Category: Conversation

In recent year the controversary surrounding vaccines have risen to the limelight, but the history surrounding this ordeal is much longer than that. Ever since the first vaccination in 1798, the impacts of vaccines have ranged from the suppression of polio to smallpox worldwide in the use to reshape the landscape of human health and medicine (Martin, 2015). In fact, vaccines have been so prominent that scientists consider them among the greatest accomplishments in the public health world. Despite the strong evidence of the benefits of immunization, a growing number of parents are deliberately postponing or refusing vaccinations due to vaccine effectiveness and safety concerns. An individual’s decision not to vaccinate their child, whatever their reasoning, is a decision that puts their community at risk from a potentially devastating disease.

Overview of the Case Study

Jenna and Chris Smith are the proud parents of a 5-day-old baby girl named Ana, who they desire to raise her as naturally as possible. For the Smiths also choose to breastfeed Ana for the first six months, make her organic baby food, and not allowing her to be vaccinated. Their new pediatrician, Dr. Angela Kerr, listens intently to the Smiths’ description of their research, related to the potential harms that could lead to autism in many children. The Smiths conclude by resolutely stating they’ve decided not to vaccinate Ana, despite the recommendations of the medical community.

Face with this dilemma, Dr. Kerr explained to the Smiths how vaccines have saved the lives of millions of children worldwide and have been largely responsible for decreases in mortality over the past century. For example, in the 1990s’ a decreased of infection related to the potentially fatal Haemophilus influenzae type b, was the results from routine immunization. Similarly, epidemics such as measles are usually associated with individuals who have not been vaccinated against the virus that can cause the disease.

Dr. Kerr goes on to endorse the safety of vaccines by informing the Smiths of updated data sources such as the federal government’s Vaccine Adverse Event Reporting System (VAERS). The VAERS is nationwide vaccine safety surveillance program sponsored by the Food and Drug Administration and the Centers for Disease Control and Prevention, that is accessible to the public at https://vaers.hhs.gov/index (Capella University, 2020). The VAERS system allows vaccine transparency by encouraging the public and healthcare providers to report adverse reactions to vaccines and permits safety to monitor by the government. No form of vaccine has been proven to cause autism spectrum disorder (ASD) or any developmental disorder. However, an ingredient known as thimerosal was once thought to cause autism, but there is no proven risk. Finally, Dr. Kerr’s ethically support about vaccination was not enough to convince the Smiths that vaccinating Ana was safe.

Analysis of Ethical Issues in the Case Study

In the case study, the main factor that led to Dr. Kerr’s ethical dilemma is Ann’s parents’ refusal of vaccination for their daughter with the belief that vaccines may weaken their child’s immune system and therefore cause autism. As Dr. Kerr respects to the belief of Ana’s parents, she decides to explain the risks and benefits of preventive that could involve. Dr. Kerr assured the family that she too is acting in the best interest of the child; therefore, she thinks it is her duty to make sure Ana receives medical attention. She explained in the conservation to the Smith by making the choice not to vaccine is an impact not only themselves and their child but also other members of the community; therefore, they have a duty to do what is necessary to minimize the impacts on others. If they were not willing to do your part for “herd immunity”, they need to take responsibility for staying out of the herd (Cappella University, 2020).

Using the Ethical Decision-Making Model to Analyze the Case Study

The three components of the ethical decision-making model—moral awareness, moral judgment, and ethical behavior—can help analyze the ethical issue outlined in the case study. Doctors are often faced with situations that require sound ethical decision-making ability. Determining the appropriate strategy to take when faced with a difficult ethical dilemma can be a challenge. Using an ethical decision-making model would not only support the doctor’s best interest, but also support Dr. Kerr in being an ethical health care provider. Dr. Kerr’s moral awareness is reflected by the fact that she recognizes the circumstances surrounding Ana not being vaccine. Her moral judgment is reflected by her decision to try to convince the Smiths that vaccinations have proven to be tremendously successful in controlling disease and mortality; however, they are not completely free of harmful side effects.

By reviewing these ethical principles, which serve as the foundation of the guidelines, will help Dr. Kerr to clarify the issue involved. The five anchor principles of an ethical decision making includes autonomy, justice, beneficence, nonmaleficence, and fidelity are each vital in and of themselves to a healthy counseling relationship (McCartney, 2017). Dr. Kerr should also document her decision-making process in the Smith’s file as a health care provider.

Effectiveness of Communication Approaches in the Case Study

Listening and trust plays a vital role in patient–healthcare professionals communication when it comes to issues such as vaccinations. The paramount challenge in achieving high acceptance of vaccines is finding interventions that will lead to full compliance with the parent satisfaction and build trust in the recommendations of the professional. The healthcare providers should aim for both parental satisfaction and a positive decision to vaccinate. By active listening to the Smiths, Dr. Kerr learning their research which included online mommy–blogs were the main resource of how vaccination may cause autism in children. Despite the recommendations of the medical community, online mommy-blogs were their main source not to vaccine Ana.

Dr. Kerr understands she cannot vaccine Ana without the Smiths’ permission, because she would be overstepping her boundaries as a health care professional. So, Dr. Kerr decides to present them with the information they need to make an informed decision. She stressed scientific studies do not support the concern that thimerosal causes autism were the least convincing and least believable of the messages tested. She also explained the benefits of the vaccine do not outweigh the perceived risks of the vaccine. With the upmost respect of the Smiths’ emotions and providing them with all-inclusive information about vaccination, Dr. Kerr communicated the situation to them in an effective manner. However, she was unable to convince the Smiths to get Ana vaccinated.

Although Dr. Kerr followed a logical approach while dealing with the issue at hand, it seems to have been ineffective as Ana’s parents continued to stand by their beliefs of vaccinations would lead to autism. However, listening patiently to the patients’ problems along with showing empathy and genuine care while communicating with them are some lessons that health care professionals can take back from this case study.

Resolving the Ethical Dilemma by Applying Ethical Principles

Whether an individual role is that of a doctor or a health care administrator, working in the field of health care can be both highly rewarding and challenging. Numerous medical treatments have both advantages and downsides and allowing the patient to have their own input and circumstances to consider. Several foundational principles are use as keystones for the best ethical practice and the process of ethical decision making to the help professions. By examining an ethical dilemma with regard to these principles, a healthcare professional may come to a better understanding of the conflicting issues. For this cast study, the beneficence principal will serve as the best the foundation of the guidelines.

Beneficence reflects the medical professional’s responsibility to contribute to the welfare of the client (McCartney, 2017). Simply means to be proactive and prevent harm when possible. Beneficence can come in many forms, such as prevention and early intervention actions that contribute to the betterment of clients. Dr. Kerr tried to convince the Smiths that vaccines are different than most medicines because they are strictly preventative to diseases that are no longer potentially a threat to babies and young children.

Conclusion

Although, health professionals such as Dr. Angela Kerr have a central role in maintaining public trust in vaccination, including addressing parents’ concerns. There are numerous reasons why parents such as the Smiths may be opposed to immunizing their children, such as fear of the side effects. By being respectful and carefully listening to the parents’ concerns, Dr. Kerr may in fact be able to ease the parents’ anxieties regarding vaccine Ana by providing benefit information as well as discussing misinterpretations that might exist.

It can be difficult to determine what is in the best interest of the child; however, it is important to balance the parents’ opinion with scientific evidence. As a healthcare provider serving the children in the communities, it is Dr. Kerr’s responsibility to treat these children with the best preventative medicine possible. In so doing, Dr. Kerr will gain the trust of the parents who may afterward make the decision to immunize.

References

1. Capella University (2020). NHS-FP4000 Exemplar Sample Ethical Case Study. Retrieved from Cases in health services management.
2. Martin, B. (2015). On the Suppression of Vaccination Dissent. Science & Engineering Ethics, 21(1), 143–157. https://doi-org.library.capella.edu/10.1007/s11948-014-9530-3
3. McCartney, J. J. (2017). The duty to vaccinate: Clarifying and broadening the basis of the obligation. American Journal of Bioethics, 17(4), 46–47. https://doi- org.library.capella.edu/10.1080/15265161.2017.1284939

This article tries to discuss and explore the interface between tourism and peace. It attempts to address how tourism a peace sensitive industry by taking COVID-19 as an agent changes in the realm of it. This article aims to assess how tourism is a peace sensitive industry, by taking the impacts of COVID-19 pandemic on tourism in its social, economic, cultural, and environmental circumstances. The incidence of pandemics affirms how tourism as peace sensitive industry which generally approves the hypothesis that tourism is the beneficiary of peace than it generates. It the fact that tourism can contribute to peace via creating contact with the various cultures which in turn facilitates mutual understanding. It has also negative impacts if we do not manage it properly. If tourism is managed properly, it enhances economic, social, cultural, and environmental sustainability which manifests the presence of positive peace. At the moment, the nexus between tourism and peace is disrupted by the coronavirus pandemic. The aim of the article is to assess how tourism is a peace sensitive industry by investigating the various impacts of COVID-19 on the industry. To do this, the researcher used different reports of national and international organizations. The different commentaries that were done by professionals, communities, and stakeholders were consulted and assessed it with the different secondary kinds of literature which give an illustration about peace sensitive tourism. The article is guided by the following research questions. What socio-cultural, economic, and environmental impacts occurred in tourism due to the prevalence of pandemic of COVID-19?

In 2019 only 1.5 billion tourists were crossing the border and it has an intense and all-embracing impact on societies, the environment, and the economy. As of the end of the same year, tourism contributes 7% of total world exports and 30 percent of total exports in services. In the year 2018, it was ranked as the third export earning category following fuels and chemicals. In general, tourism accounts for 10% of the World GDP and offers 1out of 10 jobs internationally (ITF, 2020). According to the WTTC estimates, the tourism sector was directly linked to 16.7 million jobs in 2019 in the 12 countries. In spite of some significant differences exist in estimation at the country level; this is comparable to the 15.3 million figures based on official estimates discussed earlier. WTTC also estimates an additional 18.3 million jobs to be indirectly linked to the tourism sector, thus bringing the total number of tourism-linked jobs to 35 million for the 12 countries. Thus, the figure clearly indicates that tourism is one of the dominant employment sectors for the world population (ILO, 2020).

Different authors ascertain that tourism can create employment and, consequently, contributes to the income of local communities. In job creation and income generation, tourism brings economic benefits to host communities; in so doing improving local communities’ quality of life as the economic benefits of tourist give the financial means to access modern facilities in the form of goods and services. In addition, tourism brings many prospects to improve facilities, such as outdoor recreation facilities, parks, and roads. There is a general acknowledgment that the tourism industry has increased the availability of recreation and entertainment facilities in various forms (Jaafar et al., 2015). The tourism industry is one of the world’s major companies, together with the energy industry. Nevertheless, contrasting to the energy industry, tourism is less of inevitability and henceforward is exceedingly penetrating to noteworthy tremors such as the COVID-19 pandemic (Chang, McAleer, and Ramos, 2020).

The tourism industry inclines to be very sensitive to negative environmental factors like natural disasters, epidemics, serious social conflicts, war, economic crises, and terrorism acts. Thus, these types of occasions impact tourism mobility and traveler’s motivation to travel which will have long-term consequences on the tourism industry. The eruption of coronavirus has also established anxiety on travelers (Hung, et al., 2007; Ulak, 2020).

It is worth mentioning that international tourism has been experienced in a variety of predicaments in the past. Between the years 2000 to 2015, main upsetting occasions take account of the September 11 terrorist attacks (2001), the severe acute respiratory syndrome (SARS) outbreak (2003), the global economic crisis unfolding in 2008/2009, and the 2015 Middle East Respiratory Syndrome (MERS) outbreak had affected tourism with verities of degree but neither of them had long-lasting decay in the global development of tourism, and some of them are not even notable with only SARS (-0.4%) and the global economic crisis (-4.0%) leading to declines in global arrivals. This would indicate that tourism as an organization has been resilient to external shocks. Yet, there is a considerable indication that the impact and recovery from the COVID-19 pandemic will be unique (Stefan and et al.2020; World Bank 2020a, 2020b).

Starting from last January, the world has been facing a new and unknown situation. Experiencing with policies of opening countries to encourage the arrival of tourists and travelers, as the result of the incidence of COVID-19, in just a few weeks this condition has been altered in a shocking way into disaster actions proposing blockades and unexpected closures of borders. In a very short time, the global economy is in a situation of ups and downs not known until now, whose impact generates the collapse of the main economic structures, affecting especially the tourist and commercial industry (Santod D. 2020). The impact of the virus on the tourism industry is estimated five to seven years of worth of growth have been lost (ITF, 2020).

International, regional and local travel restrictions immediately affected national economies, including tourism systems, i.e. international travel, domestic tourism, day visits, and sections as diverse as air transport, cruises, public transport, accommodation, cafes and restaurants, conventions, festivals, meetings, or sports events. With international air travel rapidly slows as a result of the crisis, and many countries imposing travel bans, closing borders, or introducing quarantine periods, international and domestic tourism declined quickly over a period of weeks more than any other sectors (Stefan Gössling and et al., 2020 ITF, 2020; Carbone,2020). The air passenger transport industry has been hit hard by COVID-19 as foreign visitors began canceling scheduled trips and countries started closing their borders as part of national emergency responses (ITAT,2020; ITF, 2020). A study by IATA estimates that passenger revenues for the airline industry will be nearly US$ 88 billion lower this year compared to 2019 and that most airlines are left with less than three months of liquidity to sustain them through this period of turmoil. In this situation, airlines have taken unprecedented measures, sending their staff on paid or unpaid leave, implementing salary cuts, or laying off workers. The shutting down of airlines has a direct impact on the tourism industry (ITAT, 2020).

The reduction in travelers has directly affected the tourism industry, which has a direct impact on loss of income and increased unemployment. The impact of the pandemic on economies that are already slowing down has made tourism particularly vulnerable, becoming the hardest hit sector to date (Carbone, 2020). According to UNWTO estimates, the tourism sector, which is 80% made up of small and medium-sized enterprises, international tourist arrivals could fall by between 1% and 3% by 2020 globally, reducing growth from an estimated 3% to 4% in early January. This would translate into an estimated $30-50 billion in lost international tourism revenue for international visitor spending in the destinations. The international movement of tourists in the world may fall this year between 20% and 30% compared to 2019, taking into account that never before have travel restrictions been introduced as those currently in place to contain the spread of the COVID-19 or coronavirus pandemic, an unprecedented decline that will mean a collapse in revenue of up to 410,000 million euros (Santos D.2020; Ulak, 2020 Carbone, 2020).

The ultimate principles underlying the justification and restriction strategies applied to control the pandemic such as distancing of individuals and quarantining of communities; contribute openly against the assets of the global economy, created around connectivity and inter-dependence. Ironically, the loss of connectivity required to inhibit the spread of the COVID-19 has prompted an economic contamination, with the crisis triggered by the COVID-19 pandemic surging across socio-economic sectors, and instigating main interruptions to trade, tourism, and energy and finance sectors (Lenzen and et al. 2020; Carbone,2020).

Countries jumbled to coming back travelers home, which in the case of important outbound markets involved hundreds of thousands of citizens in all parts of the world. For instance, on 23 March, the British Foreign Secretary insisted British tourists return home, recommending against all but crucial international travel, and emphasizing that international travel is becoming very difficult with the closure of borders, airlines suspending flights, airports closing, exit restrictions and further bans being implemented daily (FCO (The Foreign & Commonwealth Office, 2020; Stefan Gössling and et al., 2020). Cruise ships quickly became the worst incidence for anyone held in the global tourism system. Starting with the Diamond Princess on 1 February 2020, at least 25 cruise ships had confirmed COVID-19 infections by 26 March 2020 and at the end of March, ten ships remained at sea unable to find a port that would allow them to dock. Idealized safe environments (Cordesmeyer & Papathanassis, 2011) at sea turned into traps, with thousands of passengers seized in-cabin quarantine and facing the challenge of returning home. Within countries, the virus affected virtually all parts of the hospitality value (Mallapaty, 2020; Stefan Gössling and et al., 2020). These evidences show that travel has become more dangerous as the result of COVID-19 which is the main attribute and practice of tourism.

The World Travel and Tourism Council has notified the COVID-19 pandemic could cut 50 million jobs worldwide in the travel and tourism industry, particularly Asia is anticipated to be the worst affected. If the outbreak will be over, it could take about ten months for the industry to recover (World Economic Forum, 2020). This impact would depend on how long the epidemic lasts and could still be aggravated by recent preventive measures, such as those taken by the U.S. administration on travel to Europe (World Travels and Tourism Council, 2020). According to the chief executive of WTTC, the coronavirus is a substantial menace to the tourism industry that could decrease the travel sector by up to 25% in 2020 (BBC, 2020b).

Coronavirus has also revealed the danger of over-reliance on tourism, demonstrating in brutal fashion what happens when the industry supporting an entire community, at the expense of any other more sustainable activity, collapses. In May, the UN World Tourism Organization projected that incomes from international tourism might be depressed 80% this year compared to last year and that 120m jobs could be lost. Since tourism relies on the same human mobility that spreads disease and will be subject to the most stringent and lasting restrictions, it is likely to suffer more than almost any other economic activity (De Bellaigue, 2020).

It also anticipated that 60-80% degeneration in international arrivals for 2020. Given that tourism are the most important source of growth, employment, and income for many countries, principally in developing countries. According to the World Travel and Tourism Council (WTTC), in 2019, 1.5 billion people crossed international borders with tourism accounted for 29% of the world’s services exports. It is also estimated that 1 in 10 jobs, with migrant workers, young people, and women making up a significant proportion of this workforce (UNESCO, 2020). The economic impacts of the COVID-19 crisis are increasingly hitting low- and middle-income countries and the poor. International travel restrictions and the full or partial closure of businesses and industries in Asia, Europe, and North America have led to a collapse in global travel and are expected to reduce the flows of remittances. Tourism and remittances are important sources of employment and income for the poor, correspondingly (IFPRI, 2020). In a similar vein, the role of the tourism and travel sector to the total output of the Arab States is expected to decrease by about $ 126 billion in 2020, placing about 4 million jobs at risk. It is anticipated that the incomes from international tourists coming to the Arab States region will descent by 50 to 60 billion dollars. Such degeneration in tourism activity is expected to have a substantial impact on many countries in the region (UNESCO, 2020).

According to European Union statistics, some 13 million European engagements in the tourism sector are in jeopardy, whilst UNWTO reports a 19% decrease in tourism in the first quarter of 2020. 62 % of Europeans make the minimum one leisure trip every year and most of them stay in Europe. 190 billion euros is spent on tourism during a normal summer season amounting to 10% of EU GDP. The compulsory closure of World Heritage sites and attractions has cost millions in revenue. For instance, the Royal Botanic Gardens, Kew, a World Heritage site in the United Kingdom is encounter losses of £15m, potentially impacting the important research and conservation work it has carried out on plant diversity and economic botany since 1759. In the same way, the Vasa Museum in Stockholm, Sweden, which houses a 17th-century wooden ship, is almost absolutely backed by admission fees. 85% of the museum’s 1.5 million yearly visitors are foreign tourists and not only brings an estimated $300m to the city every year but also raises awareness about underwater cultural heritage, including shipwrecks and submerged cities or landscapes. This illustrated evidence affirmed that due to the pandemic of coronavirus, numerous heritages (cultural and natural) have been endangered for manmade as well as natural disasters.

In a similar vein, tourism started to decline rapidly, driven by a significant decrease in tourism arrivals from China, which in many countries account for a large share of tourism revenues. As the number of coronavirus infections increased outside China, international travel restrictions started to widen within the region. With the further spread of the virus, also tourists from outside the region canceled their previously planned trips, given the increased level of uncertainty in both safety and travel restrictions. In the course of March 2020, with the outbreak of COVID-19 in Europe, the United States, and all other parts of the world, international tourism essentially came to a halt. With lockdown measures that governments have implemented in many countries and stay-at-home recommendations, also domestic tourism took a hit (ILO, 2020).

There has been a dramatic reduction in business activity in the tourism sector, with essentially all jobs in that sector affected, and a large number of workers becoming jobless for an extended period of time. At the initial phases, the projected impacts of COVID-19 in the Asia Pacific region were substantial. At the moment, with the global close of tourism due to the further spread of COVID-19 and the actions that governments have taken in retort, there is convinced that the impact will be much higher and more lasting. Millions of workers with previously permanent incomes are henceforth at danger of descending into dearth, which is why existing circumstance needs pressing consideration (ILO, 2020). Other international organizations such as the World Travel & Tourism Council (WTTC) have stated that the tourism sector is losing one million jobs worldwide every day. As an example, data from countries such as Italy are shown: the Tour Operators’ Union Assoturismo of Italy, reported that the epidemic could bring tourism in that country back to the turnover it had in the mid-1960s by 2020, that is, a reduction of more than 260 million visits (-60%) compared to 2019. Likewise, the impact of the current crisis on the tourism industry is being received in a different way, be it destinations, companies, and institutions (Santos D., 2020).

In addition to the threat to public health, the COVID-19 pandemic has brought economic and social disruption that threatens the long-term livelihoods and well-being of millions. Like the other parts of the world, the tourism sector in Asia and Pacific has more or less ground to a termination, which brings severe costs to many of the region’s economies and to the incomes and jobs of the sector’s workers. This indicates that about 15.3 million jobs in the tourism industry in 14 countries of the Asia-Pacific region are crushed by the COVID-19 catastrophe; through shortened hours, extended paid or unpaid leaves on partial wages, or complete job loss (WTTC, 2020).

Many migrant workers engaged in the tourism sector have fled, or attempted to flee, to home provinces or countries to wait out periods of lockdown with the added stress of unemployment and income insecurity. Their capacity to sustain themselves in the largely rural provinces to which they returned is likely to be low and many will need to draw upon whatever government social assistance programs that they can find. Effective return and reintegration policies of migrant workers are important to meet migrants’ needs and develop their potential (ILO, 2020).

Some affected tourist workers are protected by labor regulations that keep them, at least temporarily, on the payrolls of their employers. Yet the capacity of employers to continue to pay wages is extremely stressed as incoming revenues run out, thus deepening their dependency on government assistance to withstand foreclosure. It is a tenuous situation that cannot continue indefinitely. Despite the availability of government assistance to tourism enterprises, already bankruptcy numbers are rising. The design of COVID-19 policy responses that focus on the crucial role of decent work is vital to alleviate the antagonistic impacts on tourism enterprises and workers and to achieve a sustained and equitable recovery of the sector (ILO, 2020c).

In today’s day and age, our global economy indicates and showcases food as becoming the main objective of neoliberal practices, which have equally altered the way in which farmers grow crops or foods and the methods they used to cultivate the land for growing. The world’s food supply completely relies on large transnational corporations and have always favored a more industrialized practice of agriculture rather than traditional knowledge. Currently, family and subsistence farmers are in danger due to the rapid growth of industrial agriculture and with it new sciences and technologies, which has distorted how the world’s historic agriculture as it evolves into large ‘corporate farms”, followed by the mass production of cash crops. The industrial agriculture corporations have confiscated the world’s food supplies and put them on the global market, to sell and bring revenue, all because of the policies created by neo-liberalism. The consequences of industrial agriculture have been detrimental and long-lasting. It caused the rural population to shift to metropolitan areas, an increase in poverty and famine, and the continued damage being done to the environment.

Due to the animosity of the policies of industrial agriculture, there is also heavy resistance that has resulted towards globalization and its related ideologies. This form of intense resistance is seen in many various facets throughout society and takes into consideration movements such as the Community Supported Agriculture (CSA) movement, La Vía Campesina, and Slow Food. The foregoing are just a small fragment of the movements that oppose the regulations that surround today’s globalizing agriculture and the food policies. In the end, majority of these movements form as one towards the injustices of global food requirements and have allowed a voice of reason for those who have been criticized or treated unfair.

Globalization

Globalization has many various definitions, some say that it refers to the process of geographical movement while others may consider it to be a process that allows businesses to create international allies to help increase their success1. One thing that can be agreed upon is how important globalization is in today’s economy. It has helped to better the economy of many nation states through interactions and the spread of goods across boundaries2. It has been proven that globalization has benefited the world’s economy however it has also had an adverse effect on various other economies that may not even be prevalent to the people. After World War II the process of globalization unquestionably gathered momentum. The United States took advantage of their place in the war and projected growth towards a more globalized process and economy, by initiating organizations and influencing mindsets that would assist in this venture. After the war, Europe needed to be restored, and in order to advocate more trade globally; The World Bank and the International Monetary Fund were conceptualized. The next institution created was The Tariffs and Trade, which was made to create and depict the various requirements and regulations intended for trading and creating a better global relations. It is obvious that globalization has had an everlasting effect on today’s economy. It has ultimately helped develop the world and its economy, however, with the good, there was also damage done to the ecosystem and the communities that reside there.

Introductions of Industrial Agriculture

Agriculture is the process of cultivating food for consumption or distribution by humans3. It can involve the cultivations of various plants, animals or even energy sources and can done on land or even in water, and is a very important source of economic advancements. Agriculture, just like the global economy has changed drastically with time and with the creation of new practices, technologies, and ideologies. Many families that rely solely on the income they obtain from their farms are now struggling financially. Small family farms, which were once considered to be a fruitful trade is now being threatened by large multinational corporations. This struggle has led many subsistence farmers to give up their land to large corporations where they can produce a great volume of goods to be later sold to the global market. These large corporate farms are known as industrial agriculture, and the ethics and values that subsistence farmers used to cultivate their crops is no longer considered viable. Pesticides/insecticides, hybrid seeds and genetically modified seeds, new technologies, and the manufacturing of monoculture for export heavily rely upon industrial agriculture4. Small subsistence farmers never had a chance against the industrial farms and it caused the small farmers to sell out to large businesses and grow crops for export. Everything became about the money when industrial agriculture became dominant mainly because it became an export and import business and the touch of family farming was lost. Large agricultural companies insisted that this type of agriculture would be advantageous for the economy and the people, they also claimed that it would eradicate poverty and world hunger. The production of food has since then increased rapidly, but it has also caused increased poverty and has profoundly damaged our ecosystems4.

World War II Role in the demise of small farms

One of the main reasons that the change from small subsistence farms into large multinational farms arose could be due to World War II5. Scientific advancements that were conceptualized and achieved during WWII, led to technological advancements and were later implemented to itemize technologies made specifically for agriculture. The new technologies that were made available after WWII were quicker and able to cultivate a great deal of produce in a short period of time, and were favored by the corporations. Small farmers were forced to deal with problems that they may have come across but at a larger scale. Insecticides and pesticides were most commonly used After WWII, this was the time when DDT rose to popularity. DDT was a widely used insecticide, which is now banned, but had a very negative effect on the environment and on many animal species and was favored by industrial agricultural technologies6. DDT was primarily used because it was efficient and it got rid of insects that was injurious to human life. With high exposure to DDT over time, it became obvious that it had a very negative effect on the environment and living species. The connection between DDT use and disease was not made, until a few years after initially using them, when researchers finally figured it out while doing tests on laboratory animals7.

The Green Revolution

On top of the various advancements that were being made, post-WWII era, researchers also began working on and increased research on plant hybridization, which was known as The Green Revolution8. The main objective of The Green Revolution was to increase the production of foods and eliminate hunger worldwide by introducing new technologies like hybrid seeds9. Hybrid seeds were high-yielding seeds, in one case study it was found that production increased 208% for wheat, 109% for rice, 157% for maize 78% for potatoes, and 36% for cassava8. This is one of the biggest benefits that occurred throughout The Green Revolution; it helped put an end to hunger in many regions, by producing much more food per year. However this food did not nourish the people from the communities it was grown in, it was transported all across the world. The Green Revolution model slowly changed completely and become more of an “import and export” model10. The World Bank encourages countries to transform from “food first” to “export first”10. The Green Revolution had replaced the older ways of farming, while also raising the cost of farming significantly due to the new technologies involved in industrial agriculture. With support from the International Monetary Fund and the World Bank, large corporations provided farmers with their hybrid seeds, in order for them to convert from subsistence farmers to industrial farmers. This caused many farmers to desert their land, which was their main source of income. Vandana Shiva, environmental activist, food sovereignty advocate, founder of the Navdanya movement, and author of The Hijacking of The Global Food Supply: The Tragedy of Industrial Agriculture, mentions in her article:

While the Green revolution has been promoted as having increased productivity in the absolute sense, when resource use is taken into account, it has been found to be counterproductive and inefficient. Perhaps one of the most fallacious myths propagated by Green Revolution advocates is the assertion that high-yielding varieties have reduced the acreage under cultivation, therefore preserving millions of hectares of biodiversity …Industrial breeding actually increases pressure on the land, since each acre of a monoculture provides a single output, and the displaced outputs have to be grown on additional acres10.

The fundamental concern that many people would agree on is that The Green Revolution was an institution that was mainly concerned with getting power over countries and did not take into consideration the driving force of world hunger and how to fix it for the long run.

Genetically Modified Organisms and Seeds

Food is a basic necessity of life that all organisms require. Obtaining a clean and healthy source of food is difficult for people who live in third-world countries, however, more developed nations are also facing these challenges due to genetically modified organisms (GMO) and seeds. GMOs are organisms who’s genes have been altered to appeal to the human populations11. One of the major contributors of GMO research was the Monsanto company. Monsanto is a large corporation responsible for producing a herbicide called Roundup – containing an ingredient called glyphosate12. They also created genetically modified seeds that were completely resistant to the Roundup herbicide. This meant that the herbicide containing glyphosate, kills everything except for the seeds engineered by the Monsanto company, and when the seeds are harvested they contain a prominent amount of this herbicide12.

Does a persistent question arise as to why Monsanto is considered the threat to small family farmers? To answer and evaluate this, we can begin with why Monsanto tried to get rid of family farms and is getting them to comply with practices/techniques of farming, even if the practices are unethical. Farmers and their families go through so many hardships when cultivating the genetically modified seeds. For example, when the crop yields proved to be unsuccessful due to either pest infestation or major seed failure, many of the individuals working there committed suicide by consuming the exact same pesticide that had led them to debt initially10. Next, Monsanto has banned saving seeds. Seed saving is a routine practice family farmers have used that dates back to the stone age, where they simply saved their seeds from one year to the next. One of the many reasons that this is an important practice is because it allows the farmers to be self-sufficient and not have to rely on other to find seeds that may be hard to come across13. The regulations under the Monsanto company require farmers to buy costly new seeds every year and if farmers do not abide by the rules, they can face penalties. Additionally, Monsanto sues farmers who go against the rules and save seeds. Approximately $24 million dollars in fines have been payed by farmers to the Monsanto company because of these allegations14. The Monsanto company is simply a small part that arose in response to the globalizing world, however, the impact of it is still prevalent in today’s society, as the pesticides and seeds have left a lasting mark on the way food is grown globally. In order to change these policies, farmers, community members and families need to stand up together and bring these issues into light so that people who are not aware of the way that there food is cultivated can really see what is happening behind the scenes.

Resistance Against Globalized Agriculture

Globalization has gathered a lot of momentum over the years and trying to overthrow it may seem challenging or even intimidating. However, millions of people each day are standing up for their rights and demanding change. Everywhere around the world, we see resistance toward corporate globalization. Not only by farmers, but activists, conservationists, and youth, are all getting together to finally make their voices heard about unethical farming practices. This type of resistance appears in all different forms all around the world, but all amalgamate into one in the injustices of neo-liberal policies.

Starting off with, Community Supported Agriculture (CSA), which is a form of resistance, that took place due to current policies regarding food which need it to be imported in from many miles away. This concept was first originated in Switzerland but really took off when it was introduced in Europe in 1980s and was adopted in the United States later on15. CSA is a program in which community members register with a local farm and pays a set amount of money, and in exchange they get an array of different produce, benefitting both the consumers and the farmers16. The consumers obtain natural and fresh produce while simultaneously learning about the process of sustainable farming. The farmers on the other hand get an annual income from the community by removing the middleman, which helps them grow the crops they choose in a sustainable fashion.

Another type of resistance movement toward industrial agriculture is the Via Campesina movement. The Via Campesina movement that brings together people of various ranks, ages ethnicities, and genders, in order to fight for our agriculture and the food we consume, and as a way to advocate for fairness and equality for all, as well as to protest against the corporate-focused agriculture that damages most social relations and the environment17. This movement strives to achieve numerous goals, one of them being to go against the industrial system by promoting agroecology, which puts people before money. Another goal of this movement is to advocate for the peasants to have equal rights17. Laborers, globally, are affected by the daily injustices they face, corruption of businesses, and various losses of their homes, that has arisen due to globalization. Many transnational corporations still continue to violate people and their rights, while individuals who work hard to defend the rights of their communities end up criminalized or even killed. The La Via Campesina movement encourages individuals to advocate a Universal Declaration for the rights of labourers, farmers, and other people working in similar in farming areas. This movement also takes into consideration the right to life, the right to a respectable standard of living, the right to land, to seeds, justice, and equality among all17.

Another form of resistance is the Slow Food Movement, which was founded by an individual named Carlo Petrini and was started in Italy when a McDonald’s was opened for business and concern set in as to what would happen to local and traditional foods18. The name “slow food” came into place in order to reject the popularity of fast foods and a fast lifestyle. This movement basically pushes toward a relaxed life, where you put thought into what you are consuming and not supporting large food chains that promote overindulgence and irresponsible agricultural practices. The snail represents this movement because of the obvious reason that a snail moves very slowly, but also because the snail is a delicacy in the Italian town where this movement was originally established in. The threats that communities are facing because of the vast depletion of local food practices is what the slow food movement is trying to fight against. It is a non-profit organization that protests the fast food chains directly. Good, clean, and fair food is what the slow food movement advocates for. It believes that the food we consume should taste great, it should be cultivated in a sustainable manner, and the farmers that produce this food should be paid fairly for all their work. This movement recognizes the relationship between our earth and the food that we consume and is committed to conserving traditional foods that are falling out of existence due to multinational food corporations.

Conclusion

Overall, globalization is a very broad subject matter and agriculture is a very mere aspect of it, however, food being the basic need of living species, its a topic that needs to be handled cautiously. Due to the establishment of neoliberal policies, many people across the globe have gathered together in passion-fuelled resistance, based in solidarity. Farmers, activists, students, and community members have taken globalization into their own hands and have stood up to the big agricultural companies. They have worked hard to create movements within their communities and across the world, to prevent further damage that can be done to our planet and its people.

Over the years globalization has become an issue that is freely examined in many communities and currently, we can clearly see that globalization is no longer an issue or taboo subject matter. With the globalization of agriculture, we saw many farming families and other rural families being stripped of their land and their farms when they did not comply to the rules and regulations of large corporate businesses. Globalization of agriculture not only impacted the way in which food grew, but it also had a direct impact on our ecosystem and environment. The movements that arose because of this allowed people to voice their opinions and take action against agricultural globalization. Community Supported Agriculture, La Via Campesina, and Slow Food were the three movements mentioned above however there are a multitude of movements all across the world that are fighting in opposition to the globalizing world. In order for a country to fully harvest the profits that come with globalization, they need to have a level of openness to import and export (trade), and they also need to have the ability to embrace new technological changes and advancements. However, this is very challenging for most countries as they are rooted in traditional forms of agriculture and ways of handling business. Not only did industrial agriculture effect the way in which food in grown, but it also impacted the farming families and the members of communities. Overall, it is important for the world to know and understand the damage that is being done and that has already been done to the planet and the people that reside on it because of industrial agriculture. Action needs to be taken and issues need to brought into the light so that alternatives can be created and implemented.

Systemic lupus erythematosus is the most known kind of lupus. It is an autoimmune disease in which the immune system strikes its own tissues, inflicting extensive inflammation and tissue injury in affected organs. It affects the joints, skin, brain, lungs, and kidneys. Lupus doesn`t have a cure, however medical interventions and lifestyle changes helps contain it. (‘Systemic Lupus Erythematosus (SLE) | CDC’, 2018)

The CDC Lupus registries estimates that a yearly prevalence from 2002–2004 was much higher for blacks than whites in Michigan and Georgia and a yearly prevalence from 2007–2009 for American Indians was a hundred and seventy-eight per one hundred thousand people.

Locally, In Trinidad, a high percentage of patients were of East Indian origin. Of the 169 patients, 91 were confirmed with SLE. (Conyette et al, 2019)

Etiology

The history of lupus is arranged in classical, neoclassical, and modern period.

The Classical period was marked by the primary illustration of the cutaneous disorder. Physician, Rogerius, thought that lesions caused by lupus appeared like wolf bites, thence lupus meaning wolf in Latin (Jewett-Tennant, 2019).

The Neoclassical period is the description of the disease’s systemic/disseminated manifestations. A claim was created that there have been two kinds of the sickness; SLE and discoid lupus.

The modern period was marked by the finding of the LE cell once researchers discovered that the cells in the bone marrow of patients with acute disseminated LE. (Jewett-Tennant, 2019)

The cause of SLE is unknown however multiple factors are linked with the development of the illness, including genetics, ethnics, immunoregulatory, hormonal, and environmental factors (M Bartels, 2019). Some potential triggers may include:

• Sunlight: Exposure can bring on lupus skin lesions
• Infections: This can commence lupus & even cause a deterioration in some persons.
• Medications: It may be activated by specific forms of BP medications, anti-seizure medications or antibiotics. (Lupus – Symptoms and causes, 2020)

Clinical Manifestation

Constitutional manifestations: Patients may present with a variety of systemic manifestations. Symptoms may include: fever, myalgias, headache, and loss of appetite/weight. The typical symptoms are nonspecific fatigue, fever, arthralgia, and weight change/s. Fatigue, the common symptom may be due to medications, lifestyle patterns and/or affective disorders. Fever, could result from active infection and drug fever. These symptoms may impersonate other infectious diseases & endocrine abnormalities. (COJOCARU & Doina VRABIE, 2011)

Musculoskeletal manifestations: Joint pain is the most common reasons for the clinical presentations in patients with SLE. Arthralgia, arthritis & myopathy are principal manifestations. These symptoms may be mistaken for a different form of inflammatory arthritis and can precede the diagnosis by months or even years. Arthralgia, myalgia, and frank arthritis could involve the mini joints of the hands, wrists, and knees. (COJOCARU & Doina VRABIE, 2011)

Dermatological manifestations: Cutaneous manifestations of SLE comprises of four diagnostic criteria.

The first is malar rash, which can be specified by a rash over the cheeks and nasal bridge. It lasts from days to weeks and usually painful.

The second is photosensitivity, which might be evoked from patients who are questioned if they have any strange rash/symptoms increasing after sun exposure.

The third may be a discoid rash. Discoid sores often also evolve in sun-exposed areas but are plaque like and with scarring.

The fourth is Alopecia. It creates a patch like pattern of hair loss. (COJOCARU & Doina VRABIE, 2011)

Renal manifestations: Renal failure and sepsis are two fundamental drivers of death in patients with SLE. Glomerular disease usually advances within the first years of having SLE and is asymptomatic. Nephrotic disorder may cause edema and weight gain. Lupus nephritis is a typical indication of SLE. It is brought about by the overthrow of immune complexes. (COJOCARU & Doina VRABIE, 2011)

Pathophysiology

Immune reactions against endogenous nuclear antigens are attributes of SLE. Autoantigens discharged by apoptotic cells are introduced by dendritic cells to T cells prompting an activation. The activated T cells help B cells emit antibodies to self-constituents by producing cytokines for instance, interleukin 10. Additionally, to the antigen-driven T cell-dependent production of autoantibodies, information supports that T cell-independent mechanisms of B cell stimulation via combined B cell antigen receptor and TLR signaling. The pathogenesis of SLE involves a number of cells and molecules which engages in apoptosis, intrinsic and adaptive immune responses. (Bertsias & Cervera, 2012)

The impact of SLE on the body

Circulatory system: Lupus grows chances of heart diseases and stroke. It is due to the long-term inflammation that accompanies lupus. Medications such as steroids raises dangers. Lupus causes inflammation of the heart which causes sharp pains in the chest.

Respiratory system: Lupus puts you at a greater risk of developing infections and getting pneumonia. It may inflame the lining of lungs; the lungs may bloom scarring from inflammation and cause a shortness of breath.

Integumentary system: People with lupus experience skin issues during the journey of their disease. Symptoms may vary depending on the type of lupus or how active it is. There may be a sensitivity to ultraviolet rays from sunlight which can cause changes to the skin. Red, scaly bumps/patches can develop around the body. Discoid lesions may surface on body/scalp. (How Lupus Affects Your Body, 2019). Skin problems in other parts of the body may include:

• Mouth/Nose sores
• Alopecia
• Blue fingers and Toes (cold environments)

Kidneys: The kidneys may be inflamed resulting in indefinite damages. It may lead to swelling in legs and a high BP. It can even lead to kidney failure which may require dialysis.

Brain and CNS: Lupus affects brain and nerves in the spinal cord in various ways:

• Clouded thinking/Memory loss
• Headaches
• Depression/anxiety
• Seizures

Eyes: The main eye problem is dryness. Occasionally blood vessel changes in the retina weakens vision. Lupus can damage nerves in muscles that control eye movements.

Joints and Muscles: Joint pain, swelling, and stiffness are problems with lupus, mostly in hands, wrists, and feet.

Treatments

Medical Management: The goal of SLE is to cease disease activity without long-term use of more than 5 mg prednisolone/day. The measures include hydroxychloroquine as well as protection from sunlight and vitamin D interchange. Patients suffering may need a lot more vaccinations than the healthy population and management of risk factors for atherosclerosis is demanding for long-term survival. Methotrexate is on par with azathioprine. If disease activity cannot be controlled in this way, belimumab is a therapeutic option. Cyclophosphamide is used but mainly in life-threatening situations such as lupus nephritis. Off-label mycophenolate mofetil can be used for lupus nephritis and off-label rituximab in refractory disease courses. (M, 2016)

Nursing Management: Persons affected by lupus and whose families are in need of help in apprehending the condition and requires support as they deal with fear and depression. Suggestions for nursing includes patient/family education about medications, energy conservation, pain/stress management, and coping techniques. (SB, 1992)

Other

Interesting facts about SLE:

• The Lupus Foundation of America approximates that at least 1.5 million Americans and about 5 million people global have lupus.
• It happens mainly in women of childbearing age. Nonetheless, children and men can also have lupus.
• Ninety percent of persons living with lupus are females. The age range of the disease is between 15-44.
• There are at least 16,000 confirmed cases a year.
• Lupus is three times more common in women of color than Caucasian women. Research previews that lupus affects 1 in every 537 African American women.
• A 2014 study found that females who tends to have lupus at a young age, experience serious complications and have a higher death rate.
• Lupus Foundation of America found that lupus was among the top 20 leading source of death in females between the ages of 5-64 (‘Lupus facts and statistics, 2016).

References

1. Bertsias, G., & Cervera, R. (2012). Eular.org. Retrieved from https://www.eular.org/myuploaddata/files/sample%20chapter20_mod%2017.pdf.
2. COJOCARU, M., & Doina VRABIE, C. (2011). Manifestations of Systemic Lupus Erythematosus. PubMed Central (PMC). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3391953/.
3. Conyette, L., Beharry, S., & Dyaanand, H. (2019). CE-34 An analysis of the demographic data in patients with systemic lupus erythematosus in south and central Trinidad. Lupus Science & Medicine. Retrieved from https://lupus.bmj.com/content/3/Suppl_1/A65.
4. How Lupus Affects Your Body. WebMD. (2019). Retrieved from https://www.webmd.com/lupus/guide/how-lupus-affects-your-body#3.
5. Jewett-Tennant, J. (2019). A Quick History of Lupus and Its Implications for You. Verywell Health. Retrieved from https://www.verywellhealth.com/lupus-overview-and-history-of-discovery-2249881.
6. Lupus facts and statistics. Lupus Foundation of America. (2016). Retrieved from https://www.lupus.org/resources/lupus-facts-and-statistics.
7. Lupus – Symptoms and causes. Mayo Clinic. (2018). Retrieved from https://www.mayoclinic.org/diseases-conditions/lupus/symptoms-causes/syc-20365789.
8. M Bartels, C. (2019). Systemic Lupus Erythematosus (SLE): Practice Essentials, Pathophysiology, Etiology. Emedicine.medscape.com. Retrieved from https://emedicine.medscape.com/article/332244-overview.
9. M, A. (2016). [Management of systemic lupus erythematosus]. – PubMed – NCBI. Ncbi.nlm.nih.gov. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27670650.
10. SB, H. (1992). Systemic lupus erythematosus: medical and nursing treatments. – PubMed – NCBI. Ncbi.nlm.nih.gov. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/1491876.
11. Systemic Lupus Erythematosus (SLE) | CDC. Cdc.gov. (2018). Retrieved from https://www.cdc.gov/lupus/facts/detailed.html.

Abstract

Antimicrobial peptides (AMPs) are molecules involved in the defense mechanisms of a broad range of organisms that are evolutionarily conserved. Produced in bacteria, insects, plants, and vertebrate animals, AMPs protect against a wide range of infectious agents. Those peptides guard against microbes, viruses, fungi, and other parasites in mammals. Novel biological effects of AMPs such as endotoxin neutralization, chemotactic and immunomodulating processes, angiogenesis activation, and wound healing have recently been reported.Such ancestral molecules are therefore essential elements of the adaptive immune system and ideal targets for experimental approaches to therapy.

Introduction

The first line of defense against microbial invasion of the skin is the stratum corneum, an inviolable, desiccated layer of the epidermis. The physical obstacle, however, is susceptible to injury which allows opportunistic microbial agents to enter the skin.. Healthy human skin may contain microorganisms but are not contaminated, allowing the usage of treatments on body surfaces to limit colonization of the microbial. Skin is first line of microbe response. Antimicrobial peptides (AMPs) are molecules involved in the evolutionary conservation of the mechanisms protection of a wide range of organisms. Produced in fungi, plants, herbs and defend vertebrates from a vast variety of infectious agents.AMPs are difficult to classify because of their enormous diversity. AMPs can be classified into many groups based on the composition , size and conformational structures of amino acids; such as peptides with α-helix structures, such as human cathelicidin; peptides with β-sheet structures supported by disulfide bridges, such as human defensines; peptides with extended structures, such as bovine AMP indolicides; and peptides with loop structures, such as cyclic defenses contained in rhesus macaques. AMPs are represented on the key barriers of organisms such as the epithelial skin and mucosal, preventing the colonization of pathogenic host tissues. Antimicrobial peptides ( AMPs) produce an ancient type of inherent immunity commonly present in all living species, supplying a key first line of protection against the attacking pathogens.Scientists also drawn significant interest to the unusual complex role and layout of AMPs, both in terms of recognizing the fundamental biology of the innate immune system and as an instrument in constructing molecular models for experimental anti-infective medicines.AMPs are short-coded gene (< 100 amino acids), amphipathic molecules with wide-spectrum antimicrobial activity, with multiple modes of action, including bacteriostatic, microbicide and cytolyticproperties.They are unfortunately a widely overlooked element immunology and are usually only discussed in the general textbooks on immunology. Each species is predicted to contain a wide variety of AMPs. None is a full inventory of antimicrobial peptides neither feasible nor planned.

Insects are one of the main origins of peptide / protein antimicrobials (AMPs). Since the antimicrobial activity was observed in the pupae hemolymph from giant silk moths Samia Cynthia and Hyalophoracecropia in 1974 and cleansing of first AMP (cecropin) insect from H. In 1980 cecropia pupae extracted or reported about 150 insect AMPs. The bulk of AMPs in insects are tiny and cationic, and are display action against bacteria and/or fungi, and other viruses and parasites. In clinical and prophylactic uses, they have promising potential. In fact, AMP-derived medications are used as topical products to manage diseases of the skin and burn. Many AMPs also exhibit anticancer or cancer properties. Their mode of action is different compared to traditional antibiotics so inducing microbial resistance is not easy for AMPs. Most may not damage or destroy normal higher cells in animals. For examples, recently, clavaspirin peptide, a tunicate Styelaclava peptide, demonstrated the potential to destroy drug-resistant pathogens (S. aureus) without observable resistance.

As part of the defense, plants contain a significant amount of toxic compounds, including antimicrobials (AMPs), which killing bacteria through phospholipid contact and permeabilization of the membranes. Antimicrobial plant peptides (AMPs) have developed independently from AMPs and other aspects of life. In addition, they are abundant in residues of cysteine that form several disulfides. The disulfides then cross-braced plant AMPs as cystine-rich peptides to confer extremely high chemical, thermal and proteolytic stability on them. The capacity of plant AMPs to accommodate hypervariable sequences utilizing retained scaffolds allows flexibility in the identification of specific targets by modifying the non-cysteine residue series. Such properties bode well in improving plant AMPs as possible therapeutics and in preserving crops through transgenic methods. AMPs have been shown to inactivate prokaryotic cells by targeting a variety of critical or metabolic processes at extracellular, plasma, and/or intracellular locations (Yount and Yeaman 2013). The majority of natural antimicrobial peptides are 10 to 50 amino acids in length, vary in size from 2 to 9 kDa, are positively charged, have a strong hydrophobic amino acid role, and frequently exhibit helical shape.

Antimicrobial Peptides and the Skin ImmuneDefense System

Microbes continually attack our skin but never get poisoned. Cutaneous development of antimicrobial peptides (AMPs) is a key defense mechanism, and the expression of certain AMPs increases further in response to microbial invasion.Cathelicidins are special AMPs, which shield the skin by 2Separate itineraries:

Direct antimicrobial function and Initiation of cytokine-releasing host reaction,Inflammation, angiogenesis, and reepithelialising.[8]

The malfunction of cathelicidin is a key factor in the pathogenesis of Several skin disorders, including atopic dermatitis, in which cathelicidin is suppressed; rosacea, in which cathelicidin peptides are abnormally exposed as inflammatory forms; and psoriasis, in which cathelicidin peptide is administered; Converts self-DNA in an autoinflammatory cascade through a powerful trigger.It was first assumed that the antimicrobial peptides (AMPs) function as Endogenous antibiotics which had the purpose of destroying microbes. Currently, while it is evident that AMPs function to create a chemical barrier on the surface of the skin, several components of the innate and adaptive immune system are often believed to be activating and organizing.Many forms of cells that live permanently in the skin develop AMPs, including keratinocytes, sebocytes, eccrine glands and mast cells. Circulating cells attracted to the skin, including neutrophils and natural killer cells, often add greatly to the overall number of AMPs available. Cathelicidins are a major class of AMP in the blood, since These became the first AMP found in the skin of primates, and after Instead, the most convincing animal models were compiled which help their antimicrobial role.Human cathelicidin is sometimes linked to by one of its peptide derivatives (LL-37) or by its parent protein nomenclature (hCAP18).The synthesis of peptides appeared as a key factor in the control for the operation for cathelicidines. HCAP18 is considered to be in its embryonic stage stay dead. On serine protease cleavage, the production of mature peptide contributes to several possible activities.

Cathelicidin has been found to be active on the skin improved defense from contamination by microbes and viruses. In healthy keratinocytes on the skin transmit small amounts of cathelicidin.Cathhelicidin is actively caused on infection or degradation of the barrier. But, in many chronic skin disorders the natural barrier to infection is weakened or inflammatory regulation is impaired. Atopic dermatitis is one case.Here virus and bacterial diseases cause inflammation of the cutaneous and hinder effective treatment. Observations of atopic patient AMP speech found that the mechanism of AMP activation in the lesional skin has been significantly diminished. The resulting reduced antimicrobial resistance was associated with these patients’ increased vulnerability to microbial superinfections. Reduced inductivity of cathelicidins and defensinesFor atopic dermatitis, it tends to be partially the product of Cytokine altered micromileu.57 TH2 cytokines, in fact, Such as IL-4 and IL-13, inhibit AMP induction and lead to a disrupted antimicrobial reaction in the inflammation. Then in this condition the sum of AMPs produced by the barrier to the skin leads to disease. While an antimicrobial agent, certain interactions of AMPs with skin diseases tend to be a result of host stimulating actions rather than intervention.

Domesticated animals have a broad range of antimicrobial peptides that function as natural endogenous defenses that inhibit microbial infection, or operate as an integral part in reaction to inflammation or microbial infection in certain cases. Such peptides vary in duration, structure, action mechanisms and spectrum of antimicrobial specificities.They are found in various organs, polymorphonuclear leukocytes, macrophages, and epithelial mucosal cells. There are a tiny number of antimicrobial anionic peptides present in ruminants, and a much greater category of antimicrobial cationic peptides contained in all domesticated animals.The cationic peptides comprise circular, helical peptides, circular peptides with a b-sheet abundant in proline which cysteine-stabilized peptides, and are commonly recognized as cathelicidin, and defensin.Such peptides are wide range for Gram-positive bacteria in general, Gram-negative or similar bacteria and fungi (e.g. myeloid antimicrobial peptides, a-, b-defensins, and protegrins) Types (e.g., cecropin porcine P1, Bac5, Bac7, PR-39 and prophenin).

Insect Antimicrobial Peptides

Insect AMPs were first discovered through the purification of Responsive bacterially mediatedhemolymph peptides / proteins. This method is constrained, as it is necessary to purify and classify only AMPs found in the hemolymph at very high concentrations.Orthologous AMP genes may also be detected in various insect species through genomic research pictures. Particularly small peptides, which are created Proteolytic removal from intermediate proteins, such as Proline-rich peptides, because the precursor proteins do not have strong similarity among various species.Consequently, there could be a significant number of insect AMPs in hemolymph which have not were either cleaned, or established. Many insect AMPs are simple (cationic) like insect defensins, cecropins, gloverins, and specific attacins.Insect AMPs have a broad activity range against microbes, fungi, certain pathogens and viruses. Also AMPs in the same class of diverse types of insects that have aggression against specific microorganisms. This may be because AMPs from numerous species of insects that varies in binding capacity to microorganisms.

Defensins

Defensins are mostly a type of simple parameter cationic peptides, which are dense in arginine. They are not insect-specific and have also been reported in more than 300 defensins so far. Defensin peptides are older organic antibiotics that function against a variety of microorganisms with good effect. This is consisting of 18–45 amino acids with 6–8 preserved cysteine residues. Classical defensins (α-defensins) consist of 29–35 amino acids, with 29–34 amino acids in the defensines of bugs. Three disulfide bonds usually stabilise the defensin molecule, and their main structural characteristic is a β-hairpin. Defensins bind to the cell membrane or form flaws in the permeable layer occurring in the secretion of essential ions and components. Insect defensines are intracellular antibacterial peptides with participation of both Gram-positive and Gram-negative bacteria. Those are all extremely effective against bacteria such as Staphylococcus aureus, which become Gram-positive and pathogenic to humans. But such peptides against Gram-negative bacteria are less effective. Insect defensines are isolated from classes of insects, including Diptera, Hymenoptera, Coleoptera, Trichoptera, Hemiptera, Odonata, etc. In insect lepidopteran, all types of AMPs are reported except for the insect defensins. Defensin from rabbit neutrophils exerts effective bactericidal action on multidrug-resistant ( MDR) strains of Pseudomonas aeruginosa.

Cecropins

Actually the original, cecropins were taken from the giant silk moth hemolymphHyalophoracecropia (cecropia moth), through which the term cecropin was taken. Such peptides are mainly produced from a large number of antibacterial and harmful peptides derived from unique species of lepidopteran and dipteran, which represent a significant part of the cell-free immunity of insects. Cecropins are bulky proteins containing function against certain Gram-positive and ram-negative bacteria (about 35 amino acid residues). The insect cecropin concept (A, B, and D) consists of 35–37 residues lacking cysteine. Cecropins is capable of lysis of bacterial cell membranes and it can also inhibit proline absorption and causing rusty membranes. Some insect cecropin words include bactericidin, lepidopteran, sarcotoxin, and so on.

Attacins

Attacins are proteins rich in glycine, which belong to the AMP group. Attacins were first detected in cecropia at Hyalophora. They are successful against bacteria Gram-negative. Attacins A – F are strongly associated proteins against bacteria, which are protected from immunized pupae hemolymph Of the species of cecropia (Hyalophoracecropia). They are a very heterogeneous group of proteins which differ in size but are rich in residues of glycine (10–22 per cent).Attacins A – F can be classified into two groups depending on the structure of the amino acids: Attacins A – D form a fundamental group; and E and F are connected, these have latent acids. Attacins act by stopping the formation of the main outer membrane proteins by segregating Gram-negative bacteria, thereby altering the permeability of cell wall and requiring development of the bacteria in long chains. Attacins are an important antibacterial component of an inducible P5 protein in the immune system Attacins will effectively destroy E. Coli, and other microorganisms of Negative Gram. Attacins is the third antimicrobial component in H’s humoral immune system, besides the cecropin and lysozyme. That would be to say, cecropia. Most of the other attacin & attacin-related proteins are Bombyxmori, Glossinamorsitans (tse-tse fly), Heliothisvirescens, Trichoplusiani, Samiacynthiaricini (wild silkmoth), and Musca domestica (household).

Lebocins

Lebocins being antibacterial peptides comprised of 32 amino acids in the silkworm hemolymphBombyxmori, immunised with E, identified by Hara and Yamakawa. Coli. Coli! Coli. Lebocin is an o-glycosylated peptide, strong in proline. In addition, in Apismellifera honeybee, 41 percent of the sequence of amino acids of lebocin is identical to abaecin, an important antibacterial peptide of 34 amino acids (YVPLPNVPQPGRPFPTFPGQGPFNPKIKWPQGY-NH2). The amino acid series DLRFLYPRGKLPVPTPPPFNPKPIYIDMGNRY-NH2 in lebocin 1 is. The significant components of lebocin 1 and 2 vary greatly in their sugar moiety. Lebocin 3 does have the same structure as lebocin 2 but leucine is residue 16 instead of proline.

Drosocin

Drosocin is indeed a peptide of a Drosophila melanogaster. Contains of 19 amino acids (GKPRPYSPRPTSHPRPIRV-NH2). The peptide is O-glycosylated and the improvement is included in optimum biological activity. Glycosylation is an important post-translation modification for any type of proline-rich AMPs. Apart from the Gram-positive bacterium M. Luteus, Drosocin is predominantly resistant to Gram-negative bacteria. Deletion of the first 5 N-terminal residues completely suppresses the production of drosocin. Glycosylated drosocine is used to defend against E. Coli and fungi. Apidaecin IB and drosocin exhibit significant sequence homology and association mechanism but lack a certain pore-forming behaviour. Apidaecins are the main components of the humoral defence against honeybee microbial invasion. Not only does the N-terminal mutation improve apidaecinsInteraction with unidentified intracellular sites, which also facilitates cell penetration success. Repeats of the Ile-Orn- and Trp-Orn-motif N-terminal structure improve the antimicrobial activity against Pseudomonas aeruginosa.

Conclusion

Beyond the antimicrobial function, AMPs do have diverse biological effects have been shown, all of which are involved in the control of infectious and inflammatory diseases, characteristics which render these peptides attractive as therapeutic instruments. A choice for their human usage is the synthesis of AMPs and the production of analogues. Another fascinating method is to stimulate the endogenous development of such peptides, while preventing the potential toxicity and harmful systemic reactions and the challenge of supplying them to the target location in an essential manner action.AMPs should be used to boost certain associated diseases lack or non-functional endogenous peptides like CF or Crohn’s. However, the careful control of such peptides should be recognized as large or constant levels will contribute to a chronic inflammatory cycle, as seen with psoriasis and rosacea.

Introduction to Migrant Laborers During the Great Depression

Are workers who travel to different parts of the country to find work or employment, this can be because they can not find work anywhere close by, so they have to go around asking for jobs. A ”migrant worker is an individual who either moves inside their nation of origin or outside it to seek after work. Vagrant laborers for the most part don’t have a goal to remain for all time in the nation or district wherein they work. Migrant workers who work outside their nation of origin users. Reasons for moving might want to move because of the limited work available in their home country or to use this as an excuse to leave harsh conditions and find a better him place to live and pursue a new life. Prior to the Great Depression, migrant laborers in California were principally of Mexican or Filipino plunge.

The Shift in Labor Demographics and Displacement

At the point when the white Dust Bowl vagrants showed up, they dislodged a significant number of the minority laborers. About 120,000 transient laborers were repatriated to Mexico from the San Joaquin Valley during the 1930s, as indicated by PBS. In the 1930s, droughts and the Great Depression created a culture of laborers who traveled from place to place harvesting crops as they ripened. Migrant farmworkers tended to be either newly arrived immigrants or individuals forced to leave their farms in the Dust Bowl. Work cards’ were given by the WPA (Works Projects Administration) in an extraordinary exertion by the Roosevelt organization to get cash into the pockets of the a large number of men who were jobless during the Great Depression.Work cards are what migrant workers received to prove they were sent from another place to work. If you didn’t have one, you couldn’t work.

The Role of Work Cards in Migrant Labor

One in each three workers was either jobless or on limited hours and diminished wages. A work card resembles an Identity Card which confirms that an individual has been given work, or is qualified to perform work in a given calling or ward. Work cards’ were given by the WPA (Works Projects Administration) in an extraordinary exertion by the Roosevelt organization to get cash into the pockets of the a large number of men who were jobless during the Great Depression.Work cards are what migrant workers received to prove they were sent from another place to work. If you didn’t have one, you couldn’t work. One in each three workers was either jobless or on limited hours and diminished wages. A work card resembles an Identity Card which confirms that an individual has been given work, or is qualified to perform work in a given calling or ward.

Agricultural Challenges and Community Life on Farms

The Great Depression changed the lives of individuals who lived and cultivated on the Great Plains and thus, changed America. The administration programs that helped them to live through the 1930s changed the eventual fate of farming until the end of time. Climate contacted all aspects of life in the ‘Messy 30s’: dust, bugs, summer warmth and winter cold. York County farm families didn’t have warmth, light or indoor restrooms like individuals who lived around. Many homestead families raised the greater part of their own nourishment – eggs and chickens, milk and meat from their own cows, and vegetables from their nurseries. Individuals who grew up during the Depression stated, ‘Nobody had any cash. We were all in a comparable situation.’ Neighbors helped each other through tough occasions, disorder, and mishaps. Homestead families got together with neighbors at school programs, church suppers, or moves.

Kids and grown-ups discovered approaches to have a ton of fun for nothing – playing prepackaged games, tuning in to the radio, or going out to see open air films around. At the point when the dryness, warmth, and grasshoppers devastated the harvests, ranchers were left with no cash to purchase staple goods or make farminstallments. A few people lost expectation and moved away. Numerous youngsters took government employments building streets and scaffolds. By 1940, typical precipitation returned, and government programs helped farmcosts and improve the dirt. About a similar time, another administration program began to attach farmhouses to power, making farmlife simpler and safe Farmers during the 1930s were expanded, growing an assortment of yields in the fields, vegetables in the nursery and natural product in the plantation.

Little homesteads typically raised chickens, eggs, swine, and dairy cattle, just as keeping ponies and donkeys for work, and at times sheep for wool and meat. A few farmers kept honey bees and collected the nectar. During the Depression, this independence persisted into their public activity. One-dish dinners and church potlucks were significant approaches to have some good times and offer nourishment. On radio and in ladies’ magazines, home financial analysts showed females how to extend their nourishment spending plan with suppers like creamed chipped meat on toast or waffles. Stew, macaroni and cheddar, soups, and creamed chicken on scones were well-known suppers. Homestead families invested quite a bit of their energy attempting to raise a harvest and develop their very own nourishment. Climate affected each part of life on the farmduring the 1930s. Homestead gardens helped keep rustic families bolstered. ‘Egg cash’ helped a few families endure, so dealing with chickens was a significant task. Numerous tasks must be done day by day: pulling water, gathering eggs, tending the nursery, and filling the wood box. What’s more, a few tasks like draining bovines and sustaining domesticated animals must be accomplished more than once per day. Hands on work began ahead of schedule, with bolstering and bridling the steeds.

Farm life was generally difficult work just to get by, however, they did every so often have a ton of fun. Cultivating families would assemble for moves or potluck meals. Children would play outside games like kick-the-can and baseball. Around evening time, families would assemble around the radio to tune in to the news or shows like The Lone Ranger and Amos ‘n’ Andy. Some farm kids went to class during the Great Depression. In some rustic regions the school was only a solitary live with various evaluations being educated by a similar instructor. Kids regularly needed to walk far to class. This got risky throughout the winter months and during dust storms. In any event, when the youngsters were in school, despite everything they had long periods of errands to do every day on the homestead. With the dry season and the residue storms, numerous ranchers in the Midwest couldn’t develop yields and they lost their homesteads. They heard that there was work in California. A huge number of families started the long excursion to California wanting to look for some kind of employment.

Impact on Clothing and Household Management

At the point when dry spell hit the Midwest during the Great Depression, the dirt transformed into dust. Ranchers in this district couldn’t develop crops in light of the fact that there wasn’t sufficient water. To exacerbate the situation, incredible residue storms framed in the zone covering everything in dust. Residue got all over the place and made life troublesome ‘Repair, reuse, make do, and don’t throw anything away’ was a motto during the Great Depression. Not many ranch families had enough cash to purchase new garments at a store. Moms repaired socks and sewed fixes over gaps in garments. Garments were ‘reused’ and reused as more youthful kids ‘managed’ with pre-worn stuff. At the point when ranchers brought home huge sacks of flour or domesticated animals feed, ranch females utilized the sacks as material to sew everything from young ladies’ dresses to young men’s shirts and even undies.

The Great Depression the life motto of many was to ‘Repair, reuse, make do, and don’t waste anything’; therefore, any creativity was apparently confined to those boundaries.During the Depression, clothing was regularly handcrafted from repurposed materials. For instance, young ladies’ dresses were made with designed flour or feed sacks. Kids’ attire was regularly put something aside for more youthful kin to save the cost of obtaining another closet for a more youthful youngster, especially in bigger families. In certain locales, grown-ups and kids wore fixed apparel to save money on the expense of new attire. Creased skirts with coordinating tops were well known during the mid 1930s. females wore calfskin boots and high-obeyed shoes. Shorter sleeves, for example, 3/4-inch sleeves and butterfly sleeves, were normal for ladies. Dresses and skirt sets were frequently combined with coats and tights during cooler months. Ladies’ dresses were sewn with creases or in a cross-cut predisposition style that made slanting creases. Open-front coats and caps were normal for females during the Depression. During the 1920s through to the early 1930s, the spot for a lady was in the home dealing with her youngsters and spouse, cooking and cleaning.

Women’s Roles and Employment During the Depression

At the point when the Great Depression struck America that cut numerous individuals’ pay or totally put them out of work. This caused issues at home on the grounds that there wasn’t sufficient cash to purchase nourishment or pay protection and now and then that implied one’s home was dispossessed. On the off chance that a lady was hitched with kids, her activity was to fill in as hard as she could to manage with the assets she had accessible to put supper on the table for her family and to put garments on their back. There were numerous stunts for housewives during the Great Depression that made nourishment stretch a little more distant and made discovering material for garments simpler. A case of this is in some cases females would make dresses out of chicken feed packs on the off chance that they couldn’t bear to purchase a dress or material for a dress. females basically worked in administration ventures, and these occupations would in general keep during the 1930s. Administrative laborers, instructors, attendants, phone administrators, and domestics generally looked for some kind of employment. In numerous examples, businesses brought down pay scales for females laborers, or even, on account of educators, neglected to pay their laborers on schedule. Be that as it may, ladies’ wages stayed an essential segment in family endurance. In numerous Great Depression families, females were the main providers. In 1930, roughly 10.5 million females worked outside the home.

By 1940, around 13 million females worked for compensation outside the home. All things being equal, ladies’ work kept on being not exactly all around respected by American culture. Pundits, over-looking the sex-composing of most work open doors for ladies, assailed working females for denying men of much-required employments. Indeed, even ladies’ universities officially charged females not to seek after professions after graduation with the goal that their places could be filled by men. By the 1930s, females had been gradually entering the workforce in more noteworthy numbers for a considerable length of time. In any case, the Great Depression drove females to look for some kind of employment with a reestablished need to keep moving as a huge number of men who were once family providers lost their positions. A 22 percent decrease in marriage rates somewhere in the range of 1929 and 1939 likewise implied progressively single females needed to help themselves. While females were allowed to join certain associations, they were given constrained effect on strategy, Kennedy composes. At last, littler wages and less advantages were the standards for females in the workforce and this was particularly valid for females of shading. In 1930, roughly 10.5 million females worked outside the home. By 1940, around 13 million females worked for compensation outside the home.

All things being equal, ladies’ work kept on being not exactly all around respected by American culture. Pundits, over-looking the sex-composing of most work open doors for ladies, assailed working females for denying men of much-required employments. Indeed, even ladies’ universities officially charged females not to seek after professions after graduation with the goal that their places could be filled by men. By the 1930s, females had been gradually entering the workforce in more noteworthy numbers for a considerable length of time. In any case, the Great Depression drove females to look for some kind of employment with a reestablished need to keep moving as a huge number of men who were once family providers lost their positions. A 22 percent decrease in marriage rates somewhere in the range of 1929 and 1939 likewise implied progressively single females needed to help themselves. While females were allowed to join certain associations, they were given constrained effect on strategy, Kennedy composes. At last, littler wages and less advantages were the standards for females in the workforce and this was particularly valid for females of shading. While employments accessible to females saved money, they were less unstable.

By 1940, 90 percent of every one of ladies’ occupations could be inventoried into 10 classifications like nursing, educating, and common assistance for white ladies, while dark and Hispanic females were to a great extent compelled to local work. For black women, meanwhile, the entry of more white women in the workforce meant jobs and decent wages became even harder to find. Some 400,000 Mexican-Americans moved out of the United States to Mexico in the 1930s, many against their will, according to Kennedy. Prior to the Great Depression, the odds of females assisting their education were thin. During the extraordinary financial change, a few females (particularly the individuals who were unmarried) accepted the open door to go to school. Before, females would depend on their spouses for budgetary help. Be that as it may, with the developing number of men without business and hence unfit for marriage females started to bring their monetary fates into their own hands, going to school for preparing for future professions. females and men had been associated to see their jobs in an unexpected way: men were the providers and females worked at home. Be that as it may, when the Depression hit, men frequently got discouraged and considered themselves to be disappointments. Ladies, then again, saw their jobs increment and worked tirelessly to bring home the bacon. Of the female workforce, 33% of them were hitched. This is a 50% expansion from the 1920s. On the off chance that females didn’t look for business somewhere else, they would have utilized their own work to represent what they would have recently acquired. For instance, they would repair their very own garments as opposed to purchasing new ones.

At the point when Depression hit, females searched work out of the house: medical caretakers, teachers, beauticians, housekeepers (servants/cooks), secretaries, and assembling occupations (sewing). As per the Censuses taken in 1930 and 1940, the quantity of females holding proficient employments expanded by 20. Curiously, antagonistic vibe originated from the females being enlisted outside of the property in light of the fact that the joblessness pace of men was equal to the business pace of ladies. (The business pace of females was 25.4% in the last 1930s; the joblessness pace of men was 25%.) The antagonistic mentality is reflected in a statement by Norman Cousins, ‘Basically fire the ladies, who shouldn’t be working in any case, and contract the men. Presto! No joblessness. No alleviation rolls. No downturn.’ Discriminatory Laws Against Women Employment: Section 213 of the 1932 Federal Economy Act banned more than one family member from working for the United States government. This was aimed at diminishing the employment of married women. In 1932 and 1935, the Atlanta Board of Education proposed that schools disallowed their female teachers from being married, or that schools would refuse to hire married, female teachers. Twenty-five percent of the National Recovery Administration codes set lower minimum wages for women doing the same jobs as men. (In 1937, annual pay was $525 for women and $1.027 for men.) There were many more laws these are very few them.

Legislative and Social Challenges Faced by Women

Roosevelt’s New Deal organizations gave business for the most part to men, particularly with respect to Civilian Conservation Corps and Civil Works Administration. Since females were thought of as not having the option to do difficult work, they were regularly set in sewing rooms. Greater part of government managed savings benefits went to men and his needy spouse. This suggested females just merited monetary rights in relations to men, disadvantaging the individuals who didn’t fit the customary housewife shape. Women worked mainly in the service industries, and during the 1930s such employment continued to remain. Most of the job was done by clerical staff, educators, doctors, telephone operators, and domestics. In many instances, companies reduced pay scales for female workers or even failed to pay their staff on time in the case of educators. Yet women’s incomes remained a part needed to survive in the home. Conditions were much harder for women as there were many more laws around what they can do and can not do, this limited the areas for women to work in as there were, women in professional occupations lost gains made in past progressively stable periods. Less females discovered situations in business in the Great Depression than during the 1920s. Losing ground in the conventional male circle, a few men additionally went into occupations up to this time consigned to ladies. This pattern happened even in the female bastion of instructing. The encouraging calling became somewhat less female during the Great Depression; females had established 85 percent of instructors in 1920, yet by 1940 they comprised just 78 perc

Abstract

Objective: The goal of this study was to explore the awareness, knowledge and habits of UKM students towards recreational noise-induced hearing loss (RNIHL).

Methods: A cross-sectional study was performed through online survey and a Malay version of Knowledge, Awareness, and Behaviors (KAB) questionnaire was given to the health science and non-health science undergraduate UKM students. Two-way ANOVA was conducted to compare knowledge and awareness between health science and non-health science students while the spearman coefficient was conducted to correlate knowledge and awareness with their habits.

Results: A total of 96 questionnaires were completed. UKM students demonstrated having positive awareness and low knowledge towards recreational noise-induced hearing loss. Health sciences and non-health sciences students reported no significant difference on their awareness and knowledge towards recreational noise-induced hearing loss. There was no correlation between knowledge, awareness and the use of hearing protective device.

Conclusion: In general, our study showed UKM students have low level of knowledge but positive awareness towards recreational noise-induced hearing loss. However, that did not promote the use of hearing protection.

Introduction

According WHO (2015), 1.1 billion young people aged between 12–35 years are at risk of hearing loss due to exposure to noise in recreational settings. Exposure to excessive noise is one major cause of hearing disorders. It can affect people of all ages, including children, teenagers, and young adults. Noise not necessarily come from workplaces, it also can be resulted from recreational activities which one intentionally exposed themselves to (Roberts et al., 2018). Some of the common source of recreational noise among young adults includes personal audio devices, nightclubs, bars, live music concerts and sporting events.

Noise-induced hearing loss (NIHL), defined as a permanent decrement in hearing threshold levels (HTLs) with the characteristics of reduction in hearing sensitivity at the frequencies of 3, 4 and, 6 kHz and with relatively better hearing sensitivity in surrounding frequencies (2 or 8 kHz) (Roberts et al., 2018). NIHL can happen when the sound is too loud, even for a very brief single exposure, or when they are both loud and long-lasting which can potentially damage the sensory hair cells and surrounding supporting cells of the inner ear, and ultimately degeneration of associated auditory nerve fibers (NIDCD, 2017). This condition can be temporary or permanent and it can affect one ear or both ears (NIDCD, 2017). Prolonged exposure to the noise levels regularly above 70 decibels (dBA) can cause hearing loss over time, leading to a permanent threshold shift (permanent hearing loss) (ASHA, 2017).

In recent years, there has been an increase among the younger generation of loud noise exposure which can lead to noise-induced hearing problems (Le Clercq et al., 2016). Entertainment venues contributed to the risk of NIHL, with a three-fold increase in those exposed to loud sounds in social settings over the past twenty years (Sliwinska-Kowalska and Davis, 2012). Beach et al. (2014) has reported that young adults between the age of 18-35 years were being involved in high-noise activities including playing an instrument, attending a nightclub or a pop concert which were measured to have noise levels >100 dB. A study of recreational noise exposure from outdoor football stadiums has also found out that 96% of the workers and fans sampled were overexposed to noise level which exceeded the American Conference of Governmental Industrial Hygienists (ACGIH) criteria (≥85 dBA, 3 dB exchange rate), with mean maximum personal noise exposure level of 116-120 dB (Engard et al., 2010).

Almost 50% of all portable music device users are listening to music in an unsafe manner (WHO, 2015). According to Scenihr (2008), 5-10% of listeners are likely to develop hearing loss in the future due to their personal preferences of volume levels and duration of listening. Vogel at al. (2011) conducted a study on adolescents risky MP3-player listening and its psychosocial correlates and indicated that among participants, 90% reported listening to music through earphones on MP3 players; 28.6% were categorized as listeners at risk for hearing loss due to estimated exposure of 89 dBA for >1 hour per day. The study had concluded that habit strength is the strongest correlate of risky listening behaviour. Besides, hearing thresholds in the 3 to 8 kHz frequency range were found significantly increased in personal listening device listeners (Peng, Tao, & Huang, 2007). These studies showed that recreational noise can place individuals at equal risk of noise-induced hearing loss caused by occupational noise, given equivalent loudness and time exposure. However, the potential risk from recreational noise exposure does not bring about the same degree of concern by the public as compared to occupational noise exposure. For instance, a regulation was established by the Malaysia Factories and Machinery Act 1967 to protect workers from excessive or prolonged exposure to occupational noise in order to reduce the risk of NIHL (FMA, 2015). But, there is hardly any safety standards or regulations concerning recreational noise exposure despite evidence of hazardous effect from non-occupational noise exposure among young people.

A study conducted by Balanay et al. (2015) included 2,151 college students and the findings revealed students with negative attitudes (noise is perceived as harmful) comprised the highest percentage, followed by neutral attitude (unaware of the possible consequences of loud noise) and positive attitude (noise is not perceived as dangerous). The study had also associated perceived hearing symptoms with attitude towards noise and hearing protection habits whereby those with more severe hearing symptoms generally have a more negative attitude towards noise and reported the use of hearing protection more than those with no hearing symptoms. However, a more recent study was conducted to explore attitudes and behaviours towards leisure noise and use of hearing protection among young adults and it was concluded that there was a lack of knowledge and concern over the impact of noise exposure and hearing problems (Hunter, 2018). This may be due to the lack of awareness and knowledge on the mechanism of normal hearing and hearing loss among young people (Lass et al, 1990). Thus, this study could be used to increase awareness about recreational noise-induced hearing loss among university students and may provide a greater understanding of university students’ knowledge and habits towards recreational noise exposure, particularly in Malaysia.

Understanding the awareness and habits towards recreational noise-induced hearing loss among university students can be served as an evidence to enhance the promotion of hearing conservation programs specifically for this population. The aim was to explore the awareness, knowledge and habits of undergraduates from The National University of Malaysia (UKM) towards recreational noise-induced hearing loss. The specific objectives of this study were to (1) measure the awareness and knowledge of UKM students towards recreational noise induced-hearing loss, (2) compare the awareness and knowledge between UKM health sciences and non-health sciences students towards recreational noise-induced hearing loss, (3) and identify the correlation between UKM students’ awareness and knowledge of recreational noise-induced hearing loss and their habits towards the recreational noise.

Methodology

The participants in this study were first year to fifth year health sciences and non-health sciences undergraduates students at The National University of Malaysia (UKM). A total of 96 students were involved in this study, 48 of them were health sciences students and 48 of them were non-health sciences students. A self-administered online questionnaire was designed to explore the awareness, knowledge and habits of students from UKM towards recreational noise-induced hearing loss.

The Knowledge, Awareness, and Behaviors (KAB) questionnaire is a valid and reliable tool for assessing knowledge, attitudes, and behaviors towards noise-induced hearing loss and hearing protection (Saunders, Dann, Griest, & Frederick, 2014). In this study, the Malay version KAB questionnaire is used to evaluate the aforementioned domains. Cronbach’s alpha for the entire scale was α=0.79.

The questionnaire utilized in this study comprised of four sections. The questionnaires have 70 questions and will take approximately 15 minutes to complete. Section 1 is to obtain information about the demographic profile of respondents. The demographic questions focused on respondent’s hearing status and understanding of recreational noise-induced hearing loss.

Section 2 consists of 16 items and assesses knowledge about noise-induced hearing loss (NIHL) and hearing conservation. Respondents would rate their agreement with the statement on the scale (a) Saya TAHU ini adalah BENAR, (b) Saya RASA ini adalah BENAR, (c) Saya TIDAK PASTI, (d) Saya RASA ini adalah SALAH, (e) Saya TAHU ini adalah SALAH. 11 items were reversely worded and required reverse scoring.

Section 3 consists of 22 items to investigate participants’ attitude towards hearing, hearing loss and recreational noise-induced hearing loss. A 5-point Likert scale with response options from ‘Sangat Tidak Setuju’ to ‘Sangat Setuju’ is used. 11 items were reversely worded and required reverse scoring.

Section 4 is designed to measure the degree to which the individual participates in noisy activities and in addition whether hearing protection is used or not. It consists of two parts, the first part is on how often are respondents involved in the recreational activities whereas second part assesses on their frequency of using hearing protection device on those activities. The respondents were given a list of 11 recreational activities which might have the risk of noise exposure. Examples of recreational activities including attend concerts, ride motorbikes and play musical instruments.

Results

Demographic Data

There were 50% (n=48) health sciences students and 50% (n=48) non-health sciences students participated in this study. 77% (n=74) of them were females and 23% (m=22) were males. 92% (n=88) of the students have no hearing loss and 8% (n=8) reported of hearing loss. 88% (n=84) of them reported they have no family member with hearing loss not due to aging. A total number of 49% (n=47) students reported no changes in hearing due to sound exposure in different places. However, 24% (n=23) students reported their hearing change due to sound exposure after attending concert.

Awareness

The distribution of total awareness scores among UKM students was examined. Majority of respondents (92.70%) were having positive awareness. Respondents showed more awareness towards the following four questions, with at least 90.6% of respondents agree and very agree with it:

• Q4- Melindungi pendengaran saya adalah penting bagi saya. [S =35.4%, SS=57.3%]
• Q5- Mengalami masalah pendengaran akan menghadkan aktiviti sosial saya. [S =33.3%, SS =57.3%)
• Q8- Kebaikan melindungi pendengaran adalah lebih banyak berbanding keburukan. [S =35.4%, SS =57.3%]
• Q20- Pendengaran yang baik diperlukan untuk komunikasi yang baik. [S=32.3%, SS =57.3%]

55.2% of the respondents were neutral towards Question 14, that was “Sukar untuk memakai alat pelindung telinga ke dalam telinga saya.” and 50.0% of them were neutral towards Question 12, “Alat pelindung telinga adalah tidak selesa dipakai.”

Each question was scored by awarding 2 points for sangat setuju, 1 point for setuju, 0 point for tidak pasti, -1 point for tidak setuju, and -2 points for sangat tidak setuju. Reverse scoring was carried for Question 1,2, 6, 10-14, and 16-18. Total scores of each respondent’s awareness were computed followed by the mean of overall scores obtained by all the respondents. Positive score means positive awareness while negative score means negative awareness. The mean obtained was 14.30 (SD=9.04) indicating that UKM students have positive awareness towards recreational noise-induced hearing loss.

Knowledge

Data from the sixteen knowledge questions was summed and analyzed. Respondents were most knowledgeable about the following three questions, with ≥ 62.5% of respondents answering correctly:

• Q4- Bunyi dari mesin basuh baju boleh merosakkan pendengaran manusia. (Salah) (n=60, 62.5%)
• Q7- Bunyi yang terlalu kuat boleh menyebabkan kerosakan pada koklea. (Benar) (n=66, 68.8%)
• Q10- Bunyi bising di sekitar anda adalah sangat kuat sekiranya anda tidak dapat mendengar percakapan seseorang yang berada pada jarak 1 meter (panjang lengan) dari anda. (Benar) (n=67, 69.8%)
• Respondents were least knowledgeable about the following three questions, with ≥ 74.0% of the respondents answering each incorrectly:
• Q2- Pendengaran manusia boleh rosak jika mendengar bunyi sekuat 70 desibel. (Salah) (n=83, 86.5%)
• Q8- Seseorang yang telah kehilangan pendengaran akibat terdedah kepada bunyi yang kuat boleh mendengar seperti biasa sekiranya mereka memakai alat bantu dengar. (Salah) (n=73, 76.0%)
• Q9- Seseorang yang telah kehilangan pendengaran akibat terdedah kepada bunyi yang kuat boleh mendengar seperti biasa jika mereka meningkatkan ‘volume’ suara alat bantu dengar. (Salah) (n=71, 74.0%)

An overall knowledge score was generated by awarding 1-point for a correct response (either “Saya TAHU ini adalah BENAR/ SALAH” or “Saya RASA ini adalah BENAR/ SALAH” ), and 0-points for an incorrect response (either “Saya TAHU ini adalah BENAR/ SALAH” or “Saya RASA ini adalah BENAR/ SALAH” or “Saya TIDAK PASTI” ). Points were summed for all 16 questions and the percentage correct based on total score was computed. The average score obtained by each respondent was 43.8% which is equivalent to 7 marks (SD= 18.8 which is equivalent to 3 marks) with scores ranging from 6.3% which is equivalent to 1 mark to 81.3% which is equivalent to 13 marks. By using a cut off point of 75% to be considered as satisfactory knowledge level (Sawmill, Towards, Loss, & Kota, 2008), results showed that UKM students with the mean score of 43.8% has low knowledge towards recreational noise induced hearing loss.

Habit

Table 1 presents data regarding the percentage of individuals who participate in each of the activity. Data showed that 100% (n=96) of students participated in listening to music using headphone or earphone either “kerap”, “kadang-kadang” or “jarang-jarang”. For the participation of “kerap” and “kadang-kadang”, the highest percentage was shown by listening to music (88.5%), followed by listening to high volume of radio (42.7%) and then going to karaoke (32.2%). One of the item (listening to music using earphone or headphone) was selected to know how many hours in a week that the respondents involved in that activity. The data collected is in numerical form. The mean obtained was 9.38 hours per week (SD=11.01) indicating low period of time spent by UKM students in listening to music either using earphone or headphone in a week.

Meanwhile, table 2 showed the percentage and number of hearing protection use for each activity. In this part, the scoring for each item ranged from 1 to 3 (1=Tidak pernah, 2=Jarang-jarang, 3=Kerap). As we can see, the highest percentage of hearing protection usage was shown by shooting activity (10.5%). However, it was still considered remarkably low. Most of the students ranging from 88% to 100% never use any hearing protection when they were participating in the activities.

Table 1. Percentage and number of individuals who participate in each activity.

Aktiviti

Peratusan dan bilangan individu melakukan aktiviti berkaitan

Tidak pernah

Jarang-jarang

Kadang-kadang

Kerap

Bermain mercun

12.5% (n=12)

78.1% (n=75)

9.4% (n=9)

0% (n=0)

Menembak (senapang/paintball)

78.1% (n=75)

19.8% (n=19)

1.0% (n=1)

1.0% (n=1)

Menunggang motosikal

36.5% (n=35)

39.6% (n=38)

14.6% (n=14)

9.4% (n=9)

Menyaksikan perlumbaan kereta atau motosikal

75.0% (n=72)

21.9% (n=21)

1.0% (n=1)

2.1% (n=2)

Pergi ke konsert rock

61.5% (n=59)

30.2% (n=29)

5.2% (n=5)

3.1% (n=3)

Pergi berkaraoke

17.7% (n=17)

50.0% (n=48)

26.0% (n=25)

6.3% (n=6)

Mendengar muzik (headphone/earphone)

0% (n=0)

11.5% (n=11)

25.0% (n=24)

63.5% (n=61)

Mendengar radio dengan kuat

16.7% (n=16)

40.6% (n=39)

28.1% (n=27)

14.6% (n=14)

Bermain alat muzik/sertai band/koir

35.4% (n=34)

39.6% (n=38)

14.6% (n=14)

10.4% (n=10)

Mesin permainan arked

45.8% (n=44)

40.6% (n=39)

12.5% (n=12)

1.0% (n=1)

Duduk/kerja di tempat bising

18.8% (n=18)

55.2% (n=53)

20.8% (n=20)

5.2% (n=5)

Table 2. Percentage and number of use of hearing protection in each activity.

Aktiviti

Peratusan dan bilangan penggunaan alat pelindung pendengaran semasa melakukan aktiviti berkaitan

Tidak pernah

Kadang-kadang

Sentiasa

Bermain mercun

100% (n=96)

0% (n=0)

0% (n=0)

Menembak (senapang/paintball)

89.6% (n=86)

6.3% (n=6)

4.2% (n=4)

Menunggang motosikal

96.9% (n=93)

3.1% (n=3)

0% (n=0)

Menyaksikan perlumbaan kereta atau motosikal

97.9% (n=94)

2.1% (n=2)

0% (n=0)

Pergi ke konsert rock

96.9% (n=93)

1.0% (n=1)

2.1% (n=2)

Pergi berkaraoke

97.9% (n=94)

2.1% (n=2)

0% (n=0)

Mendengar muzik (headphone/earphone)

N/A

N/A

N/A

Mendengar radio dengan kuat

97.9% (n=94)

2.1% (n=2)

0% (n=0)

Bermain alat muzik/sertai band/koir

99.0% (n=95)

1.0% (n=1)

0% (n=0)

Mesin permainan arked

100% (n=96)

0% (n=0)

1.0% (n=1)

Duduk/kerja di tempat bising

88.5% (n=85)

10.4% (n=10)

1.0% (n=1)

N/A = Not applicable

Comparison of the Awareness and Knowledge between UKM Health Sciences and Non-health Sciences Students

In term of knowledge, more than fifty percent of both health science (72.9%) and non-health science students (64.6%) knew that loud noise can cause damage to the cochlea. Higher number of non-health science students (60.4%) have knowledge on hearing an extremely loud sound just once can cause someone to lose some hearing than health science students (45.8%). Further, non-health science students (14.6%) had poorer knowledge in terms of the function of hearing aid than the health science students (33.3%) of which they think hearing aid can help to restore hearing.

Regarding awareness on recreational noise-induced hearing loss, from a total of 22 items, health science students had a greater awareness (mean=34.5) than non-health science students (mean=27.9). In particular, in fifteen of the 22 items, health science students had higher scores. Health science students (51) scored higher than non-health science students (29) for item “Meluangkan masa untuk mempelajari masalah pendengaran serta cara melindungi / menjaga pendengaran adalah penting bagi saya.”.

In all, two-way ANOVA demonstrated no significant interaction between health science and non-health science students on their awareness and knowledge towards recreational noise-induced hearing loss (p> .025).

Table 3. Comparison of the Awareness and Knowledge between UKM Health Sciences and Non-health Sciences Students

Dependent Variable

F

p

Knowledge

.998

.320

Awareness

2.810

.097

Correlation between UKM Students’ Awareness and Knowledge of Recreational NIHL and Their Habits

Spearman correlations were used to examine the relationships between scores on the knowledge, awareness, and use of hearing protection device. There was no significant relationship between knowledge score and the use of hearing protection device among UKM students (p > .05). Besides, there was also no significant relationship between awareness score and the use of hearing protection device (p > .05).

Table 4. Correlation between knowledge, awareness and the use of hearing protection device among UKM students.

Knowledge

Awareness

p

r

p

r

Use of Hearing Protection Device

.286

0.110

.723

-0.037

Discussion

Nowadays, we can easily get health-related information from government agencies, national advocacy organizations, and health care systems on the Internet (Medlock et al., 2015). In our study, we found out that most of the respondents are aware that protecting their hearing is important and there are more pros than cons in protecting their hearing. This might due to the increment of hearing conservation programs which had promoted hearing health (Chermak, 1996). Most of them are also aware that hearing is important in communication and social activities as they noticed that difficulty to hear clearly will lead to physical and emotional exhaustion and can cause communication problem which leads to social isolation, feeling of loneliness, stigmatization, depression and increase dependency on others (Shield 2006). Around half of the respondents were in the neutral view towards the difficulties in wearing hearing protection devices and the uncomfortableness in using it. This could be due to they are not sure on how to use hearing protection devices.

According to Crandell, Mills, & Gauthier (2004), there remains a paucity of empirical evidence on the knowledge of noise exposure and hearing protection devices (HPDs) for young adults, particularly those of diverse racial/ethnic backgrounds. Consequently, our study was interested in identifying the knowledge level towards recreational noise-induced hearing loss among students who are studying at UKM in Malaysia. In whole, results indicated that UKM students have low knowledge level on recreational noise-induced hearing loss with a mean score of 43.8%. The findings provides evidence that there should be concern about educating UKM students in particular about the severity and risk of exposure to excessive noise. According to Erlandsson (2006), providing information and knowledge regarding recreational noise exposure can be important factors in inducing behavioral change. Therefore, there is a need to improve the knowledge of UKM students perhaps that it will translate into higher usage of HPDs and effective hearing protection.

Based on our findings, health science and non-health science students reported no significant difference on their awareness and knowledge towards recreational noise-induced hearing loss. This finding is in contrast to some other studies which found higher health awareness and knowledge of health versus non-health science students (Tirodimos et al., 2009; Peltzer et al., 2016). One possible explanation for the relatively equal awareness and knowledge level among health science and non-health science students may be related to the usage of internet among youth in obtaining health information (Victoria Rideout, 2001). It seems plausible that rapid diffusion of internet technology within the public sphere has placed an unprecedented amount of health information within reach of general consumers.

From our findings, there was no correlation between the knowledge, awareness, and the use of hearing protection device among UKM students. Our result revealed an inconsistent finding from previous studies from, where the attitude towards noise was an important influence on hearing protection use (Widén et al., 2006; Balanay & Kearney, 2015). Our study revealed many of the students agree with the statement “earplugs are uncomfortable”. Thus, the possible reasons for not wearing the hearing protective devices may include discomfort or the danger of not using hearing protection device is not apparent (Maisarah & Said, 1993). However, there are another study showed that, although the participants knew that the hearing protective device can protect the hearing, most of them never wear it before due to the limited knowledge and they thought earplugs would distort the sound (Alzahrani, Alzahrani, & Alghamdi, 2018). This is similar to our result where UKM students have low knowledge and low usage of hearing protection devices despite having positive awareness of recreational noise-induced hearing loss.

Limitation

We have identified and acknowledged a few limitations in this study. First, data were collected through a self-administered, anonymous online survey and thus rely on self-reporting which may be subjected to recall bias. Another limitation is the length of the survey. The online survey consists of 70 items which may result in the possibility of respondents providing random responses towards the end of the survey. A further limitation is that factors that may contribute to the low usage of hearing protective devices were not addressed in the survey. This is important to understand the reluctance on usage of hearing protection devices among young adults and thus provides useful information on planning hearing conservation campaigns.

Conclusion

In general, our study showed low level of knowledge but positive awareness towards recreational noise-induced hearing loss among UKM students. However, the positive awareness did not promote hearing protection as shown by the low percentage of participants using hearing protection devices. This indicates that increased awareness does not necessarily increase use of hearing protection devices (Keppler et al., 2015) and thus the purpose of encouraging hearing protective behaviour among the public through education and hearing conservation programs remains challenging. In order to bring about any significant change in hearing behaviour towards recreational noise in young adults, it is crucial for hearing conservation programs to not only provide information on noise exposure, hearing loss and hearing protection devices, but also focus self-experience symptoms such as tinnitus after recreational noise exposure as well as societal norms and regulations (Keppler et al., 2015; Hunter, 2018).

The Lost Decade

The Stock Market crash is the most substantial economic crisis of its time. Beginning in 1929, all flourishing technological advances, financial security, and emotional well being were halted. Many people lost their careers; as a result, their self-worth promptly diminished. It would take around a decade for the nation to get back on its feet. Four years later, the change would gradually start seeping back into citizens’ daily lives with the election of a new president.

Franklin Delano Roosevelt (FDR) was born on January 30th, 1882. He was the 32nd president and was first elected in 1933. Roosevelt served for a prolonged amount of time, around twelve years. In modern times this cannot happen due to the passing of the twenty-second amendment. It states that future presidential officials shall only serve two terms with a maximum of eight years.

FDR was a far extended cousin to the 26th president, Theodore Roosevelt. Franklin was born into a considerably wealthy family line. He was educated as a child in Groton, an all-boys school in Massachusetts. For college, he went to Harvard University. “He strived to please the adults and took to heart the teachings of Groton’s headmaster, Endicott Peabody, who urged students to help the less fortunate through public service.” (History)

President Roosevelt passed the Works Progress Administration, or WPA, as a solution to the country’s detriment of available paying jobs. He also passed the Farm Security Administration (FSA), Civilian Conservation Corps (CCC), and the National Recovery Administration (NRA). These administrations were referred to as Roosevelt’s ‘alphabet agencies.’ The WPA and FSA were the most effective of the administrations during this period. The WPA allowed millions of unemployed citizens to earn a stable income. Nearly 1.4 million different jobs were supported, most of which were labor filled positions. A few examples of WPA jobs include building roads, sidewalks, and creating nature trails as well as more creative works, such as the documentation of these events through journalism and photography.

A vast majority of jobs involved construction and infrastructure, since many of the greatest achievements during the time required physical labor. In addition to the construction of highways, sidewalks, and nature trails. Roosevelt’s initiatives involved the development of public buildings and facilities. As a result, libraries, hospitals, and schools were built in almost every city or neighborhood. Among the WPA’s accomplishments are the assembly of 29,000 bridges, the paving of around 280,000 miles of new roads, and the construction of about 4,000 schools.

The purpose of the WPA was not only to give back jobs but also to preserve many of the nation’s soul and artistic integrity. ‘Headed by Harry Hopkins, the WPA provided jobs and income to the unemployed during the Great Depression while developing infrastructure to support the current and future society…’ (sandler) There were many subdivisions dedicated to all types of North American art, including the Federal Writers Project or FWP, Federal Music Project (FMP), and HRS or Historical Records Survey. The Records Survey was in charge of documenting the past and future vital occurrences. Luther H. Evans started and directed this bureau.

One of the significant accomplishments was interviewing and recording of many former slaves’ life stories, which until then was ignored in history. The HRS was responsible for uncovering and cataloging thousands of public documents. It included the cataloging of most things kept in Oklahoma’s Historical Society. The HRS did this after cataloging in Washington D.C, the nation’s capital. They started saving all future and old significant newspapers or prints in public libraries. ‘As part of the American Imprints Inventory, antiquarians prepared an index to American imprints with early publication dates found in state libraries’ (Historical Records Survey) The many subdivisions of the Works Progress Administration emphatically changed our nations’ soul and physical future for generations.

At the time, the most available consistent job was being a farmer. During World War One, there was a massive increase in wheat harvesting. This was partly because the population in America boomed as an effect of federal urbanization. With the war, there was an urgency to be able to feed not only American troops but additionally the forces of its allies. The country’s feeling was that wheat would win the war. Before Roosevelt, the country was in a poor state. The stock market crashed in 1929, which was followed by mass unemployment, the closing of most banks, and the loss of future investments.

A large percentage of the population lost everything. Stocks were already withering in value in early 1929. On October 18th, the crash started gaining momentum, causing a public frenzy for anybody invested in the stock market. Less than a week later, investors frantically tried to save their investments. This contributed to the abrupt collapse of the market.

In the same year of Roosevelt’s inauguration, half of the country’s banks had shut down due to financial ruin. Around 20 to 30 percent of the population lost their jobs. This meant that more than 10 million people were drifting without money trying to survive. ‘…the U.S. economy would not fully turn around until after 1939 when World War II (1939-45) revitalized American industry’ (“Franklin D. Roosevelt.”).

On March 6th, 1933, Roosevelt proposed shutting down all banks for an extended amount of time. This idea was officially named the Bank Holiday. Closing all banks meant shutting off the public’s access to money, meaning no cash could be deposited or withdrawn. This fixed the rapid fluctuation of total stored money, which was one of the main reasons banks failed at the time. Banks were closed until March 13th; this allowed people to store up wealth. More money was deposited then withdrawn the day banks reopened. Roosevelt extensively experimented with new techniques to try and relieve the problems faced by American citizens. Due to his many ideas, the change did happen, although It would take longer for the country’s economy to begin growing again.

The United States of America has always been an agricultural based country. The reason is due to many environmental factors that are unique to this location. In North America, it does not get overwhelmingly hot or cold in many places; this is perfect for crops like wheat and corn. The Dust Bowl officially started in 1931, even though the causes began several decades before.

In 1862, the government passed the Homestead Act. This act promised 160 free acres of land to anyone who would move westwards in America. The only catch was that the purpose of the property had to be for farming. During the time, most of central America past the Mississippi River was untouched. Most people lived in the east in extensively populated areas where the majority of jobs were working in factories in assembly lines. The result of poor working conditions and smoke-filled cities was a substantial motivation for people wanting a cleaner and more stable way of life.

After the Homestead Act was passed, hundreds of thousands of men and women converged west. Most Families settled in the present-day states of Kansas, New Mexico, and Texas. For the majority of farmers, wheat was the preferred crop to plant and harvest because it grew fast and in abundance. Wheat also paid the most per bushel. Around the end of the war, farmers were paid roughly four to five dollars per unit, compared to one dollar before the war started. “I believe, any man must see beauty in mile upon mile of level land where the wheat, waist-high, sways to the slightest breeze and is turning a golden yellow under a flaming July sun” (Sandler).

During the time technology was progressing faster than it had ever before, this was the case with farming techniques as well. In the past, plows were pulled by cattle, usually strong horses and oxen. There was one blade that cut deep into the earth, strengthening the roots and allowing for more nutrients to be utilized. During the wheat boom, gasoline-powered machinery like tractors and plows became more commonly used. The new machinery allowed farmers to harvest all day without relying on animals. The blades on the machine were short and spiraled. As a result of this, the procedure in which the earth had previously been plowed has unfortunately changed. The topsoil was harshly ground into fine dirt, slowly making the soil dry and malnourished.

Another significant factor in the creation of the dust bowl was ranchers. The ranchers would breed cattle in excessive amounts. As a result, most of the non-plowed land was grazed to the roots. In 1931 it stopped raining due to consistent mistreatment of the land. Soon after, the dust storms started. ‘The Nation that destroys its soil destroys itself.’ (Roosevelt)

In September of 1931, the first dust storm occurred across the great plains. The storm has been described as a rolling pitch-black mass, moving at around 60 miles per hour. Covering everything in its path with a thick layer of dirt. Understandably the public was shocked, and even weather experts had no idea why this happened. These occurrences became more constant in less than a year. After one year, there were 14 dust storms; in 1933, there were 38 more.

Inside buildings were the only safe place from these storms, anything caught in them would suffer or be covered. Most schools and community buildings permanently shut down. An average-sized duster would be around a thousand miles long and hundreds of miles wide. Imagine living on the east coast and tasting dirt in the air from the other side of the country. The combination of poor root support and raging winds would rip out full farms of crops. It would promptly be apparent that if nothing were done to reverse the weather, there would be a national urgency for safety and food.

Amid the dust bowl, many farming families had been pushed out of their homes, and even whole towns were forced to uproot their lives and leave due to lack of financially stable jobs and ways for people to support themselves and their families. Due to these factors, many took the risk of driving through Route 66. Route 66 was a critical part of American infrastructure and crucial to the connection of the east and west coast via motor vehicle. This highway was the only road that went straight to California, stretching 2,448 miles from beginning to end. As a result of the length and time it took to travel, many families would have to stop in the nearest town to find a job before they could continue their journey. They knew about the risk, although a large population of 2.5 million from states like Texas, Oklahoma, and Arkansaw began the journey. The road has been decommissioned since 1985 due to weathering and the building of new, more full roads.

California was promising to midwestern farmers because of the climate and generally easy harvest season; to the majority, it was seen as a last resort. The main harvested crops were oranges, dates, apricots, and an assortment of nuts. Most of these do not need to be ripped out of the ground to harvest, meaning the field did not require constant plowing. If anyone made it to California, they would be in the best place to make money in agriculture.

Finding steady income professions was nearly impossible in the early 1930s. This made independent careers extremely hard to make a suitable wage. Examples of these professions included traveling salesmen and women, poets, writers, and artists. As a freelancer, you have to make money yourself, and nobody paid them hourly to do their job. This meant they could make a random quantity of money that had no boundary for how much or little. If a novelist published a successful book, they had the chance to make more money in one sitting than had been earned in a year of royalties.

In the United States, nearly no freelancer made a livable wage. A way around this would be to advertise in another country that had a stable economy. The most desirable location in the world for artists across the board was France. Partially because of the general flourishment of creativity in Paris and the Prohibition Act. During the early 1920s until 1933, there was a prohibition against alcohol in the United States of America. The definition of prohibition is a ban or law denying access to a select item; in this case, it was alcohol.

For that reason, many poets temporarily lived in France where drinking and the creative process often meshed. A notable writer who often visited France was Ernest Hemingway, a World War One veteran and famously acclaimed novelist. Hemingway was part of the lost generation of writers, the aftereffect of the First World War. Other essential writers in the category included Ezra Pound, T.S.Eliot, F. Scott Fitzgerald and Gertrude Stein.

The trauma sustained because of war-displaced many people similar to the Great depression. In both of these instances, people affected felt lost, stuck without a higher purpose. The effect of the two tragic occurrences happening less than 20 years apart meant that most people were alive for both. This added to the constant anxiety of the unknown, feeling like anything can go wrong in life.

Discourse analysis is an exploration strategy for considering composed or communicated in the language in connection to its social setting. In other words, it is to search beyond what the sentences and words say. Under the title of discourse analysis, we have conversation analysis which is a particular type of examination or enquiry. Also, under the title of conversation title we have adjacency pairs which requires a person to direct a question and a person who responds to the question. In this paper the adjacency pairs are a doctor and a patient. The research is done by the primary data which included observation, interviewing, taking notes and taking records. by the researcher. Because of the privacy of the patient and the probability of ailing of the patient, the observation was brief and concise. The conversation analysis showed that the conversation between and a doctor and a patient is a formulaic response which includes initiation-respond-feedback. Another different point was that the conversation between a doctor and a familiar patient was lengthier compared to an unfamiliar patient.

The results illustrated that a conversation between a doctor and a patient is distant and is with due to regard.

Researcher: Şeyma Anlar

Introduction

As it is shown in the paper, our title for this research paper is, A Conversation Analysis Between A Doctor and A Patient. Within this topic, we will learn about discourse analysis and the subtitles, the methodology and the materials used, the results which we have found, and the it will finish with a discussions about the title. Aim of this paper is to analyze a conversation between a doctor and a patient in Turkey to see the relationship between them and also to question a small part of the circumstances of health care in Turkey. The research may be important according to the health care of Turkey.

To start with, discourse analysis is an exploration strategy for considering composed or communicated in language in connection to its social setting. It plans to see how language is utilized, in actuality, circumstances. At the point when you do talk investigation, you may concentrate on: the reasons and impacts of various kinds of language, social standards and shows in correspondence, how esteems, convictions and suppositions are imparted, how language use identifies with its social, political and verifiable setting, discourse analysis is a typical subjective research strategy in numerous humanities and sociology disciplines, including etymology, humanism, humanities, brain science and social examinations. Directing discourse analysis implies analyzing how language capacities and how important is made in various social settings. It very well may be applied to any occasion of composed or oral language, just as non-verbal parts of correspondence, for example, tone and motions. Not at all like semantic methodologies that emphasis just on the guidelines of language use, discourse analysis underlines the relevant importance of language. It centers around the social parts of correspondence and the manners in which individuals use language to accomplish explicit impacts (for example to construct trust, to make question, to inspire feelings, or to oversee struggle). Rather than concentrating on littler units of language, for example, sounds, words, or expressions, discourse analysis is utilized to ponder bigger pieces of language, for example, whole discussions, writings, or assortments of writings. Under the title of discourse analysis, we will be examining conversation analysis.

Secondly, conversation Analysis is a specific form of investigation or enquiry. A conversation refers two or more individuals talking with one another just for the sake of talking. It is a form of sociability and reflects an individual’s ability and willingness to interact with others. At a basic level, conversation analysis is viewed as the study of talk. In a broad sense, conversation analysis could refer to the study of people talking together, oral communication or even study of language use.

One particularly important principle used in CA is the adjacency pair. Utterance types of certain kinds are found to co-occur: a greeting leads to a return of greeting; a summons leads to a response; a question leads to an answer; a request or offer leads to an acceptance or refusal; a complaint leads to an apology or some kind of rejection; a statement leads to some kind of confirmation or recognition; a compliment leads to acceptance or rejection; a farewell leads to a farewell; and so on.

Materials And Methods

This research paper is a basic research that aims to develop knowledge, theories, and predictions. The data used in the research is the primary data which is collected directly by the researcher. Lastly, the method in types of sampling, timescale and location is probability sampling which allows you to generalize your findings to a broader population. Also, the method used in this essay is qualitative method which aims to produce contextual real-world knowledge about the behaviors, social structures, and shared beliefs of a specific group of people.

The major part of the study was interviewing, investigating, and observing. The other method was question-answer. While using these methods I used note taking and recording by cell-phone. After taking notes I read and critically analyze them.

The survey with the patient and the doctor was constructed was in 3rd of January 2020 in a private physical therapy and rehabilitation center in Ankara. Because of the Hippocratic oath and the privacy of the patient, I was not able to listen all the conversation between the patient and the doctor but the essential parts for this paper was the openings. That’s why the interview and observation took approximately 1 or 2 minutes; with to participants the time was approximately 5 minutes.

The participants were chosen by the patients of my father, who is a neurologist and there were only 2 participant whom I observed. The reason why I chose these methods was that they were much easier for me to have access to and the second reason is that the information which I can gather was a doctor who is in my family and his patient.

Results

The beginning of a conversation, or opening, will generally involve an exchange of greetings. In the conversation between a doctor and a patient is generally similar to a teacher and a student’s conversation. The doctor requires an initiation and the patient responds and the doctor gives feedbacks.

The conversation I have observed was thus;

The patient knocks the door and enters in the room:

• -Doctor: hi, welcome. How are you?
• -Patient: thank you ‘hocam’, how are you?
• -Doctor: thank you, get well soon. Please have a sit and tell me your complaints.
• -Patient: thank you. ‘Hocam’ I have extreme headaches and sometimes my hands get numb.
• -Doctor: have you lifted something heavy with your hands before?
• -…

The observation I have got from the doctor that he was smiling and when I asked the reason he responded to me that he must earn the patient’s trust so that s/he could tell his/her problems s/he faces. As we see the conversation between a doctor and a patient was a formulaic response which is fixed conversation between 2 or more people.

Moreover, as we have stated this observation was set in the capital of Turkey, Ankara, and the word ‘hocam’ is used commonly in this city and it refers to respectability to other people especially to the professors.

But one exception to this situation is when a patient who is familiar to the doctor, the conversation draws up additionally;

The familiar patient knocks the door and enters in doctor’s room and they hug each other, shake hands and slowly hitting the heads together (a common greeting in Turkey especially seen between men.)

• -Doctor: hi, welcome how are? Where have you been my old friend, we haven’t seen each other for a long time…
• -Patient: thanks thanks ‘hocam’, as you know we are too busy at work. I came here to you to have a check-up for my health condition.
• -Doctor: get well soon please have a sit and tell me if you have any problems you are facing with your health.
• -Patient: hi, ‘hocam’ this is your small daughter isn’t it? (pointing me)
• -Doctor: yes yes.
• -Patient: she is grown up since we haven’t seen each other, mashAllah.
• (me smiling at the corner and shake my head as response while taking notes and a record)
• -Doctor: yes, dear friend, what about your health issues…
• -…

Discussion

The research showed that not all, but probably most of the doctors in health care in Turkey that, the relations and the conversations between a doctor and a patient is distant and is with due regard. But of course, we cannot generalize this situation to all the relations between a doctor and a patient because this was very brief research on conversation analysis.

In recent years although the relation between a doctor and patient was with a distant, the Turkish doctors say that hospital violence is out of control. To compare this situation to the relation between a teacher and a student, again the results are not satisfying. Probably because of the respect rate of the new generation is not well.

The Great Depression was the worst economic depression in US history during the late 1920s and early 1930’s, this was the most severe economic downturn in history. This also affected many countries all over the world. It resulted in steep declines in industrial production and in deflation, mass unemployment and banking panics. Poverty and homelessness rates increased rapidly. The industrial production fell almost 47 percent, and GDP also declined by 30 percent. The stock market crashed on Black Tuesday, which was the fourth and last day of the stock market crash in 1929. After the crash, stock prices continued to fall. This was one of the major causes that lead to the Great Depression. During this time stockholders lost more than $40 billion dollars, and it was difficult for the stock market to recover. Bank failures were another reason to this major downfall. Thousands of banks failed, and many people lost their savings due to the failure of the banks.

Many people have argued that the Federal Reserve was the main reason of the downfall in 1929, because they did not give aid to banks and thousands of smaller ones collapsed. This was because the Federal Reserve failed to create enough cash as the money supply tightened, which increased money supply throughout the entire decade. American citizens were left in bad conditions, with poor jobs and low wages. Many no longer had savings and a severe drought struck the Southern Plains, causing the Dust Bowl. This caused many U.S. farmers to no longer have usable land for farming, in addition to being hurt by the tariffs and the trade decline. The drought and erosion of the Dust Bowl affected 100,000,000 acres, in Texas, New Mexico, Oklahoma, and Colorado. By 1934, farmers had sold ten percent of all their farms, which half of those sales were caused by the depression and drought. The Dust Bowl forced thousands of poor families to abandon their farms, since they were unable to pay mortgages or grow crops, as a result loss reached $25 million per day by 1936 and by 1937 many farmers were on federal emergency relief. After the Dust Bowl government got more involved and focused on land management and soil conservation to identify what areas that needed attention to prevent another drought.

During the Dust Bowl period, severe dust storms, called “black blizzards” swept the Great Plains. Clouds of dust would darken the sky, and in many places, the dust drifted like snow and residents had to clear it with shovels. Some people developed “dust pneumonia” and experienced chest pain and difficulty breathing, and many died from the condition. President Roosevelt ordered his administration to plant trees from Canada to Texas as windbreakers to break the wind, hold water in the soil, and hold the soil in place. The administration also began educating for on soil conservation and anti-erosion techniques, including crop rotation, strip farming, contour plowing, terracing, and other improved farming practices. By 1937, the federal government began a campaign to encourage farmers in the Dust Bowl to adopt planting and plowing methods that conserve the soil. The government also paid farmers a dollar an acre to practice the new methods. After almost ten years, the drought ended when regular rainfall returned to the region.

The second largest economic downturn in US history was the Great Recession which was between 2007-2009. The Great Recession was most seen in the United States and Western Europe, as a result of the subprime mortgage crisis. The crisis led to increases in home mortgage foreclosures worldwide and caused millions of people to lose their life savings, their jobs and their homes. This was the longest period of economic decline since the Great Depression. The Great Recession began with the bursting of an eight trillion-dollar housing bubble. The loss of consumption and the financial market triggered by the bursting bubble led to a collapse in business investment. The U.S labor market lost 8.4 million jobs, which was the most dramatic employment since the Great Depression. It took nearly 2 years for economy to grow even though its growth was not strong enough to create the jobs needed to keep pace with normal population growth. In the beginning of 2009 over 230,000 U.S. businesses closed, and more than 450 banks failed across the country. Bank failure was a major issue during the Great Depression and the Great Recession. Bank failures not only affected the economy but the people who had their savings in banks. After the Great Recession, 16 million homes foreclosed in the U.S with nearly 3 million foreclosures each year.

Laws implemented during and after each crisis

During the Great Depression Roosevelt entered office, with a plan dealing with the Great Depression. The New Deal was introduced as a result of this crisis. The new deal was a series of programs that were aimed to help restore prosperity to Americans. Roosevelt’s goal was to stabilize the economy and provide jobs and relief to those who were suffering because of the downfall of the Great Depression. Unemployment levels in some cities reached high levels. By 1933, Ohio had reached 80 percent and Massachusetts 90 percent of unemployment. As a result of this Roosevelt declared a “four day” bank holiday to stop people from withdrawing their money from banks. Congress also passed the Emergency Banking Act, which reorganized the banks and closed the ones that were at risk of bankruptcy. Three days later, the president urged everyone to put their savings back in banks to start them running again, and by the end of the month many banks were reopened successfully. During Roosevelt’s first 100 days in office he passed the Glass-Steagall Act, which was part of the Banking Act of 1933, a banking legislation that separated Wall Street from Main Street. This bill offered protection to people who entrust their savings to commercial banks. Millions of Americans lost their jobs in the Great Depression and lost their life savings after more than 4,000 U.S. banks shut down between 1929 and 1933, leaving depositors with nearly $400 million in losses. This bill also prohibited bankers from using depositors’ money to pursue high-risk investments. Later, congress passed a bill that paid farmers who produced things like wheat, dairy products, tobacco and corn, to leave their fields unplowed in order to end agricultural surpluses and boost prices.

The Smoot-Hawley Tariff law was introduced after the stock market crashed. This act was meant to protect America’s farmers from overseas competition by putting in a protection policy. The tariffs were unpopular and were retaliated against. Many countries increased their tariffs and trade between countries dropped. It was believed this act did only hurt the economy, but it made the Great Depression worse. Also, during President Franklin D. Roosevelt’s first 100 days in office, his administration initiated programs to conserve soil and restore the ecological balance of the nation. The worst dust storm occurred on April of 1934, later named “Black Sunday”. A few weeks later, President Roosevelt passed the Soil Conservation Act, which taught farmers how to plant in a more sustainable way. The government also had to stabilize prices, so they paid farmers and ordered more than six million pigs to be slaughtered. They paid to have the meat packed and distributed to the poor and as a result, the Federal Surplus Relief Corporation (FSRC) bill was passed to regulate crop and other surpluses to keep prices stable.

In February 2008, President George W. Bush signed the Economic Stimulus Act into law. This law was designed to generate new home sales and provide a boost to the economy. After the Great Recession, President Obama sign into law The Dodd–Frank Wall Street Reform and Consumer Protection Act, it was designed to restore some of the U.S. government’s power over the financial industry. This law enabled the federal government to gain control of banks considered to be on the edge of financial collapse and by applying various consumer protections designed to protect investments and prevent banks from providing high-interest loans to borrowers who will have difficulty paying.

The American Recovery and Reinvestment Act (ARRA) of 2009 was a stimulus package signed into law by President Obama, this las helped avoid the feared second Great Depression. This was developed after the Great Recession economic crisis. This law was created to save existing jobs and create new ones as soon as possible. It was also passed to provide relief to those who were affecting during this time. The stimulus package was estimated to cost $787 billion. The ARRA had three spending categories which were, to cut taxes by $288 billion, it spent $224 billion in extended unemployment benefits, education, and health care and it also created jobs by allocating $275 billion in federal contracts, grants, and loans. The economic stimulus package ended the Great Recession by stimulating consumer spending. It also was also designed to bring confidence needed to boost economic growth, and to restore trust in the financial services industry. In a 2009 report, it was mentioned that the ARRA would stimulate gross domestic product by 1.4 percent to almost 3.8 percent by the end of 2009. The stimulus package was successful in 2009, the economy kept growing from 1.5 percent and 4.5 percent. This package was the biggest improvements of this time and was the key to maintain economy strong. In was predicted that ARRA would increase employment by 7 million full-time jobs by the end of 2012. By 2015, it was estimated that the stimulus created between 2 million and 10.9 million jobs available for everyone.

What effects did each event have on lending to the individual consumer (i.e. what happened to the supply of funds at banks available to lend; what happened to interest rates, what happened to the requirements to take out loans at a bank?

Over the Great Recession, the net worth of American households and non-profits declined by more than 20 percent, with the economy being unsteady. The U.S. Federal Reserve began acting by reducing the national target interest rate. Interest rates were at 5.25 percent in September 2007 and by the end of 2008, the U.S Federal Reserve had reduced the target interest rate to zero percent for the first time, to encourage borrowing and by extension, capital investment. Many banks were also being sold to Bank of America to avoid bankruptcy. After many banks were at risk at failing, they became more aware of the markets they served. Competitor non-bank lenders were taking high risks to cut the rewards of the nontraditional loan products they offered to different groups of consumers. Market share and earnings pressures were high, forcing many commercial banks to increase their customer bases and adopt new marketing strategies and revise their lending processes to accept more risk. Bank lending increased slowly after the Great Recession. This growth resulted from improved bank industry conditions, looser lending standards, and increased loan demand.

During the Great Depression, consumer spending declined 18 percent, manufacturing output dropped 54 percent, and construction spending dropped 78 percent and 80 percent of production capacity in the automobile industry came to a stop (“Great Depression: American Social Policy,” 2018). During this time, it became very difficult to lend because of the banks collapsed after the stock market crashed. Banks were unable to collect loans. Many people believed this was the main reasons of the Great Depression. Bank failures increased rapidly and almost every town had a failing bank, and who ever had their money in that bank, they had also lost it all. Loan values fell more than 58 percent and continued to decline at a rapid pace. The Great Depression had devastating effects in many countries. Personal income, tax revenue, profits and prices dropped. As the stock market collapsed, investors who did not have funds to invest in stocks borrowed from banks to do so, by using the purchased stock as collateral. Purchasing stock with borrowed funds became common during this time. Many banks also required higher margins, and others didn’t, which exposed themselves to higher risks. Rules were also passed to prevent the Federal Reserve from making loans to banks to keep them liquid and solvent (Beck 5). After the market crashed the Federal Deposit Insurance Corporation prohibited banks from underwriting securities. This allowed the Federal Reserve to set margin requirements for loans secured by purchased securities. After WWII, the consumer lending market was still small.

Your opinion: Have we learned any lessons from these events? If so, what are those lessons we have learned? Support your answer

The Great Recession and The Great Depression were horrible economic events, and because of this I think it was important for banks to be prepared in case this was to happen again in the future. The government also acted after these events happened. Laws were passed to protect banks and the savings of people. I think this was a good idea because they will be prepared if banks failed again. Government had a little more power over the economy, and I think that it important. After looking further into these two economic events, I learned how banks got to the point where they had to close or sell to other banks, the impact it causes to everyone and the struggles it took to recover from these collapses. I’m not sure if something like this would happen in the future but I know we will be more prepared to deal with it. We will be able tell whether we are heading towards a recession or not. We can now identity the causes and effects and act right away. High interest rates are a first sign, because they limit the amount of money to invest. Another big sign would be the stock market crashing again and this reduces investment causing many damages to the environment.

Although, I did further research and came across an article that talked about financial crisis happening in the future. It was mentioned that the current global will continue to grow and by 2020 we can face a financial crisis followed by a global recession. The United States is increasing government consumption, and it has been unsustainable. Inflation will also continue to rise above target. I also read that the US Federal Reserve will continue to raise the federal funds rate from its current 2% to about 3.5% by 2020. As a result of this, short-term and long-term interest rates and the US dollar will rise. Oil prices will continue to increase. It was also mentioned that unemployment will start to rise. I wasn’t aware of this information, and it terrifies me. I just hope we act right away when we start seeing the major signs that could lead the economy to a recession. Overall, technology has increased tremendously and that will help us see upcoming changes in the economy and be able to act before it leads to a crisis.

References

1. A&E Television Networks. ‘Great Recession Timeline.’ Google Search. Google, 2017. Web. 5 Feb. 2019.
2. Amadeo, Kimberly. ‘The Worst Day in Wall Street’s History.’ The Balance Small Business. The Balance, 2018. Web. 04 Feb. 2019.
3. Amadeo, Kimberly. ‘Did Obama’s Stimulus Plan Work?’ The Balance Small Business. The Balance, 2018. Web. 04 Feb. 2019.
4. Amadeo, Kimberly. ‘Why Another Dust Bowl Is Likely.’ The Balance Small Business. The Balance, 2017. Web. 10 Feb. 2019.
5. Beck, Richard E., and Kathlyn L. Farrell. Consumer Lending. Washington, DC: American Bankers Association, 2013. Print.
6. Coghlan, Erin. ‘What Really Caused the Great Recession?’ Institute for Research on Labor and Employment. N.p., 19 Sept. 2018. Web. 07 Feb. 2019.
7. Editors, History.com. ‘Glass-Steagall Act.’ History.com. A&E Television Networks, 15 Mar. 2018. Web. 07 Feb. 2019.
8. Fiorillo, Steve. ‘Great Depression: Causes, Effects and Timeline.’ Google Search. Google, 2018. Web. 10 Feb. 2019
9. Marx, Jerry D. ‘Great Depression: American Social Policy.’ Social Welfare History Project. N.p., 26 Feb. 2018. Web. 10 Feb. 2019.
10. Rich, Robert. ‘The Great Recession.’ Federal Reserve History. N.p., n.d. Web. 07 Feb. 2019.
11. Roubini, Nouriel, and Rosa Brunello. ‘We Are Due a Recession in 2020 – and We Will Lack the Tools to Fight It | Nouriel Roubini.’ 2018. Web. 06 Feb. 2019.