Cultural diversity in the United States is a direct result of immigration. In fact, almost all ethnic groups in the country are products of immigration. For instance, the white majority in the United States are descendants of migrants from Europe. Likewise, most minority ethnic groups are descendants of migrants from other parts of the world namely Africa, South America, Asia, and North America (especially Mexico), among others. In essence, understanding the relations between ethnic groups in the United States requires a thorough look at the history of immigration. Consequently, this paper explores history of immigration and its timeline. The United States is majorly composed of immigrants. This happened in various timelines of its controversial history. In fact, United States’ immigration is considered special to the rest of the world. Firstly, no other country has ever experienced such great numbers of immigrants who came from every part of the world. Secondly, it provided jobs and alternatives for most immigrants. However, it is important to state that U.S. immigration has been quite controversial. Moreover, its immigration policy has raised eyebrows on its agenda. The policy has repeatedly failed to mitigate the type of immigrants and to control the number of immigrants entering the U.S. The first immigrants were mainly composed of British settlers (60%) who came between 1607 and 1776. During this period, there was no immigration policy. Most of these settlers came for economic and religious reasons. This period saw the coming of Germans who settled in Pennsylvania. They had their own culture and language. They were also quite controversial as they were seen as disloyal to mainstream Americans. The next batch that came into America during this period was African slaves. It is estimated that only roughly 500,000 slaves immigrated to the United Stated despite slave trade of between 11 and 12 million slaves of African descent to the greater Americas. Moreover, about 10% of Africans who lived in the North were free although they faced extreme discrimination. However, those in the South faced terrible conditions in slavery. A common characteristic of this state was continued revolts in the South. Incidentally, the first large-scale immigration was observed between 1820 and 1880. This encompassed over 10 million people. There was no immigration policy until in 1875 when the first control act was established. The first wave of immigration saw large immigration from Europe (especially the Irish and the Germans). They came mainly for economic reasons. Get your 100% original paper on any topic done in as little as 3 hours Learn More The second large-scale (over 27.5 million) immigration happened between 1880 and 1930. Most migrants were from Southern and Eastern Europe (especially Italians, Poles, and Russians). They were poor and unskilled. They lived in concentrated areas. They also had their own customs, religion, and language. About 1 million Jews also migrated during this period. In contrast to their Eastern and Southern Europe counterparts, the Jews were skilled. However, they both faced discrimination in their newfound homes. This led to the establishment of an improved immigration act that tested potential immigrants on literacy (1917), restricted the total immigration (165000 annually from1924), and introduced quota of 2% of immigrants on countries of origin. This greatly affected Asian and Eastern/Southern Europeans. Moreover, the former were further restricted through the China exclusion act (1882). Immigrants from Japan were quite dismal although they are the most decorated in history of United States. The next large-scale immigration was later seen after 1965 (prior to this, there was the great depression and World War II which affected immigration). Mexican migration was predominant in this period although some theorists suggest earlier settlement as evidenced by Mexican war of 1846, among others. Immigration policy has undergone various changes since 1965. These include the Hart Cellar act (1965), among others.
Enteral Feeding After Gastric Intestinal Resection. Optimum nutrition has always been a major target of post: operative care. Ileus is a common phenomenon after abdominal surgery, therefore early oral feeding is avoided and nasogastric decompression is being used. Conventionally, post abdominal surgery, the passage of flatus, or bowel movement was the clinical evidence of starting an oral diet. The end of post operative ileus based to be taken by the passage of flatus usually occurred within 5 days. The many studies have proved that the routine use of a nasogastric tube after abdominal Surgery and colorectal surgery may not be necessary. studies were undertaken to evaluate /whether different abdominal surgeries could benefit from early feeding. Early feeding improves the outcome of the patients with trauma and Burns although few studies have examined its use after gastro intestinal anastomosis. In case of laparoscopic colectomy patients have been fed routinely on day 2 after operation and that is being safely tolerated by the majority of patients. There are many evidences which indicate that immediate feeding after operation is actually feasible and safe whether post laparoscopic or post laparotomy , including gastro intestinal surgery. It has been proved by many studies that early enteral feeding in surgical patients improves nutrition and immunity and ultimately reducing septic complications and over all morbidity when compared with parenteral nutrition. A study conducted that compared an early regular diet to conventional post operative dietary management to determine G1 complications and mortality after major G1 anastomosis. The aim of this study was to assess the safety and tolerability outcomes of early oral feeding after elective gastro intestinal anastomosis. Patients and Methods Between July 2006 and December 2009, after the study was approved by ethical review committee, patients were offered participation and informed consent taken. Patients with chronic liver disease or those with metastasis and patients with histories of acute obstruction, perforation and intra abdominal infection were excluded. Patients were subject to a thorough history, physical examination and investigations. The patients were then randomized into two groups. Randomization done using sealed envelopes. Group 1 (Early feeding); 30 patients were offered simply a liquid diet within 6 hours of arrival on the ward. If 1 liter was being tolerated they were free for free liquid on the second day and then regular diet on the third day. (Tolerance is being indicated by an absence of vomiting or abdominal distension). Group 2 (Regular feeding) 30 patients were managed conventionally (that is nothing by mouth until the resolution of ileus, then a fluid diet, followed by regular diet. All patients underwent general anesthesia no nasogastric tube was inserted in any patients during surgery in patients in group 1 and a nasogastric tube was inserted in all patients during surgery and continued till the resolution of ileus in group 2. The patients were monitored for vomiting, abdominal distension length of ileus, tolerance of regular diet, length of hospitalization and complications. If there were two episodes of vomiting in the absence of bowel sounds or passage of flatus in the absence of any bowel movement, insertion of nasogastric tube was implemented.Also those who suffered from abdominal distension, emesis and succussion splash of stomach were diagnosed with acute dilatation of stomach, subjected to G I decompression. If there was anastomosis failure, treatment ensued such as antibiotics, nutritional support, ileostomy or colostomy. Patients with normal post operative course were discharged when they could tolerate a regular diet. Demographics were age and sex, medical and surgical histories of the patients and indications for anastomosis were noted. Different patients had different types of anastomosis were randomly allocated to group 1 irrespective of anastomotic type to eliminate bias. Table 1. Indications group 1 group 2 Tuberculous 5 5 Stricture at Ileum Closure of 20 20 Ileostomy Colorectal surgery 5 5 The main outcome was to evaluate post operative complications that included wound infection, leakage of anastomosis, obstruction, mesenteric emboli, upper G1 bleeding, wound dehiscence, prolonged ileus, and mortality. Ileus was defined as hypoactive bowel sounds, abdominal distension and no passage of flatus or bowel movement with or without nausea or vomiting after the first post operative day 3. Statistical analysis of data done by SPSS version 10. For continuous variables, descriptive statistics were calculated and were reported as mean SD. Categorical variables were described using frequency distribution. The student T-test for paired samples was used to detect difference in the mean of continuous variables and the chi-square test was used in cases with low expected frequencies (a P value <0.05 was considered to be significant). Results Between August 2006 and November 2009 60 patients who had abdominal surgery for anastomosis indications gave consent to involve in to study. 30 patients (22 males and 08 females) with 59 mean years old in group 1 and 30 patients (20 males and 10 females) with 55 mean years old in group 2. Demographically no significance between groups regarding age, medical and surgical history. Indications for anastomosis were similar between groups table 1. Table 1 The majority of patients in early feeding group 50% tolerated the early feeding. Vomiting was more common as compared to late feeding group 25% and 20% respectively but did not reach to statistical significant level table 2. Table Events group 1 group 2 p value Tolerated Early feeding vomiting N/G tube reinsertion Time to passage of flatus Hospital stay Pts satisfaction Readmission Anastomatic leakage Distended abdomen vomiting Post operative event is compared in shown in table 3 Table Post op complications anastomatic acute dilatation of pulmonary wound infections leakage stomach infections Grop 1 Group 2 12.5% pts failed tolerate early feeding.Failure was reflected by recurrent vomitingwith abdominal distension without bowel sound.They were probably not because of the method of early feeding but because of confounding factors table 4 Confounding factors Factors tolerated failed p value Comorbid Medical illness Intra op blood Loss mean operating time Discussion Delaying oral feeding until reduction of ileus in abdominal surgery had become a myth. In recent decade trend is toward earlier feeding. The routine nasogastric tube decompression after abdominal and colorectal surgery has already been refuted. A randomized study on general surgeon showed that 72% of them performed routine gastro intestinal decompression after excision and anastomosis of intestine. The volume of secreted digestive juices is about 5 to 9 litters, and the gas secreted by deglutition and intestine is about 30-300ml and the volume extracted by gastrointestinal decompression every day was less than 10% of digestive juices. After operation on abdominal region, gastro intestinal motor function is reduced and the function of intestinal absorption is not greatly reduced. Clever et al reported that paralysis of intestine could not be alleviated by gastro intestinal decompression. The gastro intestinal tract motility of patients undergoing abdominal surgery is transiently impaired. There are multiple factors for this phenomenon including physical manipulation of the bowel, surgical stress, inflammatory mediators, and changes in electrolytes, normal reflux, inhalation anesthetics, and use of opiates. Post operative ileus can result in accumulation of gas and secretion leading to distention, emesis, pain and longer hospital stay. Currently available therapies are supportive and include intra venous hydration and nasogastric suctioning 19.Conventionally post operative diet based on physical signs of bowel function and not on post operative gastro intestinal physiology. Animal and human radiological and physiologic studies do not support the practice of oral feeding based on auscultation of normal bowel sounds and passage of flatus and bowel movement. It has been shown that paralysis of the small bowel is transient (6-12 hr), the gastric paralysis lasts 12-24 h, and paralysis of colon lasts 48-72 hrs. Physiologic studies have fond that mayo electric and motor activity in the stomach is not affected after abdominal surgery. Childer et al 21 showed bowel activity before flatus was passed which dictates that patients can tolerate fluid secretions of 1-2 litre from the stomach and Pancreas immediately after surgery. Studies also have shown tolerance to clear liquids on 1st post operative day after G1 surgeries. In our study 80% tolerated early feeding and 20% presented with recurrent vomiting and abdominal distension with intestinal sound. There were also confounding factor which had a significant impact on tolerability of early oral feeding. Age, gender, type of operation and previous abdominal operation had not impact. In this study, the time to first passage of flatus (P =0.04) and the time to first defecation (P = 0.005) were sooner in the early feeding group. The post operative stays for the early feeding and the groups 2 were 6.2 0.2 day (3-11) and 6.9 0.5 days (3.12) respectively as also shown by tong et al. Peachier et al 28reported that early feeding did not affect the ileus and did not significantly shorten the length of hospitalization. Early oral feeding within 24 hours after gastro intestinal surgery is safe, well tolerated, may improve gastro intestinal motility and plays an important role in enhanced recovery and outcome. Marik and zaloga conducted Meta analysis of prospective, randomized studies comparing early VS late enteral feeding demonstrating the benefits of early nutrition. However, the preferred feeding site for enteral nutrition remains controversial. Despite this fact Seenu and Goel Showed that early oral feeding after elective coloracted surgery is safe and can be tolerated by most patients. Difronzo Et al also showed a high tolerability 86.5% to early post operative oral feeding after elective open colonic resection. These studies were not exclusive to colorectal surgeries and snchiro et al. Showed that early oral feeding even after gastrectomy is safe. In our study there was no difference in post operative morbidity like wound infections, wound dehiscence, leakage of anastomosis, mesenteric embolus, obstruction, upper G1 bleeding and mortality. Nausea and vomiting occur frequently after upper G1 surgery than post resection of the small intestine and colon. Nevertheless there is evidence that bowel rest and nil per month are beneficial for healing of wound and anastomotic integrity. In conclusion G1 decompression following excision and anastomosis of lower digestive tract can not reduce the pressure of G1 tract and has no obvious effect upon preventing of post operative complications contrary to expectation; it may increase the incidence rate of pharyngo laryngitis and other complications. If length of operation and amount of blood loss is kept at optimum, early oral feeding after G1 anastomosis is safe and can be tolerated by majority of patients. It lowered general and local complications and reduces the duration of hospital stay and may become a feature of post operative management. Enteral Feeding After Gastric Intestinal Resection
Florida State University Postpartum Stress Disorder Paper
Florida State University Postpartum Stress Disorder Paper.
Textbook: Books A la Carte Edition // Discovering the Life Span // Fourth Edition Robert S. Feldman // The ISBN is 9780134778495.Topic: Post-Partum Stress DisorderThe paper assignment must include the following structure and it must comply with APA written standards:Title page (1)Abstract page (1)Content pages (5)Conclusion page (1)And Reference page (1): You must provide at least 3 journals to support your paper.Therefore, there must be a minimum of nine (9) pages per project.You must develop the assigned topic Only provided on Week 2 through the Class announcements! Your research paper assignment will Not be accepted or graded if you submitted a different topic from the one assigned to you previouly!For more detailed information please, go to the following link: http://flash1r.apa.org/apastyle/basics/index.htm.By copying and pasting information to complete any assignment during the class such as Research papers, or Discussion Forums would not be tolerated. Therefore, your grade will receive 0.00 grade for this assignment. No Make-up or No exception!Use APA citation style in the body of your paper so I know where the information came from (like your text does). This is the (Author, date) you see in your text. It gives credit to original author’s research and are alphabetized by the author’s last name.Your research paper assignment will be your own research and writing and you are not allowed to copy or paste information! If so, you will receive a 0.00 score for this assignment!Please, refer to the DSM-5 Manual (Diagnostic and Statistical Manual of Mental Disorders) to meet the criteria for the specific disorder on your topic if your assigned topic is a psychological disorder.Texbook – Books A la Carte Edition // Discovering the Life Span // Fourth Edition Robert S. Feldman // The ISBN is 9780134778495.
Florida State University Postpartum Stress Disorder Paper
Please submit the following java programs in a zipped folder.
essay writer free Please submit the following java programs in a zipped folder.. I need support with this Java question so I can learn better.
Please submit the following java programs in a zipped folder on Canvas:
Class Definition (20 pts)
Driver Program (40 pts)
Note: these java files will have specific naming formats that must be followed (see assignment for details)
Extra Credit Question
Series Watch List – SeriesList.java (15pts)
Remember to include the following as a comment in each file:
A description of the program
Not including the required comments will result in a deduction of 10 points for the assignment (5 points per question). This deduction will not apply to the extra credit question.
Please submit the following java programs in a zipped folder.
RU Effects of Minimum Wage on Labor Demand and Supply in US Summary
RU Effects of Minimum Wage on Labor Demand and Supply in US Summary.
Paper proposal is the one I write first. You can change article or topic follow the roles from ” Guidenlines paper proposal” and ” “Guidelines summary of papers”. If the articles are nor in the top 250 or a working paper with an author who has a top 250 then you need to change the articles. The feedback of proposal: Part 1- Check grammar /english+ Be more precise about the outcome variable: ‘the economy’ is too broad/imprecise. Part 2- Justify article: Have authors published in top 250 journals? give an example. I don’t think the data is experimental-be more precise about data and methods. There should be 8 parts to the answer. Part III-Justify articles: are they in the top 250 or have the authors published in the top 250
RU Effects of Minimum Wage on Labor Demand and Supply in US Summary
Different Approaches In Child Psychotherapy Children And Young People Essay
Different Approaches In Child Psychotherapy Children And Young People Essay. In this paper, after a summary of explanations of why child psychotherapy is important in 0 to 3 years of age group, some different psychotherapy approaches will be introduced. The paper will be focus on psychoanalytic / psychodynamic models; however, other approaches will be described. Every approach will be examined in theoretical and practical aspects. Introduction The very beginning years of human life attracts the attention of researchers in recent years. Especially in the period of 0-3 years of age, brain development is very fast and also the basis of the characteristic features is discarded. Through the psychotherapy practices with adult patients, the importance of early childhood times on mental health began to understand more. Today we know that early childhood experiences have power to affect rest of one’s life in physical, emotional, cognitive or social areas (Movder, RubinsonDifferent Approaches In Child Psychotherapy Children And Young People Essay