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The effects of Deforestation
The effects of Deforestation
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Assignment 1: Literature Review
Deforestation
Concepts and Descriptions
Conceptually, deforestation is the is the removal of tree stands, which converts the land into other land uses or results into a bareness; for example, clearing of forestland to ranches, farms, or urban use (Durham & Painter, 1998). Similarly, United Nations Development Programme (UNDP) considers deforestation as a massive clearing of the Earth’s forest, which often results to degradation and reduction of the quality of land. UNDP has reiterated that the current rate of global deforestation is alarming and calls for immediate and rigorous intervention. It warns that if no proper measure is put in place, the word risks losing its forest endowments in just a hundred years to come. Also, a report by Cardenas in 2008, adds that the world is not just losing the forest cover, but a complex mixture of natural resources including the biodiversity, land productivity are subsequently deteriorating.
Global deforestation mainly affects the world’s temperate and tropical rainforest, which form the highest percentage of forest cover. The rate and extent of forest loss have proved beyond any reasonable doubt to be an urgent environmental problem. In this regard, the issue jeopardizes people’s livelihoods, intensifies global warming, and threatens the world’s plant and animal species (Lambin & Geist, 2006). Further, Andersen reports that, millions of the world population has a direct reliance on forest resources through small-scale agriculture, harvesting forest products, hunting, and gathering. Moreover, deforestation poses severe social problems, which sometimes results to violent conflicts as the different parties fight to tap the scarce resources.
Forest transformation and conversion are majorly due to human actions in relation to direct or indirect utilization, which over the years have continued to be profound (Boahene, 1998). Tress are cleared, fragmented, or converted to agricultural lands, infrastructure, and human settlements. Originally, as Lambin & Geist in 2006 put it, more than half the land of United States, nearly all of Europe, three-quarters of Canada, and vast lands of the world were under forest. However, the coverage has been removed to a large extent by wood fuel extractions, industrial usage, and farming.
Quantitative and Qualitative Data on Forest and Deforestation
The Earth’s total area covered by the forest is over four billion hectares, which quantitatively gives an average per capita of 0.6 hectares (Vajpeyi, 2001). Though, only five countries in the world are rich in forest cover, which include Canada, Brazil, the Russian Federation, China, and United States of America. Their areas under the forest are more than half of the territories; however, the vastness in forest is because the countries have developed appropriate policies and laws to monitor forest product utilization (Lambin & Geist, 2006). Moreover, almost ten countries in the world lack areas covered by forest while additional 54 countries have less than 10% land covered (Margulis, 2004).
More than one and a half of the world forests are gone. Unfortunately, every year, additional 16 million hectares are lost, which worsen the natural state of the environment. UNDP estimates that just about 22% of the Earth’s old growth remains, especially the boreal forest of Canada and Alaska, boreal forest in Russia, the Guyana Shield, and the Amazon rainforest in the Northwest Basin. However, the anthropological influence in forest cover continues to expand and accelerate in the remaining undisturbed forest, which also result to declining quality of the forest remnants (Margulis, 2004).
Deforestation rate has shown signs of decreasing, nonetheless still alarmingly high especially in Asia, Africa, and Latin America, which still rely on wood fuel as an energy source. Again, evidences show that, the tropical rainforest of South America and Africa are leading in the rates of deforestation (Lambin & Geist, 2006). According to Pearce in 1994, agriculture was the main reason for deforestation in Brazil and Indonesia. Conversely, other uses or natural causes account for the loss, for example, in the 1990s, up to 13 million hectares of forest disappeared in the world due to non-agricultural factors. Also, in the since 2000, Australia has lost huge tracts of forest as a result of drought and forest fires (Costa & Pires, 2010).
Tropical deforestation is the most detrimental aspect of global change in environmental issues such as climate, hydrology, and global biogeochemical cycles (Boahene, 1998). Rainforest in the Amazon Basin is the largest single Tropical forest of the world, but sadly, the vast coverage in Brazil has the highest rate of forest loss of about 1.5-2.0 × 106 hectares per year (Costa & Pires, 2010).
Explicitly, South America suffered the greatest net loss between the years of 2000 and 2010, by deforestation rate of 4.0 million hectares of cover lost every year. Africa followed closely with a rate of about 3.4 million hectares lost annually (United Nations Development Programme, 2000). In the same decade, Oceania had a net loss of 700000 ha every year, mainly because of the severe drought that struck Australia. On the other hand, in Central and North America, area covered by the forest in 2010 was estimated to be the same as in 2000. Fortunately, the forest cover in Europe expanded, though on a slower rate (700000 ha annually) in relation to 1990s (900000 ha annually). However, China experienced a net gain of greater than 2.2 million ha annually in the same period of 2000-2010. However, Southeast Asia and the Southern parts continued to register net losses in forest cover (Costa & Pires, 2010).
Causes of Deforestations
According to Kummer and Turner in 1994, agriculture is the direct cause of deforestation, of which subsistence farming accounts for about 45% while commercial agriculture accounts for 32% of the global deforestation. Again, industrial logging for wood processing and as fuel energy is responsible for massive rate of deforestation (Sunderlin & Center for International Forestry Research, 1996). Globalization that leads to worldwide proliferations of ideas, commodities, capital, and labor coupled with the rise in urbanizations, especially in the developing countries has endangered the world forest cover. In Africa and Asia to be specific, the exacerbated rates of deforestation are due to overreliance on wood fuel as a source of household energy. Additionally, other natural causes such as drought, forest fires, pest, and diseases have also contributed to the loss of huge tracts of the Earth’s forest.
Effects of Deforestations
Deforestation destroys wildlife habitats, which leads to decline or extinction of the world’s biodiversity, for instance, about 137 species of animals, plants, and insects are lost in a single day because of rainforest deforestation; cumulatively, adding up to 50000 species per year. Additionally, soil loss through erosions and subsequent land degradations affects world food production (Vajpeyi, 2001).
Deforestation also causes an imbalance in the hydrological cycle due to increased moisture loss from bare soil surfaces. Sadly, deforestation is the main cause of climate change and global warming due to loss of carbon sequesters. Therefore, greenhouse gases, particularly Carbon dioxide accumulate in the atmosphere at high concentrations, making global warming inevitable. It is human beings who suffer the real repercussion as their livelihoods and welfare is tampered with. Furthermore, forest cover is a surrogate to economic value of a country, which when lost leads to economic losses (Costa & Pires, 2010).
In conclusion, forest offers invaluable economic services and direct marketable good and service to the various countries of the world. Deforestation is a worldwide issue that should be address in at the country, regional and global levels. Even though worldwide campaigns have been used to reduce the rates of forest loss, effort still needs to be put in place to avoid future impacts on human livelihoods, welfare, environment, and the global economy. Therefore, appropriate and effective mitigation measures must be put in place to curb unsustainable exploitation of forest resources, both at individual and industrial levels.
Assignment 2: White Paper
Deforestation and Mitigation
Executive Summary
Forests are very important to everyone. They directly or indirectly support millions of persons in the world and over 80% of the Earth’s biological diversity. Again, forests drive local and global, hydrological, and climatic cycles, therefore; they contribute to climate change when cut down at a rate exceeding their regeneration rates (Tucker & Townshend 2000). Furthermore, a lot of scientific studies assert that forest destructions and deforestations are the third most contributors to greenhouse gases that cause global warming and climate change. Also, there are proofs that deforestations contribute thrice the greenhouse gases released from global transport sector (Potter, 1999).
Forests are biological resources, which are very sensitive to unsustainable exploitations because if the rate of cutting down the stands exceed the rate of natural regeneration, then decline in forest cover results. In this regard, forest management and conservation become mandatory if humanity still wants to tap the values from the natural resources. Therefore, a workable idea is to conserve forest carefully by avoiding forest cuttings, illegal loggings, and unscrupulous forest extraction methods. Alternatively, tree planting should be embraced as a technique to replace the felled stands, however, some planted trees grow very slowly that delay forest regenerations (Kummer & Turner 1994).
As human population continues to grow, with the advancement in world industrial activities, deforestation will continue to exacerbate to severe levels. Simultaneously, droughts and increased instances of forest fires worsen the situation of climate change and increase the vulnerability of the world population to the food crisis. Therefore, to mitigate deforestation the reasons behind tree cutting must be understood, and then plausible alternatives adopted to reduce direct reliance on the sensitive ecosystem.
That is why; this paper explores the potential strategies that must be implemented to curb deforestation. The best approach is to address the human causes of deforestations because they are the main contributors (Tucker & Townshend 2000). In addition to this, deforestation of tropical rainforest being the highest in the world, particularly in the developing countries, mitigation measures must prioritize on the African, Asian, and Latin America.
Introduction
Forest degradation occurs when trees in forested regions are subjected to land use change, for instance, an area covered by forest is converted to ranches, urban buildings, settlements, infrastructure, or for agricultural purposes. According to Costa in 2010, forest loss affects natural system cycles, which include water, weather, soil, and atmosphere circulations.
Deforestation has a lot of negative impacts to the world population, environment, and the economy. Notably, loss of forest cover is based on social, economic, and political grounds; hence these factors form the bottom line of formulating strategies to address deforestation. Logging operations, for wood and paper products, have resulted to countless tree stands cut, particularly when the action is illegal (Tucker & Townshend 2000). Moreover, commercial trade on wood products, for example hardwood from Central and Western Africa, threatens the long-term existence of the African rainforest.
Climate change and deforestation calls for effective and careful management tools to save both biological and geophysical functions of forests. Suggested measures include limited fragmentation, landscape management, education, and regulation, creating protected forest zone amongst others like adopting green energy (United Nations Development Programme, 2000). Further, strict laws and policies on forest resources must be in place to heavily prosecute illegal loggers and scrapping out impunity when environmental crimes are committed.
Factors Driving Deforestation
Causes of deforestation are profoundly multiple on the local, regional, and global scale. However, all the drivers of deforestation are based on social, economic, and political factors. Social factors define the society and how they relate to the forests, for example, most small-scale farmers and hunter-gatherer communities directly relate to the forest. On the other hand, economic factors relate to the levels of industrialization and how the industries source their inputs from the forest while political factors define the territorial boundaries and regulations put in place to monitor forest exploitation.
All over the world, intensive and extensive agriculture have led to the conversion of vast lands previously covered by forest. Furthermore, commercial trade on forest resources and illegal logging contribute to loss of tree stands. Other causes of deforestation include overexploitation, forest fires, wood fuel extraction, industrial growth, urban sprawl. It is worth noting that, all the possible sources are categorized as either natural or human, with the latter being the most severe and accelerating.
Mitigating Deforestation
Mitigation measures are the remedial interventions that eliminate or reduce the current rates of deforestation to ensure recovery of forest resources. When the lost forest is restored, biodiversity, soil, climate, and human welfare are improved to the better. Therefore, solving deforestation should be based on feasible and practical policies and conservation measures to necessitate sustainability and restoration (Kummer & Turner 1994). Several strategies that can be used to restore the lost treasure include:
Sustainable Agricultural Practices
Sustainability in agriculture involves integrated systems that incorporate crops and tree, particularly known as agroforestry. The mechanism ensures that farmers benefit from both the crops and tree stands. However, the practice has not been much developed in many parts of the world despite the benefits that come with it. Trees in croplands have multipurpose; for example, they serve as shelterbelts, enrich the soil, reduce soil erosion, improve yields, and create a microclimate. To appropriately commission such projects, countries should employ communities or public, private partnership (PPP) with the guide of agricultural and forestry agencies.
Monitoring Deforestation
Through aerial photography and satellite imagery, incidences of illegal logging can be monitored, which forms the base line of prosecuting the environmental crimes. Further, the monitoring and surveillance will necessitate a creation of a database on forest resource through hotspot analysis to guide prioritization of interventions (Tucker & Townshend 2000). Digital analysis done on satellite imagery has to great extent reduced deforestation in Brazilian Amazon.
Reforestation and Forest Plantations
Reforestation is planting of trees where the indigenous forest had been disturbed. To ensure the effectiveness, fast growing trees are encouraged, though; care must be taken to avoid the proliferation of the planted trees at an ecological expense (Potter, 1999). For example, impact assessment of most eucalyptus species has to be carried out to match the tree requirements and the ecology of a particular area. Again, forest plantations are important because they provide the industries with materials inputsand to reduce reliance on natural forest for wood products. Plantations have a yield capacity of 5-10 times that of the natural forests so it is essential to plant and manage fast growing tree species (Kummer & Turner 1994).
Forest Management
Management involves conservation and consideration of sustainability in utilization of forest resources. Secondly, management also means protection. When the forest is severely destroyed, utilization is ceased to create protected forest zones (Kummer & Turner 1994). These zones are out of bounds for all forms of use as the tree stands are left on their natural state. On the other hand, conservation allows people to tap the resources from the forest but, in an ecologically sustainable manner. Also, nature conservancies have been used in many parts of the world to raise endangered plant species and to raise seedlings. In Asia and some parts of Africa such as Senegal, communities based organizations raise seedlings and sell to the forestry agencies or donate to green schools and youth organizations.
Land Use Planning
All development must be environmental friendly, for example, growth of urban centers should not compromise the growth of indigenous forest. Instead, green towns need to integrate trees and concrete infrastructures (green structures). On the other hand, urban sprawl can be reduced by developing the rural areas. In a nutshell, before any land use is converted to another, precautionary measures should be put in place for planning and avoiding future consequences (Potter, 1999).
Eco-Forestry and Community Forestry
Only selected tree should be cut to ensure sustainable exploitation. This technique has minimal damages and gives the forest adequate time to recover. This selectivity permits commercial timber extraction in an ecologically sound scale. Furthermore, community forestry is done on local levels to allow the community to participate and manage local forests (Tucker & Townshend 2000).
Environmental Litigation
Laws and policies that govern forest resources must be complied with, failure to which, the offender faces the legal structure without going impunity. The litigation process must clearly outline the fines involved ensuring that the offenders pay as the civil laws or Acts entrench. Similarly, public policies should be developed to create incentives among the people for conservation and sustainable utilization of forests (Kummer & Turner 1994).
Adopting Alternative Sources of Energy
Wood fuel extraction is the world major cause of deforestation, meaning that if people divert to alternative energy source, the forest benefits. The most efficient and clean energy is solar, which can be installed even to the remote households (Potter, 1999). Again, relevant policies should govern charcoal production, which a significant contributor to tree cuttings, particularly in the poverty stricken areas.
Conclusion
Deforestation is a worldwide environmental issue that have led to complex network of problems, which can be trickled down to land degradation, climate change, and global warming, loss of biodiversity, reduces renewable resources, loss of human wellbeing, and livelihoods. Notably, loss of forest negatively affects the valuable ecosystem services, which are life supporting systems. The conversions of natural forest to other land use are caused by manmade and natural causes, the former being very accelerating. To curb future consequences, mitigation measures must be implemented and sustained. The tropical and temperate rainforest are the most threatened forest ecosystems in the world, and, therefore, prompt interventions must be implemented. Conclusively, reducing deforestation will benefit the world population, environment, and the global economy. Even though worldwide campaigns have been used to reduce the rates of forest loss, effort still needs to be put in place to avoid future impacts.
References
Andersen, L. E. (2002). The dynamics of deforestation and economic growth in the Brazilian Amazon. Cambridge [u.a.: Cambridge Univ. Press.
Boahene, K. (1998). The Challenge of Deforestation In Tropical Africa: Reflections On Its Principal Causes, Consequences And Solutions. Land Degradation & Development, 9(3), 247-258.
Cardenas, H. O. G. (2008). Causes and consequences of deforestation and land-cover change in rural communitites of western Mexico.
Costa, M. H., & Pires, G. F. (2010). Effects Of Amazon And Central Brazil Deforestation Scenarios On The Duration Of The Dry Season In The Arc Of Deforestation. International Journal of Climatology, 30(13), 1970-1979.
Durham, W. H., & Painter, M. (1998). The social causes of environmental destruction in Latin America. Ann Arbor: Univ. of Michigan Press.
Kummer, D. M., & Turner, B. L. (1994). The Human Causes of Deforestation in Southeast Asia. BioScience, 44(5), 323.
Lambin, E. F., & Geist, H. (2006). Land-use and land-cover change: Local processes and global impacts. Berlin: Springer.
Margulis, S. (2004). Causes of Deforestation of the Brazilian Amazon. Washington, D.C: World Bank.
Palo, M., & Vanhanen, H. (2000). World forests from deforestation to transition?. Dordrecht [u.a.: Kluwer Academic Publishers.
Pearce, D. W., & Brown, K. (1994). The causes of tropical deforestation: The economic and statistical analysis of factors giving rise to the loss of the tropical forests. Vancouver [B.C.: UBC Press.
Potter, C. S. (1999). Terrestrial Biomass and the Effects of Deforestation on the Global Carbon Cycle. BioScience, 49(10), 769.
Sunderlin, W. D., Resosudarmo, I. A. P., & Center for International Forestry Research. (1996). Rates and causes of deforestation in Indonesia: Towards a resolution of the ambiguities. Jakarta, Indonesia: Centre for International Forestry Research.
Tucker, C. J., & Townshend, J. R. (2000). Strategies for monitoring tropical deforestation using satellite data. International Journal of Remote Sensing, 21(6-7), 1461-1471.
United Nations Development Programme. (2000). World resources 2000-2001: People and ecosystems : the fraying web of life. Amsterdam: Elsevier Science.
Vajpeyi, D. K. (2001). Deforestation, environment, and sustainable development: A comparative analysis. Westport, Conn. [u.a.: Praeger.
The effects of culture on the provision of end-of-life culture on African American patient
Assignment 1 – Developing your research question
Word count: NUMWORDS * MERGEFORMAT 896
Student name: Student ID:
Title
The effects of culture on the provision of end-of-life culture on African American patient.
Research problem
Culture has been identified as a very important aspect to consider when giving end-of-life care (Ball et a., 2010; Steinberg, 2011; Ganz e al., 2006; Schim & Doorenbos, 2010). During their end-of-life days, many patients are affected by their values, societal beliefs, religious beliefs and personal beliefs (Hern et al., 1998). Steinberg (2011) identifies that, for many clinicians, the discussion and consideration of culture in a palliative patient are a difficult area. According Ganz et al. (2010), cultural variation in different regions affects decision-making during end-of life care, and this effects the outcome of care.
Considering that culture has some effect on the outcomes of care (Steinberg, 2011), adhering to the demand of respecting culture is likely to be a challenge in a multicultural setting, as the United States, where people share. Coolen (2012) observes that the problem is worse when the care provider and the patient are of different cultural backgrounds. The care of African Americans in a society dominated by the whites poses a great challenge. According to Coolen (2012), the American values emphasize autonomy in decision-making during end of life care, while African-Americans view the family as the best place institution to make decisions. Because of these disparities and conflicts, the results can be miscommunication with patient or family, inadequate care, inappropriate symptom management and poor diet for the patient. While research has been conducted to show the effects of culture on patients, few have focused on this specific group of African Americans. There is need for research in this area because African Americans live in a culture dominated by the whites, and at the same time they need to preserve their values. This research paper focuses on the need to consider cultural effects while caring for African American patients.
What is already known
Several researches have been conducted, and they agree on one thing: that culture has a significant effect on the end of life care (Coolen, 2012; Raghavan, Smith & Arnold, 2008). The values and attitudes of African Americans towards end of life care differ greatly compared with those of the entire American population (Raghavan, Smith & Arnold, 2008). Searight and Gafford (2005) agree that patient dissatisfaction, ineffective communication and poor patient-goal outcomes have been realized due to cultural differences between African American patients and white care providers. According to Steinberg (2011), a complicated challenge arises further because cultural differences exist even within the African American communities. Coolen (2012) posits that clinicians have always made a mistake by assuming that the values and beliefs of all African Americans are similar. The assumptions eventually lead to undesirable patient outcomes. Steinberg (2010) argues that culture affects not only the patient that are being nursed, but also the relatives and the healthcare workers that are attending the patients. Thus, culture should not be considered on the part of the patient alone. The beliefs of the nurse and the other members of the health care team are very likely to affect the outcome of care, as influenced by their cultural beliefs (Koening & Williams, 1995; Kwak & Harley, 2006). In relation to informal family care-giving, Herbert and Schultz (2006) argue that the family cares for the palliative patient with a lot of reference to their beliefs.
According to Raghavan, Smith & Arnold (2008), African Americans are less likely to be satisfied with end of life care, enroll in hospice, and receive appropriate symptom management. Additionally, they are more likely to stop hospice care, and receive very aggressive treatment at their end of life. According to Valente (n.d), African Americans tend to associate hospice care with giving up, while the whites have a preference for hospice care. They do not take directives from care providers very serious. Rather, they verbalize their situations with family members. According to Steinberg (2011), these behaviors are not rooted in the lack of education, because they have also been observed in African American physicians. It is thus clear that these behaviors are rooted in strong cultural beliefs among his African Americans. The behavior also reflects a strong faith on the part of African Americans, in that they believe strongly that death is controlled by God.
The other area of disparity as identified by Searight and Gafford (2005) is in revealing bad news to the client or the family. American values emphasize truth-telling regardless of the magnitude of the news. This is very much different from the African Americans who consider that plain revealing of bad news as a diagnosis of chronic disease may be a disrespect to the client or the family (Phillip & Charles, 2003). The culture of the African Americans has been that the clinician conceals the news until the family or the client has got some clue on the information. Valente (n.d) laments that, even as many people appreciate the value of communication during end of life care, some African American cultures consider talking about death a taboo. In regard to this, the care provider attending to such a patient must have the knowledge of the culture of the individual in order to incorporate cultural values in the care (Krakauer,Crenner & Fox, 2002). Failure to do this results to inappropriate care to the patient.
Gap in knowledge
The many researches that have been conducted concerning culture and its effects in end of life care, focus on two major groups: the whites, and the minority groups (Steinber, 2011; Valente, n.d; Coolen, 2012). Only a few of the researches have given some preference to specifically study a single minority group (Raghavan, Smith & Arnold, 2008). In addition, the research focus more on the differences between the values of the European Americans versus the minority groups in the US (Werth et al., 2002). A focus on the effects of violations of these beliefs and preferences has not been given priority. Where this has been discussed, assumptions made by care providers about the values of African American have been documented, leading to poor outcomes, and inappropriate care. Since with the existing knowledge, there are still many issues of violations of cultural values and preferences, leading to poor clinical outcomes, it is important to give preference to study deeply the cultural beliefs of African Americans, and their influence on the provision of care. This study thus focuses on the cultural values of African Americans, and how they affect the provision of end of life care.
Research question
The research seeks to provide a solution to the existing gap in knowledge concerning the relationship between the culture of African Americans, and the outcomes of end of life care. The research question would thus be: What are the impacts of culture on the provision of end of life care among African Americans?
What needs to be known
The reviewed literature has revealed that, even though some information is known about the preferences of African Americans, errors are still prevalent in the provision of end of life care. Assumptions have been made that all communities of African Americans share values and beliefs (Coolen, 2012), but they have not borne positive results. There is thus a need to study deeply the underlying strong cultural values of African American communities and know how best to intervene, in order to improve his end of life care. The study adopts a literature-based method. The population of the study will be the existing literature. A mixed-method of research has been adopted. In this study, provision of end of life care will be the dependent variable, because it is affected by attitudes, beliefs and values of patients and care providers. The independent variables will be the effects of culture. The existing literature will be reviewed, and data synthesis employed for analysis of results.
Project aims and expected benefits
The aim of this research is to investigate the impacts of culture on the provision of care among minority African Americans in the dominant white population of the US. The reviewed articles in this area reveal that, although some information is known about the topic, cases of assumptions have been reported, which lead to poor patient outcomes. Poor understanding of African American culture leads to inappropriate management and ineffective communication, thus dissatisfaction of the patient. The results of this research paper will be beneficial in correcting this problem, thus improving the provision of end of life care.
References
Ball, G. C., Navsaria, P., Kirkpatrick, W. C., Velcler, C. Dikson, E., Zink, J., … & Feliciano, V. D. (2010). The impact of country and culture on end of life care from injured patients: Results from an international survey. Journal of Trauma, 69(6), 1323-33.
Coolen, R. P. (2012). Cultural relevance in end of life-care. Retrieved from ethnomed at http://ethnomed.org/clinical/end-of-life/cultural-relevance-in-end-of-life-care
Ganz, D. F., Bembenishty, J., Hersch, M., Fischer, A., Gurman, G., & Sprung, C. L. (2006). The impact of regional culture on intensive care end of life decision making: An Israeli perspective from an ETHICUS study. Journal of Medical Ethics, 32(4), 196-199.
Herbert, S. R., & Schulz, R. (2006). Care-giving at the end of life. Journal of Palliative Medicine, 9(5), 1174-1187.
Hern, E. H., Koenig, A. B., Moore, L. J., & Marshal, A. P. (1998). The difference that culture can make in end-of-life-decision making. Cambridge Quarterly of Health-Care Ethics, 7(1), 27-40.
Koenig, B. A., & Williams, J. G. (1995). Understanding cultural differences in caring for dying patients. Western Journal of Medicine, 163(3), 244-249
Krakauer, E. L., Crenner, C., & Fox, K. (2002). Barriers to optimum end of life care for minority patients. Journal of the American Geriatrics Society, 50(1), 182-190.
Kwak, J., & Haley, E.W. (2005). Current research findings on end-of –life decision making among racially and ethnically diverse groups. The Gerontologist, 45(5), 634-641.
Phillip, L. D., & Charles, L. S. (2003). Cultural differences at the end of life. Critical Care Medicine, 31(5), 354-357.
Raghavan, M., Smith, A., & Arnold, R. African Americans and end of life. Retrieved online from http://www.eperc.mcw.edu/EPERC/FastFactsIndex/ff_204.htm
Schim, M.S. & Doorenbos, A.Z. (2010). A three dimensional model of cultural congruence: Framework for intervention. Journal of Social Work End Life Palliative Care, 6(3-4), 256-270.
Searight, R. H., & Gafford, J. (2005). Cultural diversity at the end of life: Issues and guidelines for family physicians. American Family Physician, 71(3), 515-522.
Steinberg, M. S. (2011). Cultural and religious aspects of palliative care. International Journal of Critical Illness and Injury, 1(2), 154-156.
Valente, S. (n.d). Culturally diverse communities and end of life care. American Psychological Association. Retrieved from HYPERLINK “http://www.apa.org/pi/aids/programs/eol/end-of-life-diversity.pdf” http://www.apa.org/pi/aids/programs/eol/end-of-life-diversity.pdf
Werth, J. L., Blevins D., Toussant K., & Dhurham M. (2002). The influence of cultural diversity on end of life care. American Behavioral Scientist 46(2), 204-219.
Predictors of problem focused coping style amongst international paramedic students.
Predictors of problem focused coping style amongst international paramedic students.
NameCourseCourse instructorDate of submissionAbstractBackground
Paramedicine is among the professions whose practitioners suffer high risks of stress and associated symptoms. Extensive studies have been carried out on the effects of these stress factors on the paramedics. The need for pre service training on stress management is a factor that has been widely discussed. The current study aimed at identifying the stress predictors among international students training as paramedics and the different coping mechanisms that they adopt.
Methods
The research took a quantitive approach and used a questionnaire as the main avenue for data collection. The questionnaire was composed of closed ended questions with choices structured on the Licker scale and a Yes/No type of collection. A cross sectional sample was targeted for the survey. A total of 30 respondents were interviewed for the survey.
Results
Computer software (SPSS Version 16) was used to analyse the data for both descriptive and statistical results. The data was presented in tabular and statistical formats. The analysis of the data showed a correlation between predictors and stress levels among the international paramedicine students.
Conclusion
The study concluded that just like other members of the paramedic profession, students in paramedicine are also prone to work related stress. It was recommended that measures be put in place to reduce these stress levels and increase job satisfaction. The study further recommends further research on ways and means of reducing the effects of exposure to the trauma that paramedicine students suffer in the course of training and practice.
IntroductionLiterature Review
Paramedics and other first responders are at high risk of psychological distress and associated symptoms such as burnout (McFarlane, Williamson and Barton, 2009). The effects of stress factors on paramedics are well studied and the correlation between these known factors and job burnout and dissatisfaction has resulted in paramedics making errors and a decreased level of patient care (Le Blanc et al. 2005). Understanding the predictors would enable policies to be instituted to help prevent and intervene and reduce such stresses (Bennett et al. 2004, McFarlane, Williamson & Barton, 2009). Vettor and Kosninski (2000) identified paramedic characteristic responses as emotional exhaustion; depersonalisation, and lastly personal negative assessment, one question is whether international paramedic students suffer similar feelings as they undergo their training and more specifically, the coping strategies they utilise to manage these feelings?
Managing stress factors for paramedics include peer support, and this along with how they express their emotions, are two types of predictors of psychological distress and burnout (Porter 2008). Clohessy and Ehlers (1999) state that the daily encounters that paramedic’s face impacts their lives and leaves an indelible mark on a paramedic’s psychological state. As an international paramedic student they learn how to assess and initiate pre-hospital care after the occurrence of the emergency mostly in the ambulance. Paramedic students learn about critical incidences that prepare them for situations that they are likely to come across in their career, which is always stressful and has negative outcomes like stress, fatigue, and burnout (Alexander & Klein 2001).
In the coping literature, two broad types of coping have been described. These are known as problem focused coping and emotion focused coping. Problem-focused coping is seen as putting effort into solving or managing the problem, which has caused the initial distress (Kilburn & Whitlock n.d.). In this process strategies focus on assimilating the necessary information in order to plan, make decisions, and resolve differences; only through gathering resources can one expect to address the problem(s) that requires specified action to resolve them (Kilburn & Whitlock n.d.). With emotion-focused coping the focus is on alleviating emotional distress by using the cognitive processes like having a positive attitude, or adopting behavioural strategies such as getting emotional support, or by using drugs or alcohol as a mechanism to cope (Kilburn & Whitlock n.d.).
Predictors to paramedic stress include factors like, avoidance, social support, and coping, like that of problem-focused and emotion-focused coping. International paramedic students gain experience how to deal with issues in situational training and are trained how to cope (Alexander & Klein 2001). International paramedic students are exposed to learn about both physical and emotional health (Corneil et al. 1999). It is from the impacts of stress and burnout that the correlations between these consequences that affect a paramedic to self-evaluate their chosen career (Nirel et al. 2008). The correlation then between predictors and stress and burnout can result in establishing estimates of length of service that a paramedic might have and, which in turn affects the continual demand for future paramedics (Nirel et al. 2008).
The need for pre service training of stress management coping is something that Regehr and Millar (2007) and Okada et al. (2005) explored and that there is an essential need for stress management tools and education. While peer support has not been linked directly to psychological stress and burnout, a paramedics’ negative attitude towards emotional expression and coping are predictors, which are related to fatigue rates, stress symptoms, and burnout (Bennett et al. 2004; Porter 2008). Just as paramedics require peer support for them to be able to cope with stress, rejection from society, confidentiality issues, people’s judgments on how they are inadequate, and ways to express their emotions (Blumenfield & Byrne 1997) another question is how does an international paramedic students learn to cope when facing the rigours of the programs they undertake?
It can be assumed that all international paramedic students suffer from stress, so the aim is to identify the coping styles and strategies that paramedic students currently use to manage this stress. By undertaking a quantitative study it is hoped that a greater understanding of the predictors associated with pre-service stress factors for international paramedics students can enable greater levels of coping mechanisms, such that, these students will have greater coping mechanisms as paramedics so as to manage their stress levels better and this will reduce burnout and improve patient care. From this there is potential to develop positive coping mechanisms for students that may help when they are in-service (Creswell 2009).
Specifically, this study involved an investigation of the current coping styles and strategies of international paramedic students and the factors that predict positive, problem focused coping style that is the most adaptive form of coping. The research question that was addressed was: What are the predictors of a problem focused coping style amongst international paramedic students? It is hypothesized that:
1) Problem focused coping style are associated with Personal control; and
2) Peer and institutional support, while
3) Emotion focused coping style were associated with depersonalisation.
Research plan, methods and techniques
Study Design
The study design involved the use of a cross-sectional survey and this provided a simplified design and expedited the collection and analysis of the data (Creswell 2009). Kraus (2005) defines a cross sectional survey or prevalencetransversal study as one where the researcher identifies a subset of the whole population under study. This subset must be well representative of the whole population. The cross sectional survey questionnaires interviews were conducted on one day again with an emphasis on time and expedience. The data collection and analysis was quantitive in nature, this approach was favoured as it would eventually produce data that was systematically arranged and that was easy to logically analyse (Creswell, Trout and Barbuto, 2004). The data hence collected was easy to analyse through various methods and mediums and help the researcher come to a deductive conclusion.
Participants and Sampling
The population was a random selection of 100 international paramedic students who were given an opportunity to participate and form this it was hoped that 6-10 participants will make up the survey. A clustering technique was used so as to offer a notification to participate in several meetings as it is impossible to ascertain a sample without a list (Creswell 2009). Since surveys were handed out to only those who were international paramedic students and were available to participate it was a convenience sample (Babbie 1990, in Creswell 2009). Convenience sampling involves picking respondents from among those who are easily available, this helps ease the rigours involved in searching for respondents from a large sample. The major shortcoming of this approach though is that the data collected might not be representative of the whole population (Creswell 2009). There was no stratification, only male participants were invited to participate (Creswell 2009). With 100 surveys and an estimated 10% response sample the calculated margin of error is 4.9% with a confidence rating of 90% (Relevant Insights 2012).
Data Collection
Data collection was done from the self-administered questionnaires (Appendix 1) that were designed using a five point Likert scales, multiple choice and yes/no questions this enables participants to rank responses (Huck 2008). The questions were closed and answers were from a limited population that enabled generalization of findings for comparison (Creswell 2009). I was able to make estimates of attributes from a small group and thereby, make assertions about a larger population (Fowler 1998; Babbie 1990, in Charema 2004). From this it was possible to make generalisations about behavioural characteristics of the population.
The survey was sectionalised first section addressed demographic information, the second discussed experience and the third directly as to stress predictors. The researcher looked at previous studies in the field of job related stress for paramedics and narrowed down the questions from these studies to suit his research question and hypotheses. The researcher was fortunate to have had the input of the course supervisor who has also written extensively on the topic of job stress previously. The quantitative data collected from the questionnaires was time efficient and enabled the researcher to rapidly turn around the data and evaluate the information to publish findings (Creswell 2009).
Data analysisThe data collected was descriptively and statistically analyzed. Descriptive analysis involves analyzing the data according to demographic characteristics such as age, year of study and number of years in the paramedic profession. This descriptive data was then presented in terms of tables, graphs and charts. Electronic means for data analysis and in particular statistical package for Social Sciences (SPSS) version 16 was used to analyze the statistical aspect of the data and to test the hypotheses.
Ethical Implications
All ethical considerations as stipulated for researchers were upheld to the best knowledge of the researcher, no participant were exposed to risk; the requirement for anonymity was foremost in these considerations. To this end, the respondents were not required to write their names on the questionnaires, for the sake of analysis; the questionnaires had unique identification numbers. The data collection was done on the basis of informed consent and the researcher went to great lengths to explain the purpose of the study and the use(s) of the data collected thereof (Creswell, 2009). The questionnaire was given out together with an introduction letter from the supervisor detailing the commissioning of the study and a consent form (Appendix 2) for the respondents to sign. The research proposal was reviewed and approved as was the methodology and a verbal script to introduce the researcher and his research topic was prepared (Creswell 2009). Since no identity information were collected all confidentiality will preserved no data were falsely manipulated to influence the findings (Creswell 2009). The respondents were also informed of their right to discontinue or withdraw from the research either before or during the filling of the forms and the right to omit any question they felt uncomfortable answering. (Fowler 2008). Measures to ensure that the questionnaires could not be identified from one another were also put in place to protect respondents from any attempts to identify their responses once collected.
Results
1.0 Descriptive statistics for demographic variables
The overall study utilized a convenience sample of 30 international students. All the participants (100%) were currently enrolled in the bachelor’s level of education. Table 1 presents the demographic characteristics of the sample participants.
TABLE 1
A summary of the demographic characteristics of the participants
Frequency Percent Valid Percent
Age
<22 years 1 3.3 3.3
22-25 years 1 3.3 3.3
25-30 years 10 33.3 33.3
30-35 years 17 56.7 56.7
>35 years 1 3.3 3.3
Education level
Bachelors 30 100.0 100.0
Education year for Bachelors’
1st year 5 16.7 16.7
2nd year 17 56.7 56.7
3rd year 8 26.7 26.7
A majority of the study participants were aged between 25 and 35 years. Notably, there were few participants (3.3%) in the age categories <25 years and >35 years.
2.0 Preliminary results for the main study outcomes
The present study was aimed at identifying the factors (predictor variables) that contribute to pre-service stress amongst international paramedic students. Five main outcome variables were identified and the descriptive results are as summarized in table 2.
TABLE 2
Descriptive statistics for the main outcome variables
Frequency Valid Percent
How much paramedic experience do you have?
2 years 5 17.2
1-5 years 8 27.6
5-10 years 12 41.4
>10 years 4 13.8
What degree of control do you have at work?
Rarely 3 10.0
50/50 9 30.0
Occasionally 11 36.7
Always 7 23.3
What is the level of support you receive from co-workers/fellow students?
Never 1 3.3
Rarely 5 16.7
Occasionally 9 30.0
Sometimes 11 36.7
almost always 4 13.3
What is the level of support you receive from supervisors/teachers?
Never 2 6.9
Rarely 2 6.9
Occasionally 7 24.1
Sometimes 12 41.4
almost always 6 20.7
Is there organizational support?
Yes 19 63.3
No 11 36.7
The results indicate that a majority of the study participants, 41.4%, had 5-10 years of paramedic experience. However, only a minor proportion of the participants, 13.8%, had more than 10 years of paramedic experience. Just over one third (36.7%), affirm that they occasionally have control at work. Notably, only a minor proportion, 10%, indicated that they rarely have control at work. On the other hand, the results indicate that co-workers and fellow students provide a great level of support to the study participants. More than one third (36.7%) of participants, indicated that they sometimes provide support while 30% indicated that they occasionally provide support. Only a minor proportion, 3%, indicated that they never provide support.
In addition, supervisors and teachers provide an equally great level of support to the participants. A majority, 41.4%, indicated that they sometimes provide support. Similarly, large proportions of the participants, 24.1% and 20.7%, indicate that supervisors and teachers occasionally and almost always provide support respectively. Essentially, a majority of the study participants, 63.3%, affirm that there is organizational support (Table 2).
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