Black Children in the Child Protection System

Black Children in the Child Protection System INTRODUCTION In recent years, child abuse among black African families has attracted a lot of attention, academically and politically in British social work practice following the tragic death of Victoria Climbie (Laming, 2003) and Adam (Sale, 2005). Many of the research and literature on child abuse since the 1989 Children Act have not extensively discussed the aspect of poverty and child abuse. For many years social work interventions with black African families and children alleged of cases of child abuse have been a controversial topic. The difficulties black African families experience are not limited only to the foreign culture they find themselves in, but other issues may be significant, such as cultural differences in child-rearing, poverty, government policy and the intervention tools and processes. Research evidence suggests that black African children in the UK are over-represented in the child protection system for a variety of reasons such as physical and sexual abuse or neglect. Chand (1999) research on black African families and the child protection system highlights the over-representation of black families (58%) compared to white families (42%) on referrals involving physical injury. Another research shows that referrals involving inadequate supervision of children are disproportionately higher among black African families than white families. Some black African children are involved in the child protection system because their families are unable to provide adequate care for them. Bernard Gupta (2008) study also found that black African children and families are more likely than white families to be drawn into the child protection system on the basis of inherent differences in beliefs and child-rearing practices. The aim of this work is to suggest that black African children and families, due to a number of reasons, are more or less likely to be investigated of child abuse by social workers and other professions. The possible implications for black families being more or less likely to be investigated are either black African children will become over-represented in local authority care under the child protection system or they will not receive the appropriate intervention by social workers under the child welfare system and make children to be subjected to further abuse or neglect by their parents (Chand, 1999). According to Chand (1999) even when abuse among black families is identified, the service provision for the abused children are hampered by lack of resources and this cause delays in assessment and the provision of treatment where specialized services are required. The 1989 Children Act may classify many African children on the child protection register in the UK as children in need as their parents are more likely to live below the poverty line (DoH, 1989). Poverty is linked with reports of abuse and neglect and African families are proportionately more likely to live in poverty than many of the other communities in the UK (Bernard Gupta, 2008). According to Fontes (2006) people who are affected by child abuse are nestled by a variety of social and material domains that are highly interconnected and interactive. Therefore the poverty status of African families living in the UK is an important factor to be considered by social workers working with African families alleged of child abuse. Many African families have negative perception about social workers who work on cases of alleged child abuse, as they employ an assessment and intervention process that is based on euro-centric child protection procedures and as such view black families, their culture and lifestyle as inherently problematic and need correcting (Chand, 1999). This negative perception of social work practice by African families and children living in the UK breed grounds for mistrust and apprehension and make working with such families a major challenge for social workers. Bernard Gupta (2008) argued that black African children and their families are more likely than white families to be investigated of child abuse and therefore are over-represented on the child protection register under the category of poor parenting behaviours. However, black African families are also under-represented in receiving preventative supports such as housing needs, financial benefits that is required to address any family needs and to improve children welfare. Singh (2006) findings show that African families and their entrenched cultural and social perceptions of parenting behaviours are difficult to understand in the context of contemporary social work practice and therefore social workers may be quick to intervene in such families. Bernard Gupta (2008) also found in their research work that the majority of black African families who have migrated to the UK because of war, poverty, and tribal anarchies in their home countries, also have difficulty not only how to adapt to the western culture in which they find themselves but how they may be viewed by social workers involved in child care. Most social work professionals working with black African families do not appreciate the poverty background of such families and would feel justified to make judgements resulting into mistrust and disengagement from both parties. However, according to Bernard Gupta (2008) the Framework for the Assessment of Children in Need and their Families places a requirement on social workers to consider families backgrounds and cultural perspectives when dealing with cases of child abuse. Korbin (2004) argues that social workers face difficulties in employing appropriate intervention in child abuse cases as the processes involved in chi ld abuse assessment may be complex and parental behaviours may not be the same in different cultures and socio-economic settings. In view of this perception, Bernard Gupta (2008) states that a focus on maltreatment or dysfunction within African families can risk stereotyping this ethnic minority as deficient, thus fostering pathological viewpoint of African family relationships'(p 478 ). This raises the question of what type of social work intervention is needed to be used by social workers working with black African families living in economic poverty so that vulnerable children are fully supported and protected, and not just drawing these children into the child protection system. This professional dilemma in social work practice presents a major challenge and therefore, calls for a new perspective in work ideologies and practices, the way information is disseminated on how the child protection system works, training on child-rearing differences in black African culture, social work values and enhancing collaboration with other professions. With a change in social work practice, social workers will develop the skills to distinguish between the styles of parenting inherent in African families which is not necessarily harmful to children and those parenting behaviours that are harmful. This point will be further discussed in chapter two. The dissertation will draw on social work theories, policies and practice, key models and literature search from electronic journals to web search on child abuse, social work intervention and child protection system. The main emphasis of this dissertation looks at the available literature on black African families involved in the child protection system, focusing on specific poverty-related parenting practices that give rise to issues of child abuse. The methodology for this work is mainly qualitative and the literature obtained from both primary and secondary sources. The dissertation examines various issues such as how social work professionals should perceive and manage child abuse among black African families living below the poverty-line, what interventions social workers need to employ that would support these families to provide adequate child-care for their children and the possible reasons why black African children and their families may be over-represented in the child pro tection systems. The first chapter examines the literature on black African children and the child protection system. Chapter two provides a discussion on the increased complexity of social work intervention in child abuse cases involving black African families living in poverty. It also analyse how poverty could complicate parenting behaviours that impact on child-rearing which, tends to draw black African children living in the UK into the child protection arena. Then chapter three draws on legislations and policies regulating social work practices in the UK. It also examines contemporary social work practice in child abuse cases among African families. Chapter four critically analyses the various methods of interventions available to social workers when working with black African families. Finally chapter five discusses the implications of social work intervention among African families living in poverty. CHAPTER ONE BLACK AFRICAN CHILDREN AND CHILD PROTECTION SYSTEMS The prevalence of Black children in the child protection system Many children are drawn into the child protection system for many different reasons. The majority of these children go through distressing and damaging experiences, which may include physical, emotional, sexual abuse and neglect. Some children living with poor families come under the child protection system as result of families parenting behaviours and practices, oppression, discriminations and cultural values. Considering the child protection system and black African families, Bernard Gupta (2006) have critically analysed the evidence on the disproportionate representation of black African families on the child protection register. Brophy et al (2003) study highlights the proportion of minority ethnic families and their children represented on the child protection register involve several allegations about parental behaviours and practices. Chand (1999) states that different child-rearing methods used in different cultures mean that as an outsider, understanding what is the norm a nd what is deviant is problematicand trying to distinguish the risks in one family from the another, social workers may fall back on moral judgements'(p.72). In contemporary social work practice many social workers are faced with difficulty situations when assessing and making decisions on child care issues among African children and their families who are living in poverty. It is paramount in view of available literature to say that when social workers acknowledge and understands these families financial backgrounds and their cultural identity through effective communications, it is possible they will come to terms with some of their parenting behaviours and practices. However, where families go over the boundaries of child-rearing to inflict physical and emotional harm on their children, which is evident in Victoria Climbie inquiry, it should be understood that such families have gone beyond what is acceptable not only within the western culture but in their own culture (Chand, 1999). Therefore, if social workers understand the causes of parental behavioural patterns of African families, they will be well-informed to determine whether a particular parenting behaviours should be considered within the protection process or to provide advice and support for such families under children in need (Chand, 1999). The challenges social work practitioners experience when using the assessment processes as detailed in the Climbie Inquiry (Laming, 2003) is crucial to the safety and protection of black children whose families have immigrated into the UK. Sometimes social workers may be stereotyped as racist and ethnocentric, as they do not acknowledge and address issues of poverty-related parental behaviours of African families in the assessment process of a child abuse case (Chand, 1999). Under the Governments Every Child Matters policy, social workers first priority is to ensure children live with their families if it is best to do so. In addition to this policy, it is the responsibility of the social services or local authorities to create the enabling environment for the provision of preventative services to families so that these families can provide appropriate care for their children. According to the Department for Education and Skills (2006b) statistical data a significant proportion of bl ack African children are on the child protection register. A number of studies tend to support the view that families of these children lives in poverty and struggle to raise their children to the standard set up by government legislation. Therefore it is difficult to say whether social services are meeting the agenda detailed in the Framework for the Assessment of Children in Need and their Families (Department of Health, 2000) which places on social workers the responsibility to consider families backgrounds and cultural values when dealing with child care issues. Thoburn et al.s (2005) review of the nature and outcomes of child welfare services for black children concluded that African children are almost twice as likely to be looked after than the white majority children in the population as a whole, which then suggest, that some of these children will be accommodated under section 20 of the 1989 Children Act, by virtue of being raised by families living in poverty. However, there are a number of contributory factors which could be perceived as important in understanding the involvement of black African families with social work agencies and the resultant over-representation of their children in the child protection system. Child abuse and neglects may be linked to poor parental practices and poverty by families who are supposed to be responsible for looking after these children. Therefore the poverty experienced by many African families and children may be resolved through a more preventative welfare services rather than child protection se rvices. Platt (2006) study on the refocusing initiative on social work practices from the child protection orientation to a child welfare orientation underpins government legislation, policies and procedures and management efforts to redirect social work interventions more towards welfare services. Also through child welfare practices social workers may appreciate the difficulties that families experience and may endeavour to meet children and their family financial and social needs through a range of social and preventative services. The government legislations and policies The most relevant legislation in the UK that aims to protect children from abuse and harm is the Children Act (1989), of which Section 47 expects local authorities to make enquiries into cases where they have reasonable cause to suspect that a child is suffering or likely to suffer significant harm and Section 17 makes provision for a child to be assessed with a view to the provision of services to children in need (Platt, 2006). Therefore there are two definitive objectives of the Children Act (1989), the child protection focus and the child welfare focus. Many black African children referred to social services under the child protection system may not necessarily be suffering from any harm or neglect if the situation is considered in the context of parenting behaviours and practices (Chand, 1999). According to Platt (2006), the Audit Commission recommendation to shift from the popular investigational work use by social workers to a family support services, was a result of many fail ings identified by many other government bodies. This wind of change for social work practice was accepted by the Department of Health, after examining the publication, Child Protection: Messages from Research (Department of Health, 1995). Chand (1999) argues that the child protection system tends to draw too many cases inappropriately onto the child protection register, of which many may be classified as border-line cases, that could have being managed under the children welfare services. Whilst other research findings support the view that the child protection system seems to have achieved as much as could be expected in terms of preventing further abuse of vulnerable children. Hayes and Spratt (2008) argue that such achievement is not in ways most readily understood by those who legislate, set policy and measure performance. Bernard Gupta (2008) highlights in their study that, in situations in which there is a risk of abuse or neglect of African children, as with other minority ethnic children, the literature suggests that fear of difference, combined with racist stereotypes, may both exacerbate defensive practice, leading to avoidance that can leave children unprotected (p486). The Department of Health (1995) emphasises that social work professionals need to rely on various policies and measures since child abuse is not an absolute concept and most family behaviours have to be seen in context before decisions of abuse are made (Chand 1999, p. 70). Although child protection social workers in the UK are trained to follow the official guidance as set out in the Department of Health (1988) Protecting Children: A guide for Social Workers undertaking a Comprehensive Assessment, this guidance in the context of black African children and their families, fall short in addressing their basic needs (Chand, 1999). Against this background, the quality of social work assessment and, hence intervention process used by social workers may stereotype black African families, their parenting behaviours and practice and culture as inherent indicators of child abuse and need correcting (Chand, 1999). The fundamental dilemma facing contemporary social work practice is the manner and extent social workers should engage in social welfare services rather than in investigational procedures and processes, so as to redirect its efforts primarily to the poor and needy in society (Karger Hernandez, 2004). From the 1990s there have been proactive and sustai ned efforts on behalf of the UK government to develop and promote legislation and policies, which challenge the influence of a child protection culture on management and social work practice, which notably are perceived as distorting the balance of service provision to children and families (Spratt Callan, 2004). Pringle (1998) argued that the family support strategies may focus on the generalization of responses compared with child protection procedures that target actual nature of the alleged abuse. Cleaver Walker (2004) argued in their research, that the implementation of this switch from child protection to child welfare services by social work agencies can have negative and difficult impact on the government Framework for the Assessment of Children in Need and their Families. According to Hayes Spratt (2008) the government has seen a remarkable reduction in the number of children drawn into the child protection system, which commends local authorities effort to help achieve performance targets. Spratt Callan (2004) criticized the reductions in number of children on the child protection register, as being achieved largely due to modern governance and measures to promote compliance with performance targets. However, following Baby P report childrens services watchdog, Ofsted, reported t hat a review of 173 serious cases in April 2009, found that social workers and other agencies, failed to act swiftly to put children suffering from physical and neglect abuse onto the child protection register (www.ofstednews.ofsted.gov.uk/article). Ofsted also identified certain poor social work practices such as the failure of social services workers to identify and report signs of abuse, poor recording and communication, and limited knowledge and application of basic policies and procedures (www.ofstednews.ofsted.gov.uk/article).This report has since seen an increase in the number of children drawn into the child protection system. According to Chand (1999), the UK government reiterated that the primary and official duties of local authorities within the context of the 1989 Children Act is to focus more on safeguarding children through the provision of advice and support services under children in need. In Spratt Callan (2004) study the Department of Health estimates four million children living in England are vulnerable to harm or neglect, due to their families living far below the poverty line, yet only 300-400,000 of these children are known to social services at any given time. Thoburn et al (2000) study on families, whose children were at risk of suffering emotional abuse and neglect, shows that 98% of the children brought to the attention of child protection system, their families live in poverty. Parton (1997) argued that due to the correlation between poverty and the need for provision of public services, only the very small number of vulnerable children who are designated as children in need receive s ervices under the welfare service. Spratt Callan (2004) suggest that a more effective way social work can help such vulnerable children, particularly black African children, who may be over-represented on the child protection register, is the government increasing resources to local authorities, increasing the number of social workers and reshaping the social services system. Therefore, with regard to the governments provision of resources, legislation and policies, the model or intervention approach social workers may employ when working with black African families living in extreme poverty, will determine whether a family receives a child protection service or a child welfare service. CHAPTER TWO POVERTY AND BLACK AFRICAN FAMILIES Poverty and Child Protection The area of poverty and child protection with black African families has been the source of controversy in British social work research for many decades. Many researchers find a correlation between economic deprivation such as poverty and social exclusion and parenting behaviour and practice, child-rearing capabilities and skills which are a prerequisite for proper child development anywhere in the world. Moreover, according to Jordan (2001) poverty is correlated with reports of abuse and neglect. For instance, the National Centre for Children in Poverty found in 1990 that the incidence of child abuse and neglect, as well as the severity of the maltreatment reported, is much greater for children from low-income families than for others (Jordan, 2001 p.1). As a large number of Africans in the UK live below the poverty line, it may be reckoned that most black African children on the child protection register live below the poverty line. Brophy et al (2003) argue that many families brought to the attention of the child protection system lives in extreme poverty and may experience social exclusion. Black African children living in the UK may be over-represented in the child protection system for reasons such as physical abuse or neglect; therefore it is understandable to say that there is a correlation between abuse and parenting behaviours and practices. The question is why African families and their children living in poverty, who are alleged of child abuse, are over-represented in the child protection system? Sossou Yogtiba (2008) noted in their study that a child is the most valuable asset of any traditional African family, as children symbolise status, respect and completeness of the nuclear family, if that is the case, then it is ironical to see African families and their children to be over-represented in the child protection system. Many black African families in the UK still lives below the poverty-line though they undertake different types of unskilled or skilled jobs, as they support large families in their countries of origin (Anane-Agyei, 2002). It may be reckon that poverty is linked with other social disadvantages such as poor education, limited employment opportunities, and poor health and may have devastating consequences for childrens development and life chances. Research shows that many African families and their children may have insecure immigration status and their existing financial predicaments only help to complicate their parenting behaviours and practices. Penrose (2002) study shows that African families seeking asylum are often forced to live at level of poverty that is just unacceptable, and this puts financial constraint on them to provide adequate childcare for their children. Unemployment levels are known to be very high among African families, and they are also subject of stigmatization and prejudice by the larger community that are suppose to accept them. According to Bernard Gupta (2008) immigration and asylum status determines income, employment opportunities and access to support services for many African people in the UK and these issues of entitlement to services only complicate their cases. Some African families living in the UK may be without jobs and may not also be entitled to social and economic benefit and therefore may find it difficult to care for their children. Children growing up with parents living in poverty may be deprived of proper childhood development ( Montith Eithne, 2005). African families living in poverty and failing to provide good care for their children may be perceived by social work professionals as failing in their parental responsibilities (Chand, 1999). For this reason, social workers may intervene in such families and often than not they are drawn into the child protection system. Amin Oppenheim (2002) argue that the unfamiliar cultural expectation of black African families living in the UK somehow contribute to the high level of poverty they experience. Research shows that many African families suffer from institutional oppression including housing, employment, education and health which not only means that they are more likely to experience poverty and deprivation, but also more susceptible to social work interventions in child abuse or maltreatment allegations. Corby (1993) noted that it may be expected that black African children are over-represented in child abuse cases because their families are more open to surveillance as they show high levels of poverty that complicate their parenting behaviours (Chand, 1999 p73). In a broader perspective, Pearce Bozalek (2004) emphasise that the child protection system that exist in Britain will be unfamiliar to many African families, especially those more recently arrived, as similar state systems do not exist in most African countries, particularly where socio-economic factors, political instability and violence overshadow intra-familial child maltreatment and effective intervention into child abuse and neglect (Bernard Gupta, 2006 p481). Brophy et al (2003) study supports the above assertion that African families experience discrimination and insecurity in child abuse cases, as the tools for assessing abuse are often euro-centric bias and prejudice the families. Chand (1999) study expresses the awareness that black African families are disadvantaged through oppression in all areas of society and this should not reflect in social work practice. Gibbon et al (2003) findings show that the child protection system was picking up more alleged child abuse cases inappropriately and putting more families and children on the child protection register than children who are subject to social welfare procedures. Therefore the over-representation of African families on the child protection register somehow, undermines the government aim of keeping children with families and reducing the number of children that are drawn onto the child protection register. The Department of Health (1995) document on child protection identified some pertinent shortcomings with the child protection system, as it seems to encourage unnecessary child protection interventions in border-line child abuse cases. Bernard Gupta (2008) in their study of black African children and the child protection system suggest that there are a series of interactions between environmental factors such as poverty, immigration status and social exclusion that affect the life cha nces of many African children and the capacity of their parents to provide adequate care. Dowling (1999) realise that social work practice in the UK focus less on poverty-alleviating strategies but throw more resources behind safeguarding and protecting vulnerable children from abuse or maltreatment. Social workers need to understand the context in which abuse occurs, irrespective of race and culture, to develop an assessment and intervention process that is fairer for black families as they are more likely to suffer racism and oppression. In view of the above argument, it is pertinent that social workers know when to employ preventative measures to support black African families who have financial needs and when to take such families through the child protection system in the quest for safeguarding children. All these factors together create complex needs for many African children living in the UK, and, in many circumstances increase their vulnerabilities which draw them into the child protection arena. Bernard Gupta (2008) argued that only by developing effective relationships with African families can social work professionals can begin to understand their parenting behaviours and practices. Poverty and Child Welfare Services Current literature shows that poverty experience by most black African families living in the UK could be alleviated by social work services that offer a pragmatic welfare services rather than drawing these families and children into the child protection system. Brophy et al (2003) study suggests that immigration and asylum issues, combined with poverty, are likely to be some of the reasons for the increased complexity for social work professionals assessing and intervening child abuse cases involving black African children. The Department of Health challenges social workers with the responsibility to work with Section 17 of the Children Act 1995, so as to provide adequate social support for children in need via the child welfare services (Platt, 2006). However, social work agencies have not fully achieved the government agenda of alleviating poverty experience by many families and children due to inadequate resources at all levels of social work practice. The Department of Health have indicated that most families, struggle to bring up their children in conditions of material and emotional adversity (DoH, 2001). For instance black African families experiencing poverty may fail in their responsibility to provide proper care for their children as they spent almost all their time working to make ends meet. Such children hardly experience family treats such as going on a family holiday trip, having birthday parties and they are deprived of having basic playing toys and games that help children to learn and grow into adulthood. The lack of affordable basic needs for children of poor families complicated with other social adversities may contribute to poor children developing aggressive behaviours, low self-esteem, picking up awkward attitudes, and may to suffer from social deprivation. Fontes (2005) realises that many traditional immigrant families, where black Africans are part of, may use an authoritative style of parenting, demanding tot al obedience and respect from their children. Although these parental practices may not necessarily constitute child abuse, it may clash with the child-rearing norms, and thus seems to bring African children and families to the attention of the child protection system (Fontes, 2005). When social workers start acknowledging borderline child abuse cases and understand the difficulties families living in poverty experience in raising their children, they would be able to strike a good balance between when to employ a child protection intervention and a child welfare intervention (Spratt Callan, 2004). It is evident that children living in poverty may benefit from the child welfare services as stipulated in section 17 of the 1989 Children Act, as it aims at alleviating poverty in families

Basal Cell Carcinoma

Basal Cell Carcinoma (BCC) or ‘rodent ulcer’ is a malignant tumor of the skin that develops from the basal cell layer of the epidermis and also from the hair follicles. It is a slow-growing tumor that usually develops in sun-affected skin. The tumor does not tend to metastases to other parts of the body but may invade surrounding tissues (Halachmi, 2006). Basal cell carcinoma is a type of skin cancer that does not develop from the cells that produce melanin (non-melanocytic type of tumors).It is the most common form of skin cancer and includes 75 % of all skin cancers (Halachmi, 2006). The condition frequently develops in individuals exposed to high amounts of radiation and sunlight (Halachmi, 2006). In the US, Basal cell carcinoma is the most common form of skin cancer. The incidences is higher in Australia, than in the UK and US. However, BCC does not seem to be a life-threatening condition. The incidence of Basal cell carcinoma is rising by about 10 % every year, thro ughout the World. The lifetime risk of developing BCC is about 30 % in Whites (Wong, 2003).There are several types of BCC including nodular, superficial types, sclerosing type, pigmented type and the multiple-superficial type. The superficial type is usually present on the face and is seen as a growth of tissues having rolled out margins. Sometimes, the contents of the tumor may be cystic. The lesion may also appear pigmented. Frequently, nodular lesions may ulcerate or bleed when minimal trauma is applied over them. The sclerosing type usually appears as a thickened scar following surgery. BCC usually develops in the age group of 40 years and above.Individuals who are frequently exposed to excessive sunlight or ultraviolet rays, those develop sunburns, or who have developed sunburns during childhood, or those who have developed skin cancers (such as BCC, squamous cell carcinoma and melanoma) are at a higher risk of developing BCC (NDZL, 2007). Sometimes BCC may develop in families. In certain conditions such as Gorlin's syndrome, albinism, basal cell nevus syndrome and Barex syndrome, which runs in families, the risk of developing BCC is higher (NDZL, 2007).Light-skinned individuals and those having blond or red-colored hair, blue or green eyes are at greater chances of developing this condition. Frequently, over-exposure to x-rays, ultraviolet and other forms of radiation may worsen the risk of developing BCC. The incidence of BCC in younger individuals is on the rise (as they may like to undergo sun tanning and spend a lot of time outdoors). Individuals who are on immunosuppressant therapy are also at a higher risk of developing BCC (Wong, 2003). BCC usually begins as a painless growth on the outer layer of relatively normal looking skin.The tumor tends to grow and spread very slowly, and may vary in size from a two to three millimeters in the early stages to a few centimeters in the later stages. Sometimes, the lesion may ulcerate and the wound does not he al with usual amount of time. The lesion may bleed easily as the blood vessels may be involved with the tumor. The nerves may also be involved with the cancer. The affected portion of the skin may appear different. Sometimes, pigmented forms of BCC may develop such as pearly or waxy bumps or swellings (usually appears in this form), white or pink lesions, brown or flesh-colored lesions.The lesion may also be felt as a bump or a small swelling. The regional lymph nodes are usually not involved during the early stages of the disease and the tumor does not spread to other parts of the body, in the initial stages. Frequently, the lesion exhibits oozing or crusting on the surface. Sometimes, the lesion may develop from a scar left back following surgery. The lesion may also develop as a small depressed spot on the surface of the skin. The tumor can develop on several parts of the body such as the head, neck, scalp, ears, chest, face, nose, eyes, hands, legs, back, genitals, etc.It is mor e frequent in the portions of the body exposed to sunlight. The diagnosis of BCC is made based on the history, symptoms, signs, detailed physical examination, laboratory tests (to determine the spread of cancerous cells in the blood) and biopsy. The physician will take a detailed history to determine if the individual has had a previous history of certain skin disorders and also to study the family risk patterns. A detailed examination of the lesion is performed, and the physician will study its size, shape, color, consistency, the regional lymph nodes and spread to the surrounding structures of the body (Halachmi, 2006).The diagnosis is usually confirmed by taking a sample of the tissue for biopsy. The biopsy demonstrates the development of the tumor from the basal cell layer of the epidermis. Cancerous features are present in the sample (Halachmi, 2006). The treatment of BCC various depending on the size of the lesion, general condition of the patient, spread to other parts of the body, part of the body involved with the cancer, involvement of neighboring tissues and lymph nodes, etc. Small superficial lesions are treated by shaving off or scraping the tumor, along with curettage and cauterization (using electric current) (NDZL, 2003).Cauterization helps to destroy the residual cancerous cells that may be present in the surrounding tissues. A suture may be applied to ensure that the lesion heals without any problems. Larger basal cell carcinoma lesions are treated by removing the diseased tissue (excision), along with a margin of the normal tissues and suturing the skin (NDZL, 2003). A graft may be required in certain situations, to ensure the lesion heals properly. In certain types of BCC, an immune-modifying agent Immiquimod can be utilized to encourage the immune system to destroy the cancerous cells.Photosensitizing agents such as Metvix can be utilized to treat the superficial forms of BCC (photodynamic therapy). Once this medication is applied over the lesion, the oxygen and light tend to bring about a chemical reaction that destroy the cancerous cells. This treatment may usually require for the sclerosing type of BCC. Cryotherapy (treatment using cold substances such as liquid nitrogen) is also effective in destroying the cancerous cells. Some tumors that do not spread to other parts of the body and to the lymph nodes can be treated with radiotherapy (in which high-energy waves are utilized to destroy the cancerous cells).It may be required especially in elders who tend to develop lesions on their face. The cure rate following radiotherapy is about 90 % (Wong, 2003). Laser therapy can also be utilized to treat the tumor. Individuals with recurrent and invasive forms of the disease may require Moh’s microscopically controlled excision. It is especially recommended if the borders of the tumor are ill-defined and cannot be determined. Microscopic examinations of the excised lesions are usually conducted whilst the patient is being operated. The tumor is removed until a margin of normal tissue is obtained.Many surgeons have gone on to remove larger than usual amounts of the tissues as the unfelt extensions of the lesion are not identified (NDZL, 2003). The success rate is usually good following Moh’s procedure. It can also be utilized to treat recurrences of BCC (NCI, 2007). The outcome of BCC is usually good, and depends on several factors such as size and spread of the tumor to the neighboring tissues, lymph nodes and distant parts of the body, and the promptness in detecting the cancer and initiating treatment. Very rarely, the tumor results in fatal outcome (Wong, 2003).Usually, the chances of recurrences are less than one percent (Halachmi, 2006). Individuals undergoing Moh’s procedure may have a higher recurrence rate (it is about 10 %) as the tumor may have spread to surrounding structures (due to delay in treatment) (Halachmi, 2006). Individuals who have been treated for BCC should be regularly be monitored. BCC can be prevented to some extent by lowering exposure to ultraviolet rays present in the sunlight. The skin should be protected with adequate clothing and UV-protective eyewear, especially during the midday and in summer months.A sunscreen that protects from UV A rays and UV B rays should be utilized. The skin should be examined regularly to determine any change in color, texture or appearance. References: American Academy of Dermatology (2006). Basal Cell Carcinoma. Retrieved on April 16, 2006, from AAD Website: http://www. aad. org/public/Publications/pamphlets/BasalCellCarcinoma. htm Halachmi, S. (2006). Basal Cell Carcinoma. Retrieved on April 16, 2006, from Medline Plus Website: http://www. nlm. nih. gov/medlineplus/ency/article/000824.htm National Cancer Institute (2006). Basal Cell Carcinoma of the Skin. Retrieved on April 16, 2006, from NCI Website: http://www. cancer. gov/cancertopics/pdq/treatment/skin/HealthProfessional/page5 New Zealand Dem atoligcal Society (2007). Basal Cell Carcinoma. Retrieved on April 16, 2006, from Derm Net NZ Website: http://dermnetnz. org/lesions/basal-cell-carcinoma. html Wong, C. S. M. , Strange, R. C. and Lear, J. T. (2003). â€Å"Basal Cell Carcinoma. † BMJ, 327, 794-798. http://www. bmj. com/cgi/content/full/327/7418/794

Effect of extracurricular activities on the gpa

An example of this would be a varsity player who has training in the afternoon till evening, then goes home with the notion that he still has to do an immense amount of paper work due the following morning. Furthermore, Roland, a professional writer, graduate of B. S. En may also pull his grades down if he becomes too engrossed [Emphasis mine] with other activities. This all boils down to the fact that poor time management will be the main downfall of an individual's academic performance. At this point, the question to ask is what's in it for one's character formation? Well, the experts have some points on this matter. First, McNealy summarizes that these activities actually are conducive to facilitate effective communication [Emphasis mine] (Francisco) because an individual is put in a situation wherein interaction is a just.To illustrate this point, there is no such thing as a theatre actor who cannot communicate with his fellow actors, much more to the audience. He cannot be calle d one if he does not exemplify this trait. Second, confidence [Emphasis mine] is also attained through the process of the venture (Francisco) Nominal 3 for the same reason that one is put in this situation wherein bravery must be exercised with the help of this so called confidence. Again to compare it with an actor, one must be able to deliver his lines with absolutely no evidence of fear while he is carrying the weight of a performance.These two points presented are further strengthened by † [a] 2001 survey of more than 50,000 high school students in Minnesota published in March 2003 issue of the Journal of School Health found that those who participated in extracurricular activities had higher [Emphasis mine] levels of social, emotional, and healthy behavior than students who did not participate (Francisco). † Altogether these findings indicate that confidence and communication skills, two of the many, are integral to building one's character through extracurricular a ctivities as backed up by the prior evidence that are found inFranciscans research. On the other hand, there are also a few drawbacks or cons when it comes to character formation when one considers other miscellaneous influences. One would be the parents' influence wherein they'd force an individual to learn this certain activity but that task isn't to his liking, thus, all the more he is stressed [Emphasis mine] out (Roland). According to Frederick's, another drawback would be the unavoidable internal influences that one may encounter such as malicious authorities and peers who will force him to do harmful vices and delinquent actions (Francisco).What's more is that the people who are participating in the extracurricular activity may actually be the one bringing themselves down for neglect of their other obligations like family, friends, etc. Without a doubt it would be disastrous if they were to treat their extra undertakings as their own vices. Finally, these findings would certa inly be mainly dependent in the kind of educational context one is in. In conclusion, after all the facts have been presented, it all depends on an individual's choice whether or not he chooses to Join and bestow upon himself the benefits and pay a price or stay free with little or no improvement.

Philip Zimbardo and the Stanford Prison Experiment

Philip G. Zimbardo, born March 23, 1933, is an influential social psychologist.  He is best known for the influential—yet controversial—study known   as the â€Å"Stanford Prison Experiment,† a study in which research participants were â€Å"prisoners† and â€Å"guards† in a mock prison. In addition to the Stanford Prison Experiment, Zimbardo has worked on a wide range of research topics and has written over 50 books and published over 300 articles. Currently, he is a professor emeritus at Stanford University and president of the Heroic Imagination Project, an organization aimed at increasing heroic behavior among everyday people. Early Life and Education Zimbardo was born in 1933 and grew up in the South Bronx in New York City. Zimbardo writes  that living in an impoverished neighborhood as a child influenced his interest in psychology: â€Å"My interest in understanding the dynamics of human aggression and violence stems from early personal experiences† of living in a rough, violent neighborhood. Zimbardo credits his teachers with helping to encourage his interest in school and motivating him to become successful. After graduating from high school, he attended Brooklyn College, where he graduated in 1954 with a triple major in psychology, anthropology, and sociology. He studied psychology in graduate school at Yale, where he earned his MA in 1955 and his PhD in 1959.  After graduating, Zimbardo taught at Yale, New York University, and Columbia, before moving to Stanford in 1968. The Stanford Prison Study In 1971, Zimbardo conducted his most famous and controversial study—the Stanford Prison Experiment. In this study, college-age men participated in a mock prison. Some  of the men were randomly chosen to be prisoners and even went through mock â€Å"arrests† at their homes by local police before being brought to the mock prison on the Stanford campus. The other participants were chosen to be prison guards. Zimbardo assigned himself the role of the superintendent of the prison. Although the study was originally planned to last two weeks, it was ended early—after just six days—because events at the prison took an unexpected turn. The guards began to act in cruel, abusive ways towards prisoners and forced them to engage in degrading and humiliating behaviors. Prisoners in the study began to show signs of depression, and some even experienced nervous breakdowns. On the fifth day of the study, Zimbardo’s girlfriend at the time, psychologist Christina Maslach, visited the mock prison and was shocked by what she saw.  Maslach (who is now Zimbardo’s wife) told him, â€Å"You know what, its terrible what youre doing to those boys.†Ã‚  After seeing the events of the prison from an outside perspective, Zimbardo stopped the study. The Prison Experiment’s Impact Why did people behave the way they did in the prison experiment? What was it about the experiment that made the prison guards behave so differently from how they did in everyday life? According to Zimbardo, the Stanford Prison Experiment speaks to the powerful way that social contexts can shape our actions and cause us to behave in ways that would have been unthinkable to us even a few short days before. Even Zimbardo himself found that his behavior changed when he took on the role of prison superintendent. Once he identified with his role, he found that he had trouble recognizing the abuses happening in his own prison: â€Å"I lost my sense of compassion,†Ã‚  he explains in an interview with Pacific Standard. Zimbardo explains that the prison experiment offers a surprising and unsettling finding about human nature. Because our behaviors are partially determined by the systems and situations we find ourselves in, we are capable of behaving in unexpected and alarming ways in extreme situations. He explains that, although people like to think of their behaviors as relatively stable and predictable, we sometimes act in ways that surprise even ourselves.  Writing about the prison experiment in The New Yorker, Maria Konnikova offers another possible explanation for the results: she suggests that the environment of the prison was a powerful situation, and that people often change their behavior to match what they think is expected of them in situations such as this. In other words, the prison experiment shows that our behavior can change drastically depending on the environment we find ourselves in. Critiques of the Prison Experiment Although the Stanford Prison Experiment has had a significant influence (it was even the inspiration for a film), some people have questioned the validity of the experiment. Instead of simply being an outside observer of the study, Zimbardo served as the prison superintendent and had one of his students serve as the prison warden. Zimbardo himself has admitted that he regrets being the prison superintendent and should have remained more objective. In a 2018 article for Medium, writer Ben Blum argues that the study suffers from several key flaws. First, he reports that several of the prisoners claimed being unable to leave the study (Zimbardo denies this allegation). Second, he suggests that Zimbardo’s student David Jaffe (the prison warden) may have influenced the behavior of the guards by encouraging them to treat prisoners more harshly. It’s been pointed out that the Stanford Prison Experiment demonstrates the importance of reviewing the ethics of each research project before the study goes forward, and for researchers to think carefully about the study methods that they use. However, despite the controversies, the Stanford Prison Experiment raises a fascinating question: how much does the social context influence our behavior? Other Work by Zimbardo After conducting the Stanford Prison Experiment, Zimbardo went on to conduct research on several other topics, such as how we think about time  and how people can overcome shyness.   Zimbardo has also worked to share his research with audiences outside of academia. In 2007, he wrote The Lucifer Effect: Understanding How Good People Turn Evil, based on what he learned about human nature through his research in the Stanford Prison Experiment. In 2008, he wrote The Time Paradox: The New Psychology of Time That Will Change Your Life about his research on time perspectives. He has also hosted a series of educational videos titled Discovering Psychology. After the humanitarian abuses at Abu Ghraib came to light, Zimbardo has also spoken about the causes of abuse in prisons. Zimbardo was an expert witness  for one of the guards at Abu Ghraib, and he explained that he believed the cause of events at the prison were systemic.  In other words, he argues that, rather than being due to the behavior of a â€Å"few bad apples,† the abuses at Abu Ghraib occurred because of the system organizing the prison.  In a 2008 TED talk, he explains why he believes the events occurred at Abu Ghraib: â€Å"If you give people power without oversight, its a prescription for abuse.†Ã‚  Zimbardo has also spoken about the need for prison reform in order to prevent future abuses at prisons: for example, in a 2015 interview with Newsweek, he explained the importance of having better oversight of prison guards in order to prevent abuses from happening at prisons. Recent Research: Understanding Heroes One of Zimbardo’s most recent projects involves researching the psychology of heroism.   Why is it that some people are willing to risk their own safety to help others, and how can we encourage more people to stand up to injustice? Although the prison experiment shows how situations can powerfully shape our behavior, Zimbardo’s current research suggests that challenging situations don’t always cause us to behave in antisocial ways. Based on  his research on heroes, Zimbardo writes that difficult situations can sometimes actually cause people to act as heroes:   Ã¢â‚¬Å"A key insight from research on heroism so far is that the very same situations that inflame the hostile imagination in some people, making them villains, can also instill the heroic imagination in other people, prompting them to perform heroic deeds.†Ã‚   Currently, Zimbardo is president of the Heroic Imagination Project, a program that works to study heroic behavior and train people in strategies to behave heroically. Recently, for example, he has studied the frequency of heroic behaviors and the factors that cause people to act heroically. Importantly, Zimbardo has found from this research that everyday people can behave in heroic ways. In other words, despite the results of the Stanford Prison Experiment, his research has shown that negative behavior isn’t inevitable—instead, we are also capable of using challenging experiences as an opportunity to behave in ways that help other people. Zimbardo writes, â€Å"Some people argue humans are born good or born bad; I think that’s nonsense. We are all born with this tremendous capacity to be anything.† References Bekiempis, Victoria.   â€Å"What Philip Zimbardo and the Stanford Prison Experiment Tell Us About the Abuse of Power.†Ã‚   Newsweek, 4 Aug. 2015, www.newsweek.com/stanford-prison-experiment-age-justice-reform-359247.Blum, Ben. â€Å"The Lifespan of a Lie.† Medium: Trust Issues. https://medium.com/s/trustissues/the-lifespan-of-a-lie-d869212b1f62.Kilkenny, Katie.   â€Å"‘It’s Painful’: Dr. Philip Zimbardo Revisits the Stanford Prison Experiment.†Ã‚   Pacific Standard, 20 Jul. 2015, psmag.com/social-justice/philip-zimbardo-revisits-the-stanford-prison-experiment.Konnikova, Maria.   â€Å"The Real Lesson of the Stanford Prison Experiment.†Ã‚   The New Yorker, 12 June 2015, www.newyorker.com/science/maria-konnikova/the-real-lesson-of-the-stanford-prison-experiment.â€Å"Philip G. Zimbardo: Stanford Prison Experiment.†Ã‚   Stanford Libraries, exhibits.stanford.edu/spe/about/philip-g-zimbardo.Ratnesar, Romesh.   â€Å"The Men ace Within.†Ã‚   Stanford Alumni, July/Aug. 2011, alumni.stanford.edu/get/page/magazine/article/?article_id40741.Slavich, George M.   â€Å"On 50 Years of Giving Psychology Away: An Interview with Philip Zimbardo.†Ã‚   Teaching of Psychology, vol. 36, no. 4, 2009, pp. 278-284, DOI: 10.1080/00986280903175772, www.georgeslavich.com/pubs/Slavich_ToP_2009.pdf.Toppo, Greg. â€Å"Time to Dismiss the Stanford Prison Experiment?† Inside Higher Ed,  2018, June 20,  https://www.insidehighered.com/news/2018/06/20/new-stanford-prison-experiment-revelations-question-findings.Zimbardo, Philip G.   â€Å"Philip G. Zimbardo.†Ã‚   Social Psychology Network, 8 Sep. 2016, zimbardo.socialpsychology.org/.Zimbardo, Philip G.   â€Å"The Psychology of Evil.†Ã‚   TED, Feb. 2008, www.ted.com/talks/philip_zimbardo_on_the_psychology_of_evil.Zimbardo, Philip G.   â€Å"The Psychology of Time.†Ã‚   TED, Feb. 2009, www.ted.com/talks/philip_zimbardo_prescribes_ a_healthy_take_on_time.Zimbardo, Philip G.   â€Å"What Makes a Hero?†Ã‚   Greater Good Science Center, 18 Jan. 2011, greatergood.berkeley.edu/article/item/what_makes_a_hero.