(When I saw a lady in a ballgown....I was frankly terrified.... and I Essay

(When I saw a lady in a ballgown....I was frankly terrified.... and I wanted to call a policeman) Are woman represented as the agents or the victims of sexual - Essay Example (eNotes, 2009.) Leo Tolstoy was born at Yasnaya Polyana, in Tula Province. He was the fourth in five children. His parents died when he was a child, and he was brought up by relatives. In 1844 Tolstoy started his studies of law and oriental languages at Kazan University, but he never took a degree. Dissatisfied with the standard of education, he returned in the middle of his studies back to Yasnaya Polyana, and then spent much of his time in Moscow and St. Petersburg. In 1847 Tolstoy was treated for venereal disease. After contracting heavy gambling debts, Tolstoy accompanied in 1851 his elder brother Nikolay to the Caucasus, and joined an artillery regiment. In the 1850s Tolstoy also began his literary career. The title of Count had been conferred on his ancestor in the early 18th century by Peter the Great. The Kreutzer Sonata is a tale of sexual obsession and jealousy. A provincial businessman (Posdnicheff) becomes obsessed with his wifes relationship with a violinist, with whom she plays duos. The climax of his jealousy comes during a performance by his wife and her violinist partner of Beethovens Violin Sonata no.9 in A major, known as the Kreutzer sonata, after which Posdnicheff murders his wife. The idea for The Kreutzer Sonata was given to Tolstoy by the actor V.N. Andreev-Burlak during his visit at Yasnaya Polyana in June 1887. In the spring of 1888 an amateur performance of Beethovens Kreutzer Sonata took place in Tolstoys home and it made the author return to an idea he had had in the 1860s. The novel is written in the form of a frame-story and set on a train. The conversations among the passengers develop into a discussion of the institution of marriage. Posdnicheff, the chief character, tells of his youth and his subsequent remorse and self-disgust. Posdnicheff believes that his wife is having an affair with a musician and he tries to strangle her, and then

Arizona Immigration Law Research Paper Example | Topics and Well Written Essays - 1750 words

Arizona Immigration Law - Research Paper Example Section 2.8b. States: â€Å"For any lawful contact made †¦ a reasonable attempt shall be made, when practicable, to determine the immigration status of the person.† (Senate research). This is crucial as it seeks to protect the rights of lawful immigrants in the country. Section 3.f. clarifies this by stating: â€Å"This section does not apply to a person who maintains authorization from the federal government to remain in the United States.† The constitution requires that governments protect their citizens from crimes such as burglary and foreign security threats. By enacting the immigration law, Arizona legislators acted in accordance with the constitution to protect the citizens. The law seeks to curb potential national threats from immigrants in possession of deadly weapons and anything that can be used in executing terror attacks. The country suffers a security threat from illegal immigrants who might commit crimes and undertake terrorist attacks hence any legi slation against them is much welcomed. In the US federal prisons, 25% of the inmates are illegal aliens, and 12% of total felonies and 25% of burglaries can be attributed to illegal aliens. The Arizona immigration law prevents law enforcement officers from color discriminations when contacting people. It provides that for one to be conducted he or she must have committed a crime. This acts, if implemented as intended, to curb racial profiling. It would be in concordant with the Fourth Amendment of the US Constitution, which states: â€Å"The right of the people to be secure in their persons, houses, papers and effects†. Being secure in their persons means that no one will be subject to discrimination by the mere fact that they are white or black, but they will have to violate the law for a contact to be made. The provision for a person to fill a legal suit if there is an adopted or implemented policy that hinders or limits the enforcement of the Federal Immigration Laws means the enforcers will feel compelled at all times to act so as to ensure the aliens are kept at bay. This will act in the benefit of the citizens and the legal aliens to keep away the negative effects associated with these illegal immigrants, some being severe such as rapes, theft, burglary and terror. In addition, this law necessitates the removal of more law breakers from will Arizona. According to the US constitution, each state’s citizens are entitled to all Privileges and Immunities of citizens in the other states. Some of these privileges include employment opportunities. In line to this, the Arizona Immigration Law (SB 1070) requires all employers to properly scrutinize their potential employees before hiring them through the e-verification in order to ensure they are legal in the country. This provision prevents the illegal immigrants from taking away jobs from the citizens and hence, a beneficial one. It further requires employers to keep a record of the employee for a t least three months and further stipulates that incase an employer has hired an illegal emigrant, he or she should be aligned in a court of law. It also gives the state the right to suspend or terminate business licenses whenever the business entities violate this legislation. This strongly defends the US citizens’ privilege to access job opportunities in their states. It can also be argued that the Arizona Immig

Active Vs Physiological Management of Third Stage of Labour

Active Vs Physiological Management of Third Stage of Labour Active versus physiological management of the third stage of labour. Introduction This essay is primarily concerned with the arguments that are currently active in relation to the benefits and disadvantages of having either an active or passive third stage of labour. We shall examine this issue from several angles including the currently accepted medical opinions as expressed in the peer reviewed press, the perspective of various opinions expressed by women in labour and the evidence base to support these opinions. It is a generally accepted truism that if there is controversy surrounding a subject, then this implies that there is not a sufficiently strong evidence base to settle the argument one way or the other. (De Martino B et al. 2006). In the case of this particular subject, this is possibly not true, as the evidence base is quite robust (and we shall examine this in due course). Midwifery deals with situations that are steeped in layers of strongly felt emotion, and this has a great tendency to colour rational argument. Blind belief in one area often appears to stem from total disbelief in another (Baines D. 2001) and in consideration of some of the literature in this area this would certainly appear to be true. Let us try to examine the basic facts of the arguments together with the evidence base that supports them. In the civilised world it is estimated that approximately 515,000 currently die annually from problems directly related to pregnancy. (extrapolated from Hill K et al. 2001). The largest single category of such deaths occur within 4 hrs. of delivery, most commonly from post partum haemorrhage and its complications (AbouZahr C 1998), the most common factor in such cases being uterine atony. (Ripley D L 1999). Depending on the area of the world (as this tends to determine the standard of care and resources available), post partum haemorrhage deaths constitutes between 10-60% of all maternal deaths (AbouZahr C 1998). Statistically, the majority of such maternal deaths occur in the developing countries where women may receive inappropriate, unskilled or inadequate care during labour or the post partum period. (PATH 2001). In developed countries the vast majority of these deaths could be (and largely are) avoided with effective obstetric intervention. (WHO 1994). One of the central argumen ts that we shall deploy in favour of the active management of the third stage of labour is the fact that relying on the identification of risk factors for women at risk of haemorrhage does not appear to decrease the overall figures for post partum haemorrhage morbidity or mortality as more than 70% of such cases of post partum haemorrhage occur in women with no identifiable risk factors. (Atkins S 1994). Prendiville, in his recently published Cochrane review (Prendiville W J et al. 2000) states that: where maternal mortality from haemorrhage is high, evidence-based practices that reduce haemorrhage incidence, such as active management of the third stage of labour, should always be followed It is hard to rationally counter such an argument, particularly in view of the strength of the evidence base presented in the review, although we shall finish this essay with a discussion of a paper by Stevenson which attempts to provide a rational counter argument in this area. It could be argued that the management of the third stage of labour, as far as formal teaching and published literature is concerned, is eclipsed by the other two stages (Baskett T F 1999). Cunningham agrees with this viewpoint with the observation that a current standard textbook of obstetrics (unnamed) devotes only 4 of its 1,500 pages to the third stage of labour but a huge amount more to the complications that can arise directly after the delivery of the baby (Cunningham, 2001). Donald makes the comment This indeed is the unforgiving stage of labour, and in it there lurks more unheralded treachery than in both the other stages combined. The normal case can, within a minute, become abnormal and successful delivery can turn swiftly to disaster. (Donald, 1979). chapter 1:define third stage of labour, The definition of the third stage of labour varies between authorities in terms of wording, but in functional terms there is general agreement that it is the part of labour that starts directly after the birth of the baby and concludes with the successful delivery of the placenta and the foetal membranes. Functionally, it is during the third stage of labour that the myometrium contracts dramatically and causes the placenta to separate from the uterine wall and then subsequently expelled from the uterine cavity. This stage can be managed actively or observed passively. Practically, it is the speed with which this stage is accomplished which effectively dictates the volume of blood that is eventually lost. It follows that if anything interferes with this process then the risk of increased blood loss gets greater. If the uterus becomes atonic, the placenta does not separate efficiently and the blood vessels that had formally supplied it are not actively constricted. (Chamberlain G et al. 1999). We shall discuss this process in greater detail shortly. Proponents of passive management of the third stage of labour rely on the normal physiological processes to shut down the bleeding from the placental site and to expel the placenta. Those who favour active management use three elements of management. One is the use of an ecbolic drug given in the minute after delivery of the baby and before the placenta is delivered. The second element is early clamping and cutting of the cord and the third is the use of controlled cord traction to facilitate the delivery of the placenta. We shall discuss each of these elements in greater detail in due course. The rationale behind active management of the third stage of labour is basically that by speeding up the natural delivery of the placenta, one can allow the uterus to contract more efficiently thereby reducing the total blood loss and minimising the risk of post partum haemorrhage. (ODriscoll K 1994) discuss optimal practice, Let us start our consideration of optimal practice with a critical analysis of the paper by Cherine (Cherine M et al. 2004) which takes a collective overview of the literature on the subject. The authors point to the fact that there have been a number of large scale randomised controlled studies which have compared the outcomes of labours which have been either actively or passively managed. One of the biggest difficulties that they experienced was the inconsistency of terminology on the subject, as a number of healthcare professionals had reported management as passive when there had been elements of active management such as controlled cord traction and early cord clamping. As an overview, they were able to conclude that actively managed women had a lower prevalence of â€Å"post partum haemorrhage, a shorter third stage of labour, reduced post partum anaemia, less need for blood transfusion or therapeutic oxytocics† (Prendiville W J et al. 2001). Other factors derived from the paper include the observation that the administration of oxytocin before delivery of the placenta (rather than afterwards), was shown to decrease the overall incidence of post partum haemorrhage, the overall amount of blood loss, the need for additional uterotonic drugs, the need for blood transfusions when compared to deliveries with similar duration of the third stage of labour as a control. In addition to all of this they noted that there was no increased incidence of the condition of retained placenta. (Elbourne D R et al. 2001). The evidence base for these comments is both robust and strong. On the face of it, there seems therefore little to recommend the adoption of passive management of the third stage of labour. Earlier we noted the difficulties in definition of active management of the third stage of labour. In consideration of any individual paper where interpretation of the figures are required, great care must therefore be taken in assessing exactly what is being measured and compared. Cherine points to the fact that some respondents categorised their management as â€Å"passive management of the third stage of labour† when, in reality they had used some aspect of active management. They may not have used ecbolic drugs (this was found to be the case in 19% of the deliveries considered). This point is worth considering further as oxytocin was given to 98% of the 148 women in the trial who received ecbolic. In terms of optimum management 34% received the ecbolic at the appropriate time (as specified in the management protocols as being before the delivery of the placenta and within one minute of the delivery of the baby). For the remaining 66%, it was given incorrectly, either after the delivery of the placenta or, in one case, later than one minute after the delivery of the baby. Further analysis of the practices reported that where uterotonic drugs were given, cord traction was not done in 49%, and early cord clamping not done in 7% of the deliveries observed where the optimum active management of the third stage of labour protocols were not followed. >From an analytical point of view, we should cite the evidence base to suggest the degree to which these two practices are associated with morbidity. Walter P et al. 1999 state that their analysis of their data shows that early cord clamping and controlled cord traction are shown to be associated with a shorter third stage and lower mean blood loss, whereas Mitchelle (G G et al. 2005) found them to be associated with a lower incidence of retained placenta. Other considerations relating to the practice of early cord clamping are that it reduces the degree of mother to baby blood transfusion. It is clear that giving uterotonic drugs without early clamping will cause the myometrium to contract and physically squeeze the placenta, thereby accelerating the both the speed and the total quantity of the transfusion. This has the effect of upsetting the physiological balance of the blood volume between baby and placenta, and can cause a number of undesirable effects in the baby including an increased tendency to jaundice. (Rogers J et al. 1998) The major features that are commonly accepted as being characteristic of active management and passive management of the third stage of labour are set out below. Physiological Versus Active Management (After Smith J R et al. 1999) physiology of third stage The physiology of the third stage can only be realistically considered in relation to some of the elements which occur in the preceding months of pregnancy. The first significant consideration are the changes in haemodynamics as the pregnancy progresses. The maternal blood volume increases by a factor of about 50% (from about 4 litres to about 6litres). (Abouzahr C 1998) This is due to a disproportionate increase in the plasma volume over the RBC volume which is seen clinically with a physiological fall in both Hb and Heamatocrit values. Supplemental iron can reduce this fall particularly if the woman concerned has poor iron reserves or was anaemic before the pregnancy began. The evolutionary physiology behind this change revolves around the fact that the placenta (or more accurately the utero-placental unit) has low resistance perfusion demands which are better served by a high circulating blood volume and it also provides a buffer for the inevitable blood loss that occurs at the time of delivery. (Dansereau J et al. 1999). The high progesterone levels encountered in pregnancy are also relevant insofar as they tend to reduce the general vascular tone thereby increase venous pooling. This, in turn, reduces the venous return to the heart and this would (if not compensated for by the increased blood volume) lead to hypotension which would contribute to reductions in levels of foetal oxygenation. (Baskett T F 1999). Coincident and concurrent with these heamodynamic changes are a number of physiological changes in the coagulation system. There is seen to be a sharp increase in the quantity of most of the clotting factors in the blood and a functional decrease in the fibrinolytic activity. (Carroli G et al. 2002). Platelet levels are observed to fall. This is thought to be due to a combination of factors. Haemodilution is one and a low level increase in platelet utilisation is also thought to be relevant. The overall functioning of the platelet system is rarely affected. All of these changes are mediated by the dramatic increase in the levels of circulating oestrogen. The relevance of these considerations is clear when we consider that one of the main hazards facing the mother during the third stage of labour is that of haemorrhage. (Soltani H et al. 2005) and the changes in the haemodynamics are largely germinal to this fact. The other major factor in our considerations is the efficiency of the haemostasis produced by the uterine contraction in the third stage of labour. The prime agent in the immediate control of blood loss after separation of the placenta, is uterine contraction which can exert a physical pressure on the arterioles to reduce immediate blood loss. Clot formation and the resultant fibrin deposition, although they occur rapidly, only become functional after the coagulation cascade has triggered off and progressed. Once operative however, this secondary mechanism becomes dominant in securing haemostasis in the days following delivery. (Sleep, 1993). The uterus both grows and enlarges as pregnancy progresses under the primary influence of oestrogen. The organ itself changes from a non-gravid weight of about 70g and cavity volume of about 10 ml. to a fully gravid weight of about 1.1 kg. and a cavity capacity of about 5 litres. This growth, together with the subsequent growth of the feto-placental unit is fed by the increased blood volume and blood flow through the uterus which, at term, is estimated to be about 5-800 ml/min or approximately 10-15% of the total cardiac output (Thilaganathan B et al. 1993). It can therefore be appreciated why haemorrhage is a significant potential danger in the third stage of labour with potentially 15% of the cardiac output being directed towards a raw placental bed. The physiology of the third stage of labour also involves the mechanism of placental expulsion. After the baby has been delivered, the uterus continues to contract rhythmically and this reduction in size causes a shear line to form at the utero-placental junction. This is thought to be mainly a physical phenomenon as the uterus is capable of contraction, whereas the placenta (being devoid of muscular tissue) is not. We should note the characteristic of the myometrium which is unique in the animal kingdom, and this is the ability of the myometrial fibres to maintain its shortened length after each contraction and then to be able to contract further with subsequent contractions. This characteristic results in a progressive and (normally) fairy rapid reduction in the overall surface area of the placental site. (Sanborn B M et al. 1998) In the words of Rogers (J et al. 1998), by this mechanism â€Å"the placenta is undermined, detached, and propelled into the lower uterine segment.† Other physiological mechanisms also come into play in this stage of labour. Placental separation also occurs by virtue of the physical separation engendered by the formation of a sub-placental haematoma. This is brought about by the dual mechanisms of venous occlusion and vascular rupture of the arterioles and capillaries in the placental bed and is secondary to the uterine contractions (Sharma J B et al. 2005). The physiology of the normal control of this phenomenon is both unique and complex. The structure of the uterine side of the placental bed is a latticework of arterioles that spiral around and inbetween the meshwork of interlacing and interlocking myometrial fibrils. As the myometrial fibres progressively shorten, they effectively actively constrict the arterioles by kinking them . Baskett (T F 1999) refers to this action and structure as the â€Å"living ligatures† and â€Å"physiologic sutures† of the uterus. These dramatic effects are triggered and mediated by a number of mechanisms. The actual definitive trigger for labour is still a matter of active debate, but we can observe that the myometrium becomes significantly more sensitive to oxytocin towards the end of the pregnancy and the amounts of oxytocin produced by the posterior pituitary glad increase dramatically just before the onset of labour. (Gà ¼lmezoglu A M et al. 2001) It is known that the F-series, and some other) prostaglandins are equally active and may have a role to play in the genesis of labour. (Gulmezoglu A M et al. 2004) >From an interventional point of view, we note that a number of synthetic ergot alkaloids are also capable of causing sustained uterine contractions. (Elbourne D R et al. 2002) chapter 2 discuss active management, criteria, implications for mother and fetus. This essay is asking us to consider the essential differences between active management and passive management of the third stage of labour. In this segment we shall discuss the principles of active management and contrast them with the principles of passive management. Those clinicians who practice the passive management of the third stage of labour put forward arguments that mothers have been giving birth without the assistance of the trained healthcare professionals for millennia and, to a degree, the human body is the product of evolutionary forces which have focussed upon the perpetuation of the species as their prime driving force. Whilst accepting that both of these concepts are manifestly true, such arguments do not take account of the â€Å"natural wastage† that drives such evolutionary adaptations. In human terms such â€Å"natural wastage† is simply not ethically or morally acceptable in modern society. (Sugarman J et al. 2001) There may be some validity in the arguments that natural processes will achieve normal separation and delivery of the placenta and may lead to fewer complications and if the patient should suffer from post partum haemorrhage then there are techniques, medications and equipment that can be utilised to contain and control the clinical situation. Additional arguments are invoked that controlled cord traction can increase the risk of uterine inversion and ecbolic drugs can increase the risks of other complications such as retained placenta and difficulties in delivering an undiagnosed twin. (El-Refaey H et al. 2003) The proponents of active management counter these arguments by suggesting that the use of ecbolic agents reduces the risks of post partum haemorrhage, faster separation of the placenta, reduction of maternal blood loss. Inversion of the uterus can be avoided by using only gentle controlled cord traction when the uterus is well contracted together with the controlling of the uterus by the Brandt-Andrews manoeuvre. The arguments relating to the undiagnosed second twin are loosing ground as this eventuality is becoming progressively more rare. The advent of ultrasound together with the advent of protocols which call for the mandatory examination of the uterus after the birth and before the administration of the ecbolic agent effectively minimise this possibility. (Prendiville, 2002). If we consider the works of Prendiville (referred to above) we note the meta-analyses done of the various trials on the comparison of active management against the passive management of the third stage of labour and find that active management consistently leads to several benefits when compared to passive management. The most significant of which are set out below. Benefits of Active Management Versus Physiological Management *95% confidence interval † Number needed to treat (After Prendiville, 2002). The statistics obtained make interesting consideration. In these figures we can deduce that for every 12 patients receiving active management (rather than passive management) one post partum haemorrhage is avoided and further extrapolation suggests that for every 67 patients managed actively one blood transfusion is avoided. With regard to the assertions relating to problems with a retained placenta, there was no evidence to support it, indeed the figures showed that there was no increase in the incidence of retained placenta. Equally it was noted that the third stage of labour was significantly shorter in the actively managed group. In terms of significance for the mother there were negative findings in relation to active management and these included a higher incidence of raised blood pressure post delivery (the criteria used being > 100 mm Hg). Higher incidences of reported nausea and vomiting were also found although these were apparently related to the use of ergot ecbolic and not with oxytocin. This is possibly a reflection of the fact that ergot acts on all smooth muscle (including the gut) whereas the oxytocin derivatives act only on uterine muscle. (Dansereau, 1999). None of the trials included in the meta-analysis reported and incidence of either uterine inversions or undiagnosed second twins. Critical analysis of these findings would have to consider that one would have to envisage truly enormous study cohorts in order to obtain statistical significance with these very rare events. (Concato, J et al. 2000) With specific regard to the mother and baby we note some authors recommend the use of early suckling as nipple stimulation is thought to increase uterine contractions and thereby reduce the likelihood of post partum haemorrhage. Studies have shown that this does not appear to be the case (Bullough, 1989), although the authors suggest that it should still be recommended as it promotes both bonding and breastfeeding. The most important element of active management of the third stage of labour is the administration of an ecbolic agent directly after the delivery of the anterior shoulder or within a minute of the complete delivery of the baby. The significance of the anterior shoulder delivery is that if the ecbolic is given prior to delivery of the anterior shoulder then there is a significantly increased risk of shoulder dystocia which, with a strongly contracting uterus, can be technically very difficult to reduce and will have significant detrimental effects on the baby by reducing its oxygen supply from the placenta still further. The fundal height should be assessed immediately after delivery to exclude the possibility of an undiagnosed second twin. (Sandler L C et al. 2000) There are a number of different (but widely accepted) protocols for ecbolic administration. Commonly, 10 IU of oxytocin is given intramuscularly or occasionally a 5 IU IV bolus. Ergot compounds should be avoided in patients who have raised blood pressure, migraine and Raynaud’s phenomenon. (Pierre, 1992). The issue of early clamping of the cord is complex and, of the three components of the active management of the third stage of labour this, arguably, gives rise to the least demonstrable benefits in terms of the evidence base in the literature. We have already discussed the increased incidence of postnatal jaundice in the newborn infant if cord clamping is delayed but this has to be offset against both the occasional need for the invoking of prompt resuscitation measures (i.e. cord around the neck) or the reduction in the incidence of childhood anaemia and higher iron stores (Gupta, 2002). In a very recent paper, Mercer also points to the lower rates of neonatal intraventricular haemorrhage although it has to be said that the evidence base is less secure in this area. (Mercer J S et al. 2006) Other foetal issues are seldom encountered in this regard except for the comparatively rare occurrence when some form of dystocia occurs and the infant had to be manipulated and represented (viz. the Zavanelli procedure). If the cord has already been divided then this effectively deprives the infant of any possibility of placental support while the manoeuvre is being carried out with consequences that clearly could be fatal. (Thornton J G et al. 1999) In the recent past, the emergence of the practice of harvesting foetal stem cells from the cord blood may also have an influence on the timing of the clamping but this should not interfere with issues relating to the clinical management of the third stage. (Lavender T et al. 2006) There are some references in the literature to the practice of allowing the placenta to exsanguinate after clamping of the distal portion as some authorities suggest that this may aid in both separation (Soltani H et al. 2005) and delivery (Sharma J P et al. 2005). of the placenta. It has to be noted that such references are limited in their value to the evidence base and perhaps it would be wiser to consider this point unproven. We have searched the literature for trials that consider the effect of controlled cord traction without the administration of embolic drugs. The only published trial on the issue suggested that controlled cord traction, when used alone to deliver the placenta, had no positive effect on the incidence of post partum haemorrhage (Jackson, 2001). The same author also considered the results of the administration of ecbolic agents directly after placental delivery and found that the results (in terms of post partum haemorrhage at least), were similar to those obtained with ecbolics given with the anterior shoulder delivery, although an earlier trial (Zamora, 1999) showed that active management (as above) did result in a statistically significant reduction in the incidence of post partum haemorrhage when compared to controlled cord traction and ecbolics at the time of placental delivery. In this segment we should also consider the situation where the atonic uterus (in passive management of the third stage of labour) can result in the placenta becoming detached but remaining at the level of the internal os. This can be clinically manifest by a lengthening of the cord but no subsequent delivery of the placenta. In these circumstances the placental site can continue to bleed and the uterus can fill with blood, which distends the uterus and thereby increases the tendency for the placental site to bleed further. This clearly has very significant implications for the mother. (Neilson J et al. 2003) There are other issues which impact on the foetal and maternal wellbeing in this stage of the delivery but these are generally not a feature issues relating to the active or passive management of the third stage of labour and therefore will not be considered further. There are a number of other factors which can influence the progress of the third stage of labour and these can be iatrogenic. Concurrent administration of some drugs can affect the physiology of the body in such a way as to change the way it responds to normal physiological processes. On a first principles basis, one could suggest that, from what we have already discussed, any agent that causes relaxation of the myometrium or a reduction in uterine tone could potentially interfere with the efficient contraction of the uterine musculature in the third stage and thereby potentially increase the incidence of post partum haemorrhage. Beta-agonists (the sympathomimetic group) work by relaxing smooth muscle via the beta-2 pathway. The commonest of these is salbutamol. When given in its usual form of an inhaler for asthma, the blood levels are very small indeed and therefore scarcely clinically significant but higher doses may well exert a negative effect in this respect. (Steer P et al. 1999) The NSAIA group have two potential modes of action that can interfere with the third stage. Firstly they have an action on the platelet function and can impair the clotting process which potentially could interfere with the body’s ability to achieve haemostasis after placental delivery. (Li D-K et al. 2003) Secondly their main mode of therapeutic action is via the prostaglandin pathway (inhibitory action) and, as such they are often used for the treatment of both uterine cramping, dysmenorrhoea and post delivery afterpains. (Nielsen G L et al. 2001) They achieve their effect by reducing the ability of the myometrium to contract and, as such, clearly are contraindicated when strong uterine contractions are required, both in the immediate post partum period and if any degree of post partum haemorrhage has occurred. Other commonly used medications can also interfere with the ability of the myometrium to contract. The calcium antagonist group (e.g. nifedipine) are able to do this (Pittrof R et al. 1996) and therefore are changed for an alternative medication if their cardiovascular effects need to be maintained. (Khan R K et al. 1998) We should also note that some anaesthetic agents can inhibit myometrium contractility. Although they are usually of rapid onset of action, and therefore rapid elimination from the body, they may still be clinically significant if given at the time of childbirth for some form of operative vaginal delivery. (Gà ¼lmezoglu A et al. 2003) relevant legal and ethical issues related to topic and midwife, Many of the legal and ethical issues in this area revolve around issues of consent, which we shall discuss in detail shortly, and competence. Professional competence is an area which is difficult to define and is evolving as the status of the midwife, together with the technical expectations expected of her, increase with the advance of technology.

Teaching Race Explicitly in the Classroom Essay -- Education

Teaching Race Explicitly in the Classroom Many literacy experts point out the fact that at the college level, black students who attend all-black schools tend to be more successful than those attending predominantly white schools. Even though these schools often lack resources and financial stability, they nonetheless produce more high achieving black students than predominantly white schools. For instance, according to Fleming, black students attending Historically Black Universities and Colleges (HBUC) have higher graduation rates than those attending predominately white institutions. Also, students who graduate from a HBUC and go on to attend predominantly white graduate schools do just as well as students who have graduated from predominantly white colleges (Fleming 1). What is it that black schools and black teachers have that produces academically successful black students? What approaches to learning can white teachers adopt from black teachers in order to maximize the learning of these students? Bell Hooks, author of Teaching to Transgress: Education as the Practice of Freedom, grew up in the South. As a young child, she attended a segregated school, but then made the transition into a desegregated school later in her youth. Hooks believes that the education she received at the all-black school was far better than the education at the desegregated school. Hooks explains: Almost all of our teachers at Booker T. Washington were black women. They were committed to nurturing our intellect so that we could become scholars, thinkers, and cultural workers—black folks who used our "minds"†¦Within these segregated schools, black children who were deemed exceptional, gifted were given special care†¦When we entered rac... ..., Jacqueline Jordan and James W. Fraser. "Warm Demanders." Education Week 17 (1998): n. pag. Online. Internet. 21 May 1998. Available FTP: http//:www.edweek.org/ew/vol-17/35irvine.h17 Jones, LeAlan and Newman, Lloyd. Our America: Life and Death on the South Side of Chicago. New York: Washington Square Press Publication, 1997. Ladson-Billings, Gloria. The Dreamkeepers: Successful Teachers of African American Children. San Francisco: Jossey-Bass Publishers, 1994. Smitherman, Geneva. "The Blacker the Berry, The Sweeter the Juice." 1994. Tatum, Beverly. Why Are All the Black Kids Sitting Together in the Cafeteria? New York: Basic Books, 1997. Villegas, A. "School Failure and Cultural Mismatch: Another View." The Urban Review, 20.4 (1988): 253-265. Wellman, David. Portraits of White Racism. Cambridge: Cambridge University Press, 1977.

Reflection

Reflection about the learning modules and simulation Chapter 8 This module was very Informative. The module provided detail Information In regards to the history and the organizations of the courts. Looking back on the primitive days leading up to modern day court system the same elements still exist. The best module I liked was the courtroom rules. In this module, it showed the key player and their roles. Now I have a better understand as to what each duty is. I learned the difference between grand Jury and trial Jury.Grand Jury, may consist of up to 23 Jurors, and serve for a particular period and may serve on multiple Juries at one time. They handle cases that are high-profile. They are able to require testimony and tangible evidences. This juror is used to bring an indictment protects law enforcement from accusation of bias. Trial Juror consists of 6-12 Jurors, serve only for the duration of the trial and decides the facts of the case with very strict and controlled procedures by the Judge. In addition to the module. The video was helpful because It describes a typical day of a judge.The video was like a real life experience working as a judge, prosecutor, and a defense attorney. In the second video, relating to issue 1: The affect of the backlog of cases on the court, she discussed how long it takes to complete one case, approximately 15 hours. She also describes how CO Simpson case moved fairly quickly through the court processes the courts. The activities were very helpful. They were like a refresher at the end of the reading and knowledge check. I enjoy these activities because It a good interaction tool with learning and having fun at the same time. Reflection CHRISTINE N. MONTIAGUE 1MTO1 REFLECTION PAPER â€Å" OUTREACH PROGRAM† Being a part of this outreach program makes me feel very honored and thankful. Honestly, this is the first time in my entire life to be included in this kind of program. At that time, I feel nervous but at the same time excited since it will be a new experience for me. When we already arrived at the location, I felt very happy seeing the â€Å"lolo’s† and lola’s† waiting for us.I can see the happiness and excitement in their faces as soon as we enter the hall. After the program has been started, we have given a chance to talk to them one by one. I found out a lot of things about them like how did they end being there, their everyday lifestyle and so on. They open up stories about their families and past events. I was holding back my tears as they talk about their life. I felt saddened because their family abandoned them and there is no one who visits them daily.For me, even if my grandma or grandpa comes to a point when they don’t recognize me anymore, I’m not going to leave them instead I’m going to give my best to take care of them and give them love and care. There was one â€Å"lola† who I’ve been attached the most. Every time I talk to her, she always ask what grade am I in and I always told her that I’m taking up Med Tech as a first year student. For the record, she repeated this question almost 10 times but still I understand why she does that.Talking to each one of them reminds me of my lola in the province that I haven’t seen for a long time. I felt very emotional since the beginning until the end of the program. I had a lot of fun taking pictures, dancing and playing with them. I want to cherish all of them in my heart. Actually, that day I haven’t taken up my breakfast but after seeing their faces and knowing that their having fun I didn’t feel any hunger even an inch of hunger, there is none.You can never explain the feeling of helping other people because of a lot of emotions building up in you. I want to share all the experiences I had to other people so that as an individual they will realize how it is to help people whole-heartedly. CHRISTINE N. MONTIAGUEMAM AHNIEL 1MTO1 1. Kung bibigyan pa ako ng pagkakataong bumalik bilang pagkabata, nais ko sanang maranasan ulit ang pakiramadam na makarga ulit ng aking mga magulang dahil sa tuwing ginagawa nila ito sa akin noong ako’y bata pa, pakiramdam ko’y mahal na mahal nila ako.Gusto kong balikan ang mga panahong nagagawa ko pa lahat ng mga bagay na walang akong inaalala at saka ang pakikipaglaro sa labas ng aming bahay hanggang sa gumabi na at tawagin na ako ng aking nanay. Mga panahong ang alam mo lamang ay ang paglalaro at hindi sumasagi sa inyong isipan ang mga problema. Sana ay maranasan ko ulit sila. 2. Malaki na ang pinagbago ng mga kabataan ngayon kung ikukumpara mo ito sa mga nagdaang panahon. Unang-una ay ang pagkakalulong ng mga kabataan sa bisyo.Sa panahon ngayon, halos hindi na mabilang ang mga taong lulong sa droga, sigarilyo at alak. Kahit anong bawal sa kanila, sarili pa rin nila ang kanilang sinusunod. Hindi naman nagkulang ang mga magulang natin sa pagpapa alala sa atin kung ano ang tamang Gawain sa hindi. 3. Bilang isang magulang, kinakailangan na ikaw ang magiging â€Å"role model† ng iyong anak. Sa medaling salita, kailangan magsimula muna sa iyo ang lahat dahil ikaw ang tinutularan ng iyong anak kung kaya bilang isang ina dapat maipakita ko sa aking anak na ang mga ginagawa ko ay mabuti at nasa tama.Kapag nahubog ko na ang aking sarli, maari na akong magpalaki ng isang mabuting anak. Bata pa lamang siya, gusto ko ng ipaalam sa kanya ang bagay na hindi dapat niya gawin at mga bagay na dapat niyang gawin. Hindi sa lahat ng panahon, mapagbibigyan ko lahat ng nais niya. Habang siya ay tumatanda, gusto ko nasa tabi niya ako palagi para kung may katanungan m an siya sa mga bagay na naguguluhan siya ay may matatakbuhan siya at makahahanap siya ng tamang sagot. Higit sa lahat, maipakita ko na siya ang buhay ko. Reflection CHRISTINE N. MONTIAGUE 1MTO1 REFLECTION PAPER â€Å" OUTREACH PROGRAM† Being a part of this outreach program makes me feel very honored and thankful. Honestly, this is the first time in my entire life to be included in this kind of program. At that time, I feel nervous but at the same time excited since it will be a new experience for me. When we already arrived at the location, I felt very happy seeing the â€Å"lolo’s† and lola’s† waiting for us.I can see the happiness and excitement in their faces as soon as we enter the hall. After the program has been started, we have given a chance to talk to them one by one. I found out a lot of things about them like how did they end being there, their everyday lifestyle and so on. They open up stories about their families and past events. I was holding back my tears as they talk about their life. I felt saddened because their family abandoned them and there is no one who visits them daily.For me, even if my grandma or grandpa comes to a point when they don’t recognize me anymore, I’m not going to leave them instead I’m going to give my best to take care of them and give them love and care. There was one â€Å"lola† who I’ve been attached the most. Every time I talk to her, she always ask what grade am I in and I always told her that I’m taking up Med Tech as a first year student. For the record, she repeated this question almost 10 times but still I understand why she does that.Talking to each one of them reminds me of my lola in the province that I haven’t seen for a long time. I felt very emotional since the beginning until the end of the program. I had a lot of fun taking pictures, dancing and playing with them. I want to cherish all of them in my heart. Actually, that day I haven’t taken up my breakfast but after seeing their faces and knowing that their having fun I didn’t feel any hunger even an inch of hunger, there is none.You can never explain the feeling of helping other people because of a lot of emotions building up in you. I want to share all the experiences I had to other people so that as an individual they will realize how it is to help people whole-heartedly. CHRISTINE N. MONTIAGUEMAM AHNIEL 1MTO1 1. Kung bibigyan pa ako ng pagkakataong bumalik bilang pagkabata, nais ko sanang maranasan ulit ang pakiramadam na makarga ulit ng aking mga magulang dahil sa tuwing ginagawa nila ito sa akin noong ako’y bata pa, pakiramdam ko’y mahal na mahal nila ako.Gusto kong balikan ang mga panahong nagagawa ko pa lahat ng mga bagay na walang akong inaalala at saka ang pakikipaglaro sa labas ng aming bahay hanggang sa gumabi na at tawagin na ako ng aking nanay. Mga panahong ang alam mo lamang ay ang paglalaro at hindi sumasagi sa inyong isipan ang mga problema. Sana ay maranasan ko ulit sila. 2. Malaki na ang pinagbago ng mga kabataan ngayon kung ikukumpara mo ito sa mga nagdaang panahon. Unang-una ay ang pagkakalulong ng mga kabataan sa bisyo.Sa panahon ngayon, halos hindi na mabilang ang mga taong lulong sa droga, sigarilyo at alak. Kahit anong bawal sa kanila, sarili pa rin nila ang kanilang sinusunod. Hindi naman nagkulang ang mga magulang natin sa pagpapa alala sa atin kung ano ang tamang Gawain sa hindi. 3. Bilang isang magulang, kinakailangan na ikaw ang magiging â€Å"role model† ng iyong anak. Sa medaling salita, kailangan magsimula muna sa iyo ang lahat dahil ikaw ang tinutularan ng iyong anak kung kaya bilang isang ina dapat maipakita ko sa aking anak na ang mga ginagawa ko ay mabuti at nasa tama.Kapag nahubog ko na ang aking sarli, maari na akong magpalaki ng isang mabuting anak. Bata pa lamang siya, gusto ko ng ipaalam sa kanya ang bagay na hindi dapat niya gawin at mga bagay na dapat niyang gawin. Hindi sa lahat ng panahon, mapagbibigyan ko lahat ng nais niya. Habang siya ay tumatanda, gusto ko nasa tabi niya ako palagi para kung may katanungan m an siya sa mga bagay na naguguluhan siya ay may matatakbuhan siya at makahahanap siya ng tamang sagot. Higit sa lahat, maipakita ko na siya ang buhay ko. Reflection Reflection about the learning modules and simulation Chapter 8 This module was very Informative. The module provided detail Information In regards to the history and the organizations of the courts. Looking back on the primitive days leading up to modern day court system the same elements still exist. The best module I liked was the courtroom rules. In this module, it showed the key player and their roles. Now I have a better understand as to what each duty is. I learned the difference between grand Jury and trial Jury.Grand Jury, may consist of up to 23 Jurors, and serve for a particular period and may serve on multiple Juries at one time. They handle cases that are high-profile. They are able to require testimony and tangible evidences. This juror is used to bring an indictment protects law enforcement from accusation of bias. Trial Juror consists of 6-12 Jurors, serve only for the duration of the trial and decides the facts of the case with very strict and controlled procedures by the Judge. In addition to the module. The video was helpful because It describes a typical day of a judge.The video was like a real life experience working as a judge, prosecutor, and a defense attorney. In the second video, relating to issue 1: The affect of the backlog of cases on the court, she discussed how long it takes to complete one case, approximately 15 hours. She also describes how CO Simpson case moved fairly quickly through the court processes the courts. The activities were very helpful. They were like a refresher at the end of the reading and knowledge check. I enjoy these activities because It a good interaction tool with learning and having fun at the same time. Reflection This essay will reflect upon an incident in practice when I administered a drug to a child. I will use Gibbs reflective model (Gibbs 1988)(see appendix 1). This model of reflection will be applied to the essay to facilitate critical thought and relating theory to practice where the model allows. Discussion on the incident will include the knowledge underpinning practice and the evidence base for the administration of the drug. A conclusion to the essay will then be given which will discuss my knowledge and competence of the incidence being reflected upon. The drug that I have chosen to reflect upon is Fragmin (see Drug Profile 1 Appendix 2) which was administered as a parenteral subcutaneous injection to a 14 year old girl, who shall remain anonymous for the purpose of patient confidentiality in accordance with the regulations of the NMC (2008). I have chosen to reflect on this drug as it was the first injection I had given during my training which encouraged me to further develop my knowledge within this area. The first stage of Gibbs model (1988) of reflection requires a description of events (see Appendix 3). The next stage of Gibbs (1988) reflective cycle is related to thoughts and feelings aroused during the event which I can use to reflect upon (see appendix 4). The third stage of Gibbs (1988) model of reflection encourages exploration of both positive and negative experiences encountered and I have chosen a few that I propose to discuss further within this reflection. Throughout the incident the correct hospital policy was followed by my mentor in relation to preparing and administering an injection. However I was not familiar with this policy which could have negatively affected my practice as Grey (2008) suggests, that when administering medication by the parenteral routes, familiarization with local drug administration policy is essential. The patient’s initial refusal of the injection into the abdomen made me think about the child’s rights in refusing to consent to the administration of a medication as I was aware that the law states that anyone under the age of 18 is a child (Children Act 1989, section 105) and as such there are certain matters with which they are not able to make their own decisions. The patient’s refusal to allow me to use the abdomen as an injection site also made me question my knowledge base on this subject, as I did not know where I would have injected in the abdomen if consent had been given. I also realized at that point that I have no knowledge on why different injection sites are used and for what purpose as studies suggest that the selection of the injection site will vary depending on the size and age of the child (Cocoman, 2008). It was only through my mentor’s guidance that I felt confident on allowing the change of the site. Stage four Gibbs (1988), is the critical analysis. After reflecting on this incident I will now analyse what I feel are the most important aspects by looking at the evidence underpinning it. References Cocoman, A. , & Barron, C. (2008). ‘Administering subcutaneous injections to children: what does the evidence say? ’ Journal of Children’s and Young People’s Nursing, 2 (2), pp: 84-89 Gray, T. , Miller H. (2008) ‘Injection technique’, The Foundation Years, 4 (6), pp: 252-255 Royal Cornwall Hospital NHS Trust: ‘Medicines Policy’ Available at: http://www. rcht. nhs. uk/DocumentsLibrary/RoyalCornwallHospitalsTrust/Clinical/Pharmacy/RulesAndGuidanceOnOrderingStoringAndAdministeringMedicines. df (accessed on 30/05/2011) Appendices Appendix 1 This model of reflection incorporates description, feelings, evaluation analysis, conclusion and an action plan (Gibbs 1988). Appendix 3 I was asked if I would like to administer a subcutaneous fragmin injection under supervision, to a 14 year old gir l. The medication was in a pre-prepared syringe in the clean prep room by following local hospital policy. However, on inspection of the injection, I did question the need for the air bubble within the syringe but was assured by my mentor that it is normal to find an air bubble in a pre-prepared syringe and to leave it there for administration. The medication was checked by another staff nurse in accordance to local policy and my mentor and I approached the patient. The patient was lying in bed with no relatives present and I asked consent before administration. The patient became a little distressed at this point and refused to have the injection in her abdomen saying it was too painful, however she did consent to me using her upper arm for the site and after onfirming this with my mentor I proceeded to administer the medication with no further complications. Appendix 4 My initial feeling after being asked to administer the Fragmin injection was apprehension, as I had not administered an injection before in practice. As I was administering it under the supervision of my mentor this made me feel very nervous and self conscious, however I also acknowledged the fact that I should appear confident and at ease in front of the patient as she was herself showing signs of distress. After the patient’s initial refusal I began to doubt my competence of skills and considered asking my mentor to take over, however my mentor put me at ease by explaining that if the patient consented, then it would be fine to proceed with the injection in the upper arm. After the administration, the patient thanked me for not hurting her which immediately boosted my confidence and left me feeling extremely content with the knowledge that I had performed my first injection correctly. Reflection This essay will reflect upon an incident in practice when I administered a drug to a child. I will use Gibbs reflective model (Gibbs 1988)(see appendix 1). This model of reflection will be applied to the essay to facilitate critical thought and relating theory to practice where the model allows. Discussion on the incident will include the knowledge underpinning practice and the evidence base for the administration of the drug. A conclusion to the essay will then be given which will discuss my knowledge and competence of the incidence being reflected upon. The drug that I have chosen to reflect upon is Fragmin (see Drug Profile 1 Appendix 2) which was administered as a parenteral subcutaneous injection to a 14 year old girl, who shall remain anonymous for the purpose of patient confidentiality in accordance with the regulations of the NMC (2008). I have chosen to reflect on this drug as it was the first injection I had given during my training which encouraged me to further develop my knowledge within this area. The first stage of Gibbs model (1988) of reflection requires a description of events (see Appendix 3). The next stage of Gibbs (1988) reflective cycle is related to thoughts and feelings aroused during the event which I can use to reflect upon (see appendix 4). The third stage of Gibbs (1988) model of reflection encourages exploration of both positive and negative experiences encountered and I have chosen a few that I propose to discuss further within this reflection. Throughout the incident the correct hospital policy was followed by my mentor in relation to preparing and administering an injection. However I was not familiar with this policy which could have negatively affected my practice as Grey (2008) suggests, that when administering medication by the parenteral routes, familiarization with local drug administration policy is essential. The patient’s initial refusal of the injection into the abdomen made me think about the child’s rights in refusing to consent to the administration of a medication as I was aware that the law states that anyone under the age of 18 is a child (Children Act 1989, section 105) and as such there are certain matters with which they are not able to make their own decisions. The patient’s refusal to allow me to use the abdomen as an injection site also made me question my knowledge base on this subject, as I did not know where I would have injected in the abdomen if consent had been given. I also realized at that point that I have no knowledge on why different injection sites are used and for what purpose as studies suggest that the selection of the injection site will vary depending on the size and age of the child (Cocoman, 2008). It was only through my mentor’s guidance that I felt confident on allowing the change of the site. Stage four Gibbs (1988), is the critical analysis. After reflecting on this incident I will now analyse what I feel are the most important aspects by looking at the evidence underpinning it. References Cocoman, A. , & Barron, C. (2008). ‘Administering subcutaneous injections to children: what does the evidence say? ’ Journal of Children’s and Young People’s Nursing, 2 (2), pp: 84-89 Gray, T. , Miller H. (2008) ‘Injection technique’, The Foundation Years, 4 (6), pp: 252-255 Royal Cornwall Hospital NHS Trust: ‘Medicines Policy’ Available at: http://www. rcht. nhs. uk/DocumentsLibrary/RoyalCornwallHospitalsTrust/Clinical/Pharmacy/RulesAndGuidanceOnOrderingStoringAndAdministeringMedicines. df (accessed on 30/05/2011) Appendices Appendix 1 This model of reflection incorporates description, feelings, evaluation analysis, conclusion and an action plan (Gibbs 1988). Appendix 3 I was asked if I would like to administer a subcutaneous fragmin injection under supervision, to a 14 year old gir l. The medication was in a pre-prepared syringe in the clean prep room by following local hospital policy. However, on inspection of the injection, I did question the need for the air bubble within the syringe but was assured by my mentor that it is normal to find an air bubble in a pre-prepared syringe and to leave it there for administration. The medication was checked by another staff nurse in accordance to local policy and my mentor and I approached the patient. The patient was lying in bed with no relatives present and I asked consent before administration. The patient became a little distressed at this point and refused to have the injection in her abdomen saying it was too painful, however she did consent to me using her upper arm for the site and after onfirming this with my mentor I proceeded to administer the medication with no further complications. Appendix 4 My initial feeling after being asked to administer the Fragmin injection was apprehension, as I had not administered an injection before in practice. As I was administering it under the supervision of my mentor this made me feel very nervous and self conscious, however I also acknowledged the fact that I should appear confident and at ease in front of the patient as she was herself showing signs of distress. After the patient’s initial refusal I began to doubt my competence of skills and considered asking my mentor to take over, however my mentor put me at ease by explaining that if the patient consented, then it would be fine to proceed with the injection in the upper arm. After the administration, the patient thanked me for not hurting her which immediately boosted my confidence and left me feeling extremely content with the knowledge that I had performed my first injection correctly.

Vandalism in Street Art

Art has been involved in the human society since day one. The first appearance of art that was discovered were the cave paintings in France which date back to 32,000 years ago. These paintings were created on walls, meaning they were meant to be seen by everyone. Street art is very similar, because it is art work that is displayed on a public level, similar to the cave paintings thousands of years ago. Street Art is a new movement in today’s art society that is taking the world by storm. In street art the artist’s works are displayed for the world to see.Artist use urban environments such as buildings, sidewalks, streets, and walls as there canvas to create spectacular works of art for everyone to see. Artist display their work in public spaces by using paint, spray paint, stencils, stickers, and installations. Street art takes everyday objects we see and transforms them into something extraordinary. Designs of faces cartoons, political figures, pictures, illusions, scu lptures and statues can be seen on the side of large buildings, asphalt, billboards, everyday walls, and even through traffic signs. Lewisohn 3)Seeing this art work on the side of a ten story building can be breathtaking, and the question comes into play, how did it get there? Well the first thing that is needed to create street art is an artist. The artist will than choose a location were he/she best feels the art needs to be. A location is half of the process, a good location can take weeks to find than there is the process of scoping it out for cameras, law enforcement, traffic in the local area and most importantly when will the operation take place.These are all vital pieces of information to successfully create a street art master piece. So, there is a location and a set time, now the second half of the process begins. When arriving to the location there needs to an idea of what is going to happen, game plan. The game plan for most artists is to be stealthy, quick and effectiv e. As the artist approaches the wall he/she has their materials at hand ready to go. Depending on what street art genre is about to be create there is a need for different materials.The materials used to create a propaganda poster that will be placed on the wall are the poster , adhesive glue in a bucket and a rolling paint brush. is to the wall and the first artist roll on adhesive glue all over the wall with their brush, They then apply the poster over the glue by rolling it out and then brush more glue on top of it to protect it from the elements and insure a long viewing life. Final step Walk away and admire the beauty of street art. With the popularity of street art growing and more art work appearing, local law enforcements are noticing the amount of street art.To law enforcement officers street art is seen as an act of vandalism, which is punishable by state law. Though street art can be considered an act of vandalism at the state level, it will never be punishable under fede ral law. The laws of America are created under the United States Constitution. The constitution is federal law, which indicates that all fifty states most abide by those set laws. This includes many crimes that, if they did not occur on U. S. federal property would otherwise fall under state or local law.Within the state there can be state laws created by the state legislature and then be signed into law by the state governor. Each state has its own set of laws that state citizens abide by. With individual state laws comes individual state punishment. Every crime is punishable by law and every state has their way of handle it. ( Eichelkraut) So, what is vandalism a federal law or a state law? Vandalism is covered by state laws, and changes by state. Some states refer to vandalism as â€Å"criminal damage†, â€Å"malicious trespass â€Å"and â€Å"malicious mischief†.In an effort to control the impact of vandalism, many states have specific laws that may decrease cert ain forms of vandalism. For example, some states have local â€Å"aerosol container laws† that limit the purchase of spray paint containers or other â€Å"vandalism tools† which could be used for graffiti or vandalism purposes. (Eichelkraut ) These local laws help prevent graffiti but what is the difference compared to street art. Graffiti is the name for images or lettering scratched, scrawled, painted or marked in any manner on property. These markings are known as â€Å"tags†.Tags can be considered any type of public markings that may appear in the forms of simple written words to elaborate wall paintings. A high percentage of graffiti and tags are gang related. The goal of a tag is to mark territory by displaying their trademarks on hard-to-reach places, like billboards and the tops of buildings. The more places they go the more they are recognized. If there are two taggers in the same area they will compete to display their trademarks more and in unique pla ces. (Lewisohn ) It is the same concept in street art but with more of a political or social message that makes the asser buy ponder on what he/she saw. Street artist do the same thing the more their art work is seen the more well known it becomes. They have their art displayed were ever they can. Remove the word street from street art and there is just art, it could be hanging in a museum or on display in a building but when street is added to art it transforms into art in the streets. That’s what street art is, beautiful subjective master pieces that were created by the hands of an artist to be critiqued by the public.There are many genres of art that fall underneath street art and graffiti is one of them. Street art cannot be generalized down into one genre such as graffiti but it all can be defined as vandalism. The artists in the act of creating art know that it is illegal, they know the consequences of being caught but they take the risk of being caught so that their ar t will be seen. It is simple, street artist know what they are doing is considered vandalism, and that it is punishable by increasing levels of fines, jail time and community service.While law enforcement officers are keeping a closer eye on the scene of street art, graffiti and vandalism, there are still and will always be street artist getting away with their art being displayed all over the world. Few artist, such as Banksy, Invader, are incognito and the higher authorities do not identify who they are or how to find them. These artists have large works that are well known all around Europe, Middle East and American. If an artist of this magnitude were to be caught what would there criminal punishment be?When a criminal is caught their crimes are categorized in state law as either a misdemeanor a felony but if the crime is adequate it will be tried as a federal offence. A misdemeanor is considered a crime of low seriousness, and a felony one of high seriousness in state. A federa l offence is any law that goes against U. S. Legislature. The act of vandalism will be giving a misdemeanor or a felony never will it be taking to federal charges (Eichelkraut ). The punishment for vandalism does not need to be taking any further than in state law because state law officers are cracking down on vandalism.If vandalism grows to increasing numbers and cities become overwhelmed than vandalism will become a federal offence. And if vandalism is tried as a federal crime, would the jail sentence for the defendant be the same or will the difference be that the time served is in Federal prison. The fines and warnings given out buy local law enforcement officers are keeping vandalism under wraps, there does not need to be federal agents patrolling the street to look after empty brick walls and street signs. Even the most severe cases of street art vandalism have never been giving a federal sentence and that’s how it will stay.For example a local street artist outside of Pittsburgh was arrested and sentenced two and half years to five years in jail due to over $700,000 in damages to private and public property. And when he is released from prison, he will owe $234,000 in restoration and be expected to serve 2,500 hours of community service. (Sudbanthad) This punishment is the most severe sentence that has happened in the street art world. On the other hand, Shepard Fairey, a famous street artist who invented the Obama campaign posters, was charged with vandalism in Boston, Ma.His charges were on misdemeanor level where he had to appear in court, Fairey was told not to carry any street art supplies with him when he is in Boston or he will be fined. There are many ways inside state laws that the government will reprimand street art vandalism. There is no set punishment for vandalism weather it’s done with spray paint or paper and a roller each penalty will depend on the severity of the crime. For an unknown artist serving behind bars because h e continued what he loved, it’s worth it for him in the end.Vandalism in any area is a crime but artists, do it for people who will not realize (at least for a few moments) that what you have done is art. Avoid recognizable art-categories, avoid politics, don't stick around to argue, don't be sentimental; be ruthless, take risks, vandalize only what MUST be defaced, do something children will remember all their lives. Dress up. Leave a false name. Be legendary. The best Poetic Terrorism is against the law, but don't get caught. (underspary) Create Art as crime and think of crime as art.