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Case Study


Ms Singh has bilateral hearing aids and reading glasses, showing that her sight and hearing ability is not that good. The patient also suffered from Cerebrovascular accident (CVA) with residual right (R) sided hemiplegia, dysphagia and dysphasia. Hemiplegia is the type of stroke which causes the complete paralysis of one side. The effects are the loss of speech, dysphagia, and the disorder of language, dysphasia. The patient’s temperatures readings are below the average range. This is because the normal range is 38 degrees C, while the patients is 36.9 degrees C. Ms Singh’s blood pressure is also very high comparing to the normal one being 120/80.

At the patient’s age, their pulse rate should be about fifty to eighty beats per minute. Therefore, with her pulse rate being at a hundred and fifteen beats per minute, then it means there is a problem especially at that age (Cook, 1992). All these alterations happen not to range within the normal range for a healthy human. The most probable cause of these alterations in the vital signs is the stroke the patient suffered. Dysphagia is a very serious condition, and it can cause aspiration pneumonia, dehydration, malnutrition and eventually death.

A special dysphagia has divisions which mount up to five levels, which differ depending on the type of food stuff. Food such as bread, hard legumes, and nuts are prohibited while peanut butter, pasta and candy are not advisable. A dysphagia patient must also maintain a straight posture when feeding and remain the same way for thirty minutes after having their meal. Food that is extremely cold or hot should also be avoided with the patients taking the most time when feeding (Crutchlow, 2012). The patients are also advised to take small bites, and sips, to make swallowing easier. Another very keen measure that should be taken is that dysphagia patients should feed in a quiet place.

For a patient suffering from dysphagia, diet is very keen thing and, therefore, the best feeding material is necessary. The patient needs to take a healthy diet and lots of water and nutrients but conservatively on the latter. Ms Singh may also require taking solid food that has already been softened or fruits. This would make the patient avoid complications during swallowing of the food. To assist the patient with walking and at the same time avoiding the risk of falling, the patient may be forced to use crutches

This should help the patient manage their weight well and avoid the shift falling on one side. The patient should also be advised to physical exercise and activities. Though due to her age, she cannot involve in very tiring activities, and exercise, there is still need to involve in the activities.

The easiest method of helping the patient with urine elimination is to have someone walk her to the toilet every time she feels the urge. The method, however, is not reliable and is tiresome in a way. There is another option of having a pipe tied up to her excretory system. That way if the patient feels the urge to visit the toilets, she does not even have to move. If there is a restricted blood supply to the bowel, the condition is called a bowel infarction. The colostomy is a result of avoiding the large intestines getting infections (Crutchlow, 2012). The other reason why a colostomy is carried out is to curb the spread of disease or an infection.

The first precaution one needs to take before changing the patient’s colostomy bag is hygiene, and the hands of the one changing should be clean. Use on the arm to support the skin, while the other hand takes of the pouch slowly. The pouch should be emptied by cutting the bottom part, and its contents disposed in a lavatory. The pouch should then be disposed in a plastic disposal bag after rinsing the pouch. One can, however, dispose the pouch without cutting out its content, direct into a plastic disposal bag (Encyclopedia of family health, 2005). Warm water should be used to wipe the area around the stoma, then wipe gently with a dry wipe taking care not to rub. After the area around the stoma is clean, one can now fix the colostomy bag. It is necessary to cut the bag to make sure it fits in the right size in the stoma.

The discharge plan for Ms Singh happens to be very tricky since the daughter is on a full time job and does not have time to cater for her mother. Therefore, the best option would be to discharge her with an available option of someone who can take care of the patient. The person should be a nurse if possible or someone who has the knowledge of the condition of the patient. The person should also learn that Ms Singh is very religious and should learn to respect her religion, culture and spiritual life. Interference with her religious, cultural and spiritual life at her age may cause drastic results, which can be avoided.

Aspiration pneumonia is a condition where the lungs or large airways swell due to infection. This occurs when food stuffs, vomit or liquids getting in the airway that leads to the lungs. Old age and the consumption of too much alcohol also lead to the condition. Ms Singher's stroke may be the cause of the aspiration pneumonia (Schlossberg, 2008). Pressure ulcers, first of all is a condition that affects people of age around 70 and above, and this happens to be the patient’s age. Early detection makes prevention of the condition much easier. Once one has determined the risk factors, it becomes much easier to detain the situation.

The major cause of pressure ulcers is a sharp unending pressure on one part of the skin. The damage is caused through making the blood supply in the area reduce. This makes the part susceptible damage when it comes to contact with another substance. Excess moisture in terms of urine or fecal incontinence, poor nutrition and hydration also cause the condition. Poor health in general may lead to one contracting pressure ulcers (Maklebust, 2000).

The most proven method of preventing pressure sores from getting worse is to have daily skin inspections. This method identifies the affected parts that have been identified from the uninfected parts of the body. The other method is cleaning the affected part then covering it and letting it stay that way. The sore area should not also be left to dry out.

Advance Health Care Directives, just like the name refers to the instructions that the patient gives concerning their future health. This is because of the patient or doctors predicting a bad situation or the situation itself taking place. The decision is either made by the patient or a person whom the patient has appointed. The case of the patient asking not to be resuscitated is a very tricky one. Before agreeing and respecting her decision, it would be necessary to find out her reason why, and see if she can change her mind. The next thing would to inform the immediate family, whom if they have agreed also, leaves me no option but to also agree.

References

Cook, R., & 3M Company. (1992). Vital Signs. S.l.: Penguin Group US.
Crutchlow, E. M., Dudac, P. J., MacAvoy, S., & Madara, B. R. (2002). Pathophysiology. Thorofare: Slack.Encyclopedia of family health. (2005). London: Marshall Cavendish.
Maklebust, J. A., & Sieggreen, M. (2000). Pressure ulcers: Guidelines for prevention and management. Springhouse, Pa: Springhouse Corp.





    

Curriculum on Attendance

     

Curriculum is a procedure used while analyzing a situation and when researching. Researchers use different methods and procedures while developing reasons towards an already known concept and while making studies. It includes the analysis of manipulated independent variables that do not have common control (that is random controls). (Gliner, 2010) On the other hand, researchers may include the analysis of studies that have important controls in their studies.

While considering the case of a new curriculum, it has a significant effect on the attendance. While carrying out research, change in the methods used while analyzing the study leads to a change on the researchers’ perception ton the study. The essay will focus on methods that a researcher can explore the impacts of a new curriculum on attendance. (Gliner, 2010)

There are different research methods used by researchers. These methods are determined by the number of individuals involved in the research. On the other hand, the time allocation of the research determines the method used in the research. While responding to impact of change in the curriculum on attendance, researchers can use different methods to analyze the effects. Single group time-series design is one research method commonly used by researchers while responding to the change in curriculum. This method involves the analysis of the dependent variables before and after manipulation of the independent variables. Interrupted time series design is one method of a single group series (Gliner, 2010).

A time series is a set of measurements of variables taken at various points in time. An interrupted time-series design, which is a time series, is interrupted by the manipulation of the independent variables (that is factors that are not easily manipulated in the study). (Gliner, 2010) This design is similar to a pretest-posttest design. However, it includes multiple posttests. The interrupted time series design allows one to see how long the effect of the manipulation lasts.

This implies that in this study method used by researchers depends on the impact time of the manipulation. Like in the pretests-posttest design, the interrupted time series design can be augmented with either a non-equivalent control group or a true control group. Therefore, this research method used by researchers while exploring the impact of a new curriculum on attendance gives the researchers a clear point of responding to the trends of attendance as people adapt to the new curriculum. It gives them the opportunity to learn the response time among people while adapting to the new curriculum introduced in the study institution. (Gliner, 2010)

Sometimes, the independent variables in an interrupted time series design are not manipulated but changes just naturally. For example, research shows that the number of suicides in the general population increases right after a particularly prominent suicide (suicide of famous people). This design includes no manipulation and does not include any attempt to control extraneous variables. If the number of suicides increases suddenly after a prominent suicide, this seems to be a strong evidence of a causal connection especially if the same results can be shown after many different prominent suicides. (Gliner, 2010)

On the other hand, shows that researchers exploring the impact of a new curriculum on attendance have a chance to learn the adopted behaviors of the people affected by the new curriculum. Single group method of research gives the researchers a chance to learn new behaviors of a single group by analyzing the changes resulting from the change in curriculum. This method is quite effective and applicable to researchers while analyzing different trends that arise from changing trends of carrying out activities and as well changing variables in the study. Within a short period of time, researchers have an opportunity to learn these trends by comparing the changes before and after the changing variables (introduction of the new curriculum). (Gliner, 2010)

Time based research methods are stronger than other research methods that are not time based. This because time based research methods gives researchers a chance to learn trends in the study at different intervals. These methods give the researcher a chance to make comparisons of the changing variables at different intervals of time (Gliner, 2010). However, while using methods that are not time based, comparison of trends at different intervals of time is not possible. This implies that the researcher does not have a clear analysis of the changes taking place on the variables on the study.

On the other hand, while using time based research methods, the researcher has an opportunity to view how the effects of the changing variables last. On the other hand, while using research methods not based on time, the researcher does not have the opportunity to develop the effects of manipulation and as well the impact it has on the study. While exploring the impacts of a new curriculum on attendance, while using time based research methods, the researcher learns the time period before the new curriculum is adopted. On the other hand, comparison of the response to the curriculum is possible while using this method unlike while using methods that are not time based. Therefore, time based research methods are stronger than methods that are not time series. (Gliner, 2010)
    
    References

    Gliner, J. A., Morgan, G. A., & Leech, N. L. (2010). Research methods in applied settings: An integrated approach to design and analysis. New York: Routledge




Case Study Essay


Reliability, according to the free online dictionary, is the capability of a person or an item that makes them dependable. The term reliability is used in a couple of doctrines like; engineering, philosophical studies, computer networking and psychometrics (Bain, 1991). In all these diverse doctrines, reliability portrays a different meaning from one doctrine to another. For an item or person to be considered reliable, they must possess the capability to produce stable and consistent results when assessed.

There are methods that are used to assess the reliability of an item. Reliability can be calculated mathematically to configure an accurate answer. This is the reason why reliability is measured through estimation which gives a rough figure. This paper presents the methods that Gliner can use to measure the reliability of his multiple choice test, and the difference between validity and reliability. Lastly, the possible repercussions of Gliner concluding his test is reliable and finding out it is not.

The first and most common method that Gliner can use to measure the reliability of his multiple choice test is the test-retest reliability. This process involves assessing the same test two times to a group of individuals. The administering of the test should be at two different times and with the same audience every time. The results of Test one and Test two then should be compared to assert the difference if there is one. This test beats the basic human thinking that the results must be the same for the two tests.

At times, this is not the case, and the same individuals may produce different results every time compared to the timeline between taking the two tests. This method, however, may not be recommendable as it may prove to be more reliable than expected (Bain, 1991). This is the case when the individuals take the second test just a short while after they have undertaken the first one. The individuals will, therefore, remember the answers that they gave for the first test, and since they are similar produce the same results. The results obtained from the two tests should show the consistency of the results expected.

The parallel forms reliability is another method that can be used to assess the reliability of Gliner’s multi-choice test. The first step of using this method is the creation of a large number of questions and then splitting them into two to create parallel tests. In this case, Gliner would have to split his multiple choice test into two making it seem like two different tests since the questions are different. The different tests then would be administered to a similar group of students at two different times.

The results will then be compared to try and figure out the most reliable ones. In this case, the set of questions used should be those that were a little bit harder since the test should not be easy. This method is quite dependable since it gives on an option to choose from two sets of questions. The only negative thing about this method is the assumption that the split questions are the same, yet this might not be the case.

The inter-rater reliability is a method that involves the use of different opinions and ratings that the judges who evaluate the test identify. This method is considered better than the previous methods. This is because the judges’ way of thinking is different from those taking the tests, and their opinion is rather professional than rational (Bain, 1991). In this method, disagreements are bound to occur before a unanimous decision is arrived at since everyone in the panel is trying to articulate their view. In consideration that people think differently, disagreements are, therefore, inevitable.

Validity, on the other hand, is a measure of how well a test achieves its purpose or goal. For a test to be considered valid, the results it provides must be must have the capability to be well interpreted or applied. Validity, like reliability, cannot be measured statistically, and there are methods used to estimate the validity of an item (Lissitz, 2009). Content validity is the first method that can measure the validity of the test. Individual test questions come from a very large pool of topics that need to be tested. Therefore, it a test contains content validity; this means it contains all the questions that are necessary for it to cover.

The criterion related validity ascertains that the test can be used for future predicaments, in addition to its current use. The test must possess the ability to fulfill the current duties and also be useful in future assignments that may arise. For example, this test would be used to assess in what other way Gliner’s multiple choice test would be used other than joining grad school. The test is proven to possess constructing validity if the results of the test show any relation to the predicted results. A very good example of a test that has construct validity is an intelligence test. This method involves the experts coming up with expected results of the tests after which students are subjected to the tests to try and prove these expected results right or wrong.

In conclusion, if Gliner decides that his test is reliable then it becomes proven otherwise, this might call for rapid action. If the test is not reliable, Gliner might, therefore, be put in a decision where he has to investigate the parts of the test that are not reliable (Baumgarten, 2013). After this, the next best move would be to eliminate those questions and possible replace them with reliable ones. An assessment of the validity and reliability of his test is important to portray the success of the test. If the test fails the reliability and validity assessment, then it might not be approved at the school.

References

Bain, L. J., & Engelhardt, M. (1991). Statistical analysis of reliability and life-testing models: Theory and methods. New York: M. Dekker.
Lissitz, R. W. (2009). The concept of validity: Revisions, new directions, and applications. Charlotte, NC: Information Age Pub.
Baumgarten, M. (2013). Paradigm wars - validity and reliability in qualitative research. S.l.: Grin Verlag.




Capital Punishment


The essence of punishment is to correct someone so that the same mistake cannot be done again. However, the administration of capital punishment ruins the whole need for correcting someone. How is one supposed to change when he no longer exists? Human is bound to error, and punishment is a form of discipline. But death penalty is like a form of injustice towards the kith and kin of discipline. Imprisoning someone is already stigmatizing enough for the inmate to learn there are other better methods of punishment, as the objective of a legal way of punishment is to prevent crime. It should be noted that these crimes are mostly not committed out of self will, they are emotionally based and the doer is at times not aware of his intention until he does it.

Historical background:

Capital punishment is synonymously known as the death sentence or execution. It is defined by the consequential beheading of an individual’s head with prior permission from the state. The endeavors resulting in capital punishment include; espionage, military justice, treason, genocide and murder. Nevertheless, it can be a punishment for sexual and religious crimes like rape and apostasy, respectively (Rogers, 18). The utilization of capital punishment dates to historic and ancient periods.

A) Origin: 1. Historic documentation:

The movement towards human execution is documented in New England. It was characterized with gospel messages prior to taking an individual’s life. A significant exemplar of such an execution was documented in December 1803. In France, it was practiced prior to the 18th century. Capital punishment is also documented in early monastic and dynasties. For instance, it was depicted in ancient Rome at the colosseum. A striking exemplar is the execution of Christian martyrs by letting hungry lions feed on them in the arena. It was also depicted as a form of political assassination of eminent enemies.

2. Early methods:

The earliest form of execution was stoning. It is dated to the period of the Common Era. It was considered in ancient societies, which applied Moses, laws. Another archaic method is hanging the criminal by overturning the stool on which they stood upon. In the ancient times advancements were considered to fasten and ease execution. These led to the evolution of dropping an individual from a cliff in an attempt to dislocate their necks with the spinal cord. At the launch of the19th century, France adopted guillotine method for execution.

II. States without capital punishment:

The initial state to burn capital punishment was China. It banded it in the period of 747 and 759. Emperor Saga was responsible for its abolishment in Japan. Nevertheless, the abolishment was short-lived as it lasted until 1156. The official abolishment conducted during the modern period was by Leopold Peter. He abolished it in Tuscany. He was inspired by writings of Beccaria, an Italian novelist, on the inhuman and societal torture of execution. The Roman republic banned it in 1849. The endeavors to abolish the punishment spread to Venezuela, and it was implemented in 1863. The Portuguese abolished it in 1867 after a series of legislative amends and controversy.

Canada condemned the utilization of the form of punishment in 1976. In Australia and France it was abolished in 1973 and 12981, respectively. The United Kingdom did not entirely ban the practice, but they limited its implementation to treason, piracy and arson. Michigan was the first state to abolish it in the America states. In Africa, South Africa does not indulge or propagate execution of capital criminals. Gabon is documented to have abolished the practice in 2010, making it the most recent movement to abolish execution. The following states do not practice capital punishment; Alaska, Hawaii, Illinois, Iowa, Maine, Michigan, Minnesota, New Jersey, North Dakota, Rhode island, Vermont, West Virginia and Wisconsin.

The death penalty is a sentence given to offenders after conviction by a Court of Law, capital punishment is different from execution carried out by extrajudicial executions carried out without due process of the law. Crimes that attract the death penalty are referred to as capital offences (Mandery, and Evan 65). In 2010, the United Nation called out non binding resolutions calling for global moratoriums of executions.

Article 3 of the Universal Declaration of Human Rights (UNDHR) Act entitles every person has a right to life, liberty and security, Article 5 stipulates that no person shall be subjected to torture, cruelty, inhuman or degrading treatment or punishment. Everybody is entitled to life as it is a fundamental right according to the human rights watch, and although it is not clear on to everybody as also in the article it does not speak against death (Mandery, and Evan 65).

The United States of America is the only European Country practicing the execution punishment despite controversies over its merits and its effectiveness as a measure of deterrence over serious crimes by nature. According to the law capital punishment is a legal sentence. Amnesty Intentional strongly disapproves of death penalty regardless of the crime committed together with the method used in executing an individual, according to Amnesty 140 countries have abolished the death penalty (Mandery, and Evan 65).

This sentence is carried out in various lawful ways; lethal injection, electrocution, hanging, firing squad and a being placed in a gas killing chamber. The first infliction of the death penalty took place in Jameson an American colony in 1608 during Revolutionary War, at this time it was widely accepted.

A National Moratorium placed in 1967 as the United State considered its constitutionality in the case of furman v. georgia, 408 U.S. 23l8, 92 S. Ct. 2726, 33 L. Ed 2d 346 the death penalty was considered to have ended declaring it unconstitutional and cruel to the society, words of the juries (Mandery, and Evan 65). However in 1976 Florida drafted its own death penalty and the Supreme Court of united State upheld them without any repudiation, capital punishment ha survived regardless of the controversies made about it, out of nine judges’ only two judges such as Thurgood Marshall and William J Brennan Jr opposed the death penalty claiming it to be unconstitutional

A senior judge once stated, “If death penalty is not a deterrent, and it is not, and if the death penalty does not make us safer, and it does not, then it is only high-cost revenge.”  

In reality the costs of life imprisonment may appeal to a whole lot of people compared to death sentence due to the cost incurred while executing death sentence, the cost of death penalty amounts to the net of taxpayers, it involves more pre-trials, more attorneys, and more experts with a series of appeals once the inmate discovers they are on the death parole (Rogers 335).

Molesters, serial killers, rapists, would rarely consider their potential demise prior to committing crimes, since criminals normally operate on the hope that they won’t be caught. Thus the death penalty would not deter any offender considering long term imprisonment (Rogers 335). It is proven on record that states that have death penalty don’t have less criminal records indicating no lower rates in crimes thus deterrence has been discredited by social and science research over the past years.

The possibility of having innocent people put on these death paroles is scary and inhumane, and some might even go mental nut case on the idea of going on the death penalty, this is so because since the modern death penalty 87 people have been freed that were mistakenly convicted and sentenced on death penalty, it is better 5 guilty people to go free than have one innocent life taken (Gershman 250). Mistakes made on death penalty are never revocable and the society might have to live with the guilty of killing an innocent life, let us pause and be civilized and not risk innocent lives.

Punishments are supposed to rehabilitate someone. Ironically, death extinguishes the person. Therefore there will be no correction done on the criminal. Moreover, it is claimed that by executing someone, it would make others fear death and hence not commit such acts. Most of the times, murder is committed out of passion, anger, rage and emotional imbalance. Many people kill as a form of revenge.

Therefore, when one is overcome by the “heat of passion,” where will he get the time to fear death? Those who commit stone cold murder usually have nothing to do. An example is sending a survived suicide bomber for execution. He wanted to do that to himself! So in essence, you will be just fulfilling his dreams. They have no regard for life, not even theirs. The serial killers too are not afraid of death. Therefore those who would be afraid of death even in their normal self are killed because of other murderers who would care less.

Death sentence does not deter individuals from committing crimes in the society compared to the life imprisonment sentences. The practice does not deter violence and instead results to greater probability of doubling the rates of homicide. Therefore, it does not protect society from crimes as it portrays the law to be harsh and in support of murder because it shows injustice.

There are some alternatives for the death penalty which are just to the humanity. This includes life sentence, which allows new, evidence or correction of mistakes to take place. This is effective in protecting the society by preventing offenders from committing crimes again. It does not entail inhumane acts of killing the criminals. The life sentence is cheaper than the death penalty in terms of maintenance costs for the criminal.

The quality of the representation provided for the capital crimes determines their chances of receiving the death penalty (Adams 82). In most capital cases, the defendants cannot afford attorneys. There have been cases of inexperienced, overworked, underpaid lawyers. Such lawyers are not ready for the sentencing phase during the trial which results to sentencing of criminals to the death penalty.

There are many human rights activists and groups that argue against death sentence because this contrasts the government’s commitment to protecting human rights. The state should stop crimes against humanity and support moral code. Death sentence shows torture of human to death and is a form of injustice which is wrong.

The capital punishment may be surrounded by issues such as fraud, racism, discrimination against the poor, religious minorities, the mentally ill, children and women. This is unfair and unjust because it entails taking advantage of the less fortunate in the society.
 
Capital punishment sends the wrong message of killing. Why kill people when you ask them not to commit murder. It is barbaric and outdated shame and ridicule is brought to countries that still practice it. It emotionally drains the family as they suffer from watching their loved one undergo the death penalty (Gershman 250). It defeats logic, and actually amounts to a defeat and mockery of the legal system that seeks to rehabilitate individuals instead of instituting such punitive measures as a means to deter other individuals from committing any heinous crimes.

The message sent to the members of the society is that the legal system can at instances, play God, having the power to determine who lives and who is destined for the gallows (Melusky 82). The outcry of the right groups that seek to abolish the capital punishment clause is spurred not by individual interests but by the longing to have equality of the legal system, an equality that does not draw its efficiency by intimidating individuals into submission but which rehabilitates individuals via the adoption of humane actions.

The ultimate income created by the poor who die for this country after all the rhetoric that takes place in the legislative assemblies, when the net income is cast out (Adams 432). The poor lads in the society are the ones who suffer because of their inability to employ competent attorneys for their defense thus leading to the suspects being convicted of death sentence.

In conclusion, the death penalty is also the death sentence, capital punishment or execution. This is a legal process where the state put an individual to death as punishment for a crime. The crimes resulting to the death sentence are capital offences or capital crimes including aggravated murder, drug trafficking and crimes related to homicide. Most societies have been practicing death penalty in the past, but most have abolished the practice due to controversies fueled by religions, political ideologies and laws concerning the protection of human rights.

The societies, which still use, the death penalty to date are China, United States of America, India and Indonesia. In the past, the execution has been through beheading while lethal injection is common in recent decades. There are different reasons that support the abolishing of the death penalty. The death penalty executions require extremely high costs. Estimate show that it is more expensive to execute people than sentencing them for life imprisonment. The states impose heavy taxes to their citizens in order to maintain the capital punishment system.

It is so expensive because death row inmates require exceptional cells, unique dining arrangements, exercising, medical care, and distinctive guards. The legal costs are the greatest where the government must pay attorneys to prosecute the appeal cases for the death row inmates. There have been executions of innocent people where the governments are unable to prevent such accidental executions. Wrongful execution is injustice towards the people and cannot be reversed. A person can face death sentence when innocent of any crime. There have been people released from the death row minutes before their execution.


Works cited

Mandery, Evan J, and Evan J. Mandery. Capital Punishment in America: A Balanced Examination. Sudbury, MA: Jones & Bartlett Learning, 2011. Print.
Siegel, Larry J. Introduction to Criminal Justice. Belmont, CA: Wadsworth, Cengage Learning, 2010. Print.
Melusky, Joseph A, and Keith A. Pesto. Capital Punishment. Santa Barbara, Calif: Greenwood, 2011. Print.
Rogers, Alan. Murder and the Death Penalty in Massachusetts. Amherst: University of Massachusetts Press, 2008. Print.
Gershman, Gary P. Death Penalty on Trial: A Handbook with Cases, Laws, and Documents. Santa Barbara, Calif: ABC-CLIO, 2005. Print.
Adams, W R. Viewpoints: Readings Worth Thinking and Writing About. Boston, MA: Cengage Learning, 2010. Print