Motivation and emotion/Book/2015/Breast cancer and anxiety in women
How does anxiety impact on women with breast cancer?
Breast Cancer. It is a sensitive topic for just about every one of us. It's a debilitating disease that according to the World Health Organization website, more than 500,000 women die from every year worldwide, making it the most common form of cancer amongst women (Baqutayan, 2012). Women are not the only ones who can develop breast cancer, as men can too. Regardless of gender, the short and long-term effects are substantial, with many patients being forced to make career and relationship sacrifices, and in some cases, the ability to have a child. Sadly, it is not only cancer that directly affects a person. The level of anxiety a patient can experience may also change the way in which they behave and react to various situations. It's something so severe that it can produce another illness on top of breast cancer, which ultimately inhibits a person's ability to function on a day-to-day basis. This chapter will include an in-depth exploration into the two illnesses and how they co-occur, with breast cancer being focused on first.
The breast is comprised of two types of tissue; glandular and stromal tissue. Glandular tissue contains the milk-producing glands and the ducts, while the stromal tissue includes the fatty and fibrous connective tissues of the breast (as cited in Baqutayan, 2012). Breast cancer develops when an abnormal cell in the glandular tissue grows uncontrollably, which can eventually spread to the underlying chest wall and other parts of the body (as cited in Baqutayan, 2012) if left untreated.
Cancer Australia (2012) released a document that provides information for all women with breast cancer, including the various risk factors. Being a woman, having a family history of three or more first or second-degree relatives with either ovarian or breast cancer, inheriting a defective gene and being 40yrs+ all increase the risk (Cancer Australia, 2012). There is even evidence for lesbian and bisexual women to be at an increased risk (Boehmer, Glickman & Winter, 2012).
Breast cancer awareness
Self-examination is the first step to early diagnosis. It is essential for women to regularly check their breasts every month as it increases survival rate. According to the Cancer Australia website, the changes to look out for include unusual lumps (especially if they appear in only one breast), a change in the size of the breasts, a change in the colour of the skin, such as dimpling or redness, any nipple discharge that occurs without sneezing, a change to the nipple in terms of crusting, an inversion or an ulcer and any unusual pain that doesn't go away (see Figure 2).
Reasons for putting off self-examinations or going through with them may come down to two key theories. Rosenstark's Health Belief Model (as cited in Katz, Meyers & Walls, 1995) and the Theory of Planned Behaviour (Ajzen, 1991) are believed to play a role in self-examination and a woman's perceived susceptibility to cancer.
The health belief model
Rosenstark (as cited in Katz et al., 1995) created the Health Belief Model to explain preventive health behaviour and why people refuse to seek help in detecting a potential disease. The table below highlights the four main perceived concepts from the Health Belief Model, with two additional concepts added by Rosenstock to explain when people want to change a bad habit, i.e. smoking.
Constructs from The Health Belief Model (Glanz, Marcus Lewis & Rimer, 1997).
|Perceived susceptability||One's opinion of chances of getting a condition||Define population(s) at risk, risk levels; personalise risk based on a person's features or behavior; heighten perceived susceptibility if too low|
|Perceived severity||One's opinion of how serious a condition and its consequences are||Specify consequences of the risk and the condition|
|Perceived benefits||One's belief in the efficacy of the advised action to reduce risk or seriousness of impact||Define action to take; how, where, when; clarify the positive effects to be expected|
|Perceived barriers||One's opinion of the tangible and psychological costs of the advised action||Identify and reduce barriers through reassurance, incentives, assistance|
|Cues to action||Strategies to activate "readiness"||Provide how-to information, promote awareness, reminders|
|Self-efficacy||Confidence in one's ability to take action||Provide training, guidance in performing action|
In relation to breast cancer, when a woman believes she's susceptible to the disease and understands the severity of it, the benefit of determining whether she's at risk of developing breast cancer outweighs the barriers of not completing a self-examination or screening protocol, which may be because she's afraid or has no time to. When a woman has high self-efficacy, it's then that she realises she has the confidence to actually go ahead with the cues to action.
Theory of planned behaviour
Formally called the Theory of Reasoned Action, the Theory of Planned Behaviour suggests that intentions to complete an action are predicted by three motivational determinants: attitude, subjective norm and perceived behavioural control (Drossaert, Boer & Seydel, 2003; Rutter, 2000). The determinants on the left relate to the benefits and limitations of performing the behaviour, approval or disapproval from others and the person's judgement of their ability to perform the behaviour (Drossaert et al., 2003). The theory is useful in predicting why patients attend and re-attend screening assessments, yet there are limited studies on why this might be (Drossaert et al., 2003). In the past, women have been more likely to get screened when their families and friends have approved of it and when they had a positive attitude (Drossaert et al., 2003; Rutter, 2000). In the studies above, re-attendance was high, with 91% of women attending the third screening session in Drossaert et al's., (2003) study and 64% compared to 14% of the control group's participants in Rutter's (2000) experiment followed up on their screening.
Understanding what factors promote attendance is important for new beneficial health interventions to improve breast cancer screening protocols. Interventions should focus on changing women's attitudes, their perceived control over the situation and any difficulties they expect to occur when they attend, as these factors explain women's intentions and their actual behaviour (Drossaert et al., 2003).
Determining which stage of cancer a woman has ultimately decides which treatment is going to be the most effective. Cancer Australia (2012) highlights the differences between each stage, with relevant methods of treatment. One form of treatment for women in stage I of cancer (when the tumor is <2cm) is to undergo a mastectomy, in which one or both breasts are surgically removed (Maughan, Lutterbie & Ham, 2010). Alternatively, in more recent years breast-conserving surgery has been an option. This method involves removing the tumor without damaging any healthy tissue (Maughan et al., 2010). Radiotherapy follows breast-conserving surgery to ensure that no part of the tumor is still hiding underneath the surface. Results from a study by Clarke et al., (as cited in Maughan et al., 2010, p. 1342) showed that radiation following surgery significantly reduced the five-year local recurrence rate.
Following on from surgery and radiotherapy, chemotherapy is the number one form of treatment for women in stage II with tumors larger than 1-2cm (Cancer Australia, 2012; Maughan et al., 2010), although it is been shown to increase anxiety more than any other form of treatment (Lim, Devi & Ang, 2011). This is likely due to side effects such as nausea, loss of hair, dry skin and fatigue (Carelle et al., 2002). According to Hortobagyi (1998), combined treatment for shorter than 3 months is much less effective than treatment for 4-6 months. The American Cancer Society states that chemotherapy typically lasts 3-6 months, whereas hormone therapy lasts 5-10 years. Adjuvant systematic therapies such as endocrine therapy and tissue-targeted therapy are a few of the many options out there that utilise the use of surgery, therapy or both (Maughan et al., 2010).
Statistics from Cancer Australia (2012) indicate that 88% of Australian women with breast cancer are still alive five years after early diagnosis.
The emotional effects of breast cancer
When first diagnosed, women understandably tend to respond with anxiety (Stark & House, 2000).
Many experience a sense of denial and helplessness, which explains why some cancer patients feel that they've lost their self-identity. The psychological issues that can arise from a cancer diagnosis largely depend on gender, age and the type of cancer (Rosen, Rodriguez-Wallberg & Rosenzweig, 2009). For most women, losing their hair, completing regular chemotherapy, infertility and the risk of dying are all huge concerns (Rosen et al., 2009). The greatest concern that's associated with emotional distress is when women are told they have become infertile as a result of their cancer treatment. Being told such devastating news has been shown to have the same emotional impact on a woman as having a life-threatening disease, such as heart disease or AIDS (Domar, Zuttermeister & Friedman, 1993).
A vital way to reduce infertility-related anxiety and depression is for specialists and patients to maintain communication, especially in regards to other fertility options (Domar et al., 1993; Partridge et al., 2004). A number of studies have shown that other options are rarely discussed (Duffy, Allen & Clark, 2005; Partridge et al., 2004; Quinn et al., 2007) which doesn't provide women with the quality of care they require. As suggested by Partridge and colleagues (2004), if there was more focus on infertility issues at diagnosis and on psychosocial and medical interventions during the treatment phase, then the impact of infertility may reduce, leaving breast cancer patients with one less thing to worry about. Other emotional factors that may upset women include the fact they can't return to work for a large period of time and have to see how their cancer affects their friends and families, which unfortunately for some women can cause significant stress when they see their loved ones are struggling.
Breast cancer foundations
As breast cancer diagnosis rates have increased over the years, multiple foundations have been formed in support of the disease. The four major Australian breast cancer organisations are listed below. Together, they focus on establishing the best care for women living with breast cancer in order to meet their individual missions.
- Breast Cancer Network Australia
- National Breast Cancer Foundation
- McGrath Foundation
- Cancer Australia
"I am the tightening of your chest, the snowballing worries that feel like they might become an avalanche and just bury you in an instant. I am the obsessive, and I'm the compulsive. I'm the voice, you know the one, it's always questioning questioning questioning" - Beyond Blue
Anxiety is a serious illness in which persistent fear and/or anxiety interferes with day-to-day life. Fear is a present-oriented mood state that is associated with the "fight or flight" mechanism and escape behaviours, while anxiety is a future-oriented mood state that provokes muscle tension in preparation for a future threat (American Psychiatric Association, 2013). Beyond Blue are a depression and anxiety support service that say anxiety is usually triggered from a stress-induced situation, health problem, substance use or from family history. An anxiety disorder is then diagnosed when this fear or anxiety lasts beyond an acceptable time (i.e. six months or more) and when symptoms cannot be attributed to any physiological effects from some form of medication, medical disorder, or medical condition (American Psychiatric Association, 2013). The six main anxiety disorders are Generalised Anxiety Disorder (GAD), Post-traumatic Disorder (PTSD), Specific Phobia, Obsessive Compulsive Disorder (OCD), Social Anxiety Disorder and Panic Disorder (American Psychiatric Association, 2013).
According to the Beyond Blue website, there are physical and psychological symptoms that aren't normally obvious, but may be apparent over time. Some of these symptoms include excessive worry, restlessness, difficulty concentrating, headaches, muscle tension, nausea, trouble falling asleep and sweating (as cited in Baqutayan, 2012). An anxiety checklist can be accessed here.
The lifetime prevalence of an anxiety disorder is 17% (Somers, Goldner, Waraich & Hsu, 2006), with the female to male ratio being 2:1 respectively (American Psychiatric Association, 2013). Those who are more at risk are generally younger women with a lack of social support and previous psychological problems (Burgess et al., 2005). Many of the phobia disorders are diagnosed in childhood, with the median diagnosis age for GAD and Panic Disorder being early 30's (American Psychiatric Association, 2013). Generally, anxiety disorders will persist for the majority of a person's life, unless adequately treated.
There are self-help, psychological and medical treatments available. Medical treatments are usually supplied first, either alone or in-conjunction with therapy. Antidepressant medication is the most common, as it suppresses symptoms for as long as its taken, however no evidence exists for whether it reduces the underlying risk once a person discontinues their use (Hollon, Stewart & Strunk, 2006). Psychological treatments involve a variety of therapies, such as Cognitive Behavioural Therapy and Interpersonal Psychotherapy and can be as effective as antidepressant medication. Both psychotherapies address social stressors, change thought patterns and help a person manage their anxiety better, which in turn is likely to decrease the chance of relapsing (Hollon et al., 2006).
Self-help treatment involves interventions such as exercise, yoga and a healthy diet, which are effective, but won't work alone. As for social support, it is important for those close to the person to understand the meaning attached to particular events as these are the basis for perceived threat. Education and communication are also important to recognise and respond to when someone is really struggling (Stark & House, 2000).
Breast cancer and anxiety
It is normal for everybody to have anxiety-provoking thoughts at some point in their life, but at what degree is it considered a serious condition?
It can be difficult to determine the level of anxiety that is present in cancer patients (Stark & House, 2000), especially as the diagnosis of anxiety in cancer is often a subjective judgement (Stark & House, 2000) and is complex because it overlaps with other symptoms such as fatigue and pain (Baqutayan, 2012). Stressful factors such as hormonal changes, fertility fears, changes in body image, financial problems and numerous hospital visits are broadly classified into four causal categories; physical, psychological, social and environment, which inevitably makes it more difficult for professionals to determine what is a normal level of anxiety and what constitutes a disorder (Lim et al., 2011). Holland (1989) states that it is completely normal to experience anxiety for 7-10 days after receiving terrible news, although as the threat of cancer has varied over the years, it can affect the levels of what is considered to be normal anxiety as well. In a Canadian study conducted by Ashbury, Findlay, Reynolds and McKerracher (1998), 77% of patients within two years of treatment recalled experiencing anxiety. This was also found by Burgess et al., (2005) who found that 50% of women had depression, anxiety, or both in the year after diagnosis. The percentage of women experiencing anxiety is equivalent to that of the general female population (Burgess et al., 2005), meaning that although the degree of anxiety may not be enough to diagnose a breast cancer patient with an anxiety disorder as well, the severity of anxiousness is high.
When there's little to no anxiety present in the initial stages of cancer, it can also be a reason for concern, as the main period in which anxiety is generally reduced is during the remission stage (Stark & House, 2000). This point of transition is still challenging to define (Stark & House, 2000), but is made easier when questionnaires such as the Responses to Stress Questionnaire (Pediatric Cancer version) are used. This questionnaire includes 12 cancer-related stressor questions (i.e. changes in personal appearance, continual hospital visits) and various coping scales to assess a range of different patients with cancer, including children and adolescents (Compas et al., 2014). When an anxiety disorder is present in a breast cancer patient, an effective treatment is mindfulness-based therapy. The use of mindfulness, yoga and other relaxation techniques has proven to reduce anxiety and improve quality of life and overall mood (Hofmann, Sawyer, Witt & Oh, 2010).
When an actual anxiety disorder is present, it can persist until five years after breast cancer diagnosis but is generally due to the patient and not the cancer (Burgess et al., 2005) which has lead researchers into determining who is primarily at risk of developing an actual anxiety disorder while having breast cancer as well.
Who is at risk?
Specific groups of women may be more prone to developing anxiety when they have breast cancer already. One example is excessive worrying, which can act like a double edged sword. Constantly worrying about the smallest issues can produce a negative frame of mind which makes it difficult to focus on what matters and pushes loved ones further away. Yet on the other hand, more worrying can be positive in relation to screening for breast cancer in the first place. McCaul, Schroeder and Reid (1996) found that higher worry in women meant they were more likely to perform a self-examination or get a mammogram. Burgess et al., (2005) found that in the long-term, anxiety was higher in women who weren't in an intimate relationship, had severe non-cancer related difficulties, an earlier episode of anxiety, depression, or both after diagnosis and were of a younger age, which is still in line with studies conducted back in 1986 and 1994 (Burgess et al., 2005). Therefore, characteristics such as strength, hope and faith will help patients remain positive, along with social support. When these factors are present in women with severe anxiety, it can greatly increase their life expectancy (Baqutayan, 2012).
The costs of breast cancer and anxiety are substantial, but increase even more when they're both present. Discharging a patient from hospital to a general practice can be costly and difficult, which may be due to the severity of the breast cancer or reluctance from an anxious patient (Thomas, Glynne-Jones, Chait & Marks, 1997). However, most of the cost goes to the professionals who care for the patient. A breast cancer patient who has anxiety as well will have a large team of people that include psychologists, general practitioners, surgeons, nurses and radiation oncologists (Cancer Australia, 2012). Most women feel they must continue working in order to pay for the care that each of these professionals provide in addition to travel and medication costs. When this isn't possible, it puts a financial strain on the patient and their family, which often sees a social disruption to social functioning and relationships according to Matthews (as cited in Raque-Bogdan et al., 2015, p. 10). The most concerning part is that the health expenditure for 2004-2005 was $331 million for women with breast cancer in Australia (Cancer Australia, 2012) and that is excluding anxiety-related costs. For these reasons, it is important to maintain a connection with loved ones and discuss insurance with the selected health fund, as well as how to manage medical costs (Cancer Australia, 2012).
To conclude, everyone will experience anxiety to some degree in their life, but not everyone will go through what it is like to have breast cancer. The trauma of dealing with a breast cancer diagnosis leaves most women shocked, frightened and devastated which also affects those around them.
Ways of staying positive depend on a woman's level of optimism and self-efficacy, which according to the Health Belief Model and the Theory of Planned Behaviour explain why some women handle their cancer better than others. Despite the social and economic costs, there are wonderful foundations that promote awareness and support for those in need, and with the advancement in treatment options, it might not be long before treatment is specified to each woman's individual tumor characteristics (Maughan et al., 2010), or even better, a cure for breast cancer is finally found.
Overall, future research would benefit from focusing on models of motivation and emotion to explain health behaviour and by addressing the various psychological problems that can arise in anxious women with advanced breast cancer (Burgess et al., 2005).
- Cancer chapter
- Anxiety chapter
- Health Belief Model
- Theory of Planned Behaviour
- Adjuvant therapy
- Anxiety disorder
American Cancer Society. (2015). Treatment of invasive breast cancer, by stage. Retrieved from http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-treating-by-stage
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author
Ashbury, F. D., Findlay, H., Reynolds, B., & McKerracher, K. (1998). A Canadian survey of cancer patients’ experiences: are their needs being met? Journal of Pain and Symptom Management, 16(5), 298-306. doi:10.1016/S0885-3924(98)00102-X
Baqutayan, S. M. S. (2012). The effect of anxiety on breast cancer patients. Indian Journal of Psychological Medicine, 34(2), 119-123. doi:10.4103/0253-7176.101774
Beyond Blue. (2015). Get to know anxiety. Retrieved from Beyond Blue website: https://www.beyondblue.org.au/transcripts/get-to-know-anxiety
Boehmer, U., Glickman, M., & Winter, M. (2012). Anxiety and depression in breast cancer survivors of different sexual orientations. Journal of Consulting and Clinical Psychology, 80(3), 382-395. doi:10.1037/a0027494
Burgess, C., Cornelius, V., Love, S., Graham, J., Richards, M., & Ramirez, A. (2005). Depression and anxiety in women with early breast cancer: five year observational cohort study. Bmj, 330(7493), 702-705. doi:10.1136/bmj.38343.670868.D3
Cancer Australia. (2015). Breast changes. Retrieved from http://canceraustralia.gov.au/affected-cancer/cancer-types/breast-cancer/awareness/breast-changes
Cancer Australia. (2012). Guide for women with early breast cancer. Retrieved from http://canceraustralia.gov.au/publications-and-resources/cancer-australia-publications/guide-women-early-breast-cancer
Carelle, N., Piotto, E., Bellanger, A., Germanaud, J., Thuillier, A., & Khayat, D. (2002). Changing patient perceptions of the side effects of cancer chemotherapy. Cancer, 95(1), 155-163. doi:10.1002/cncr.10630
Compas, B. E., Desjardins, L., Vannatta, K., Young-Saleme, T., Rodriguez, E. M., Dunn, M., ... & Gerhardt, C. A. (2014). Children and adolescents coping with cancer: Self-and parent reports of coping and anxiety/depression. Health Psychology, 33(8), 853-861. doi:10.1037/hea0000083
Domar, A. D., Zuttermeister, P. C., & Friedman, R. (1993). The psychological impact of infertility: a comparison with patients with other medical conditions. Journal of Psychosomatic Obstetrics and Gynaecology, 14, 45-52. Retrieved from http://www.massgeneral.org/bhi/assets/pdfs/publications/Domar%201993%20J%20Psychosom%20Obstet%20Gynaecol.pdf
Drossaert, C. H. C., Boer, H., & Seydel, E. R. (2003). Prospective study on the determinants of repeat attendance and attendance patterns in breast cancer screening using the theory of planned behaviour. Psychology and Health, 18(5), 551-565. doi:10.1080/0887044031000141207
Duffy, C. M., Allen, S. M., & Clark, M. A. (2005). Discussions regarding reproductive health for young women with breast cancer undergoing chemotherapy. Journal of Clinical Oncology, 23(4), 766-773. doi:10.1200/JCO.2005.01.134
Glanz, K., Marcus Lewis, F. & Rimer, B.K. (1997). Theory at a glance: a guide for health promotion practice. National Institute of Health
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical Psychology, 78(2), 169-183. doi:10.1037/a0018555
Holland, J. C. (1989). Anxiety and cancer: The patient and the family. Journal of Clinical Psychiatry, 50(11), 20-25. Retrieved from http://psycnet.apa.org/psycinfo/1990-12708-001
Hollon, S. D., Stewart, M. O., & Strunk, D. (2006). Enduring effects for cognitive behavior therapy in the treatment of depression and anxiety. Annual Review of Psychology, 57, 285-315. doi:10.1146/annurev.psych.57.102904.190044
Hortobagyi, G. N. (1998). Treatment of breast cancer. New England Journal of Medicine, 339(14), 974-984. doi:10.1056/NEJM199810013391407
Katz, R. C., Meyers, K., & Walls, J. (1995). Cancer awareness and self-examination practices in young men and women. Journal of Behavioral Medicine, 18(4), 377-384. doi:10.1007/BF01857661
Lim, C. C., Devi, M. K., & Ang, E. (2011). Anxiety in women with breast cancer undergoing treatment: a systematic review. International Journal of Evidence‐Based Healthcare, 9(3), 215-235. doi:10.1111/j.1744-1609.2011.00221.x
Maughan, K. L., Lutterbie, M. A., & Ham, P. S. (2010). Treatment of breast cancer. American Family Physician, 81(11), 1339-1346. Retrieved from http://www.goodsamim.com/resprog/internalmedicine/Academic%20Half%20Day/April%202013/Breast%20Cancer%20April%209%20Lecture%203.pdf
McCaul, K. D., Schroeder, D. M., & Reid, P. A. (1996). Breast cancer worry and screening: some prospective data. Health Psychology, 15(6), 430-433. doi:10.1037/0278-6184.108.40.2060
Quinn, G. P., Vadaparampil, S. T., Gwede, C. K., Miree, C., King, L. M., Clayton, H. B., ... & Munster, P. (2007). Discussion of fertility preservation with newly diagnosed patients: oncologists’ views. Journal of Cancer Survivorship, 1(2), 146-155. doi:10.1007/s11764-007-0019-9
Raque-Bogdan, T. L., Hoffman, M. A., Ginter, A. C., Piontkowski, S., Schexnayder, K., & White, R. (2015). The work life and career development of young breast cancer survivors. Journal of Counseling Psychology, 1, 1-15. doi:10.1037/cou0000068
Rosen, A., Rodriguez-Wallberg, K. A., & Rosenzweig, L. (2009). Psychosocial distress in young cancer survivors. Seminars in Oncology Nursing, 25(4), 268-277. doi:10.1016/j.soncn.2009.08.004
Rutter, D. R. (2000). Attendance and reattendance for breast cancer screening: a prospective 3-year test of the theory of planned behaviour. British Journal of Health Psychology, 5, 1-13. doi:10.1348/135910700168720
Somers, J. M., Goldner, E. M., Waraich, P., & Hsu, L. (2006). Prevalence and incidence studies of anxiety disorders: a systematic review of the literature. Canadian Journal of Psychiatry, 51(2), 100-113. Retrieved from http://ww1.cpa-apc.org/Publications/Archives/CJP/2006/february/sommers-RP.asp
Stark, D. P. H., & House, A. (2000). Anxiety in cancer patients. British Journal of Cancer, 83(10), 1261-1267. doi:10.1054/bjoc.2000.1405
Thomas, S. F., Glynne‐Jones, R., Chait, I., & Marks, D. F. (1997). Anxiety in long‐term cancer survivors influences the acceptability of planned discharge from follow‐up. Psycho‐Oncology, 6(3), 190-196. doi:10.1002/(SICI)1099-1611(199709)6:3<190::AID-PON274>3.0.CO;2-0
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Famous Supreme Court decisions
Studying these cases and learning about the Constitution are essential parts of most every grade level curriculum. These sites provide a diverse array of teacher friendly lessons that can be used or changed to reflect the appropriate learning level.
Supreme Court decisions that deal with teaching.
A must read for all educators.
The Supreme Court site
As dull as can be with sophisticated materials hidden if you use the search engine. If you can’t fall asleep visit this site.
A terrific site with all the major Supreme Court decisions and lesson plans available.
A link site to many lessons about the Supreme Court and its decisions
Constitution Day resoruces
Evolution and the Law
This resource has many links to this continuing legal discussion.
Religion in Supreme Court decisions
Students’ rights under the law
Very good for getting interest in this subject
Jim Crow laws and the Constitution
Relates to Civil Rights through the ages.
A very simple interactive site about the Court
Nice site with useful graphics on checks and balances.
A valuable stie that has a long list of decisins and simple explanations of them. A good place to find cases for a debate.
The Constitution Center
This search engine has a lot of good resources.
Supreme Court Historical Society
Some good materials, but too sophisticated for elementary.
Congress for Kids
A variety of lessons for younger students
Hear actual Supreme Court cases
Very interesting site
This huge site enables students to find information about all types of cases. Teachers need to use site to find materials. Too difficult for younger students.
African American related cases
Constitutional Rights Foundation
Center for Civic Education


According to foreign studies, about 20% of diseases in veterinary medicine accounted for ear infections.Every dog owner sooner or later confronted with this problem, and he was faced with the question of how to treat your beloved pet's ears.
Diseases ears (otitis) are divided into inflammation (otitis media), and inflammation of the outer ear (otitis media) of the middle ear.Unfortunately, most owners notice the disease arose when there is blood from the dog's ears due to constant scratching.
Causes of otitis
Among the causes of inflammation of the outer ear, you can list such as hypothermia due to the low temperature, ingress of foreign particles in the ear or water, allergies and various neoplasms.Particular attention should be paid to otodektoz (ear itch).Otodektoz called in the ear canal parasitic mites (Otodectes).The development of otitis in this case is due to the constant itch mite induced physiological waste, and is a secondary phenomenon.Unlike cats, dogs otodektoz rarer.
Otitis outer ear occurs predominantly in long-eared and long-haired dogs and dogs suffering from obesity.Caring for these dogs require especially careful, ear cleaning should be carried out as a preventive measure on a weekly basis.
inflammation of the outer ear.Symptoms and treatment
To the dog will no longer have any complications, it is necessary to diagnose the disease.The owner must regularly inspect the dog, it will help to identify disease at an early stage and to decide how to treat your ears.The very first symptom, which is necessary to pay attention to is the slight redness of the skin in the ear canal of the outer ear.Animal bows his head in the direction of the hearth pain and shakes his head from side to side.
If the skin is formed scaly thickening and pressing at the base of the ear causes acute pain and is accompanied by a squish, the disease is in an advanced stage.In the transition to the stage of chronic diseases, ear canal skin thickens, becomes rough, and the lumen of the ear is significantly narrowed.Since chronic otitis virtually impossible to treat, an important question remains of early diagnosis and early treatment of the disease.
How to treat your ears?How to start treatment?First of all, you should contact your veterinarian, it will set the root cause of the disease emerged.It is taken from the ear of the animal, and the scraping of the analysis is determined by the presence of otitis parasitic or non-parasitic origin.When you first apply special otodektoz protivokleschevoy drugs and then treated directly with otitis media.For the treatment of otitis media caused by allergies or impaired metabolic processes, strict diet, and the ear with a cotton swab of fluid removed and processed green paint scratches.
Inflammation of the middle ear.Symptoms and treatment
This kind of disease is much greater than the inflammation of the outer ear.During the illness may be pus, especially in late or incorrect treatment.It spread fear of inflammation of the inner ear and then to the brain.This happens most often in cats while running otodektoz.When purulent inflammation of the ear may be an increase in body temperature of the dog, pain reaction, decreased or loss of appetite.Purulent inflammation is often asymptomatic.
Remember that when the first signs of otitis need to find a vet how to treat your pet's ears.


Credit Recovery Explained
By Rebecca St. Andrie
Say the words “summer school,” and an image immediately flashes into your mind. The same doesn’t hold, however, for “credit recovery” -- a movement born out of the No Child Left Behind Act.
Credit recovery programs -- also described by some as “summer school after school” -- are designed to help struggling students graduate. Using many different strategies, often involving online class work, the programs give students who have fallen behind the chance to “recover” credits that otherwise would be lost.
This worthy effort nevertheless raises many questions for those involved in education simply because so little is known about it. No federal definition of credit recovery exists, although classes are supported by several government funding mechanisms. Similarly, no coherent definition has emerged among states that cite credit recovery programs in statutes or administrative codes.
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I am Hashem your G-d Who took you out from the Land of Egypt, from the house of slaves. (Shemot 20:2)
1. The description of Hashem as Redeemer.
Parshat Yitro describes the communication of the Aseret HaDibrot – the Decalogue – to Bnai Yisrael. The first statement of Decalogue is contained in the above passage. In this statement, Hashem introduces Himself as the G-d Who redeemed the Bnai Yisrael from Egypt. Our Sages note that Hashem does not introduce Himself as Creator. Instead, He describes Himself as the redeemer of Bnai Yisrael. Why does He choose to refer to Himself in this manner? Rashi quotes the Midrash as explaining that Hashem was communicating that the redemption of the nation from Egypt was in-itself an adequate event to bind the nation in service to Hashem. In other words, the message of the Hashem’s statement is that because He redeemed the nation from Egypt, the nation owes its service to Him.
Rav Yosef Dov Soloveitchik Zt”l explains that this first statement establishes the unique relationship between Hashem and Bnai Yisrael. This relationship was established or demonstrated through His rescue of the nation from oppression and the annihilation by the Egyptians. In this context – as a basis for the unique bond between Hashem and His nation – His role as Creator is not relevant. Acknowledgement and service to Hashem as Creator are responsibilities shared by all of humanity. He is the Creator of all humankind. Redemption from Egypt provides a basis for service to Hashem that is unique to Bnai Yisrael.
2. The purpose of the first statement of the Decalogue.
Rav Soloveitchik’s interpretation of the Midrash’s comments provides an important insight into the purpose and objective of this first statement of the Decalogue. The objective of this statement is not to educate the nation regarding Hashem’s nature or His relationship with the universe and reality. If this were the intention of the statement, then it would have indeed been appropriate for Hashem to introduce Himself as the Creator and Sovereign of the universe. This description provides a more fundamental understanding to Hashem’s relationship to all that exists than reference to His redemption of Bnai Yisrael. Instead, the objective of this introduction is to establish a basis or to serve as a preamble to the commandments that will follow. Bnai Yisrael are poised to enter into an exclusive relationship with Hashem. This introduction explains the foundation, rational, and the ethical imperative that underlie this relationship. We are compelled to serve the One who redeemed us from certain annihilation in Egypt.
3. Conflicting perceptions of Hashem.
Rashi continues his comments on the above passage. Again, drawing from the Midrash, he explains that there is an alternative explanation of the passage. The nation had observed Hashem at the Reed Sea as a young warrior vanquishing His enemies. Now, at Sinai, they see Him as a compassionate elder. These vastly different perceptions seem irreconcilable and suggest that the nation has witnessed the acts of two different deities – that the deity that had ruthlessly destroyed the Egyptians could not possibly be the same as the deity of Sinai. Hashem addressed this notion by responding, “I am Hashem your G-d that took you out to Egypt…” One deity destroyed Egypt and now, presents Himself at Sinai.
Rashi’s comments from the Midrash present two challenges. First, it is clear from the Midrash that Bnai Yisrael believed that one god could not be responsible for both the destruction of Egypt and the Revelation at Sinai. Wherein lies the contradiction in these two perceptions of Hashem? Second, the Midrash seems to attribute a message to the statement that is not readily evident from the statement. What evidence does the Midrash find in the passage to support its interpretation?
Rav Soloveitchik explains that the Midrash is noting that the perception of Hashem’s nature that emerged from the destruction of the Egyptians at the Reed Sea was that He is a G-d of vengeance. He destroyed the idolatrous Egyptians who had persecuted His nation. He showed no compassion for His enemies and granted them no mercy. The G-d revealed in the Decalogue was very different from this vengeful deity. He instructed His servant to treat each other with justice. He tought them to control their passions and not needlessly harm others. Hashem’s servants must control their passions. They may not even covet another’s possessions. These two perceptions seemed contradictory to Bnai Yisrael. It seemed that two different deities had revealed themselves – one a mighty god of wrath and vengeance, the other a god of love and compassion. At Sinai, Hashem responded: I am One. The G-d revealed at Sinai is the self-same G-d Who revealed Himself at the Reed Sea.
What evidence of this message did the Midrash find in the passage? Rav Soloveitchik explain that the Midrash is based upon the very first word of the passage. In the Hebrew language there are two words that can be used to communicate “I” – the first person. Most commonly the word ani is used. Occasionally, the word anochi is employed. What is the difference between these two words? Generally, the term anochi is used when the speaker wishes to emphasis himself as the subject. Often, he is identifying himself in distinction from others. Anochi means “I” in a specific sense and in distinction from anyone else. A few examples will illustrate one manner in which the Torah employs the word anochi:
• Hashem asked Kayin where his brother Hevel was. Kayin responded “Am I my brother’s guardian?” Kayin was responding that Hevel’s welfare was not his responsibility. He was saying, “Why ask me?” In this context the Torah uses the word anochi. Kayin was protesting his appointment as Hevel’s guardian. He was protesting, “Why me more than someone else?”
• Sarah gave her servant Hagar to Avraham as a wife. Hagar conceived and began to act towards Sarah with condescension. Sarah protested to Avraham. She said, “I placed my servant at your chest. She saw that she had conceived and I became inconsequential in her eyes.” Sarah was emphasizing the unjust irony of her situation. She was the one – no one else – who gave Hagar to Avraham and now, she was suffering from Hagar’s attitude of superiority. Again, in this context the term anochi is appropriate.
• Yaakov appeared before his father Yitzcahak disguised as his brother Esav. Yitzchak asked him to identify himself. He responded “I am Esav your first born.” His was telling his father that he is the real Esav. In other words he was saying, “I – and I alone – am Esav. Again, the appropriate term is employed – anochi.
In the first statement of the Decalogue, Hashem says, “I –Anochi – am Hashem your G-d Who brought you out of Egypt. The use of the word anochi indicates that Hashem is saying, “I Who speaks to you now at Sinai am the same G-d that appeared to you at the Reed Sea.” Hashem is telling the nation that the G-d of Sinai is the self-same G-d that annihilated the Egyptians. Now, the Midrash’s understanding of the passage is easily grasped. Hashem is telling the people that one G-d redeemed them from Egypt and now is delivering to them the gift of Torah. This statement must have been necessitated by the nation’s confusion stemming from their varied perceptions of Hashem. Hashem responds that He is One even though He is perceived differently in different situations.
 Rabbaynu Shlomo ben Yitzchak (Rashi), Commentary on Sefer Shemot 20:2.
 Maimonides explains in his Sefer HaMitzvot that this passage is one of the 613 commandments of the Torah. He describes the commandment as recognition of Hashem as Cause of all existence. Others disagree and do not regard this statement as a commandment. Nachmanides, in his glosses to Sefer HaMitzvot, explains that those who dispute Maimonides’ position, regard the statement as introductory to the commandments. Hashem introduces Himself to the nation. Once the nation accepts Him as Sovereign, then He will legislate the commandments. This dispute between Maimonides and his opponents can be readily understood based upon the above discussion. Maimonides opponents regard the statement as a rational or the basis for a moral imperative to serve Hashem. We must serve Him because He saved us. Maimonides disagrees. He regards the statement as an intellectual lesson. Hashem is providing the nation with the most profound understanding of the universe that humanity can achieve. Hashem is its Cause. He gives the universe its existence every moment. Maimonides regards the acknowledgement of Hashem’s relationship with the universe and His centrality to its existence as a commandment. It is not a preamble to commandments or a rational for them. Instead, the statement is a profound and fundamental teaching that shapes the Jew’s perceptions of the universe that surrounds him.
Of course, Maimonides’ position seems suspect. Why did Hashem not describe Himself as Creator? Why did He refer to Himself as the Redeemer of the nation if His intent was to impart the profound understanding of Hashem and the universe that Maimonides attributes to this statement? Nachamanides actually addresses this issue in his commentary on the Torah at the end of Parshat Bo. He explains that the redemption of Bnai Yisrael from Egypt through unprecedented miracles that contravened the laws of nature and the natural order demonstrated Hashem’s omnipotence and sovereignty over the universe. This omnipotence can only be attributed to the Creator. In other words, it was impossible for the generation that stood at Sinai to have first-hand knowledge of creation – an event in antiquity. However, the miracles of Egypt provided first-hand proof – proof the generation witnessed – that Hashem was Creator. (Shemot 13:16).
 Rav Yosef Dov Soloveitchik, Recorded Lecture on Aseret HaDibrot, part 1, 1969.


Cross-curricular learning using video games.
GUEST COLUMN | by Suzi Wilczynski
For thousands of years, excellent teachers have known that games and learning belong together. Today we have remarkable technology available to us that makes the game experience more comprehensive and interactive than ever before. Using this technology, gaming transforms from a fun distraction into an opportunity to create a cross-curricular approach to learning for students. Interactive, cross-curricular games allow for that magically immersive experience in education referred to as “deeper learning” where students are continually engaged and interacting with subjects they love, progressing to higher levels of understanding and ability in crucial areas.
Effective educational games bear certain hallmarks that should be known and considered.
In school environments, math, science, social studies and language arts have traditionally been taught at different times of day, in different classrooms, and with different teachers. Game developers have the chance to break down these artificially-imposed barriers between subjects to create interdisciplinary learning. If one of the main objectives of the Common Core State Standards is to make college-ready students, then an interdisciplinary, cross-curricular approach is vital. Interdisciplinary studies that require students to use knowledge in a new way are powerful tools that help students achieve deeper learning.
Cross-curricular games provide students an opportunity to apply their skills outside the isolated environment of their math, science, social studies and language arts classrooms. When problem solving is put into a larger context with real-world applications, students internalize concepts and process them in a way that makes sense to them, leading to deeper understanding and better retention. Every good teacher knows that true learning comes from students finding the answers on their own and in their own way, an essential part of gaming and cross-curricular gaming in particular.
Whether or not you support the Common Core State Standards, we can all agree that the goal of education is to create “men and women who are creative, inventive and discoverers, who can be critical and verify, and not accept, everything they are offered” (Piaget). Cross-curricular gaming in the classroom is an important step in that process. Not all games are the same, however, so how do you know whether a game will successfully assist a student in accomplishing deeper learning, or any academic learning at all?
What to look for in a game
Effective educational games bear certain hallmarks that should be known and considered. Here are a few key elements to look for in a solid learning game experience:
Purpose-aligned learning. An effective game encourages a student use what they have learned for a future purpose. Inevitably, at some point, students will ask or wonder some variation of the famous phrase, ‘When am I ever going to need to know this?’ Learning games that clearly show a student that they can use what they learn for a future purpose instill a level of confidence and willingness in that student that makes teaching and learning look effortless. Such games are carefully developed; look for those clearly aligned to a future purpose for the student.
Content area knowledge. The gaming industry is crowded with games of every variety. While zombies and guns are popular, what you are looking for are those games that actually help a student along an academic course in science, social studies, music, art, etc., and that help them in these areas because ‘Zombie Hunter’ is not a real job listing. Scientist, educator, project manager, curator, artist are all real-world possibilities and while Common Core is a great guideline, more importantly, the future is what we make it.
Opportunities to explore. In educating a child, their self-determinism, the opportunity for them to look in wonder and to make a choice, one that they feel may be correct or interesting or one that merely satisfies their curiosity, is precious. Games provide a unique opportunity for children to explore and investigate things that are specifically of interest to them. There is a certain pleasure in learning new things, and even in going over the familiar, especially when one is in control of that learning. Look for games that provide the student situations in which they can choose a path forward and in which they control the level and pace of exposure to new information.
Multiple cognitive skills to problem solve. Even simple games engage multiple skills. Shooting zombies involves coordination, strategic thinking, and often collaboration with other players. Those skills are important, but literacy, mathematical knowledge, and comprehensive understanding of particular content are more useful in the long run. Good cross-curricular games are just that: they combine two or more curriculum areas into an engaging whole. They put students in situations where they must draw on information and skills learned in multiple classes, an ability that will serve them well in college and the job market.
What this means for the future
So, what does all this mean for the future? When it comes to learning and games, what should teachers look for? What should concerned parents look for? Games that enhance learning and develop knowledge come in many shapes and sizes. Teachers and parents should look for games that have at least one of the elements above, and the more they have the more the student will get out of the game. But the most educational game in the world is completely useless if it is lacking one key quality: fun. Fun is what sets games apart from other learning methods. Some people may think that “fun educational game” is an oxymoron, but the fact is, games that allow children to explore, use multiple cognitive skills, demonstrate content knowledge and provide them context for what they are learning are inherently fun. When we as educators, parents and even game developers accept the challenge to present knowledge in a clear, enticing and engaging way to our students, teaching and learning become not a challenge at all, but a true pleasure.
Suzi Wilczynski is the founder and CEO of Dig-It! Games, a company that believes in the power of games to promote critical thinking, independent learning, and cultural understanding. Their games incorporate age-appropriate content in math, science, social studies and language arts into fun, interactive and engaging learning experiences.


Quantitative macroeconomics subject focuses on the evaluation of economic theory and present global uses of associated concepts and their restrictions in the present sphere. This subject focuses on the study of the economic habitat of customers and manufacturing companies and their interconnection in markets for products, services, and other features of manufacturing, strategic interconnection, and evaluation of public products. Students seek Quantitative Macroeconomics Assignment Help as economics assignments require great time and dedication. Are you wondering who can do your Quantitative Macroeconomics Assignment Help at affordable prices? Well, experts at My Assignment Services Canada are here to make your academic life better, easier, and stress-free. Our experts provide solutions on various macroeconomics topics like the functioning of the national economy and aggregate economic variables, outcomes, employment, and unemployment-based factors, gross domestic product, inflation, and various cabinet laws that impact variables.
Macroeconomics is the branch of economics that focuses on the formation, management, performance, and decision-making of a business marketplace. It gathers regional, global, and national economies. Macroeconomics deals with the changes in the economy like consumption, gross domestic product, and so on.
Quantitative macroeconomics deals with constructing and evaluating macroeconomics models of economic development and business procedures. It also deals with advanced mathematical techniques to resolve economic dynamic development structures both numerically and analytically. Here are some of the objectives of learning quantitative macroeconomics:
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A macroeconomist is needed to foretell economic circumstances to assist customers, organizations, and governments to make better decisions:
The total amount of goods and services that a nation manufactures is commonly called the Gross Domestic Product. It is considered the blueprint of the economy at a specific point in time. When talking about GDP, a macroeconomist uses real GDP, which takes inflation into reports compared with nominal GDP, which contemplates only reforms in costs. The nominal GDP statistics are higher when the inflation rate goes high year after year, so we can say that it is not an essential indicator of higher outcome standards, only of higher prices.
The unemployment rate helps macroeconomic analysts determine the number of individuals from the available labour unit is inadequate to discover work. Macroeconomists consent that when the economy records developments from period to period, which is specified in the GDP growth rate, the unemployment rate tends to be below. This is so that as the real GDP stages, we realize that the outcome is higher, and hence, more workers are required to maintain the levels with the greater levels of manufacturing.
Inflation rate is the third concept with which macroeconomists deal. It is simply defined as the rise in prices of goods and services. The inflation rate is mainly measured in two techniques which are the Consumer Price Index (CPI) and the Gross Domestic Rate (GDP) deflator. The CPI depicts the present rate of a selected hamper of products and services that is modernized periodically. The GDP deflator is defined as the ratio of nominal GDP to real GDP. The costs of goods and services are considered to be rising when the nominal GDP is higher than the real GDP. Both the GDP deflator and CPI are regarded to shift in the same direction and vary by less than 1%.
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Pupils' conceptions of learning geography under the National Curriculum
Conceptions of geography and learning geography have been studied through recording the experiences of a group of secondary school pupils over a threeyear period. This group formed part of the first cohort to experience Key Stage 3 Geography in the National Curriculum. The study is set within the context of Geography in the National Curriculum and the formulation and issues arising from this are discussed. A review of recent research in geographical education is presented to indicate how this study adds to current thought and practice. The study sought evidence to answer two specific questions: 1. What is geography? 2. What is learning geography? The study is set in a secondary school in Kent where the researcher has taught for sixteen years. Evidence was obtained from two classes of pupils, these were taught geography by the researcher for the whole period of Key Stage 3 1991- 1994. Data was obtained through applying a range of methods. The study was conducted in the phenomenographic tradition, seeking qualitatively different ways in which pupils understood the phenomena of geography and learning geography, and describing the "structural" and "referential" aspects of each. Categories of description of the distinctly different ways in which the phenomena are understood have been identified, presented and discussed. The categories are illustrated by quotes from individual pupils. These form the results of the study. The results of the study shed light on the ways in which pupils understand aspects of geography and learning geography as developed in the context of Geography in the National Curriculum. The longitudinal perspective adopted illuminates how these understandings change over time. A discussion is presented which clarifies the main features of the conceptions discovered. This is followed by a consideration as to how the results of the research could be applied by teachers to their understanding of geography, the pupils they teach, and in planning learning experiences. The thesis concludes by drawing together the contextual setting of the research, methodology and key findings. It suggests reasons that may have influenced the findings before considering their utility and avenues for further research.


How P-16 education can increase women in STEM fields
On Pi Day, which lands during Women's History Month, we dive into the complexities of recruiting and retaining women in STEM fields
Sandra Cauffman was just seven years old when the Apollo 11 crew made a historic landing on the moon on July 20, 1969. Cauffman and other children in the neighborhood gathered around a neighbor’s flickering black and white television screen to watch Neil Armstrong plant his foot into the dusty lunar terrain — a mesmerizing moment during which she felt anything was possible.
“I told my mom I want to go to the moon,” said Cauffman. “And my mother said ‘you can be anything you want, just put your mind to it, you never know.’”
Cauffman is now the Deputy Director of the Earth Science Division in the Science Mission Directorate at NASA. But getting to that point was not easy; growing up in a poor Costa Rican family in San José Canton district meant Cauffman would have a number of barriers to obtaining her goal, not the least of which was gender.
Data show only 29% of the science and engineering workforce is comprised of women. And with the onus resting on the shoulders of higher education leaders to provide graduates for gaps in the workforce, as well as significant ROI for students — barriers in the pathway create not only moral challenges, but economic ones.
Pressures for women don’t start in college, but early on — and finding a solution to workforce demands requires leaders across the spectrum to collaborate in order to patch a leaky pipeline.
Early Education: Implicit bias creates the beginnings of a gender gap
Growing up Cauffman says her mother, a single parent, worked multiple jobs concurrently to keep the family afloat. But that didn’t stop her from being one of her daughter’s strongest advocates.
“I think parents and teachers have the power of elevating kids and helping them succeed, or they can consume them and tell them they can’t do anything,” said Cauffman. “I had a lot of encouragement from my mother and and that really pointed me … it helped me decide I wanted to be an engineer.”
In addition to her mother, Cauffman cites one particularly encouraging teacher as supporting her in her quest to get to the moon.
“I had a wonderful elementary school teacher, who was loving and demanded a lot out of her students. She taught me to participate in everything and pay attention,” said Cauffman. “I had her all the years, and she was very encouraging.”
But not all girls get the same encouragement. Experts show a lack of encouragement and confidence building from both parents and early instructors can result in girls devaluing their abilities, a symptom that can conflate throughout college and beyond.
Authors of a Joan Ganz Cooney Center report on early STEM education, “STEM starts early,” found gender-based perceptions around girls’ abilities can start affecting them as early as their toddler years. A longitudinal study of more than 12,000 students showed that while there isn’t a math gender gap in kindergarten, one forms and grows by the end of third grade among some of the top performing students — and much of it is attributable to the effects of teacher bias. Additional studies show girls begin downplaying their intelligence by around age 6.
“What we were seeing is even if you have a boy and a girl who are equally engaged with the material, equally well engaged in class [...] and that boy and girl has the same test score, it turns out that the teacher often says the boy has a higher math ability than the girl,” said Joseph Cimpian, one of the report’s authors. “The punchline is teachers underrating the ability of girls actually leads to the gender gap growing — it’s a self-fulfilling prophecy.”
And the same thing happens in terms of parental encouragement, says Cindy Hoisington, an early childhood and elementary science teacher, at the Education Development Center. She mentioned a recent study where girl and boy toddlers traded clothing to see how parents would interact with them.
“The adults came in and the children they thought were girls — they were pushing dolls on them, talking a lot about feelings, and loving the baby doll and feeding it.“But, with the boys they were interacting with them with trucks and asking questions like ‘How do you think this works?’ Already with toddlers you will see that’s the kind of mindset that starts science learning,” said Hoisington.
Cimpian and his colleagues recommend more alignment between pre-K and elementary STEM education, including initiatives that offer information to parents on how to start engaging their children in these subjects. But closer collaboration with higher ed and industry at a younger age is also needed.
Research shows that interest in STEM peaks in middle school but can disappear in high school — often due to societal pressures. This particularly manifests in subjects like calculus, which are key to getting into STEM careers, with research showing that declining interest in STEM among girls from grade 4 onwards, controlling for for academic preparedness, career intentions, and instruction, means the odds overall of a woman being dissuaded from continuing in the subject is 1.5 times greater than that for a man.
More help from higher education and industry to build the pipeline
To tackle this higher education and tech industry leaders can begin to publicize more female role models and offer hands-on opportunities in science to younger girls through K-12 partnerships.
For example, the Women in Engineering program at the University of Maryland, College Park builds out the pathway for women by reaching out to girls in 4th through 12th grade with STEM programs offered throughout the summer and academic year. Initially, the program only targeted 11th and 12th graders, but the directors realized that by that it time, it was too late to attract and sustain interest.
By focusing on a greater segment of their desired future enrollees, the school is fostering a more viable talent pool from which to recruit. By tapping into girls’ curiosity while young and then building the confidence in their abilities into high school, these institutions are able to engage more women at a key transitional point at which they decide whether to go into a STEM major upon entering college.
Higher Education to career: Fear of failure leads to low retention rates
Cauffman managed to finish high school and went on to the University of Costa Rica, where she was told by professors studying electrical engineering wasn’t “womanly” enough.
“They told me I couldn’t study electrical engineering because I was a woman,” said Cauffman, who reports being steered toward industrial engineering instead. “I spent seven semesters in this, and I didn’t like it. So I decided to pack up and come to the United States.”
Cauffman would go on to learn English and take on a side job as a cashier in a hardware store to pay her way through bachelor’s and master’s degrees at George Mason University. She eventually graduated with degrees in electrical engineering and physics and was hired on the spot by NASA. But for many women, the pressures of not being “fit” for these types of careers compels them to give up and go into an alternative field — even if the interest and performance was sustained through high school.
Lisa Flores, a researcher from the University of Missouri whose work centers on retention factors for women in STEM, found engineering fields often lack women when there is an impression from the campus community they will not succeed. More specifically, her team found women often “expect negative experiences in the field and that might be enough to deter them.”
Cultural change is needed
Women leave the tech industry at a rate 45% higher than men and the gender gap in computing jobs has widened in the last 30 years. Colleges seeking to keep up their retention rates for women in STEM fields may be taking a step in the right direction by allowing industry partners to actively recruit women on campus, but leveling the playing field requires addressing culture in the classroom and in the workforce.
That’s the basis of efforts by The United Nations Women, which developed its HeForShe initiative to create networks between corporations, governments, and higher education institutions around the world to not only advance gender equity, making it clear that certain places of work are not just made for men.
Stony Brook University President Samuel L. Stanley, Jr., who is participating in the initiative,
said despite typically low retention rates in STEM fields, he found that those classes offering mentorship opportunities with female faculty members led to the institution retaining and graduating higher numbers of women in STEM.
“Women at Stony Brook graduate at a higher rate than men, so we’re missing opportunities to produce more engineers by not getting more women interested in STEM,” he said, calling the failure to attract more women to the disciplines “a tremendous waste of potential.”
Code.org CEO, Hadi Partovi said tech companies also have a responsibility to “promote role models who have diverse backgrounds to help show the younger generation examples of existing leaders in technology.”
“The internal culture of some of these companies is famously bad on diversity issues, and people should recognize that creates a disincentive for students to get into them and stay in the field,” she said.
“There is some understanding that needs to occur. Yes there are women and there are men, and that doesn’t determine what you can do,” said Cauffman, who recalled that during her work on the Hubble Space Telescope, male colleagues questioned her ability to do the work. “It’s a matter of speaking up and saying what your needs are — but also demonstrating your commitment.”
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A new exhibit has opened up at Chico State showing the history of Japanese internment camps in America.
It's called Imprisoned at Home at the Valene l. Smith Museum of Anthropology.
About 120-thousand Japanese-Americans living in the country after the bombing of Pearl Harbor who were then forced to live in what were known as war relocation centers.
Stan Umeda was seven years old when he was forced into an internment camp, and was on hand for the exhibit's opening reception:
He said, "But in essence, 9/11 happened. Holy cow this is happening to somebody else, we can't let this happen again. So we got more active again because it really is something that unless you are vigilant, things will happen again, it really is frightening at times.”
The exhibit runs through august the Valene Smith Museum of Anthropology is located in the Meriam Library Complex on campus.
- Chico State opens new exhibit
- Moon exhibit at Chico museum
- Gold Nugget Museum opens new exhibit
- Turtle Bay Opens New Prehistoric Exhibition
- New Exhibits Open Thursday at MONCA
- 'Black and White in Black and White' Exhibit Opens in Chico
- Chico State opens new agriculture center
- Chico State graduates open hot yoga studio in Chico
- Outdoor recreation and fishing exhibit opens in Paradise
- Gateway Science Museum new exhibit


The protagonist is the chief actor, or main character, in your book. It might be a man or a woman, or even a fictional character with no gender (such as a tree). For today’s post, we’re going to refer to the protagonist as “him” for continuity’s sake.
Why is it important for your protagonist to be powerful? I don’t mean physically strong. I don’t even mean personally effective or likeable. Your protagonist may be on your readers’ hate list, but perhaps they have a grudging respect for him. I’m talking about powerful in terms of making an impact with your readers. A main character who doesn’t make an impact with your readers is going to lead you down the path to the dark side of being unpublishable.
In order to understand what makes him powerful, let’s look first at what makes him weak. A protagonist who is perpetually stupid, whines about everything, and can’t make a decision for himself is weak. A useless person with no good reason for never standing up and being courageous, instead preferring to cower behind somebody else. What kind of a story could you have about such a person if he stayed that way throughout the entire book? While he might be a great “good guy,” if nobody cares what happens to him, he’s weak. If your readers feel like slapping him in the face and screaming, “Get a grip, guy!”, he’s weak. If you readers don’t keep reading, he’s weak.
THIS ARTICLE describes it very well in calling him a “useless” protagonist.
How to make him powerful? Give him foibles and weaknesses, but create him in a way that makes readers care about what happens to him. There has to be something special about him; something nobody else in the story has. (Not like three eyes—unless you’re writing fantasy.) Your protagonist may start out weak and wimpy, but he has to grow and change as the story progresses. Or he may pretend to be weak, but is truly effective in overcoming his problems and knowing when to take charge as necessary to stand up for himself, as well as others.
THIS ARTICLE is very good in discussing strong and weak characters.
You can go overboard with an all-powerful protagonist. If your superhero main character overcomes everything thrown at him and shows no weaknesses—or even emotions—then he’s Mr. Perfect. Nothing can touch Mr. Perfect, including the antagonist (bad guy), so you end up with the same problem as before—what can you write about him? Your protagonist must be balanced to be effective for your story.
How do you find out if your protagonist isn’t powerful? Beta readers are excellent people to give you feedback on such a problem. You might send questions along with the MS which will help you specifically focus on this issue. Rather than drowning them with forms to fill out, try a simple question: “Did you care about the main character? If not, why?” You might be surprised at their answer!
Next week we’ll discuss ‘Writer’s Block’
This series is not meant to be (nor will it be) simple static information.
I’ll be here for each post to answer questions, offer suggestions as necessary, and interact with you.
If there’s something you specifically want (or need!) to see addressed in terms of self-editing, please let me know in the comments under this, or any of the articles of the series.


Your body has various sophisticated ways to automatically detox every day through its main systems and organs, but also through some other, perhaps more surprising ways…
- Bowel movements – when our intestines break down nutrients, the waste materials include toxins and unhelpful bacteria which are expelled by the colon. Excessive bowel movements, whether frequent or diarrhoea are our body’s way of ejecting toxins as quickly as possible.
- Urination – urine is a waste product from both the kidneys and liver functions.
- Snot & mucous – lovely! But a good way of pushing out this internal breeding ground for bacteria and disease.
- Bile and vomit – the liver cleans the blood, producing enzymes to destroy toxins that come from our food, water and the air. These toxins can then be expelled through both urine and bile. Vomiting is a more extreme ejection of toxins from the body such as food poisoning.
Those four are well known, but did you know the next four?
- Skin – one of the best ways to expel toxins is by sweating. Sweating not only regulates temperature it also pushes out toxins. Spots and acne are another representation of the body pushing out toxins to its outermost layer.
- Breathing – we breathe in toxins, but we also expel them through our breath, helping the lymphatic system cleanse. Through deep and regular breathing, we also expel negative feelings and anxiety.
- Menstruation – some women do not see the regular arrival of their period in a good light, but actually it is a great and additional way that women’s bodies detox every month. The menstrual period is a natural cleansing process, releasing bacteria from inside the reproductive system and helping the body to discharge excess iron, which in turn helps lower the risk of cardiovascular disease.
- Tears – our bodies’ release valve for stress, sadness, grief, anxiety and frustration. There are 3 different types of tears – ‘reflex’ for clearing dust particles, ‘continuous’ for lubrication of the eyes, and ‘emotional’ tears. They all have healing roles but the emotional tears have high amounts of the protein-based hormones produced by the body when under stress. Weeping helps to wash these toxic chemicals out of the body, elevating mood and lowering stress, which is linked to many health problems including lowered immunity, heart disease, high blood pressure, type-2 diabetes and obesity. So don’t hold back the tears!
It is reassuring to know that the body is always working hard to remove toxins and is so good at self-maintenance. A few extra glasses of wine one evening it can usually handle; a prolonged poor diet may make the body work harder over time and need a boost such as a fast or juice detox, but on the whole it will continue to work well though we do accumulate toxins in the body as we age.
Where it does need extra help is when something really significant has interacted with the body and is so overwhelming that the body struggles and can’t detox without extra help. At this point more serious symptoms can occur. One or more of the following can affect the immune system and organs with longer lasting and detrimental consequences to health:
- Heavy metals (from vaccines, environmental pollutants)
- Oral contraceptive pill, morning after pill, birth control injection
- Vaccines, eg HPV, DPT
- Other medication eg anti histamines
This is where homeopathy can step in and give the body some extra information that will help it combat what it views as too many toxic chemicals to handle, no matter how much they may have helped at the time.
My Homeopathic Detox Therapy programs address all the above examples and are tailored to the individual. Homeopathic remedies are gentle, non-toxic and non-addictive. Give it a try, your body will know what to do.


Many modern-day office chairs make use of hydraulics or ‘pneumatically-driven’ lift systems that permit the individual to move the chair backwards and forwards easily. This enables them to use the scientific research of comfort designs.
What is Comfort design?
Ergonomics is a combination of self-controls such as composition, physiology, psychology and engineering. Essentially, it’s worried about how people connect with their environment as well as the ways the setting can be changed to make sure risk-free and reliable functioning methods. For instance, comfort designs can be applied to physical objects such as chairs and desks, or it could be related to a system, such as communications in between different departments.
An ergonomic chair is created specifically to support the body throughout extended periods spent sitting. They have lots of functions that are developed to enhance pose and also convenience as well as to help sustain the health of the individual whilst they are working at a desk. These ergonomic chairs typically have mechanisms to aid to change the seating placements promptly and conveniently– making use of hydraulics via a lever below the chair.
What does the term ‘hydraulics’ imply?
Hydraulics– as well as pneumatics– are the terms used for applications of fluid power. Hydraulics utilizes incompressible liquid steel (such as oil) to allow equipment activity, and pneumatics make use of a conveniently compressible gas such as air (or a pure gas) to enable the very same functionality. Hydraulic systems can relocate hefty lots, nonetheless, pneumatic modern technology is cleaner, utilized for lighter loads (such as workplace chairs), and also is both much safer as well as easier to save. Both systems make use of the same modern technology, nonetheless, pneumatics are normally used for office chairs.
Exactly how does a pneumatically-driven system job?
Pneumatically-driven chairs are adjustable using a lever typically positioned simply below the seat. This lever moves the seat up and down in a fluid activity. But just how does this job? There are several elements that are included right into a pneumatic chair! They are:
The chair base (normally 3, 4 or five wheels);.
a gas cyndrical tube that keeps the compressed air;.
a seat that is covered with a plate holding the adjustable bar;.
a cushioned back assistance.
What is a gas cylinder and how does it function?
Gas cylinders, or pneumatic cyndrical tubes, are tools that take the pressured power of pressed gas as well as require it via a chamber which after that moves a piston in the called for area. This movement and also pressure allow the workplace chairs’ seats to rise or lower down. When the bar on the chair is pushed, the gas is pushed in and out of the chamber, facilitating this movement.
Why has your workplace chair quit relocating?
If a workplace chair is made use of on a daily basis and is quite old, the height modification may be the first thing to go. If your chair won’t increase or down, it is normally because of a malfunctioning gas cyndrical tube, or because of a lift system that won’t work. Depending upon how old the chair, you could either send it back to the maker, repair it on your own or …
The most important aspect of a chair is comfort designs however lets speak about functional designs a little.
Some office trends may ebb and flow, nevertheless, ergonomic workplace furniture is one facet of industrial office design that continues to obtain popularity. The clinically created furnishings and modern technology has actually been verified to benefit the health as well as wellness of workplace staff. Today, ergonomic workplace pieces blend state-of-the-art technology with an attractive visual to help develop a space that gives health benefits to users. Below’s what you require to find out about ergonomic styles in your business room.
What Is Ergonomics?
Simply put, ergonomics is about producing a work environment in accordance with its customers’ demands. Ergonomics focuses on designing daily workplace tools to fit the handler’s kind, thus boosting performance and also reducing pain. This scientific strategy to work environment style takes into consideration angles, positioning, assistance, as well as most significantly, takes a look at just how each associates with our specific human types.
Take into consideration the height of your office chair in relation to the computer monitor. Ergonomic positioning of each can drastically enhance position, flexibility, as well as comfort while reducing pressure on muscle mass, joints, and also eyes. Through understanding the human body and its activity, functional designs looks for to enhance all facets of the workplace setting with conscious and thoughtful style.
What is Ergonomic Furniture?
The ergonomic workplace chair has actually been around for years and remains to be a vital item in any modern commercial office space. Every year, we see new innovations in ergonomic style that seek to enhance customers’ experience by promoting their physical health. We invest about 8 hours a day in the workplace and also a substantial quantity of time in our desk chairs. The modern-day ergonomic office chair might currently consist of tilters, flexible lumbar support, memory foam seats, and also portable arm rests. The science behind each attribute is based on the selection of human body types, capabilities, and requires.
Ergonomics additionally looks for to urge movement throughout the day. Conventional workplace furniture has forced individuals to continue to be inflexible and less active; nonetheless, the sit-to-stand workdesk permits the operator to work in healthy seated and also standing positions throughout the day. Supplying comfortable floor coverings with standing desks will decrease reduced back pain as well as joint anxiety. Ergonomic keyboards, phones, and headsets motivate all-natural activity when using each product. Customers won’t strain to hold a phone in between their neck and shoulder, nor will certainly they hold wrists as well as hands in unpleasant positions when keying or dialing.
Innovations in Functional designs.
Scientific research has answered numerous physical demands via innovations in ergonomic workplace furnishings style. We are currently seeing a better focus positioned on the avoidance of psychological stress, anxiety, and also burn-out. Ergonomics is expanding to include methods past monitor placement, neutral positioning, as well as physical movement. Applications to advertise micro-breaks and also mindfulness can be thought about ergonomic technologies, decreasing discomfort and also pain on a mental degree.
So whether you are trying to find executive office chairs (καρέκλεσ γραφείου διευθυντικέσ) or staff office chairs (καρεκλες γραφειου) or waiting area office chairs (πολυθρονες γραφειου ), ergonomics and hydraulics are all issues that should be attended to appropriately.


Video Game Technology Embraced by Med Students: Survey
WEDNESDAY, Aug. 11 -- The vast majority of medical school students believe that technology in the form of virtual reality exercises could help them to develop the skills they will need as future doctors, a new survey reveals.
The survey of 200 medical students from the University of Michigan and the University of Wisconsin-Madison found nearly all (98 percent) believing the technology to be a definite aid to higher learning.
"Due in large part to their high degree of technological literacy, today's medical students are a radically different audience than the students of 15 to 20 years ago," study co-author Dr. Frederick W. Kron, a former assistant professor of family medicine at the University of Wisconsin and current president of Medical Cyberworlds, Inc., said in a University of Michigan news release.
"They are actually more comfortable in image-rich environments than with text," Kron added.
The findings were published online recently in BMC Medical Education.
Four out of five of those polled said that video games can have educational value, while more than three-quarters said they would be willing to engage in an online role-play in a virtual health-care setting alongside other student players, if it could help them meet educational goals, the survey found.
"Allowing students to step into the shoes of practitioners in different specialties, health-care settings and economic systems, in an immersive and authentic way, could help guide their decisions regarding which career choices would be the best fit with their values and personal characteristics," co-author Dr. Michael D. Fetters, an associate professor in family medicine and director of the Japanese Family Health Program at the University of Michigan, noted in the news release.
The study authors noted that simulation techniques and computerized mannequins have already become the norm in medical school, serving as a training tool to prepare students for various operating room scenarios. The survey's findings, therefore, could encourage schools to go even further in harnessing technology to improve the educational process, they added.
For more on video gaming and education, visit the Science Education Resource Center at Carleton College.
Posted: August 2010
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Julius Streicher, the Nazi leader who was considered "Jew-baiter No.1" because of his violent anti-Semitism, was captured today by American officers on a farm in Bavaria, where he was trying to hide, using false identification documents.
The virulent anti-Semite, who became infamous as a result of his pornographic anti-Jewish weekly "Der Stuermer," and who was very much admired by Hitler for his wild anti-Jewish activities, was discovered by members of the 101st Airborne Division. He was reported to have amassed a huge fortune by robbing Jews and confiscating their property. He was chosen by Hitler in March 1933, to direct a boycott against Jews as a prelude to organised persecution and robbery of the Jewish population in Germany and later in German-occupied territories.
The Berlin radio today resumed broadcasting, under control of the Russians, giving lengthy descriptions of the mass-extermination of Jews in the camps at Maidanek and Oswiecim and queting eye-witness reports. The broadcasts will be repeated for several days in order to acquaint the German population with the crimes committed against the Jews during the Hitler regime.
The Archive of the Jewish Telegraphic Agency includes articles published from 1923 to 2008. Archive stories reflect the journalistic standards and practices of the time they were published.


Burchardt, Tania and Vizard, Polly (2007) Definition of equality and framework for measurement: final recommendations of the equalities review steering group on measurement. CASEpapers, CASE/120. Centre for Analysis of Social Exclusion, London School of Economics and Political Science, London, UK.
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In October 2007, a unified Commission on Equality and Human Rights (CEHR) will begin operation in Britain. The Commission will have responsibility for monitoring and promoting human rights and equality on the grounds of gender, ethnicity, disability, age, sexual orientation, transgender status, and religion/belief. As a precursor to the Commission, the Prime Minister established the Equalities Review, an independent, high-level, investigation of the causes of persistent inequality and disadvantage in British society. Its final report, Fairness and Freedom, in February 2007 adopted the capability approach as its measurement framework and recommended that all public bodies use the framework to “agree priorities, set targets, and evaluate progress towards equality” (p.110). In particular, the Review recommended that the framework be used by the CEHR to inform its regular ‘state of the nation’ report. This paper, and its companion, Developing a Capability List: Final Recommendations of the Equalities Review Steering Group on Measurement (CASEpaper 121), were prepared as background papers to assist in the development of the measurement framework for the Equalities Review. It discusses the challenges in translating capability theory into a practical measurement tool in the context of measuring inequality in Britain in the 21st century. This includes the definition of equality, a procedure for generating and revising a list of central and valuable capabilities (this is considered in more detail in CASE/121), a measurement framework for monitoring trends in inequality, exploring the causes of inequality, and identifying possible policy interventions, and, finally, the types of information and analysis which are required.
|Item Type:||Monograph (Discussion Paper)|
|Additional Information:||© 2007 The Authors|
|Library of Congress subject classification:||H Social Sciences > HV Social pathology. Social and public welfare. Criminology|
|Journal of Economic Literature Classification System:||I - Health, Education, and Welfare > I3 - Welfare and Poverty > I32 - Measurement and Analysis of Poverty
I - Health, Education, and Welfare > I3 - Welfare and Poverty > I31 - General Welfare; Basic Needs; Living Standards; Quality of Life; Happiness
|Sets:||Collections > Economists Online
Research centres and groups > Centre for Analysis of Social Exclusion (CASE)
|Date Deposited:||30 Jun 2008 14:43|
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By Nan Talleno
PHILADELPHIA (CBS) – Dogs vocalize in several ways including barking, whining, yelping, howling and growling, among others. It’s all forms of communication. As a canine behaviorist, I’ve seen that the most disconcerting – for most people and other canines alike – is growling, due to its very nature.
Growling is a way for the dog to communicate any number of things including fear, anxiety, insecurity or stress. It could also be purely territorial or used as a warning along with very distinctive body language, such as ears up, hackles up and tail erect to signify an offensive stance or ears pulled back and a lowered tail to signify a defensive and fearful stature but still a serious warning to stay away.
Growling is intense communication but not necessarily a bad thing in and of itself. It’s how and why that matter. The dog is trying all he/she can to warn. When a dog growls, it signifies that he/she is perceiving an onset of a threatening situation. It’s a dog’s way of saying that if the threat isn’t removed “I need to aggress,” although the reasons vary with each individual situation. Try to determine WHY your dog is growling BEFORE any aggression on the part of the animal ever takes place.
Appropriate and responsible leadership skills, making sure the dogs needs are adequately met, along with increased exercise for excess energy to be naturally and safely depleted may be required. But in intensive instances, it’s always best to seek the help of a qualified trainer or behaviorist first.


Satish Deshpande (Ed.)
|Year of Publication||
Caste is one of the oldest concerns of the social sciences in India that continues to be relevant even today. This book tracks how scholars from different disciplines have responded to the caste question in independent India and highlights recent shifts in perspective.
The general perception about caste is that it is an outdated concept that was slowly but inevitably dying out until it was revived by colonial policies and promoted by vested interests and electoral politics after independence. However, this hegemonic perception changed irrevocably in the 1990s after the controversial reservations for the Other Backward Classes recommended by the Mandal Commission. Mandal triggered a new awakening by revealing that only a privileged upper caste minority believed in the declining significance of caste—for the vast majority of Indians caste continued to be a crucial determinant of life opportunities.
This volume collects significant writings spanning seven decades, three generations and several disciplines. The introduction contextualises established perspectives in relation to emergent concerns, and is followed by forty essays organised into six sections.
The first section offers a sample of disciplinary responses ranging from sociology to law. The second explores the relationship between caste and class, while the third highlights the interplay between caste and politics.
The fourth section covers old and new challenges in law and policy. Emergent research areas are represented in section five and section six showcases post-Mandal innovations in caste studies.
This transdisciplinary volume brings together sociologists, anthropologists, political scientists, historians, economists and others. It will be essential reading for students and scholars across these disciplines.