denver County. In 2003, Denver police estimated that there were 14,000 gang members in Denver who were affiliated with 220 different gangs (Gang activity in Denver, 2013). The Denver Police Department has since created gang prevention programs including education, a gang hotline, outreach programs for former gang members, crime stoppers anonymous tips hotline, and the Denver Police Department Gang Bureau (Denver Police Department, 2014). Even with gang prevention involvement in the community and with these prevention programs in place, from January-September 2013 there was a total of 143 total crimes that could be directly related to gang activity (Gurman, 2013). These crimes included homicides, sexual assault, robberies, and aggravated assault (Gurman, 2013). Denver County is also populated with a high level of alcohol and drug abuse. The availability of marijuana with the recent legalization of recreational marijuana makes marijuana the most widely abused drug in Denver County (Mendelson, 2014). Alcohol, methamphetamines, heroin, cocaine, and prescription drugs are all found within the city limits of Denver as well (Mendelson, 2014). Denver County is centrally located between two interstates; I-25 and I-70. These interstates have many different entry and exit points to and from the city that provide easier access for drug trafficking and other illegal activities. Denver County has many different programs protecting its air and water quality. The Environmental Quality Division (EQD) is responsible for a variety of measures including conducting compliance inspections of air emissions, monitoring pollutant levels, issuing permits, and constructing models of air pollutant levels in the Denver area (Department of Environmental Health, 2014a). In February 2014 Colorado became the first state to regulate methane emissions from hydraulic fracking (Kroh, 2014). This new regulation will directly increase water quality and decrease smog in the Denver area. The Department of Environmental Health (DEH) is responsible for monitoring the quality of water in Denver’s lakes and  streams. The DEH collects an average of 13,000+ water samples and conducts more than 50,000 tests annually to ensure that Denver’s drinking water is clean and safe (Department of Environmental Health, 2014c). The goal is for the city of Denver to have fishable and swim mable waters in all the lakes and streams by 2020 (Department of Environmental Health, 2014c). Denver’s Departments of Environmental Health, Public Works, and Parks and Recreation are all work together to ensure that the City meets this goal (Department of Environmental Health, 2014c). Denver’s current number one pollutant is trash and litter. Urban Drainage and Flood control district alone collects approximately 100 tons of trash from the streams and rivers in Denver annually (Department of Environmental Health, 2014b). There are several health risks living within Denver County. These risks include earthquakes, hazardous materials, winter storms, and severe thunderstorms with hail, lightening, tornados, and/or flooding (Office of Emergency Management, 2014b). Hit and run injuries have become an epidemic in Denver County with an increase in fatal crashes in Denver County. Denver police reported 18,662 hit-and-run accidents, both sustaining injuries and sustaining no injuries, during 2011-2013 (Hubbard, 2014). At least one person in Denver metro area is injured every day by a hit-and-run driver and nearly three times a month a pedestrian is fatally injured by a motorist who flees the scene (Hubbard, 2014). Colorado legislators have recently increased the potential prison sentence for hit-and-run cases resulting in bodily injury and/or death. They have also formalized an alert program to inform the public on suspects, vehicles, and/or license plate numbers in an attempt to help in track down perpetrators (Hubbard, 2014). Disaster Assessment and Planning The state of Colorado and city of Denver has worked hard to organize a variety of disaster and emergency preparedness plans within the community. One source of information, READYColorado, offers a variety of data sources for the community. Their website, READYColorado.com, offers awareness and disaster preparedness for a variety of natural disasters, technological disasters, and human caused disasters. The website also contains statistics, facts, and a calendar list of current events and training exercises. It offers links for volunteer opportunities regarding community involvement and educational classes and it also lists ways to stay informed of emergencies  from such sources such as radio, television, text, live twitter feeds, and blogs. Three critical facilities in Denver County include three specific venues; Coors Field with 50K capacity, The Pepsi Center with 19K capacity, and Sports Authority at Mile High Stadium with 76K capacity (City and County of Denver, 2011). The most vulnerable populations to these disasters are the 22.3% of households with children less than 18 years of age, the approximately 23,000 individuals 65+ that live independently, and the residents in 51 long term care facilities within Denver County (City and County of Denver, 2011). The primary disaster of concern for the Denver County is winter weather. Winter weather is an expectation living in Colorado. READYColorado contains information for home and vehicle preparation, emergency communications planning, proper dress for indoors and outdoors to protect the body from hypothermia, and hypothermia/frostbite warning signs. One can also find more information at Ready.gov, Colorado Department of Transportation, NOAA watch, and the American Red Cross regarding winter weather and the risks involved. Avalanches are of great threat to the mountainous regions of Colorado but do not pose a threat within Denver County. The risk of earthquakes is low in Denver County. However if an earthquake was to occur, the city would be very susceptible to extensive damage. Residencies and some of the older buildings in Denver are not made to withstand earthquakes and would most likely suffer damage to their structures (Office of Emergency Management, 2014b). Severe thunderstorms bringing hail, lightening, and tornados pose threats to the Denver County annually. Residents of the Colorado’s Front Range area are located in the heart of â€Å"Hail Alley† which begins mid-April and lasts through mid-August. The Front Range and Denver County receives a high frequency of large hail annually, averaging three to four hailstorms a year, and costing at least 25 million dollars in insured damage for each event (READYColorado and the State of Colorado, 2014b). Lightening poses the greatest threat to areas where the mountains and plains intersect (READYColorado and the State of Colorado, 2014b). Three deaths related to  lightning strikes have known to occur in Denver since 2001 (National Weather Service, 2011). Tornados pose a threat to all areas of Colorado; however tornados to not typically get high intensity ratings within Denver County (City and County of Denver, 2011). Flying debris from high winds cause most injuries. NOAA weathe r radio, telephone alerts, and television sources provide alerts severe thunderstorms and the destructive events that they bring. Denver County also has an outdoor warning siren system consisting of 76 electro-mechanical sirens that sound when there are tornado alerts and warnings (Office of Emergency Management, 2014a). Wildfire ignition by lightning is a bigger concern rural Colorado areas compared to the city. Respiratory problems can still result from the inhalation of smoke spread by wind. Wildfires burn thousands of acres and destroy hundreds of structures annually in Colorado. These fires are generally ignited by lightening or human causes and can easily be fueled by drought conditions, insect infestations, and heat. READYColorado offers information on risk assessment, home preparation, evacuation plans, and shelter information. More information regarding wildfires can be found at Ready.gov, Ready, Set, Go!, Surviving Wildfire, The Red Cross, US Fire Administration – FEMA, and Colorado State Forest Service websites. Colorado Wildfire Risk Assessment Portal is also a useful tool in determining fire risks. Currently, Denver’s fire risk is between lowest intensity and moderate intensity risk (Colorado State Forest Service, 2014). Flooding has a big impact on Colorado and in 2013 challenged many residents in the Denver area. NOAA Weather Radio, commercial radio, television, and internet sources provide information on flood watches and warnings, including flash floods in Denver County. Flash flooding along streams such as Cherry Creek, Clear Creek, and Harvard Gulch pose the greatest threats within the Denver area. The Corps of Engineers, Colorado Department of Public Health and Environment, and the Urban Drainage and Flood Control District websites provide 2013 flood information, current projects, and resources for flooding preparation and damage control in Colorado. Health risks involved from flooding include contamination from bacteria (ie. E.coli), parasites (ie. giaria), and viruses (ie. Hepatitis A), respiratory infections from mold and other irritants, and bodily injury from swiftly moving currents, electricity hazards, and hypothermia. It is very important for all Denver County residents to be up to date with Tetanus  vaccinations. Terrorism poses a rather unpredictable threat to Denver County. Denver County has a large metropolis population and houses both government buildings and military installations, contains large sports stadiums and an international airport. It is known that failure of the Cherry Creek Dam would cause catastrophic damage to both life and property within Denver County (City and County of Denver, 2011). There have been known international and domestic terrorist groups identified in Colorado during previous years (City and County of Denver, 2011). Education regarding the â€Å"eight signs of terrorism† can be found at multiple terrorism related websites including READYColorado.com. Denver also has specialized units including Denver Police Department Mounted Patrol, S.W.A.T.(Special Weapons And Tactics) who’s primary objective deals with hostage negotiation, drug busts and counterterrorism (City and County of Denver, 2011). Hazardous material spill have an increase potential in Denver County related to the many different companies storing hazardous materials within city limits. There are approximately 400 facilities storing reportable quantities of hazardous materials on properties located throughout the county (Office of Emergency Management, 2014). Each company is regulated by law to hold emergency plans that would go into effect if an accidental release of substance was to occur. The interstates bring added risk to Denver County related to the traffic along I-25 and I-70. These two interstates pass through densely populated areas of Denver County Denver fire and police have Hazardous Materials Response teams in place that are trained to respond to such an event(s). Denver County has nearly a dozen different hospitals with a vast amount of public transportation options such as bicycle, RTD bus and light rail services, taxi cabs, car2go, and Lyft services. Denver County has excellent communications and response teams in the event of a disaster with a vast amount of online education; however this information is published mostly in the English language. With such a large population of homeless in Denver County and 18.9% of all households at or below poverty level (U.S. Census  Bureau, 2010), the internet is not a good primary option for learning. Also, approximately 28% of all households speak a language other than English (City and County of Denver, 2011). Community Diagnosis Denver County is a very strong community regarding the number of educated workforce, median household income, number of hospitals, amount of public ground transportation, the protection of air and water quality, and the number of fire and police with specialty training teams and programs operating within the community. There is a very small percentage of residents 65+ who live independently and slightly over 1/5 of all households have children less than 18 years of age. The primary language is English and the community culture has a good overall team mentality. Denver County’s birth rate double the death rate with the leading cause of death cardiovascular disease in a primary death rate existing in the population 85+ (Colorado Department of Public Health, 2012). Denver County has many open avenues regarding opportunities and readiness attitudes within community. The population of Denver County is approximately 50% male and 50% female with a median age of 33.7 years old (U.S. Census Bureau, 2010a). This provides the community with the opportunity to explore young ideas and diversity among sexes. Denver County has a large number of homeless population with approximately 1/5 of the total population at or below poverty. These numbers exceed the national average. Denver County has two specific food programs being utilized greatly; SNAP and WIC benefits. There is a high number of crime, violence, and gangs within Denver County. There is a high level of alcohol and drug abuse within the community as well. Specialized police teams and community resources/programs assist with deterring these types of activities and assist in recovery efforts for those individuals. Colorado has recently legalized recreational marijuana which could be positive in terms of tax revenue for the state and future funding of programs and resources for the community. There could also be negative consequences regarding adolescent drug use and the increase of impaired drivers on the streets; however these statistics have not yet been measured and studied. Denver County is  contains a 100% urban population. This is both a strength and weakness to the city in terms of emergency evacuation. There are three critical facilities that exist in Denver County at specific venues with a capacity between 19K and 76K (City and County of Denver, 2011). Denver County is centrally located between I-25 and I-70 which can be an opportunity for evacuation or a barrier regarding avenues for drug trafficking and other illegal activities. There is a high ratio of hit-and-run injuries and fatalities within Denver County. Colorado legislators have recently increased potential prison sentences for hit-and-run cases resulting bodily injury and/or death. They have also formalized an alert program to inform and involve the public as an attempt to help track down perpetrators. The formulation of a city-wide educational program focusing on the prevention of hit-and-run occurrences may be beneficial in reducing these numbers as well. It is important for the Denver Police Department to have quicker response times to both emergent and non-emergent calls. Hopefully with the addition of new recruits for the force who are currently in training, Denver County will see quicker response time to all calls made. This will also hopefully decrease the amount of gang-related crimes and deter community activity in general. It is evident that Denver County has a large trash and litter problem. The initiation of more trash cans and recycle containers parallel with city-wide education would be beneficial in decreasing this problem. It would also be of benefit to the community and the court systems to enact a community service program that revolved around helping clean up the neighborhoods and streets. Denver County has good disaster and emergency preparedness plans within the community; however educational resources to the public need to be explored with a variety of different materials and other languages for maximum effectiveness. The primary educational method is by internet with most of the materials written in the English language only. Nearly 1/3 of all households in Denver County speak a language other than English. References City and County of Denver. (2011, Oct). Hazard Identification and Risk Assessment. Retrieved March 8, 2014, fromhttp://www.google.com/url?sa=trct=jq=esrc=ssource =webcd=1ved=0CCUQFjAAurl=http%3A%2F%2Fwww.denvergov.org%2FPortals%2F428%2Fdocuments%2FDenver%2520Hazard%2520Identification%2520and%2520Risk%2520Assessment.pdfei=AvEtU6etF8OJogSh5oDwDwusg=AFQjCNEEQhg_2-JDt_OVeX3pIyYSKGcx9gbvm=bv.62922401,d.cGU Colorado Department of Public Health and Environment. (n.d.). Health Statistics: 2012. Retrieved March 10, 2014, from http://www.google.com/url?sa=trct=jq=esrc=s source=webcd=1ved=0CCUQFjAAurl=http%3A%2F%2Fwww.chd.dphe.state.co .us%2FResources%2Fvs%2F2012%2FDenver.pdfei+I14tU9zPA-SNygGZ-IDYBwus G=AFQjCNH_VbyYxdRvmxNekgRu-y0LhIgrzwbvm=bv.62922401,d.aWc Colorado State Forest Service. (2014). Colorado Wildfire Risk Assessment Portal. Retrieved March 10, 2014, from http://www.coloradowildfirerisk.com/map Denver Fire Department. (2014, January 7). In Wikipedia. Retrieved March 9, 2014, from http://en.wikipedia.org/wiki/Denver_Fire_Department Denver Police Department. (2014, January 6). Reported Offenses In The City And County Of Denver By Month. Retrieved March 8, 2014, from http://www.denvergov.org/police/ PoliceDepartment/CrimeInformation/CrimeStatisticsMaps/tabid/441370/Default.aspx Denver’s Water Quality Program. (2014, February 14). Sampling Results. Retrieved March 9, 2014, from https://www.facebook.com/DenversWaterQualityProgram?sk=app_190322 544333196app_data Department of Environmental Health. (2014a). Air Quality Program: Our Role In Protecting Air Quality. Retrieved March 9, 2014, from http://wwwdenvergov.org/environmental Health/EnvironmentalHealth/EnvironmentalQuality/EnvironmenatlAssessmentPolicy AirQuality/tabid/444649/Default.aspx Department of Environmental Health. (2014b). Water Quality Program: Trash and Litter. Retrieved March 9, 2014, from http://wwwdenvergov.org/environmentalhealth/ EnvironmentalHealth/EnvironmentalQuality/WaterQuality/tabid/444650/Default.aspx Department of Environmental Health. (2014c). Water Quality Program: Water Quality In Lakes and Streams. Retreived March 9, 2014, from https://wwwdenver.gov.org/environmental health/EnvironmentalHealth/EnvironmentalQuality/WaterQuality/tabid/444650/Default. Aspx Gang activity in Denver. (2013, August 17). In Wikipedia. Retrieved March 9, 2014, from http:// en.wikipedia.org/wiki/Gang_activity_in_Denver Gurman, Sadie. (2013, October 15). The Denver Post. Denver Police: Gang violence rises this year, involves more victims. Retrieved March 9, 2014, from http://www.denverpost.com /breakingnews/ci_24309448/denver-police-gang-violence-rises-this-year?source=rss Hubbard, Brent. (2014, Feburary 17). Rocky Mountain PBS. Hit-and-run fatal crashes rising in Colorado. Retrieved March 10, 2014, from http://www.coloradoan.com/article/201 40217/WINDSORBEACON01/302170069/Hit-run-fatal-crashes-rising-Colorado Kroh, Kiley. (2014, February 24). Climate Progress: Colorado Become The First State To Regulate Methane Emissions from Fracking. Retrieved March 9, 2014, from http:// thinkprogress.org/climate/2014/02/24/3322651/Colorado-methane-fracking/ Maass, Brian. (2013, October 3). CBS Denver. Denver Police Response Times Worsen, Complaints Rising. Retrieved March 9, 2014, from http://denver.cbslocal.com/2013/ 10/03/denver-police-response-times-worsen-complaints-rising/ Mendelson, Bruce. (2014, Feburary). National Institute on Drug Abuse. Drug Abuse Patterns and Trends in Colorado and the Denver/Boulder Metropolitan Area – Update: Jan 2014. Retrieved March 9, 2014, from http://www.drugabuse.gov/about-nida/organization/work groups-interest-groups-consortia/community-epidemiology-work-group-cewg/meeting- reports/highlights-summaries-january-2014-4 Metro Denver Homeless Initiative and National Law Center on Homelessness and Poverty. (2013, January). The Gathering Place – Homelessness and Poverty Statistics. Retrieved On March 8, 2014, from http://www.tgpdenver.org/homelessnessfaq?printable National Weather Service. (2011, June 21). Colorado and National Lightning Casualty Statistics. Retrieved March 10, 2014, from http://www.crh.noaa.gov/pub/?n=/Itg/Itg_stats_index. php Office of Emergency Management. (2014a). Alert and Warning Systems. Retrieved March 10, 2014, https://www.denvergov.org/AlertandWarning/tabid/391430/default.aspx Office of Emergency Management. (2014b). Potential Threats. Retrieved March 9, 2014, from http://www.denvergov.org/Redirect_404/tabid/391429/Default.aspx? READYColorado and the State of Colorado. (2014a). Retrieved March 10, 2014, from https:// www.readycolorado.com/ READYColorado and the State of Colorado. (2014b). Severe Weather/Thunderstorm. Retrieved March 10, 2014, from https://www.readycolorado.com/hazard/severe-weatherthunder storm READYColorado and the State of Colorado. (2014c). Tornado. Retrieved March 10, 2014, from https://www.readycolorado.com/hazard/tornado READYColorado and the State of Colorado. (2014d). Wildfire. Retrieved March 10, 2014, from https://www.readycolorado.com/hazard/wildfire

Pathophysiology of Huntington Disease

Pathophysiology of Huntington Disease George Huntington first described Huntington Disease in 1872 as coming on gradually but surely, increasing by degrees, and often occupying years in its development until the hapless sufferer is but a quivering wreck of his former self (Visser, 2010). Huntington disease is an inherited genetic disorder, which causes the progressive degeneration of selected nerve cells in the brain. This degeneration of nerve cells results in impairment of both mental capability and physical control which results in death (Visser, 2010). This essay will look at the pathophysiology of Huntington disease in relation to the possible signs and symptoms. While also identifying the risk factors and examining the relevant tests available with regards to screening, diagnosing and monitoring treatment within New Zealand. It will then further explore the treatment options available in New Zealand and treatment developments worldwide. Pathophysiology of Huntington disease in relation to signs and symptoms Huntington disease is caused by a genetic fault in a small section located on chromosome 4, which encodes a protein called Huntington (Porth, 2011). However, the function of the Huntington protein is still unknown, yet this protein appears to be important to neurons in the brain (Visser, 2010). This genetic fault results in a segment of DNA, known as a CAG trinucleotide repeat, this segment of DNA is made up of a series of DNA building blocks cytosine, adenine and guanine that appear multiple times in a row (Visser, 2010). The normal copy of this gene contains 6 to 35 copies of the trinucleotide repeat, compared to the faulty gene which contains 40 to 120 copies of the trinucleotide repeat resulting in this gene producing an expansion of Huntington’s gene (Porth, 2011). The larger number of trinucleotide repeats is generally associated with an earlier onset of Huntington’s’ disease. This is shown as adults with Huntington’s disease generally have 40-50 tri nucleotide repeats where people with the juvenile form of this disorder tend to have more than 50 trinucleotide repeats (Visser, 2010). Also, Visser (2010) suggests that due to the elongation of the CAG trinucleotide segment, the segment gains a toxic function that disrupts the normal function of neurons and eventually leads to the death of neurons. Cells are known as building blocks of life that use energy to carry out biological functions, while also producing oxidants that can potentially damage themselves; Yet, these cells can make such chemicals harmless (Visser, 2010). Current studies suggests that the protein Huntington somehow prevents the brain cells from protecting themselves against the toxic chemicals which results in Huntington’s disease causing the localized death of brain and spinal cord cells (Porth, 2011). Basal ganglia are the first neurons to be affected by Huntington disease; these neurons are associated with a variety of functions that modulate motor movements, emotions, cognitive and learning abilities (Porth, 2011). Therefore the deteriation of basal ganglia results in many symptoms which commonly occur around 35 and 55 years of age, however these symptoms will progressively get worse which results in the individual passing away in around 10-20 years (Porth, 2011). There are early signs and symptoms of Huntington disease which include uncontrolled muscular movements, memory problems and mood changes (Visser, 2010). Yet, these symptoms quickly develop into serious motor impairment conditions such as eye movement disorders, spasticity, dysphagia, dysarthria, myoclonus, and the main impairment chorea which involves rapid, jerking movements that the individual has no control over (Porth, 2011). As Huntington disease develops it results in a cognitive decline, mental slowing which is the inability to remember people and to make decisions for oneself (Porth, 2011). This can all eventually lead to dementia. There are many factors that influence behavioural symptoms which include stress about the disease, family relationships, and as the pathways through the basal ganglia become disconnected which results in a loss of frontal lobe functions (Visser, 2010). The major behavioural symptom is depression with 30% of individuals with Huntington disease exper iencing major depressive or dysthymic disorders and 6% resulting in suicide (Porth, 2011). Other behavioural symptoms such as personality changes results in the individual appearing to have no interest in life or the individual having increased anger and irritability which further links to impulsive actions and violence, these actions can cause stress in relationships between family members (Visser, 2010). Risk Factors of Huntington disease Everyone receives two copies of each gene which are singularly known as alleles, one from each parent, that are present in all cells of the body (Lemiere, 2004). Therefore most individuals are born with two normal copies of each allele (Lemiere, 2004). However in the case of hereditary disorders specifically Huntington’s disease, an individual is born with one normal gene and a gene defect which is called a mutation (Lemiere, 2004). Huntington disease has an autosomal dominant inheritance pattern which means that a child of a parent who carries the mutation has a 50% chance of inheriting the mutation (Frank, 2014). If the child inherits the mutation the child will develop Huntington’s disease some point in the individual’s life, and can also pass it on to their children. But if the individual does not inherit the mutation then they cannot pass it on to their children (Frank, 2014). Yet, there are also rare cases where individuals develop Huntington’s disea se, without a family history of the condition (Visser, 2010). This generally happens because of a genetic mutation during the father’s sperm development (Visser, 2010). However, there is a process where fertilized embryos can be tested for Huntington’s disease prior to the embryos being implanted within a mother’s womb called pre-implantation genetic diagnosis (Christian, 2007). This technique allows the parent that carries the Huntington’s disease to avoid passing the genetic condition to their children (Christian, 2007). Pre-implantation genetic diagnosis is completed through in-vitro fertilization (IVF) where the mother’s egg is fertilized with the father’s sperm outside the body (Christian, 2007). The eggs then develop into embryos, after three days of being cultured in the laboratory the technique of embryo biopsy is performed, this test checks the embryo for the Huntington’s disease and therefore all the embryos are then implanted back into the mother (Christian, 2007). New Zealand has been ethically approved for pre-implantation genetic diagnosis however this is only under special circumstances (Chris tian, 2007). The government only funds pre-implantation genetic diagnosis for 40 couples a year with one single attempt at pregnancy; this funding includes all serious genetic conditions (Christian, 2007). Relevant diagnostic, screening and monitoring tests in New Zealand Genetic tests are an example of a diagnostic as it is a procedure performed that establishes if an individual has the presence or absence of Huntington’s disease (Lyon, 2013). Individuals that have symptomatic symptoms of Huntington’s disease may be recommended by health care professionals to undertake a genetic test for the faulty Huntington gene (Visser, 2010). However, there is also predictive DNA testing which is for asymptomatic individuals with a 50% chance of developing Huntington’s disease, these individuals are tested to see if they will be affected or not by the faulty gene in adulthood (Visser, 2010). Both of these genetic tests are accomplished in the same way and can be done in Auckland laboratory (Lyon, 2013). Genetic testing is done by DNA being extracted from the individual’s blood sample, and then the DNA being purified (Lyon, 2013). A technique called polymerase chain reaction is then implicated to locate the two Huntington genes, once fo und millions of exact copies are made for further analysis (Lyon, 2013). This further analysing is when the DNA is sorted by size to determine the number of CAG repeats in each gene. The three outcomes to the test are based on the CAG repeats (Lyon, 2013). If an individual receives a negative test it means the CAG repeat size is 30 or less and therefore the individual is not at risk of developing Huntingtons disease, but if an individual receives a positive test it means the CAG repeat size is 40 or more and the individual will develop Huntington’s disease generally in adulthood (Lyon, 2013). However if an individual receives uninformative it mean the CAG repeat is in the immediate range between 31-39 and is unclear if the individual will develop Huntington’s disease (Lyon, 2013). Other tests available are known as screening this is where a series of tests are used to predict the presence of disease in individuals at risk (Lemiere, 2004). These tests include neurological examinations, along with structural and functional imaging. Neurological examinations are performed by a neurologist, which intensively interviews an individual to obtain the medical history and rule out other possible medical conditions (Lemiere, 2004). Some key aspects neurologists use to identify Huntington’s disease include taking a family history as Huntington disease is an inherited disorder and taking note of reflexes, muscle strength and eye movements as some of the earliest manifestations of the disease are â€Å"subtle chorea, eye movement and fine motor abnormalities† (Lemiere, 2004). However, Lemiere (2004) suggests that the Huntington gene defect may influence brain function and behaviour during asymptomatic years, this research has been conducted using presymptomati c individuals who have a positive gene defect. These individuals had a volume reduction of â€Å"30.9% for the caudate, 29.3% for the globus pallidus and 25.7% for the putamen† (Lemiere, 2004) compared to individuals with a negative gene defect from offspring of Huntington disease patients (Lemiere, 2004). This research shows that the decline of basal ganglia occurs gradually before the onset of Huntington disease symptoms (Lemiere, 2004). Therefore healthcare professionals can use MRI and CT scans of the brain to help determine if patients have Huntington’s disease (Lemiere, 2004). The monitoring of treatment is extremely important in Huntington’s disease and dependently relies on the motor, behavioural and cognitive aspects of the individual (Frank, 2014). After the onset of Huntington disease the individuals’ functional abilities gradually worsen over time due to the Huntington gene mutation that causes a localized death of neurons which helped to regulate the motor movements, emotional and cognitive abilities (Frank, 2014). The loss of these abilities requires the individual to seek help for all activities of daily care, yet later in the disease the individual will be confined to a bed with the inability to speak (Frank, 2014). This gradual decline of the individuals’ condition makes it important for health care professional to monitor the individuals’ treatments and adjust the treatment accordingly to the disease progress (Frank, 2014). Further, the drugs used in treatment of Huntington’s disease has the potential to cause significant side effects that can worsen symptoms of the disease (Frank, 2014). Therefore it is critically important for health care professionals to monitor the risk- benefit ratio effect the treatment has on an individual (Frank, 2014). Treatment available in New Zealand and further treatment developments worldwide Currently, there is no cure for Huntington disease, but medications, psychotherapy, speech and physical therapy can be implemented to help minimize symptoms while also allowing the individual to adapt to their condition (Frank, 2014). Medications to help treat movement disorders in New Zealand include Xenazine this medication helps to suppress chorea, but has possible side effects of aggravating depression (Frank, 2014). Also, the use of certain antipsychotic drugs such as haloperidol and clozapine can help alleviate choreic movements and further controlling hallucinations and violent outbursts, but the possible side effects can worsen dystonia and muscle rigidity (Frank, 2014). Due to the loss of frontal lobe functions as an effect of the disease, there needs to be increased psychiatric support for individuals with Huntington’s disease (Visser, 2010). This support can come from medications that support depression such as antidepressants which include fluoxetine, sertraline and esctislopram (Frank, 2014). This treatment of depression can further help to improve the symptoms of sleep disturbance, social withdrawal and lack of interest in general life (Frank, 2014). However, using antidepressants can include the side effects of insomnia, diarrhoea, nausea and sexual problems (Frank, 2014). Other medications to help individuals can be antipsychotic and mood stabilizing drugs which help to supress violent outbursts, highs and low mood swings, the common side effects of these medications include weight gain, tremor and gastrointestinal problems (Frank, 2014). Psychologists can provide talking therapy for an individual with Huntington disease, this therapy allows the individual to understanding the conditions effects, while further discussing the problems and feeling the individual has (Frank, 2014). Such problems the individual could be concerned about are talking, eating and swallowing this is because Huntington disease impairs the control of muscles of the mouth and throat (Frank, 2014). A speech therapist can address these issues and improve the individual’s ability of communication by implementation communication devices (Frank, 2014). Physical therapy is also an important part of Huntington disease as the exercises provide help improve strength, balance and coordination, which further results in the individual maintain mobility for as long as possible and minimizing the possible falls (Frank, 2014). Even though there is no treatment the research field is still dynamic there are a high number of on-going or recently completed studies in relation to Huntington disease (Frank, 2014). Also, in the USA there has been a break through approach called gene-silencing (Carrol, 2013). This approach relies on the fact that DNA is not directly copied from the protein, but is made up from a chemical RNA first; this RNA message is chopped up and thereby stops the cell making the Huntington protein (Carrol, 2013). Although this approach does not stop the individual from carrying the Huntington disease and, therefore the individual can still pass the gene on, this approach stops making the protein that attacks the brain cells (Carrol, 2013). Another breakthrough development happened in the UK this is of a tool called CRISPR (clustered regularly interspaced short palindromic repeats) that targets and cuts out specific small pieces of RNA (Carrol, 2013). This tool is used in the approach genome ed iting. This approach is different to gene silencing as it corrects the defect, which results in the individual not having the genetic defect and therefore produce babies without Huntington disease (Carrol, 2013).

Several differences between private and public schools

Several differences between private and public schools Introduction Extant literature proposes that there are several differences between private and public schools in term of governance, facilities and even the curriculum. These studies do however record both the similarities and differences of these institutions as well as the controversial aspects of these institutions structures. Like other countries of the world, Kuwait has also various factors that affect the running of public and private schools. In this context, it is true that many several students feel and experience the difference that exists between private and public schools. The general consensus however is that private schools are better as compared to the public schools as postulated by Hannaway (1991) when he argued thatprivate schools perform better due to greater school level autonomy and their responsiveness to the needs of students and parents. Public schools have always paid for higher education programs out of general public taxation. This has prompted several students to pay little or no tuition fees at all and has also enabled number of admissions in the public schools as compared to the little or rather fewer admission in the more expensive private institutions. Most students have been able to gain access to public institutions for higher education through selective exams programs; this is mainly in an effort to have of quality education and better performance in these schools which usually enjoy adequate government funding. Due to the difference in students abilities and competition in public schools, students with low ability have a choice of increasing their education level or being uneducated depending on their financial capabilities. This simply means that a student with a low ability can equally be enrolled in a private school but after paying full tuition money which is always very expensive. On the other hand, a student with low ability and lacks enough finances remains uneducated. But studies have shown that there is an increasing demand for public schools due to high demand of higher quality education coupled with high level of students competition for the government funded learning opportunities. Overview of the Kuwaiti Education system The Kuwaiti education system in the early 20th century comprised of very basic education that was delivered through very few Koranic schools with funding from the various wealthy Kuwaiti citizens. The Koranic schools main taught the students how to read write and solve. The initial step towards the modern education system began in 1921.Thse schools mainly concentrated on the teaching of commerce and mathematics. It was later on that that writing skills were introduced. In 1967, it became necessary to compulsory to enroll students or rather school going children to primary schools (Kjeilen,2009). The Kuwaiti government dedicated a very large sum of money in funding of its educational system. The government also has made efforts to device programs that aid in improving the entry of the Kuwaiti women from education institutions to their professional work life.A considerable percentage of the Kuwaiti education is made up of private schools with about 40% being in the kindergartens and secondary category. The private schools are mainly financed by foreigners while the tuition fees and other subsidies are derived from government support. In a nutshell, the Kuwaiti education system ranks very high and attendance is open to both sexes. The Kuwaiti education is also compulsory and free for all the Kuwaiti citizens. Social changes in Kuwait have rapidly sped up since the oil boom that started in 1950s. Right before the super affluence which was caused by oil, Kuwait as a country was one of the poorest states both technologically and economically; the people from Kuwait majorly lived and survived on activities such as trading, herding, pearling and fishing. The decades following the development in Kuwait after 1950s attracted many immigrants especially those from poorer states that include Arabs from the Middle East who wanted to be part of Kuwait by Citizenship. As time accelerated to a different Kuwaiti era, more and more developments were established as the native Kuwaitis led much comfortable lives in urbanization, thus leaving most of the labor work to the foreigners who were more of laborers. Early education foundation was based on only a few Quranic schools that provided majorly religious teachings and basic literacy in Arabic tutelage at the beginning of the 20th century. In the Middle East, Kuwait was one of the nations that flagged the most sophisticated, generous, and comprehensive educational infrastructures that enabled a much extensive education boosting in the country. Al Mubarakiyya school was founded in the year 1912 as one of the most profound and modern educational institutions in Kuwait through funding by merchants to supply clerks who at least had the basic knowledge in fields of commerce, letter writing and arithmetic. This was later followed by introduction of other subjects in the curriculum like geography, history and art. English courses were first stated in the year 1921 by Al Ahmadia School and shortly followed by the first girls school which was founded and established to offer instructions in home economics, Islamic studies and Arabic. In the 1930s, the modern period of establishment of educational facilities was initiated and on going; this was after the pearling based devastation of the Kuwaitis economy. In the year 1935, public education was established after the education system was partly adopted for control by the Kuwaiti state. This chapter initiated the starting of new schools, sending of Kuwaiti students abroad for higher learning and also founding of an education mission by Palestine teachers. Among the schools which were founded, three of those schools merged a total of 600 boys, while the other primary schools were established for girls and were able to accommodate a total of 140 girls. A year later in 1936, a department of education was instituted in order to monitor the running of the public schools, oversee foreign teachers from Iraq, Egypt, Syria, Palestine, and Lebanon who were the pioneers of the secondary education program in Kuwait. By the year 1945, a total of 17 schools in the country were est ablished. In the academic year of 1954-1955, the first technical school and the first kindergarten were established. This clearly shows the rapid acceleration of education facilities in Kuwait since the year 1950s. In the technical college, the first year saw accommodation of 80 students who were enrolled and an increase in number courses which were gradually introduced as demand for more fields of study heightened. The educational developments continued pacing up as a new institution for the blind was inaugurated in the year 1956 with a total of 36 pupils in enrollment records. This was not enough since by the year 1973, there were approximately 1,644 students who were identified to be in need of special facilities for education. Some of these students include the blind, the deaf, and other handicapped ones. All these special students were enrolled in 11 institutions which were specially designed for them in acquiring education as other normal students. Adult education for women officially ca me underway in the year 1963; this was a result of the existing similar programs for women though dormant(Meleis et al ,1979). This system saw continuous enrollment of approximately 45,000 students of which 18,000 were girls. The education department of Kuwait was then officially inaugurated as the Education Ministry in the year 1962. This establishment gave the education ministry full mandate to oversee and manage all directions in education maintenance and development over the decades. Kuwaits state education has since progressed since the Kuwaiti nationals got involved in their education process twenty years back from the beginning of the millennium. This progress made has been quite remarkable especially in terms of expatriate to national ratio of teachers who were employed. In the year 1982, there were 24,367 teachers in total; 6,478 teachers were Kuwaiti nationals. The academic year of 1997-1998 saw total of 27,359 teachers employed in public schools and an estimate of 10,000 teachers in private schools. Of the 27,359 teachers in public school, 17,357 teachers were Kuwaiti. The ratio of Kuwaiti teachers to expatriate ones changed from approximately 1.7:1 from 1:3.76. The state of Kuwaiti managed to promote their education process by extensively increasing the number of Kuwaiti teachers between the early eighties to the late nineties. The doubling of the Kuwaiti teachers between the eighties and the nineties has relieved the reliance of foreign professional teac hers in Kuwaiti schools. This was a great change but not good enough since most of the Kuwaiti professional teachers were particularly in practice at the lower levels, mostly the primary schools. The entry of male teachers in the profession also saw many of them teaching in primary schools. Kuwaits transformation into a modern nation with remarkable education institutions has been so, thanks to the governments early decision to distribute the oil revenues to citizens through investment of education, social welfare, housing and healthcare. The Kuwaiti education system is tailored to cater for the nations needs. In their endeavor to ensure that most of its citizens are educated, the Kuwaiti government has ensured that the education is provided free of charge. This has been the case since 1966.In order to ensure that the share of national budget that is targeted towards the provision of free education yield good outcome in terms of raising the Kuwaiti Literacy level, the government has made education to be compulsory for student aged 6-14. The Kuwaiti government has in its vision and commitments the need to provide its citizens with a stable and highly educated human resource base. This is in an effort to meet the social challenges attributed to development challenges as outlined in their Millennium Development Goals (MDGs).This is through the guarantee of an education slot to each and every citizen who wishes to pursue their education to whatever level that they desire. It is quite evident from the number of schools alone, the governments commitment towards ensuring that the Kuwaiti population is properly educated. The general Kuwaiti education system is made up of elementary, intermediate and secondary schooling systems. As of 1995, there were about 861 state and private institutions (schools) that fell into these categories. Once an individual goes past these three basic levels of education, they proceed to institutions of higher learning such as the Kuwait School and other educational centers where they learn various courses in various fields of study Cost of private schooling in Kuwait The private education in Kuwait makes a very crucial element of the Kuwaiti education system. There is a very strong government presence in the private schools in Kuwait. The private schools do enroll about one third of children at the elementary level.The cost of private schooling in Kuwait was a preserve for the high income families only before Kuwaiti was invaded by Saddam.This situation has however changed and students from moderate and modest families also do enroll in the private schools. This move is mainly fueled by the perceived decline in the quality of education in the public school system. Their main attraction is however pegged on the quality education that they desire for their children. There is however situations that necessitate the parents to return their children to the public schooling system due to the increase in the school fees paid in the private schools in Kuwait. Some of these parents resort to this move despite the availability of loans to fund for their ch ildrens education (Kuwaiti Times, 2007) Different students get enrolled in different schools majorly due to their level of performances and their family income, this has always been the question asked mostly and a major source of debate whether students in private schools are better than their counterparts in public schools. Several parents and guardians have developed the mentality that paying extra money for their kids education makes all the difference as far as quality and success in their childrens education is concerned. With this kind of belief in existence, more wealthy parents or guardians prefer paying so as to secure well the future of their children in the private learning institutions. On the other hand, some parents, guardians, students and even college professors believe that education is generally the same whether it is from a public institution or a private one. This depends on the attitude and mental preparedness of the student towards their education and future. When comparing the public schools to the private ones, it is quite obvious that the quality of education in private schools is much lower than those in public schools. This is mainly reflected in the strategies used when competing for students. In public schools, there has always been a setting of qualification which must be achieved by a student before being accepted for admission; this kind of admission setting is designed to enable public schools act as monopolies whereby zero tuition fees for students with high abilities is initiated. When it comes to private schools, the mode of competing for students is not through the ability of a student but the financial capability. This means low ability students can be admitted so long as they can pay for the private fee; this has enabled many students to accede higher education, thus boosts total income in the economy. Competition between private and public schools is determined by numerous variables including exams taken as well as general prices in the institutions. An active role played by schools in setting the exams and the tuition fees determines the level of quality of education provided. While public schools have always maximized public surplus. That is, the total sum of students earnings less the all the costs spent in providing education, the private schools have always aimed at maximizing profits; which is, all income generated by the students who have been admitted in the institution less all the expenses incurred in providing education for the students in the schools. This clearly shows that private schools use price as admission policy so as to ascertain their sustainability in providing better education, this is because money from students is basically the only funding they use in running their institutions. As far as price is concerned, there are variations in pricing in different p rivate schools depending on various factors of which educational quality is the most paramount. Thus the better the quality level of a private school, the higher the tuition fees paid by the parents (Tabora, 2008). Students who attend public schools under public monopoly are basically the same students who are admitted in these institutions under competition. These students have always obtained similar quality in school in both cases. The existence of private schools for higher has raised total welfare since students who have not been admitted in the public monopoly have been given a chance of joining the private schools and get educated. When observing the market partitions in which both public and private schools compete for students, there is a very unique equilibrium that exists in which the private schools are lower in quality than the public schools. Importance of schooling The concept of schooling was invented in order to empower the human capital. Previous research on human capital has however been targeted on the quality and quantity of returns that a person obtains as a result of schooling. As advanced by Mincer in his outstanding and standard formulation, the amount of investment invested in a particular cause can be translated into various observable differences that various from one individual to the next (Mincer, 1976). Therefore, in case the investment in an individuals education is considered to decline on a linear scale, an all the amount of investment are considered to be forgone income, a very simple and direct correlation can be derived between the earnings and the years that an individual spends while schooling. The application of the commonly available data portrays that there is a characteristic that is eminent in all the schools allover the world. Is very important that the world provide their citizens with the best level of education. The importance of the human capital cannot be overemphasized. This is because of the various gains that result of the gainful and observable changes that come with having a population with a high literacy rate. Every country in the world must have its own dependable and experienced workforce in order for it to succeed in its endeavors of being both sovereign and prosperous. This requires the individual countries to device their own efficient and customized education system and curricula that would fully take care of its industrial and intellectual deficiencies. The investment in human capital therefore very crucial for the success of every nation. In certain cases however, it becomes crucial for certain sectors of a nations economy to require specialist support from expatriates. This is due to the fact that certain courses or rather education needs are never relevant or rather are never heavily invested on in certain specialist areas of the economy. Thus the need for expatriate support in certain areas such as engineering and other very technical areas of the economy. It is therefore necessary for every government to be heavily involved in the education of its citizens. This is very applicable in almost every country. There is however a generalizability that is used as an indicator of the role and importance of return variation of schooling investment in different nations across the globe (Psacharopoulos, 1994). The exact role of government in education is however still subject to debate and is subject to various different views. It is worthwhile to note that a high returns on the schooling level does not necessarily imply that it is the role of government intervention that has subsequent resulted to the better academic yield. However, in order to conclusively justify the level of government intervention, it is important to take into account various parameters that affect the educational yields or rather outcome. For quite a long time, the role of education to a given society has been researched upon by various scholars. The role of the government has been featured as one of the major determinants of the success in terms of schooling in the lives of the citizens. Kuwait for example has her government put in place various mechanisms to ensure that the citizens and foreigners who attend its education system do get certain critical notions and ideas imparted upon them. Kuwait being a Muslim state, has most of its schooling requirements tailored to meet the strict requirements of the Muslim religion. In fact in earlier years, the rules that govern schooling were very strict. The education of the girl child for example was forbidden for a long time. But later on, partly due to the effects of westernization, the education of the girl child became accepted as one of the steps toward a democratically balanced Kuwaiti society. The role of government intervention can however be justified using certain mechanisms such as market failure. Importance of resources availability to the quality of education Several researchers have focused their attention to the important role that is played by the availability of resources to the success in the schooling process in various countries. It is however very important that the amount of resources that are devoted to the process of acquiring proper education can not be directly tied to the outcome of the various schooling processes. In Kuwait for example, the private schools that are in essence run and managed by foreigners are better equipped as compared to the public schools. The analysis that focuses on the role of resources in the outcome of schooling process is however subject to a lot of discussions and debate. This is because of the multivariate nature of the schooling process. Despite the controversies that surround the analysis, there is however a considerable amount of evidence that supports that fact that a positive correlation exists. This is based on the minority of scholarly work that exposes a substantial and positive correlati on (Schneider, 2002). Other studies however, are focused on the simple relationship between the resources and the outcome of the schooling process. In these studies, a simple correlation is devised in order to relate the causal factors and the outcomes of the schooling process. The relationships that have been derived do not however have a systematic review but the causal factors do have a certain level of support in the review process. A proxy relationship can however be conclusively be justified as appropriate. The existence of this stronger relationship that exists between the resources and other causal factors may be applicable. Factors such as the amount of wealth in a students family background may to a large extent be an influence and a major contributor to the level of students performance as a result of a dedication and provision of more resources into the schooling of the student. The growth setting however, has no direct proxy relationship. In certain instances, poor proxies have however been a ssigned to the process of getting a correlation between the amount of resources and the outcome of schooling (Hanushek Kimko , 2000). International schooling policies have been supported hugely and are now gaining increased income. Numerous debates have been carried out and the arguments have supported interventions by the government based on spillovers which are as a result of the growth process in education. This is why the general endogenous growth model has clearly shown that education level in an economy influences the growth of a country. That is, if the education level of an economy is low, the growth of that particular nation will definitely drag unlike if the education level is was higher. The structure of the endogenous development model brings in a spillover that people will not take into consideration their own decision making process. Empirical work carried out has underscored the merits of schooling quantity in these particular places. The relationship between individual earnings and schooling have shown the most consistent and strongest support in education performance; when an individual uses own mo ney to finance schooling, the seriousness becomes extreme to the extent that exam performance of that individual turns out to be quite pleasing. While basing reliance on evidence that is limited, there has been quite promising support that exists on the importance of education and schooling in relation to effects of growth as well as the distribution of earnings (Gregorio, 1999) The economic effects as a result of differences in educational quality of secondary and elementary schools are not well comprehended as the effects of quantity, especially in relation to the aggregate performance the nations economy. This poor understanding of the implications of quality in education makes it difficult to reflect measurement. It is very difficult to precisely define the quality of education since the term quality reflects the extent of an institutions knowledge base as well as the analytical skills employed as the focal points of learning institutions. To properly build the base of this discussion, this study will rely on data sourced from standardized exams of achievements in academics and students ability in education. Re lying on this information from standardized tests to reflect quality measures is controversial in a way that there are gaps available in evidence and also the emanated conclusions follow (as stated below). All in all, these measures prove to be th e most effective indicators available of quality and have a relationship with the results that we positively satisfy us. Numerous research studies have been carried out and documented in the field of labor markets which directly focus on personal differences when it comes to cognitive ability and effects in earnings (as well as modify the estimates of returns in terms of quality). 4. The latest direct research study of cognitive achievement have recorded substantial returns in the labor market has measured individual variations when it comes to cognitive achievement. For example, ONeill (1990), Murnane, Willett, and Levy (1995), Bishop (1989, 1991), Neal and Johnson (1996), Currie and Thomas (2000), Grogger and Eide (1993), and Murnane et al. (2000) each conclude that the earnings advantages are quite substantial when standardized test are highly achieved. These conclusions have been extracted from various approaches. Bishop (1989) is much concerned about the errors that result in the most testing environments and emphasize on extreme care when dealing with that problem since it has very dramatic consequences on the estimated importance of the test variations. On the other hand, Grogger and Eide (1993), ONeill (1990), Neal and Johnson (1996), and Bishop (1991) have greatly put their reliance on the latest labor market information as well as representative sampling which suggests that earnings advantage to measured variations in skill is much greater than those of the earlier times and earlier research studies (even when reliability of the test is not corrected. In Kuwait, just like in other quickly-developing education systems, one main domain of interest is ensuring that the quality of education that is offered by both private and public providers is up to standards needed. This paper elaborates by way of a thorough review the history of development of Kuwaiti education system since its initiation. It considers several quality systems that are currently employed in other countries in the Gulf States so as to identify the effects of the education systems both private and public on the attitudes of the students towards schooling. Two main results emerge from the present analysis. The first suggests that there are no significant effects from class attendance. The second indicates that smaller classes do not translate into gains in achievement. Other results include the lack of significant peer effects and evidence of variability in teaching effects, which is, however; also not significant. These findings need to be interpreted carefully. For instance, the result of no attendance effects may not necessarily indicate that attendance does not matter per se: on the contrary, it can instead be the case that attendance does matter but that the students in our data choose optimally how many classes to attend, so that marginal variation around that attendance level does not translate into any gains in terms of achievement. The outlook of the 21st century Kuwaiti education The Gulf States have undergone a number of serious challenges both on their economic and political existence. These numerous challenges have been brought about by the prosperity and accelerated growth as well as the heightened levels in social services. There tends to be some sort of deception in some certain levels when one looks at the external wealth and modernity of some of these Gulf States. For example, it is true that Kuwait as a country is in possession of 9.5% of the proven oil reserves in the world (out of a combination of 64.9% of all Gulf States) and many of the Kuwaitis are very rich people thanks to their oil rich nation. While this is so, the oil revenues in Kuwait are very modest when comparisons are made to the gross domestic product of the developed countries of the world. The fluctuating prices of oil have greatly influenced the reliability of development as well as long term planning; this is so especially when the price per every barrel remains low on the world m arket like it was in the eighties and the nineties. According to reliable sources, studies have shown that the low oil prices in 1980s was the cause of deficit budget operation by the Gulf States; which was barely the size of Switzerlands GDP if they were combined i.e. (U.A.E, Kuwait, Oman, Iran, Bahrain, Iraq, Saudi Arabia, Qatar). The Gulf States wealth illusion is as a result of control of the oil reserves by only a hand full of people who easily access the world markets through exports in ships; this clearly explains the long gap between the rich and the poor; which is bad for the economy. These Gulf States have had to deal with the grapples that affect their budgetary uncertainties in the oil markets. Some of these problems are public sector dominance, visible and hidden unemployment, poor revenues for the huge populations, dominance of foreign workers among, and also poor participation in the decision making process with the exception of Kuwait which has an elected body that represents it. The core feature of this analysis, however, is how the quality of schooling influences the national and economic growth. It is obvious that schools (no matter their geographical locations) have numerous variations as far as knowledge and general quality is concerned. These differences are always very difficult to deal with since the implications for comprehending the core issues are emphasized in this study.