Thursday, April 4, 2019

Modern Behaviour Patterns: Middle Stone Age Record of Africa

Modern Behaviour Patterns position St matchless Age Record of AfricaIs on that point induction for the establishment of modern behavior patterns in the place Stone Age record of Africa?Behavioural modernity refers to developed behavioral traits we associated with modern humans (Jacobs Richard, 2009). These demeanoural traits be what distinguish modern humans their recent ancestors from other extinct hominids as well as twain menstruation past primates. What we now classify as modern human behaviours atomic number 18 ethnic universals sh atomic number 18d by all roughbodys, these behaviours allow in traits like language, religion decoration, or whats bopn as the behavioral Bs blades, beads, burials, beat-tool making beauty (Calvin, 2004). This essay discusses the shew for the establishment of modern behaviour patterns in the Middle Stone Age (MSA) record of Africa.What is the Middle Stone Age record?The MSA was a extent of Afri posterior prehistory generally co n slopered to suck spanned amid 280,000 eld past 5025,000 historic period ago. The term MSA is employ synonymously with the term Middle Palaeolithic, used in the remainder of the Old realness where comparable artefacts traditions are rig is now closely associated with the appearance of behavioural modern humans. (Clark, 1998)InnovationsA put of innovations characterise the MSA, this following section mouths about some of these, why how they came about.TechnologyThere is label variation in Middle Stone Age assemblages, which could break off through been caused by a number of factors including environmental conditions, resource type availability, choice of different reduction techniques strategies of tool manufacture. Technological patterns in these asemblages reflect earlier stages of modern human behaviour, with little standardisation inwardly them.The start-off of the Middle Stone Age is identify by pitchs in the lithic components of the industries, namely, b y the disappearance of bifaces ( softwoodaxes and cleavers) of the Acheulean type and the appearance of of composite tools which incorporated points signalling the beginning of the reorganisation of technology(Zenobia Roberts, 2009).Tool kits of this time admitd prepared core technology aka the Levallois method of flake issue in which a core was apportion deary prepared on one side so that a flake of a certain, predetermined shape and size could be produced with a single blow (______). confused tool kits likewise became common in this time period. These composite tools allowed tools to be hafted to other accompaniments, about usually wood to create spears, and included triangular flakes, denticulates (tools retouched to form a serated edge), awls used to perferte hides and retouched points and scrapers. Occasional grinding tilts and wad points have also been pitch during this time periodThe approximately potent attest for behaviourally modern stone tools come from the sites of Still Bay (SB) Howiesons Poort dated between 72-71 ka 65-60 ka jimmyively (Zenobia Roberts, 2009). Among the Still Bay toolkit are bifacial flaked points that probably formed s ever sos of spearheads, whereas the Howiesons Poort toolkits include blade-like tools that were blunted on one side hafted as sort of composite weapons.These Middle Stone Age assemblages contain significant evidence of modern human behaviour which is reflected in raw material procurement, exchange patterns, adaptive behaviour, mastery of craftsmanship (Onjala, 2006).Hunting gatheringThe demeanor out of modern track down capabilities is one of the behavioural traits which classify modern human behaviour, there is a neat deal of debate as to the effectiveness of the hunting strategies of MSA humans thus weather the man-to-mans of this time period were in fact behaviourally modern.One argument presented is that MSA individuals were less effective hunters than their LSA successors (Faith, 2008), Klein in his radical The difficulty of modern human origins argued that this was a result of a major neural change that took place between 50-40 ka, creating humans with a fully modern intellect. Klein believes there were several behavioural technological consequences of this change such(prenominal) as the development of more effective hunting capabilities, the ultimate dispersal of modern humans into Eurasia (Klein, 1994). close to re huntingers further, maintain that MSA individuals were fully adept hunters thus the emergence of modern hunting skills is one of the modern behavioural traits that appeared during the MSA (Faith, 2008)Many sites from across Africa show accumulation of fish ashes from fresh water, brackish oceanic environments, these sites include Klasies River, Her superannuateds bay Hoedjies Punt open sites among many others. The fish found at these sites are often to bear-sized to have been introduced by costal birds therefore point to the deve lopment of fishing techniques. At blombos cave, South Africa, these include deep water varaieties pointing to a large increase in technology. Some sites also contain marine mammals such as Die Kelders where remains of Cape fur seals have been found.Inland sites contain remains of many mammals, usually medium sized herbavores such as zebra, eland antelopes, all of which were common during the time period. different the LSA, hunting of large dangerous animals appears rare, which Richard Klein suggests indicates the individuals of this time period had non developed the technologies to deal with this kind of behaviour. fatality rate profiles for animals from the MSA suggest the key target range for hunting during this time period was the young or the old animals which were weak or vulnerable.While hunting is one come-at-able accruement of meat resources it is likely that a large range of meat gathering strategies were used during this time period including scavenging, long distanc e hunting ambush hunting (Scarre, 2013)Site modification, Art, Ornamentation SymbolsA major signifier of modern behaviour is the organised use of space. While this is non common during the MSA there are a few examples of site modification, most commonly arc-shaped walls of stone, possibly created as wind breaks. (Scarre, 2013)Evidence for art, ornamentation symbolic representation however have been found at several sites across Africa. Many items from sites across Africa have been found to have been intentionally marked with abstract geometric symbols both carved painted (Wurz, 2014). These items most notably include engraved ochre, bone ostrich shell Engravings paintings beads.Of the engraved items, possibly the most notable from this time period is a 77,000-year-old minute of dark-red ochre with a cross-hatched pattern bounded by parallel lines engraved on one side rec overed from Still Bay (Wurz, 2014) while other engraved items include bone from Blombos Cave at Kla sies River a bone engraved with four parallel lines has been found (Wilkins, 2010). Egg shell is another item which has much been engraved upon, examples include from the site of Diepkloof in the Western Cape, where 270 fragments of intentionally marked ostrich casing believed to have been used as containers have been recovered dating to 60kya including geometric motifs such as secernly parallel lines, cross-hatching, a hatched band (Wurz, 2014). Other sites including engraved egg shells in their assemblages include Howiesons Poort Apollo 11 (Wilkins, 2010)Beads as personal ornamentation are the last prospect of art, ornamentation symbolism that will be discussed in this essay. Beads made from shell occur from around 100,000 years ago in some sites in Africa (Wurz, 2014) the most notable of which being the assemblage from Still Bay at Blombos Cave where over 40 beads made of Nassarius kraussianus shells. Keyhole perforations had been created in each shell, most likely with a bone tool, were then strung worn as personal ornament. Some beds also contain ochre resi collectable, although wether this is from deliberate colouring or from transfer when worn is unknown (Henshilwood Dubreuil).ConclusionThe innovative technologies and social arranges mentioned higher up are only one part of a behavioral montage that spread through Africa during the MSA. speedy advances in human cognition were manifested in material-culture rehearses not previously observed in the Africa or anyplace else in the world supplying evidence for Africa as the place of establishment of modern behaviour.Evidence ground Care Hand HygieneEvidence base Care Hand HygieneUtilising Evidence Based CareThis essay endeavours to investigate impart hygiene, and feel I need to gain more fellowship in this field by utilising the available evidence effectively. I also intend to discuss suck in held traditions, customs and rituals.The common method of go pastwasing is usually with unmedica ted soaps, whist an anti-bacterial soap may be used for union tump over decontamination. (Hugonnet Pittet 2000). As breast feeding staff can wash their men up to forty generation per hour, it may be one of the most frequently practiced nursing skills (National uncomplaining Safety Agency, 2004). jibe to Pittet (2000) health reverence professionals barely reach fifty per cent compliance with handwashing. Holland, Jenkins, Soloman et al (2003) point out that reach are the primary factor is spreading bacteria, especially as they come into contact with body fluids, furniture, dressings and equiptment.During a placement on a surgical ward I witnessed execrable hand hygiene and matte I needed to deepen my friendship of effective and appropriate hand washing to be a competent, safe practitioner. health care-associated infection is a major cause of morbidity and mortality. Hand hygiene is regarded as an effective pr howevertive measure against transmission of hospital acquired infection between patient to patient (Gould et al (2007). As a health care professional I am aware I mustiness work within the guidelines of the care for and Midwifery Council (NMC) and the government body, the Department of health (DoH). Within this essay I intend to utilise two sources of question, critique them, and use the findings accordingly.The Nursing and Midwifery Council Code of Conduct (2008) states that care and advice to patients must be ground on the best available evidence (NMC 2008 p4). Fitzpatrick (2007) states healthcare professionals must award effective integration of evidence, including findings of question into their decision making.Evidence based practice is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available clinical evidence from systematic explore Sackett et al (1996).Within evidence available for utilisation is an evidence hierarchy. At the fleet of the hierarchy are well designed disarrange control guide trials. The UK Cochrane Centre specialises in random controlled controlled trials (RCTs). The Cochrane centre operates globally to maintain and publish up to date reviews of disarrange controlled tests for health care. (Sheldon and Chalmers 1994). Hamer (1999a) also states that randomized controlled trials (RCTs) are frequently called the gold standard of explore evidence. The Cochrane Centre work out the validity of look into by equalisation them. Grading starts at A-C, A being the highest score, and showing it has met all the fictitious character requirements (Mulrow Oxman, (1997). Hierarchies are also used in clinical guidelines, graded by both standard of evidence and recommendations. The highest standard of evidence grade, matched by the highest recommendation grade, suggests higher-ranking validity and ought to be conside red to be implemented in practice (Cook et al, 1992) investigate evidence appropriateness can be based on how the data was collected. Examples of different search designs are RCTS, case-controlled studies, age bracket studies, professional, or qualitive. The two research paper I am examining use a mix of methods.Lockett (1997) cl sticks evidence-based practice is a combination of scientific and professional practices. The evidence -based aspect refers to scientific rationale and the practice part refers to behaviour of the healthcare professional (Lockett 1997). The importance of evidence -based practice is highlighted by Hamer (1999b), stating the primary aim is to embolden professionals in effective decision making to reduce ineffective, inappropriate possible hazardous practices. This would suggest, as with guidelines great deal out by the NMC that the use of evidence-based practice has much rationale. The American Nurses Association (2003) points out that in order to enable n urses to tally with the expectations of society, a strong evidence base for practice is essential. winmore, for nursing to be recognised a genuine profession, it is essential to have all of its practices based on evidence (Royal College of Nursing 1982). at one time a topic had been chosen to explore I conducted a search via databases. I found ab initio to use solely the term handwashing, which yielded a surplus of data.I set the date parameters on the search to the last 5 years to maximise the validity of the research, which not only get outd more suitable data, except narrowed the search to yield less results. This facilitated the search for applicable research. I added other words to the search, such as compliance and the word and/or. Also truncation was used, this maximised the search further. Especially as there are many variations of the work handwashing. Furthermore, handwashing was not the only term used to describe handwashing, hand hygiene was also used. This too, yie lded successful results. The term nurse was also added, this too was truncated to nurs*, which allowed terms such as nursing, nurses, nursed to be detected, thus increasing the probability of locating the desired results. I set the parameters to detect full text and on the English language.As I am not accustomed to using databases I sought the advice of the librarian, EBSCO, CINAHL and BNI were recommended resources. Also the Cochrane library has been praised as the gold standard in randomised controlled studies. As randomised controlled studies are at the top of the hierarchy of evidence I decided to seek a randomised controlled study. I found located the primary fleck of evidence from the Cochrane library.On this occasion I did not use main stream search locomotive engines, although I would consider using a search engine in the future to find research. Fitzpatrick (2007) claims internet searches engines can yield credible results.My second piece of research was discovered on Ovi d. Once selected, Ovid requires users to select databases within that database. I excluded paediatrics as this was not relevant to the search.Interventions to improve hand hygiene compliance in patient care conducted by Gould (2007) is the selected primary source.The quality of the abstract was clear, with sub heading, and reflected the aim of the paper and its content. The objectives were to assess the long term success and improve hand hygiene compliance and to determine whether a sustained increase in hand hygiene can lower hospital infections. This was relevant to my search as this is an area I wanted to increase my knowledge on, and utilise in practice, if the research is deemed valid and credible.The types of studies used were randomised controlled trials (RCTs), controlled clinical trials (CCTs), controlled before and later studies (CBAs) and cut off time series analyses (ITSs) meeting the requirements of the Cochrane Effective Practice and Organisation of Care Group (EPOC) .The research is a systematic review. jibe to Mulrow (1995) systematic reviews do the hard work of critiquing the research so time exceptional health care workers can access valid data. Systematic reviews are the gold standard of research (NHS Centre for reviews and Dissemination, p.1 1996)Systematic reviews locate, appraise and synthesis evidence from scientific studies in order to provide informatative, verifiable answers to scientific research questions.Muir Gray (1997) and Sackett et al (1997) claim randomised controlled trials are survey to be the most dependable and trustworthy source of evidence.I interpret the above as indicting the research may be of a high standard to meet the criteria of the Cochrane Effective Practice and Organisation of Care Group (EPOC). Although the research paper is not yet fully critiqued, this is a positive validity indicator.The participants were target groups, of doctors and nurse. Theatre staffs were excluded due to different hand hygiene t echniques being used. To exclude theatre staff was relevant as hand hygiene is part of the scrubbing in ritual, and if included may have caused inaccurate results.Data collection and analysis was conducted by two reviews, and they accessed the data quality. All of the data they had gathered was via databases searches, and two studies out of over seventy five met the criteria review.The author concluded no implications for practice, as the review had not been able to provide abounding evidence. The implications for research were more studies are urgently needed to evaluate improvements to hand hygiene. The biasness of the paper is not easy to find out as I could not discover the professions of the researchers. It could be suggested that if they were nurses, this could create a potential for bias.When searching for this primary piece of research I did not need to be refer about UK and American spellings are the words used did not have UK American versions. However in future I would chose to look for both to show abundant data. The keywords used for finding this particular piece were, hand*, hygiene, wash*, comlianc*, concordanc* and nurs*.Quantitive research sample sizes normally exceed one hundred participants. Interviews or questionnaire have set questions. Data is usually recording statistically (Siviter 2005). The data within this research was presented in tabular form. The CASP (2006) quantitive tool was apply in the critiquing of this research. Had the research paper been qualitive, I would have used the CASP quantitive tool. This is a priceless and effective tool in analysing the research for strengths and weaknesses (Hek Moule 2006). Although on this occasion I used CASP to critique the paper I would in future consider using other critiquing frameworks, such as Bray and Rees (1995) and Benton and Cormack (2000) or Popay et al (1998).As to if the research was ethical or not is indistinguishable as no consent issues arose as all evidence was found v ia databases. Although, consensual issues are not the only ethical issues to be considered. Beauchamp Childress (1994) claim healthcare ethics is when moral issues and questions are raised within the healthcare realm. Respect to an individual values and beliefs are a part of being ethical. However in terms of the primary research paper there are no visible signs of a breach of ethics.The results show that both the randomised controlled trials were poorly controlled. One trail shows an increase in hand washing compliance four months after interventions. The second trail has shown no post intervention increase in hand hygiene. The author found both samples were of low quality and was conducted over a too small time frame.The author concludes there is not any strong evidence to cite an informed choice to better hand washing. According to the author, one off teaching sessions will not expected to make any lasting changes to compliance. Further robust research is recommended by the aut hor. Therefore, currently from this research there is inadequate data that could be use in evidence-based practice.Hand hygiene practices student perceptions is the second piece of research chosen. This is a qualitive piece of research.The aim of the research was clear from the abstract and the title. Student nurses were interviewed to gain depth of data. Student nurses were also guaranteed anomity, which may have assisted the researcher gain rich data. Had the researcher chose a quantitive methodology, it would have been complex to achieve students perspectives. The NMC (2008) praises qualitive research methods as they respect patients individuality and feelings in the demeanor nursing staff are presumed to, and is suitable for nursing research. According to Parahoo (2006), qualitive research may be considered to be of less value than quantitive research. Another positive aspect of qualitive research is the broad picture it provides, history, context, and the causes ( Blaxter, Hu ghes Tight, 2006). Siviter (2005) defines the norm qualitive research sample size as fairly small, with an average of fifteen to twenty. Data is usually gathered through semi-structured interviews and open ended questions.The researchers who conducted the research are both nurses and have a professional interest in the paper, and it is noted that the possibility of bias could occur. This was recognised by the nurse researchers.Evan (2003) Hierarchy of evidence concludes case studies lack validity in comparison to random controlled trials and general reviews.A barrier to utilising research to support evidence-based practice may be lack of knowledge and skill. Hundley et al (2000) noted that although attempts are being made to incorporate research education into current nurse curriculum, poor analysis skills are button up a barrier to reading research. Hundley et al (2000) also states time is a primary barrier to utilising evidence-based practice. Retsas (2000) offers advice in co nquering the time barrier, advising organisations need to increase time to study in order for evidence-based practice to be achieved. abridges with autonomy, or lack of, have been suggested as potential barriers in the implementation of nursing research. Doctors were named as a potentially obstructive (Lacey 1994). Shaw et al (2005) suggest that to know and understand possible barrier and enablers to utilising evidence is critical in the identification of evidence-practice orifices. Grol and Wensing (2004) discuss the many different enablers and barriers that might be found when change is attempted to be implemented. These range from awareness, knowledge, motivation to change and behavioural routines (Grol and Wensing 2004).Traditional rituals within nursing are a barrier to implementing evidence -based practice. Walsh and cross (1990) define rituals asRitual live up to implies carrying out a task without thinking it through in a problem-solving way. The nurse does something be cause this is the way it has perpetually been done. The nurse does not have to think about the problem and work out an individual solution, the attain is a ritual.Billy and Wright (1997) defend rituals, claiming some are healing, and have some positive outcomes. Parahoo (2006b) argues that rituals are when practice rationale is forgotten. Thompson (1998) discusses the research-practice gap, claiming there is a gap between knowledge and practice. This would indicate there is a gap between producers and users of research (Caplan 1982).Larsen et al (2002) argues that the research-practice gap does not exist in nursing as it is not an evidence-based profession. One way of passing on the message of evidence-based practice is through clinical guidelines. Woolf et al (1999) clinical guidelines improve quality of decisions made by healthcare professionals, although a downfall may be recommendations are wrongly interpreted.A First Class Service (Department of Health, 1998) summarizes the g overnment ideas for improving evidence base, and how to implement the findings. This indicates the governments acknowledgement of the benefits to quality of care, and its links to evidence-based practice. Since then the government has included evidence-based practice in its strategies, such as NHS Research and Development in 1992 and Making a Difference in 1999. Evidence-based healthcare was at the core of these strategies (Department of Health, 1992). In the North Bristol Trust the Clean your Hands campaign is in use. This was implemented by The National Patient Safety Agency Alcohol gels were put all around the trust, in an attempt to make hand hygiene facilities more accessible. Nursing staff also wore its ok to ask badges encouraging patients to remind crabbed staff to wash their hands (Infection Control Policy and Manual North Bristol Trust, 2006).In conclusion I have learnt there is a colossal sum of research to be potentially be utilised in practice. From accessing valid da ta, to having the time to critique research once in practice, to trying to implement change when in practice, I have realised there are many obstacles to achieving evidence-based practice.Research should always be analysed to establish whether or not the data it produces is valid and if it ought to be implemented in practice or not. From the two research papers I have analysed I found that neither were valid enough to consider implementing in practice. I have also learnt that change within health care is not as easy to implement as I have previously thought, many parts of the interprofessional police squad must be involved. Managers are key to helping change take place. I do still believe that effective handwashing is definitely one of the most effective measures in the role of infection control. A valid, robust research paper on this essential nursing skill would aid effective hand hygiene, as currently many research paper out there do not make the grade for them to be implemented in practice.From this I have learned a valuable lesson that in effect(p) because research is there, does not necessarily make it credible and valuable.ReferenceAmerican Nurses Association (2003) Education for club in nursing research. http//nursingworld.org/readroom/position/research/rseducat.htm (accessed sept 2009)Barrett, R., Randle, J. (2008). Hand hygiene practices student nurse perceptions. daybook of clinical Nursing, 17, 1851-1857Beauchamp, T.L. Childress ,J.F. (1994)Principles of Biomedical Ethics, 4th edn. overbold York Oxford University PresBilly, Wright C.M (1997). The History of nursing research in Austrialia. Reflections, 21, 117-18.Benton, D.C., Cormack, F.S. (2000) Reviewing and evaluating the literature. In Cormack, D. (Ed) The Research Process in Nursing. Oxford Blackwell ScienceBlaxter,L ,. Hughes, C,. Tight, M. (2006). How to research (3rd). Buckingham Open university press.Bray, J., Rees, C. (1995) Reading research articles. Practice Nursing 6 11, 11-13.C aplan N (1982) Social research and public policy at the national level. In D B P Kallan, G B Kosse, H C Wagennar, J JDepartment of Health (1998). A First Class Service, Quality in the NHS, capital of the United Kingdom. Department of Health.Cook D.J, Mulrow C.D. Haynes B. (1998) Synthesis of best evidence for clinical decisions. InSystematic Reviews Thesis of Best Evidence for Health Care Decisions (eds Mulrow C.D Cook D) deprecative Appraisal Skills Programme (CASP 2006) http//www.phru.nhs.uk/Doclinks/Qualitive%20Tool.pdf (Accessed online October 2009)Department of Health (1992) Research Development Stratagy London Department of Health.Department Of Health (1999) Making a Differnce- Strengthening the Nursing, Midwifrey and Health Visiting Contribution to Health and Healthcare. London Department of Health.J Kloprogge and M Vorbeck (eds), Social Science Research and Public Policy- MakingA Reappraisal (Netherlands NFER).Evans, D. (2003). Hierachy of evidence a frame work for rankin g evidence evaluating healthcare interventions. Journal of Clinical Nursing.Fitzpatrick, J (2007) Finding research for evidence-based practice. The development of EBP. Nursing times.net vol 103. P32-33. (accessed online October 2009)Gould D, Chudleigh JH, Moralejo D, Drey N. Interventions to improve hand hygiene compliance in patient care. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No. CD005186. DOI 10.1002/14651858.CD005186.pub2.Hamer. S (1999a).Achieving evidence-based practice. A hannbook for practitioners. Bailliere Tindall. RCN. p19Hamer. S (1999b).Achieving evidence-based practice. A hannbook for practitioners. Bailliere Tindall. RCN. p6-7Hek, G., Moule, P. (2006). Making sense of research- An introduction for health and social care practitioners (3rd ed.) London Sage Publications Limited.Holland K., Jenkins J., Soloman J., Whittam S. (2003) Applying the Roper, Logan, Tierney Model in Practice, London, Churc hill Livingston.Hugonnet S., Pittet D. (2000) Hand hygiene-beliefs or science? Clinical Microbiology Infection, Vol. 6, Issue , p348.Hundley V, Milne J, Leighton-Beck L, Graham W and Fitzmaurice A (2000) Raising research awareness among midwives and nurses Does it work? Journal of advanced Nursing, 31, 178-88National Patient Safety Agency (2004) Patient Safety Alert Clean hands help save lives. National health Service London. Accessed on October 2009 http.//www.npsa.nhs.uk/site/media/documnents/644 cyhMulrow C.D Oxman A.D (1997) CocharaneCollaboataion Handbook (database on plough and CDROM). The Cochrane library, The Cochrane Collaboartion, Oxford, Update Software.Nursing and Midwifery Code of Conduct NMC www.nmc.co.uk (accessed online October 2009)Nursing and Midwifery Code of Conduct NMC. (2008). Standards of conduct, death penalty and ethics for nurses and midwifes. London NMC.Muir Gray J.A (1997) Evidence-based Healthcare. Churchill, Livingston, New York.Parahoo, K. (2006). Nursing research- principles, Process and issues ( 2nd ed.). London Macmillan Press.Parahoo, K. (2006b). Nursing research- principles, Process and issues (2nd ed.). London Macmillan Press p 5.Pittet, D. (2000) Compliance with hand disinfection and its impact on hospital acquired infections. Journal of Hospital Infection. Vol. 48 p40-46Popay J, Williams G (1998) Qualitive research and evidence based health care. Journal of The Royal Society of Medicine 91 35 32-37.Royal College of Nursing (1982) Research-Mindedness and Nurse Education (London Royal College of Nursing)Restas, A. (2000) Barriers to using research evidence in nursing practice. Journal of Advanced nursing. 31, 3599-606Sackett D.L., Richardson W.S Rosenberg W. Haynes R.B (1997) Evidence Based Medicine How to Practice and Teach EBM. Churchill Livingston, New York.Shaw B, Cheater F, Baker R, Gillies C, Hearnshaw H. Flottoprp S, et al. Tailored interventions to overcome identified barriers to change effects pn professional practice and healthcare outcomes. Cochrane Databaes e Syst Rev. 2005 (3) CDOD5470.Siviter. B, (2005) The student nurse handbook, Elsevier, China.Sheldon, T. Chalmers, I. (1994). The UK Cochrane Centre and the NHS Centre for reviews and dissemination respective roles within the Infromation Systems Stratagey of the NHS RD Programme, coordination, principles and underlying collaboration. Health economics, 3 201-203.Thompson M A (1998) Closing the gap between nursing research and practice. Evidence-based Nursing, 1, 117-18.Walsh M and Ford P (1990) Nursing Rituals, Research and Rational Actions, 2nd edn (Oxford Heinemann Nursing).Counterculture Analysis Irish classCounterculture Analysis Irish occludeGary SmithA promise culture is a group of people that reject the values, norms, and practices of the larger society and replaces them with a new set of cultural patterns (Thomas). The Irish the vulgar for example is considered one of the biggest counter cultures there ever was because of their unionized crime. The Irish bunch is also t he oldest organized crime group and biggest. The Irish mob had cliques in New York, Boston, Philadelphia, and even Chicago (City Data). The Irish Mob consisted of many different individual bands that had some really big names in them.The wintertimetime hill gang was a gang founded by jam buddy Mclean and consisted of mostly Irish and Italian Americans. Some of the biggest names of the Irish mob where in this gang at the times such as blood brother McLean, whitey Bulger, Howie Winter, Johnny Martorano, Joe McDonald, and Stephen Flemmi. The winter hill gang got their name from a journalist and because they lived in the winter hill neighborhood in Somerville Massachusetts.James buddy Mclean was a truck driver and the founder/leader of the winter hill gang (PRWEB). Mclean had a reputation for being a great street fighter which initially earned him his respect as being the gang founder and leader. Mclean and his gang (The winter hill gang) would shortly begin to get over Boston when it came to running numbers, loansharking, and even hijacking (PRWEB). Mclean was murdered in 1965 as he was shot in the head by Stevie Hughes which put Howie Winter in command of the winter hill gang however that didnt last too long because soon after Howie Winter was sent to prison for 5 years putting Whitey Bulger in charge of the Winter Hill Gang (George).Whitey Bulger took over the winter hill gang after the death of the former well respected boss James Buddy Mclean who was shot and killed in 1965. As well as being the winter hill gangs leader he was also a FBI informant. In 1956 Whitey was sentenced to 25 years in prison for numerous intrust robberies (Guest). Although he was sentenced to 25 years in prison he only served 9 years and soon after returned to his regular spiritedness in Boston where he would join the Winter Hill Gang. In 1979 Whitey took over the winter hill gang and began to control Bostons drug dealing, bookmarking, and loansharking. As an FBI informant W hitey began feeding the police information on other gangs such as the Patriarcas which was a New England organized crime family. The police brought the Patriarcas down with the help of Whitey which made the Winter Hill Gang even more powerful that another family was gone. Whitey got into trouble with police and decided to go on the run which lasted until June of 2011 when he was arrested after 16 years. Whitey was sentenced to two life sentences plus five years in prison in November of 2013 (globe).The Irish gang war was a war between the winter hill gang the McLaughlin gang. The dispute occurred after one of the member of the McLaughlin gang tried to pick up one of the Winter Hills gangs girlfriends and ultimately got beat up so badly for it they dropped him off at the hospital (Evan). When Bernie McLaughlin went to talk to the Winter Hills Gangs leader who was James buddy Mclean at the time to figure out what had happened and who was involved he became very frustrated when Mclean wouldnt tell him exactly and he quickly made enemies with the wrong people which led to his in Charles town city square where he was killed by the winter hills gang leader himself James Buddy Mclean (ignatiev).The Irish Mob was considered a counter culture because of the way of members chose to live their life. The Irish Mob was one of the biggest structures when it came to organized crime which put them outside of the norm. Constantly breaking the laws society saw them as an outcast and even feared them. Members of the Irish mob believed that they had to take apart in the organized crime so that they could take care of themselves and their families. Most members of the Irish Mob are brought in by family or friends. They know what they are doing is wrong but do it any way as a way of life even if it means killing somebody. Ethnocentrism is when one views its own culture and or group as superior to others (Thomas R13). Ethnocentrism existed in all organized crime and especially in th e Irish Mob. Because every gang thought they were better than other conflicts constantly occurred between them which is whys gangs are always fighting each other.The Irish Mob has their own ways of handling things which is cultural relativism. Cultural relativism is the belief that cultures should be judged by their own standards (Thomas R11). The Irish Mob behave and act the way they do because they believe that it is the only way to live. Individual members of the mob make it their job and there only way to receive income. Because this is the only way to take care of themselves and their loved ones they think that it is ok to commit these crimes. Every Mob and or gang has their own way of handling situations and conflicts such as when somebody in their group decides to rat them out to the police some gangs might kill him on the spot while others torture him.In my opinion the Irish Mobs way of life is not acceptable and should not be tolerated in the American society. The Irish Mob are held accountable for numerous deaths that took place killing other gang members and even innocent citizens whether it be on purpose or accident its not acceptable. The Irish mob also have been known for selling illegal drugs such as cocaine. The Irish Mob are known for being the oldest organized crime group and also one of the biggest and had some of the biggest Mobsters such as Whitey Bulger who is considered to be one of the biggest and feared mobsters who ever lived.ReferencesCity Data. 13 july 2013. 11 adjoin 2017.Evan, Andrews. History. 14 june 2014. 11 contact 2017.George, Hasset. Gangs of Boston. strategic media books, 2013.globe, Boston. boston. 2017. 11 march 2017.Guest, Emily. Irish Central. 4 Augest 2010. 11 march 2017.ignatiev, Noel. The divide between blacks and irish. 17 march 2010. 11 march 2017.PRWEB. PRWEB. 10 september 2015. 11 march 2017.Thomas, W. sociology the study of human relation ships. Austin Holt,winston, 2003. 39. textbook.

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