Agonist-to-Antagonist Spectrum of Action     

Respond to two colleagues in one of the following ways:

If your colleagues’ posts influenced your understanding of these concepts, be sure to share how and why.

Include additional insights you gained.If you think your colleagues might have misunderstood these concepts, offer your alternative perspective and be sure to provide an explanation for them.

Include resources to support your perspective.

Main Post

Agonist-to-Antagonist Spectrum of Action

Molecules that bind to receptors are referred to as ligands (“Pharmacology Corner: Agonists and Antagonists”, 2015).  Ligands are capable of binding to receptor sites and producing a biological response. These ligands are called agonists (“Pharmacology Corner”, 2015).  The opposite effect can also take place. Ligands that block the responses of agonists are referred to as antagonists. An agonist binds to a receptor site, activates it, and causes a signal to be transmitted. This reaction is called a biological response (“Pharmacology Corner,” 2015).  Conversely, an antagonist also binds to a receptor site, but blocks binding from any other agonists, thus preventing any biological response (“Pharmacology Corner”, 2015).  Several types of agonists exist on a spectrum. Their place on this spectrum is measured by comparing their binding ability versus endogenous agonists already present in the body (“Pharmacology Corner”, 2015).  Endogenous agonists are present in the body. Super agonists produce a greater biological response than endogenous agonists. Next on the spectrum are full agonists, which mimic the efficacy of the endogenous agonists. Next in line are the partial agonists, which only exert a partial biological response as their name suggests (“Pharmacology Corner”, 2015).  The next group of agonists are the inverse agonists which act in two ways. They inhibit the normal receptor site activity, and exert the opposite pharmacological activity at the same time. Last on the spectrum are the irreversible agonists which permanently bind and activate the receptor site. Since this action is permanent, it only occurs once and results in the destruction of the receptor (“Pharmacology Corner”, 2015).
G-Couple Proteins and Ion-Gated Channels

Receptors called G-protein-coupled receptors (GPCRs) facilitate most physiological responses to neurotransmitters, hormones, and stimulants in the environment. As such, they have great potential to be targeted for the treatment of many diseases (Rosenbaum, Rasmussen, & Kobilka, 2009). GPCRs comprise the largest group of membrane proteins and are responsible for most cellular responses to neurotransmitters and hormones. They also contribute significantly to the human senses of vision, smell, and taste (Rosenbaum et al., 2009).  GPCRs are made up of seven alpha-helical segments separated by intracellular and extracellular looped areas (Rosenbaum et al., 2009).

The fastest and least complex of signal pathways occur with signals whose receptors are gated ion channels (Ahern & Rajagopal, 2019).  Gated ion channels consist of many transmembrane proteins that create a hole, or a channel in the cell membrane. Each ion channel will allow the passage of a certain ionic species depending on its type. They are called gated because the passage is controlled by a gate which must be opened to allow the ions to pass (Ahern & Rajagopal, 2019).  The opening of the gates is controlled by the binding of a signal to the receptor. This causes the immediate passage of millions of ions across the membrane (Ahern & Rajagopal, 2019).
Epigenetics in Pharmacologic Action

Epigenetics refers to genetic information that exists beyond the information contained solely in the individual’s genetic code (Stefanska & MacEwan, 2015). Human diseases can be caused by a single base genetic mutation. Scientists have made great strides in unraveling the genetic code, recording the first complete sequence of the human genome in 2001 (Stafanska & MacEwan, 2015). These advances have prompted scientists to think beyond treating illness through drugs activating receptors, but in a more global fashion. Epigenetic mechanisms are systems that are able to alter or cancel genetic activation, and are present in all genes (Stefanska & MacEwan, 2015). These mechanisms may affect more than one gene or group of proteins, and can even regulate large groups of genes. Cancer is one disease in which the understanding of epigenetics can be key to more effective treatment (Stefanska & MacEwan, 2015).
Specific Client Example

One example of a common client issue is the opioid epidemic. Naloxone (Narcan) is an opioid antagonist that binds to the opioid receptors in the patient’s brain, reversing or blocking the effects of the opioid (“Opioid overdose reversal with naloxone (Narcan, Evzio)”, 2018). This is essential to save the patient’s life who has accidentally or intentionally overdosed on opiate drugs. Naloxone can quickly restore a normal breathing pattern in a person whose respirations have slowed or stopped as a result of the opiate (“Opioid overdose reversal”, 2018). Naloxone (Narcan) can be administered using a pre-filled delivery device that is sprayed into the nostril while the patient lies supine. This device is simple to use and requires no assembly (“Opioid overdose reversal”, 2018).

References

Ahern, K., & Rajagopal, I. (2019). Ligand-gated Ion Channel Receptors. Retrieved from https://bio.libretexts.org/Bookshelves/Biochemistry/Book:_Biochemistry_Free_and_Easy_(Ahern_and_Rajagopal)/08:_Signaling/8.2:_Ligand-        gated_Ion_Channel_Receptors.Opioid overdose reversal with naloxone (Narcan, Evzio). (2018). Retrieved from drugabuse.gov.Pharmacology Corner: Agonists and Antagonists. (2015). Retrieved from aegislabs.com/agonistsRosenbaum, D.M., Rasmussen, S.G.F., & Kobilka, B.K. (2009). The structure and function of G-protein-coupled receptors. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3967846/#_ffn_sectitle.Stefanska, B., & MacEwan, D.J. (2015). Epigenetics and pharmacology. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439868/#_ffn_sectitle.
Reply Quote Email Author

What Students Are Saying About Us

.......... Customer ID: 12*** | Rating: ⭐⭐⭐⭐⭐
"Honestly, I was afraid to send my paper to you, but splendidwritings.com proved they are a trustworthy service. My essay was done in less than a day, and I received a brilliant piece. I didn’t even believe it was my essay at first 🙂 Great job, thank you!"

.......... Customer ID: 14***| Rating: ⭐⭐⭐⭐⭐
"The company has some nice prices and good content. I ordered a term paper here and got a very good one. I'll keep ordering from this website."

"Order a Custom Paper on Similar Assignment! No Plagiarism! Enjoy 20% Discount"

Health Insurance Portability and Accountability Act influence on medical research

Topic 3: HIPAA’s influence on medical research

Affirmative (Pros): HIPAA should be amended to allow greater access of medical information to medical researchers. (Group 4A)

Negative(Cons): HIPAA should NOT be amended to allow greater access of medical information to medical researchers. (group4N)

 

In your paper: Identify and define the issue. Include information for BOTH sides of the argument. Whom does it affect? What are the pros and cons? Discuss both sides of the issue. What does the public need to know?

CriteriaRatingsPtsThis criterion is linked to a Learning OutcomeIntro

25.0 to >19.0 ptsHigh Proficiency
Deliberate, creates interest Gives title/author if needed Clear, concise and specific thesis statement
19.0 to >14.0 ptsModerately High Proficiency
Adequately introduces topic Thesis statement may be lacking specificity.
14.0 to >9.0 ptsProficient
Intro is too short – does not introduce topic Thesis statement is vague- should be more narrow
9.0 to >4.0 ptsLow-Level Proficiency
Some intro components missing Thesis statement is poor or unidentifiable
4.0 to >0 ptsNon-Proficient
Thesis missing Introduction does not introduce topic25.0 pts
This criterion is linked to a Learning OutcomeBody: Organization

25.0 to >19.0 ptsHigh Proficiency
Organized throughout Logical, clear sequence Completely supports thesis Exhibits critical thinking Has consistent transitions Proper in-text citations Excellent transitions
19.0 to >14.0 ptsModerately High Proficiency
Well organized Easy to follow Thesis could use more support (adequate but not extended) Majority of citations are correct Shows some original thought Has several transitions Majority of citations are correct
14.0 to >9.0 ptsProficient
Some org. problems Some gaps in flow Not enough thesis support Shows little original thought Some transitions Citations are incorrect
9.0 to >4.0 ptsLow-Level Proficiency
Difficult to follow May jump topics Does not prove/support thesis Citations incorrect Very few transitions
4.0 to >0 ptsNon-Proficient
No sequence Jumps topics frequently No in-text citations No transitions25.0 pts
This criterion is linked to a Learning OutcomeBody: Fluency & Mechanics

25.0 to >19.0 ptsHigh Proficiency
Uses excellent vocabulary Stays on topic/meets assignment Correct tense/point of view Has sentence variety Correct spelling/punctuation Writes in scholarly style
19.0 to >14.0 ptsModerately High Proficiency
Attempts higher level vocabulary with some success Stays on topic/meets assignment Mostly correct tense/point of view A few sentences lacking in variety Few spelling errors Writes in scholarly style
14.0 to >9.0 ptsProficient
Range of vocabulary Some tense/point of view errors Occasionally strays off topic Some sentence fragments/run-ons Proper spelling Quality of formal language
9.0 to >4.0 ptsLow-Level Proficiency
Vocabulary level Some tense/point of view errors Does not meet assignment requirements Many sentence fragments/run-ons Many spelling errors Majority of writing is informal
4.0 to >0 ptsNon-Proficient
Improper word choices Many tense and point of view errors Fails to meet assignment Many mechanical errors Writes informally25.0 pts
This criterion is linked to a Learning OutcomeConclusion

25.0 to >19.0 ptsHigh Proficiency
Deliberate closing strategy Does not introduce new material Paraphrases thesis, but does not merely repeat introduction
19.0 to >14.0 ptsModerately High Proficiency
Adequate closing Does not introduce new material Re-states thesis in same words, but does not completely repeat introduction
14.0 to >9.0 ptsProficient
Weak closing Does not introduce new material Merely repeats introduction
9.0 to >4.0 ptsLow-Level Proficiency
Weak closing Introduces new material Does not refer to thesis
4.0 to >0 ptsNon-Proficient
No formal closing New material introduced Does not refer to introduction25.0 pts
This criterion is linked to a Learning OutcomeAppearance

25.0 to >19.0 ptsHigh Proficiency
No APA errors in margins, font type and size, spacing, headers, references, and citations
19.0 to >14.0 ptsModerately High Proficiency
Has 1-4 APA formatting errors
14.0 to >9.0 ptsProficient
Has 5-7 APA formatting errors
9.0 to >4.0 ptsLow-Level Proficiency
Has more than 7 APA formatting errors
4.0 to >0 ptsNon-Proficient
No evidence of APA in paper25.0 pts
Total Points: 125.0

I’m doing my Community practice in a health insurance company as a Case Manager.

Discuss two areas of difficulty you encountered or two new nursing interventions you learned this week at your clinical site.

What Students Are Saying About Us

.......... Customer ID: 12*** | Rating: ⭐⭐⭐⭐⭐
"Honestly, I was afraid to send my paper to you, but splendidwritings.com proved they are a trustworthy service. My essay was done in less than a day, and I received a brilliant piece. I didn’t even believe it was my essay at first 🙂 Great job, thank you!"

.......... Customer ID: 14***| Rating: ⭐⭐⭐⭐⭐
"The company has some nice prices and good content. I ordered a term paper here and got a very good one. I'll keep ordering from this website."

"Order a Custom Paper on Similar Assignment! No Plagiarism! Enjoy 20% Discount"

EPIDEMIOLOGY

Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment.

Communicable Disease Selection:

Tuberculosis

Epidemiology Paper Requirements

  1. Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.
  2. Describe the social determinants of health and explain how those factors contribute to the development of this disease.
  3. Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?
  4. Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community.
  5. Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.
  6. Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.

A minimum of three peer-reviewed or professional references is required.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

What Students Are Saying About Us

.......... Customer ID: 12*** | Rating: ⭐⭐⭐⭐⭐
"Honestly, I was afraid to send my paper to you, but splendidwritings.com proved they are a trustworthy service. My essay was done in less than a day, and I received a brilliant piece. I didn’t even believe it was my essay at first 🙂 Great job, thank you!"

.......... Customer ID: 14***| Rating: ⭐⭐⭐⭐⭐
"The company has some nice prices and good content. I ordered a term paper here and got a very good one. I'll keep ordering from this website."

"Order a Custom Paper on Similar Assignment! No Plagiarism! Enjoy 20% Discount"

Back Depression Inventory

Beck Depression Inventroy

Post an explanation of the psychometric properties of the assessment tool you were assigned. Explain when it is appropriate to use this assessment tool with clients, including whether the tool can be used to evaluate the efficacy of psychopharmacologic medications. Support your approach with evidence-based literature. references 2015-2019

discuss the theory  is Madeleine lingering transcultural nursing theory .

Please make Essay about the : Relevance to MSN Essentials of this theory

·       EPIDEMIOLOGY

·       ETIOLOGY

·       RISK FACTORS

·       ASSOCIATED CONDITIONS

·       HISTORY

·       PHYSICAL EXAM

·       DIFFERENTIAL DIAGNOSIS

·       TESTS

·       TREATMENT

·       PROGNOSIS

·       REFERENCES

What Students Are Saying About Us

.......... Customer ID: 12*** | Rating: ⭐⭐⭐⭐⭐
"Honestly, I was afraid to send my paper to you, but splendidwritings.com proved they are a trustworthy service. My essay was done in less than a day, and I received a brilliant piece. I didn’t even believe it was my essay at first 🙂 Great job, thank you!"

.......... Customer ID: 14***| Rating: ⭐⭐⭐⭐⭐
"The company has some nice prices and good content. I ordered a term paper here and got a very good one. I'll keep ordering from this website."

"Order a Custom Paper on Similar Assignment! No Plagiarism! Enjoy 20% Discount"

Essay – Ideal Citizen in a Totalitarian Government

Essay – Ideal Citizen in a Totalitarian Government

Required Resources
Read/review the following resources for this activity:

  • Textbook: Chapter 6, 10
  • Lesson

Instructions
Aristotle defined tyranny as an illegitimate form of government by one individual that tightly controlled every part of life and government. Adolf Hitler is the most notorious tyrant. Using a totalitarian society from the past or present, discuss how the state and its leader attempt to impede citizens from exercising their rights. In your discussion, explain some components of an “ideal citizen,” consequences of voter apathy, and ways the state controls the citizen.

Writing Requirements (APA format)

  • Length: 1.5-2 pages (not including title page or references page)
  • 1-inch margins
  • Double spaced
  • 12-point Times New Roman font
  • Title page
  • References page (minimum of 2 scholarly sources)
  • Chapter 6. The Totalitarian Model: A False Utopia

    Learning Objectives

    · 1Define totalitarianism.

    · 2Describe the role of ideology in totalitarian states.

    · 3Identify the three most infamous totalitarian rulers and how they earned that reputation.

    · 4Describe the three developmental stages in the life of a totalitarian state.

    · 5Determine the value of studying totalitarianism even though the world’s worst examples of totalitarian rule have passed into the pages of history.

    A new and more malignant form of tyranny called totalitarianism reared its ugly head in the twentieth century. The term itself denotes complete domination of a society and its members by tyrannical rulers and imposed beliefs. The totalitarian obsession with control extends beyond the public realm into the private lives of citizens.

    Imagine living in a world in which politics is forbidden and everything is political—including work, education, religion, sports, social organizations, and even the family. Neighbors spy on neighbors and children are encouraged to report “disloyal” parents. “Enemies of the people” are exterminated.

    Who are these “enemies“? Defined in terms of whole categories or groups within society, they typically encompass hundreds of thousands and even millions of people who are “objectively” counterrevolutionary—for example, Jews and Gypsies (Romany) in Nazi Germany, the bourgeoisie (middle class) and kulaks (rich farmers) in Soviet Russia, and so on. By contrast, authoritarian governments typically seek to maintain political power (rather than to transform society) and more narrowly define political enemies as individuals (not groups) actively engaged in opposing the existing state.

    Why study totalitarianism now that the Soviet Union no longer exists? First, communism is not the only possible form of totalitarian state. The examples of Nazi Germany and Fascist Italy are reminders that totalitarianism is not a product of one ideology, regime, or ruler. Second, totalitarianism is an integral part of contemporary history. Many who suffered directly at the hands of totalitarian dictators or lost loved ones in Hitler’s Holocaust, Stalin’s Reign of Terror, Mao’s horrific purges, or other more recent instances of totalitarian brutality are still living. The physical and emotional scars of the victims remain even after the tyrants are long gone. Third, totalitarian states demonstrate the risks of idealism gone awry. Based on a millenarian vision of social progress and perfection that cannot be pursued without resort to barbaric measures (and cannot be achieved even then), they all have failed miserably as experiments in utopian nation-building. Finally, as we will see, totalitarianism remains a possibility wherever there is great poverty, injustice, and therefore the potential for violence and turmoil—recent examples include Iran, North Korea, and Burma (Myanmar).

    One of the lessons of 9/11 is that extremism remains a fact of political life in the contemporary world. It can take many malignant forms. Terrorism is one; totalitarianism is another. This chapter demonstrates clearly that totalitarianism and terror go hand in hand.

    The Essence of Totalitarianism

    Violence is at the core of every totalitarian state—at its worst, it assumes the form of indiscriminate mass terror and genocide aimed at whole groups, categories, or classes of people who are labeled enemies, counterrevolutionaries, spies, or saboteurs. Mass mobilization is carried out through a highly regimented and centralized one-party system in the name of an official ideology that functions as a kind of state religion. The state employs a propaganda and censorship apparatus far more sophisticated and effective than that typically found in authoritarian states. As the late sociologist William Kornhauser wrote in a highly acclaimed study, “Totalitarianism is limited only by the need to keep large numbers of people in a state of constant activity controlled by the elite.”*

    Totalitarian ideologies promise the advent of a new social order—whether a racially pure “Aryan” society envisioned by Adolf Hitler, or the classless society promised by Lenin and Josef Stalin, or the peasant society in a permanent state of revolution Mao Zedong imagined. All such totalitarian prophets “have exhibited a basic likeness … [in seeking] a higher and unprecedented kind of human existence.”* We can trace the totalitarian leader’s claim of political legitimacy directly to this self-proclaimed aim of creating a new utopian society.*

    Totalitarian societies are “thoroughly egalitarian: no social differences will remain; even authority and expertise, from the scientific to the artistic, cannot be tolerated.”* Thus, individualism is rejected and even criminalized. The rights of society are paramount, leaving no room at all for the rights of the individual.

    At the heart of this harmonious community lies the concept of a reformulated human nature. The impulse to human perfection was reflected in Lenin’s repeated references to the creation of a “new Soviet man” and in the Nazi assertion that party workers and leaders represented a new type of human being or a new breed of “racially pure” rulers. Mao Zedong displayed a near obsession with something he called rectification—the radical purging of all capitalist tendencies, such as materialism and individualism, at all levels of Chinese society.

    The clearest examples of such utopian political orders have been Nazi Germany, the Soviet Union (especially during Stalin’s Reign of Terror), and Maoist China. Other examples in recent history include Pol Pot’s Cambodia (1976–1979) and Mengistu’s Ethiopia (1977–1991), while North Korea is a contemporary case. In the following section we examine the stages in the evolution of totalitarian regimes.

    he Revolutionary Stage of Totalitarianism

    How do totalitarian movements start? Typically, they emerge from the wreckage of a collapsed or collapsing state. In such turbulent times, a charismatic leader sometimes steps onto the scene. Leadership is crucial to the success of any revolution. In the case of total revolution, leadership is one of five key elements. Ideology, organization, propaganda, and violence are the other four.

    Leadership

    Perhaps the most conspicuous trait of total revolution has been reliance on what we may term the cult of leadership. Virtually every such revolution has been identified with—indeed, personified in—the image of a larger-than-life figure. The Russian Revolution had its Lenin, the Third Reich its Hitler, the Chinese Revolution its Mao, Cuba its Castro, and so forth. Each of these leaders became the object of hero worship. Without such a leader, observed Eric Hoffer, “there will be no [mass] movement”:

    It was Lenin who forced the flow of events into the channels of the Bolshevik revolution. Had he died in Switzerland or on his way to Russia in 1917, it is almost certain that the other prominent Bolsheviks would have joined a coalition government. The result might have been a more or less liberal republic run chiefly by the bourgeoisie. In the case of Mussolini or Hitler, the evidence is even more decisive: without them there would have been neither a Fascist nor a Nazi movement.*

    Revolutionary leaders instinctively understand that the masses possess the raw power to change the world but lack the will and direction. Without a charismatic leader—one who can read their minds, capture their imagination, and win their hearts—there is nothing to act as a catalyst. A leader such as Lenin or Mao, then, is to a mass movement what a detonator is to a bomb.

    Ideology

    Whatever the quality of leadership, total revolutions depend in the final analysis on the willingness of converts to engage in extraordinary acts of self-sacrifice in the name of the cause. Such reckless devotion cannot be inspired by rational appeals. It must arise, rather, from the true believer’s blind faith in the absolute truth provided by a comprehensive political doctrine.

    Consider what an ideology must do for its followers if it is to be successful:

    It must claim scientific authority which gives the believer a conviction of having the exclusive key to all knowledge; it must promise a millennium to be brought about for the chosen race or class by the elect who holds this key; it must identify a host of ogres and demons to be overcome before this happy state is brought about; it must enlist the dynamic of hatred, envy, and fear (whether of class or race) and justify these low passions by the loftiness of its aims.*

    The Need for a Scapegoat: Reinterpreting the Past

    As a critique of the past, ideology generally focuses on some form of absolute evil to which it can attribute all national (or worldwide) wrongs and social injustices. To the revolutionary ideologue, the true causes of economic recession, inflation, military defeat, official corruption, national humiliation, moral decadence, and other perceived problems are rooted in the mysteries and plots of a rejected past.

    If an enemy does not exist, it is necessary to invent one. Usually it is an individual or a group that was already widely feared, hated, or envied. Lenin blamed the plight of workers on money-grubbing capitalists. Hitler blamed Jews and communists for the German loss in World War I and the economic crises that preceded his assumption of power. Mao found his enemy first in wealthy landlords and later in “capitalist roaders.” Clearly, the purpose of these ploys was to focus mass attention on a readily identifiable scapegoat on whose shoulders all the nation’s ills could be placed.

    According to Hoffer, “Mass movements can rise and spread without a belief in God, but never without a belief in a devil.”* Hate and prejudice, rather than love and high principle, seem the most effective forces in bringing people together in a common cause.

    Revolutionary Struggle: Explaining the Present

    As a guide to the present, ideology provides the true believer with keys to a “correct” analysis of the underlying forces at work in contemporary society. Concepts such as class struggle for Marxist-Leninists, Herrenvolk (master race) for the Nazis, and “contradictions” for Mao’s followers were used to explain and predict social reality. Yesterday the enemy was preeminent; today the enemy will be defeated.

    Advocates of total revolution believe struggle is the very essence of politics. For Marxist-Leninists, class struggle was the engine of progress in history. For Maoists, struggle was a desirable end in itself; only through the direct experience of revolutionary struggle, they believed, could the masses (and especially the young) learn the true meaning of self-sacrifice. Hitler glorified the struggle for power by proclaiming war to be the supreme test of national greatness. (Revealingly, Hitler outlined his own path to political power in a book titled Mein Kampf, “my struggle.”) Whether the aim is to overthrow monopoly capitalists or to purify a race, revolutionary struggle is always described in terms of good versus evil. It was common for leading Nazis to depict Jews not simply as enemies of the state but as untermenschen (“subhumans”) and, frequently, as insects or lice.* The repeated use of such degrading characterizations dehumanizes the victims; it is a lot easier to justify the extermination of insects than human beings.

    Utopia: Foretelling the Future

    As a promise of the future, ideology tends to paint a radiant picture of perfect justice and perpetual peace. Marxist-Leninists envisioned this utopia as a classless society, one from which all social and economic inequality would be abolished. Similarly, the Nazi utopia was a society from which all racial “impurities” would be removed through the extermination or enslavement of racial “inferiors.”

    Whatever its precise character, the vision of the future always included a radical redistribution of wealth and property. Marxism-Leninism promised to take from the rich (the bourgeoisie) and give to the poor (the proletariat). Hitler made a similar promise when he proclaimed his intention to provide Lebensraum (“living space”) in the east; he would take land from the land-rich but slothful Slavs and give it to the land-poor but industrious Germans.

    Marxism is based on a deterministic worldview in which the success of the proletarian revolution is dictated by inflexible “laws” of history. Hitler, too, was an unabashed determinist. In Mein Kampf, he wrote, “Man must realize that a fundamental law of necessity reigns throughout the whole realm of Nature.”* Hitler also frequently ranted about “the iron law of our historical development,” the “march of history,” and the “inner logic of events.” No less than Lenin, Stalin, or Mao, Hitler claimed that he (and the German people, or Volk) had a world-shattering mission to accomplish, and that success was inevitable. He expressed this notion in what is perhaps his most famous (or infamous) pronouncement: “I go the way that Providence dictates with the assurance of a sleepwalker.”*

    Ideology and Truth

    The past, present, and future as described by a given revolutionary ideology may seem far-fetched or even ludicrous to a disinterested observer. The racial theory put forth by the Nazis utterly lacked historical, sociological, genetic, and moral foundations. By the same token, the economic facet of Hitler’s ideology—the “socialism” in National Socialism—lacked any meaningful content. So watered down was Hitler’s conception of socialism that in the words of one authority, “Anyone genuinely concerned about the people was in Hitler’s eyes a socialist.”*

    Why would any sane person embrace such an ideology? First, it appealed to popular prejudices and made them respectable. Second, it was not the message that counted so much as the messenger—the leader’s personal magnetism attracted a following, whether the words made sense or not. Third, certitude was far more important than rectitude. Fourth, ideologues can often get away with absurd allegations and gross falsehoods if they also address real problems faced by ordinary people.

    Many Germans recognized the extremist nature of the Nazis’ racial theories but probably believed Hitler would discard such absurdities once the work of unifying the country, reviving the economy, and restoring the nation’s lost honor had been accomplished. By the same token, even if many of Lenin’s followers did not truly believe the workers’ paradise was just around the corner, the Russian peasants did believe in land reform, an end to Russia’s disastrous involvement in World War I, and improvements in nutrition, medical care, and education as promised by Lenin.

    Organization

    Cohesive structure was one of the missing ingredients in pre-twentieth-century rebellions. Most such outbreaks were spontaneous affairs—they burst into flame, occasionally spread, but almost always burned themselves out. The October Revolution, however, was a different story.

    Lenin founded the Bolshevik Party more than fourteen years before seizing power in 1917. Admitting only hard-core adherents into the party, Lenin reasoned the czar could be defeated through a long, clandestine struggle led by a small group of disciplined revolutionaries (a “vanguard”) rather than by a large, amorphous mass of unruly malcontents.

    To ensure secrecy, discipline, and centralized control, Lenin organized the Bolshevik Party into tiny cells. As the Bolsheviks grew in number and established cells in cities outside St. Petersburg (see “Landmarks in History”), however, intermediate layers of authority became necessary, although the principles of strict party discipline and total subordination of lower levels to higher ones were not relaxed. Factionalism was not tolerated; party members were still expected to place party interests above personal interests at all times. This spirit of self-sacrifice and total commitment to the party was called partiinost.

    Unlike its Russian counterpart, the Chinese Revolution was primarily a rural uprising by a mass of discontented peasants. Mao’s most pressing organizational problem was to mold the amorphous peasant mass into an effective military force capable of carrying out a protracted guerrilla war. His success won over many leftists (especially in developing nations) who admired and even imitated Mao’s theory and practice of peasant-based revolution in a poor and benighted rural society.

    Landmarks in History The October Revolution

    In October 1917, the Russian capital of St. Petersburg (also called Petrograd) was in turmoil due to hardships and popular anger caused by the long years of World War I and the bitter capitulation to Germany. The October Revolution was led by Nikolai Lenin and the Bolsheviks, with the backing of the Mensheviks, the Left Socialist revolutionaries, and an assortment of anarchists.

    There were actually two revolutions in Russia in 1917. The first, the so-called February Revolution, brought about three dramatic results: the ouster of Czar Nicholas II, the end of the Russian monarchy, and the creation of a power vacuum. Following a failed attempt by Aleksandr Kerensky to form a Western-style parliamentary democracy, Lenin and Trotsky masterminded a power seizure in the capital in October. This move had a dual character—half popular uprising and half coup d’état.

    In fact, the revolution did spread, and it was fomented by Lenin’s Bolsheviks. However, it was not entirely, or even mainly, a proletarian revolution of the kind Marx had imagined. Instead, it included disaffected soldiers and sailors, as well as land-hungry peasants. Russia did not have an extensive industrial labor force in 1917. It was still primarily a peasant society with an agrarian economy. Moreover, the “revolution” in St. Petersburg was actually led by Leon Trotsky, not Lenin.

    Nonetheless, Lenin was the prime mover. His role in creating a conspiratorial organization, orchestrating events between February and October 1917, and inspiring the masses made him the undisputed leader of the revolutionary Soviet state—so much so that St. Petersburg was renamed Leningrad three days after Lenin’s death in 1924. The name was changed back to St. Petersburg in September 1991, shortly before the Soviet Union was formally dissolved.

    Mao’s long march to power contrasts with Hitler’s quixotic rise in Germany, which started with a violent, abortive coup in the early 1920s and culminated in a kind of constitutional coup d’état in the 1930s. A compliant organization in the form of the Nazi Party was crucial to Hitler’s ultimate success. Hitler made extensive use of brute force to intimidate his opposition, but he also created numerous party-controlled clubs and associations. The Hitler Youth, a Nazi women’s league, a Nazi workers’ organization, a Nazi student league, and various other academic and social organizations gave the Nazis considerable political power even before Hitler took over the reins of government. Later, under an innocuous-sounding policy called Gleichschaltung (“coordination”), he destroyed virtually all preexisting social organizations and substituted Nazi associations in their place. Partly for this reason, Hitler’s promises and threats carried great weight throughout German society. Like all modern revolutionaries, Hitler understood the value of a carefully constructed revolutionary organization.

    Propaganda

    As more people have become engaged in modern political life, propaganda—the dissemination of information based on falsehoods and half-truths designed to advance an ideological cause—has become a potent political weapon.* To be successful, as Hitler noted, propaganda must address the masses exclusively; hence, “its effect for the most part must be aimed at the emotions and only to a very limited degree at the so-called intellect.”*

    An avid student of the science of propaganda, Hitler proposed that “all propaganda must be popular and its intellectual level must be adjusted to the most limited intelligence among those to whom it is addressed.” Hence, “the greater the mass it is intended to reach, the lower its purely intellectual level will have to be…. Effective propaganda must be limited to a very few points and must harp on these in slogans until the last member of the public understands what you want him to understand.” Given these premises, it follows that the “very first axiom of all propagandist activity [is] the basically subjective and one-sided attitude it must take toward every question it deals with.”* And the bigger the lie, the better.

    Hitler theorized that the success of any propaganda campaign depends on the propagandist’s understanding of the “primitive sentiments” of the popular masses. Propaganda cannot have multiple shadings: Concepts and “facts” must be presented to the public as true or false, right or wrong, black or white. In Mein Kampf, Hitler heaped high praise on British propaganda efforts in World War I and expressed contempt for German propaganda, which he faulted for not painting the world in stark black-and-white terms.

    Unlike Hitler, who was a highly effective orator, Lenin was a master pamphleteer and polemicist who relied most heavily on the written word. In the infancy of his movement, Lenin’s chief weapon was the underground newspaper. Endowed with such names as “The Spark” and “Forward,” these propaganda tabloids were printed clandestinely or smuggled into the capital, St. Petersburg, in false-bottom briefcases.

    Violence

    The fifth and final characteristic of totalitarian revolution is the use of violence and terror as accepted instruments of political policy. According to the Nazi theorist Eugene Hadamovsky, “Propaganda and violence are never contradictions. Use of violence can be part of the propaganda.”* Assassinations and kidnappings, indiscriminate bombings, and sabotage are all part of the totalitarian tool box. Sabotage is designed to disrupt production, transportation, and communications systems; terror is aimed at a greater, pervasive sense of insecurity (see Chapter 15).

    State terror—violence perpetrated by the government—has played a prominent role in mass movements of both the Right and the Left. The notorious “combat groups” (fasci di combattimento) Italian Fascist Party leader Benito Mussolini formed shortly after World War I provide a striking example. After attempts to woo the working class away from the Socialist Party failed, Mussolini began to cultivate the middle classes and seek financing from wealthy industrialists and big landowners. One of the more novel forms of terror the fascists devised was the punitive expedition, in which armed bands conducted raids against defenseless communities. The local police would often cooperate by looking the other way.

    Mussolini’s aim was threefold:

    · to create an artificial atmosphere of crisis;

    · (2)

    to demonstrate that the state was no longer capable of providing law-abiding, taxpaying citizens with protection from unprovoked attacks on their persons and property; and

    · (3)

    to prod an increasingly fearful, desperate, and fragmented citizenry to turn for refuge and order to the very same political movement that was deliberately exacerbating the problem.

    The Nazis in Germany used the same sort of tactics. The similarities between this kind of organized violence and plain gangsterism are obvious—the crucial difference has to do with ends rather than means: Gangsters seek to gain control over lucrative (and often illegal) businesses, not to overthrow the government.

    The Consolidation of Power

    Once the old order has been overthrown or fatally discredited, the totalitarian leadership can operate from a solid power base within the government. The next task it faces is to eliminate any competing political parties and factions. The final step in the consolidation process is the elimination of all those within the party who pose a real or potential danger to the totalitarian leader. At this stage, Machiavelli’s advice is especially valuable: “One ought not to say to someone whom one wants to kill, ‘Give me your gun, I want to kill you with it,’ but merely, ‘Give me your gun,’ for once you have the gun in your hand, you can satisfy your desire.”*

    Eliminating Opposition Parties

    Any opposition group, no matter how small or ineffectual, poses a potential danger to the ruler. By the same token, the mere existence of political opponents inhibits the kind of radical change mandated by the movement’s ideology.

    In dealing with rival political parties, Lenin famously employed salami tactics *—the practice of marginalizing or eliminating opposition by slicing it into pieces and playing one group off against the other. Thus, after the new Constituent Assembly (legislature) was elected, Lenin exploited an already existing division in the dominant Socialist Revolutionary Party by forming an alliance with its left wing. This alliance enabled Lenin to move against the party’s more moderate wing, as well as against other rightist parties.

    Lenin also repressed Russia’s huge peasant population. The lack of peasant support for the Bolshevik regime became a particularly acute problem during the civil war (1918–1920), when foodstuffs and other basic necessities were extremely scarce. In response, Lenin “instituted in the villages a ‘civil war within a civil war’ by setting poor peasants against those who were less poor,”* thereby helping to undermine the political opposition.

    Hitler employed a different strategy. Bolstered by his Nazi Party’s steadily growing popularity in the polls (thanks to a formidable following of true believers), his superb oratorical skills, and a special group of shock troops known as storm troopers, he played a waiting game. Once in office, he gradually expanded his authority, first by gaining passage of new emergency powers and suspending civil liberties. Only then did he move to shut down all opposition parties. Hitler thus used the charade of legality to destroy his opponents politically before using the power of the state to destroy them physically.

    Purging Real or Imagined Rivals Within the Party

    Political purges involve removing opponents from the party leadership or from positions of power, or rounding up whole (often fictitious) categories of people (“bourgeois capitalists” or “enemies of the people”) but not necessarily killing them. Arresting people you don’t trust and either imprisoning or exiling them can be just as effective as killing them—and ostensibly more civilized. In carrying out purges, totalitarian governments almost invariably accuse their victims of subversive activity or treason—a convenient rationale for eliminating individuals who are perceived as threats or political liabilities.* Thus, Hitler turned on Ernst Röhm and other party members who had been instrumental in the Nazis’ rise to power; on the Führer’s orders, the Röhm faction was murdered in June 1934. Blaming the whole incident on his political enemies, Hitler used the Röhm purge to solidify his popular support and give credence to his fear-mongering propaganda.

    Purges played an even bigger role in the consolidation of power in the Soviet Union. In 1921, thousands of trade unionists and sailors, formerly the backbone of the Bolsheviks’ popular support, were murdered by the secret police when they demanded free trade unions and elections. Next, Lenin purged the so-called Workers’ Opposition faction of his own Bolshevik party, which demanded worker self-management of industry. Lenin pronounced the group guilty of “factionalism” and accused it of endangering both the party and the revolution. The members of the Workers’ Opposition group were expelled from the party but not murdered.

    Such relatively mild actions were not characteristic of Lenin’s successor, Joseph Stalin, who, as the head of the Soviet Communist Party (1924–1953), did not hesitate to murder those whom he perceived to be his political enemies. How Stalin gathered total power in his hands is a textbook example of cutthroat power politics. He shrewdly adapted Lenin’s salami tactics. However, whereas Lenin set rival parties against each other, Stalin set rivals within his own party—virtually all the great Bolshevik heroes of the October Revolution—against each other. Stalin purged and eventually murdered virtually the entire top party leadership after Lenin’s death in 1924.

    Creating a Monolithic Society

    The totalitarian state stops at nothing short of total control over the economy, the arts, the military, the schools, the government—every aspect of society. As Nazi propaganda chief Joseph Goebbels (1897–1945) remarked, “The revolution we have made is a total revolution…. It is completely irrelevant what means it uses.”* Ironically, the golden society at the end of the utopian rainbow is incompatible with intellectual freedom. Thus, one Nazi official asked this rhetorical question: “If the brains of all university professors were put at one end of the scale and the brains of the Führer at the other, which end, do you think, would tip?”*

    Total control requires total loyalty. During the Nazi era, even in small towns, any magistrates and petty officials who had not publicly supported the Nazis were removed from power. Simultaneously, numerous “enemies of the people” were identified and punished by the brutal Gestapo or secret police.* The effectiveness of these terror tactics helps explain why there was so little overt resistance to the Nazi takeover, but it does not tell the whole story. Cowardice, apathy, and self-interest played important roles as well. A true story told by a German refugee who had been on the faculty of the prestigious University of Frankfurt speaks directly to this point.* Following the appointment of a Nazi commissar at the university, every professor and graduate assistant was summoned for an important faculty meeting:

    The new Nazi commissar … immediately announced that Jews would be forbidden to enter university premises and would be dismissed without salary on March 15…. Then he launched into a tirade of abuse, fifth, and four-letter words such as had been heard rarely even in the barracks and never before in academia. He pointed his finger at one department chairman after another and said, “You either do what I tell you or we’ll put you into a concentration camp.” There was silence when he finished; everybody waited for the distinguished biochemist-physiologist.

    The great liberal got up, cleared his throat, and said, “Very interesting, Mr. Commissar, and in some respects very illuminating; but one point I didn’t get too clearly. Will there be more money for research in Physiology?” The meeting broke up shortly thereafter with the commissar assuring the scholars that indeed there would be plenty of money for “racially pure science.”*

    The English philosopher Edmund Burke is reported to have said, “All that is necessary for evil to succeed is for good men to do nothing.” Indeed.

    The Transformation of Society

    The transformation stage generally coincides with the regime’s assumption of control over the economy and requires active government planning and intervention.* In justifying the drive for a new social order, totalitarian regimes typically blame everything that is wrong with the country on counterrevolutionaries, spies, and saboteurs.

    Carl Friedrich and Zbigniew Brzezinski, two respected students of this subject, have identified six characteristics shared by all totalitarian governments:

    · (1)

    an official ideology;

    · (2)

    a single, hierarchical party;

    · (3)

    a secret police;

    · (4)

    a tightly controlled armed forces;

    · (5)

    a media monopoly; and

    · (6)

    central control over the economy.*

    These characteristics derive from the main features and functions of the revolutionary movement we have discussed (leadership, ideology, organization, propaganda, and violence), now redirected to the state’s day-to-day administration and transformation.

    The attempted transformation of the state follows a predetermined ideological path, with some concessions to pragmatism where necessary. But practicality is rarely of prime importance for the total tyrant bent on transformation. Examples from the political careers of Stalin, Hitler, and Mao illustrate this point.

    The Soviet Union under Stalin

    In 1928, having defeated his political rivals, Stalin stood poised to launch his drive to collectivize and industrialize the Soviet economy. His first Five-Year Plan for the Soviet economy (1928–1932) marked the beginning of a cataclysm. Over the next ten years, millions of innocent people were killed or sent to labor camps, and a whole class of relatively well-to-do landholders, the kulaks, ceased to exist. In addition, the whole pattern of Soviet agricultural production was radically reshaped.

    To understand why Stalin would inflict so much suffering on the Soviet farm population, we must first understand the role of ideology in totalitarian systems. Stalin’s first Five-Year Plan, which instituted a highly centralized economic system designed to foster rapid development of the Soviet economy, was motivated by a lust for power. However, Stalin was also committed to creating an advanced industrial society based on collective, rather than capitalist, principles. The way to accomplish this remarkable feat in the shortest possible time, Stalin reasoned, was to invest massively in heavy industry while squeezing every last drop of profit from agriculture, the traditional foundation of the Russian economy.

    Private ownership of farmland, animals, and implements would have to be eliminated and farming “collectivized.” Under Stalin’s collectivization plan, most agricultural production took place in large cooperative units known as kolkhozy (collective farms), whose members shared whatever income was left after making compulsory deliveries to the state, or in sovkhozy (state farms), whose laborers received wages.

    One of the most ruthless dictators of the twentieth century, Joseph Stalin (1879–1954) moved away from the Soviet model of an international communist revolution proposed by Marx and Lenin to focus on “socialism in one country.” In pursuit of his aims, Stalin committed mass murders on a grand scale and enslaved millions in a vast system of gulags (forced-labor camps). It’s amazing, even shocking given what we now know about Stalin, that he was named Time magazine’s “Man of the Year” in 1942.

    Soviet agriculture was collectivized to underwrite Soviet industrialization. Through a massive transfer of resources from farms to cities, Stalin believed industrial production could double or even triple during the period of the first Five-Year Plan. But doing so would necessitate crushing all pockets of rural resistance, herding the peasants into collective farms, and imposing a draconian system of “tax” collections, or compulsory deliveries of scarce food supplies to the state in order to feed the growing army of industrial workers and to pay for imported capital goods.

    One reason the plan failed was the excessive and indiscriminate brutality Stalin employed. Stories spread through the countryside of how Stalin’s agents had machine-gunned whole villages. Many Russian peasants deliberately burned their crops and killed their cattle rather than cooperate with Stalin’s requisition squads. Despite an all-out national effort, industrial production grew only slightly, if at all. In the meantime, famine depopulated the countryside.

    Stalin made no apologies and no policy adjustments. Instead, he fabricated statistics, which no one dared question, to “prove” that real progress was being made. In the words of one expert, “The Stalin regime was ruthlessly consistent: All facts that did not agree, or were likely to disagree, with the official fiction—data on crop yields, criminality, true incidences of ‘counterrevolutionary’ activities … were treated as nonfacts.”*

    In 1934, as the death toll mounted and the first Five-Year Plan came to an unspectacular end, the Soviet dictator declared he had uncovered a far-reaching conspiracy, orchestrated by foreign agents and counterrevolutionaries, to resurrect capitalism in Soviet Russia. This conspiracy theory gained credibility when Sergei Kirov, the dynamic young leader of the Leningrad party organization, was assassinated in December 1934. Harsh reprisals, numerous arrests, phony trials, summary executions, and large-scale deportations followed. Many of the victims were loosely identified as members of a fabricated conspiracy called the Leningrad Center. The alleged plot furnished Stalin with the pretext for a purge of Lenin’s original circle of revolutionary leaders, the so-called Old Bolsheviks.

    During the first phase of the Great Terror (January 1934 to April 1936)—also known as the Great Purge—Communist Party membership fell by nearly 800,000, or approximately 25%. The Soviet press denounced these ex-communicants as “wreckers, spies, diversionists, and murderers sheltering behind the party card and disguised as Bolsheviks.”*

    Landmarks in History The Great Purge

    Between 1934 and 1938, Stalin ordered most of the Soviet political and military elite executed as enemies of the state, including:

    · 1,100 delegates to the 17th Party Congress (more than half)

    · 70% of the 139-member Party Central Committee

    · 3 of 5 Soviet marshals (the highest-ranking generals)

    · 14 of 26 army commanders

    · All 8 admirals

    · 60 of 67 corps commanders

    · Half the 397 brigade commanders

    · All but 5 of the 81 top-ranking political commissars

    The second phase of the Stalin purges (1936–1938) was highlighted by the infamous show trials, in which the Old Bolsheviks, along with many other top-ranking party leaders, were placed on public trial and forced to make outrageous “confessions.” The trials represented only the tip of the iceberg (see “Landmarks in History”).

    Nor were the rank-and-file workers spared. Throughout the mid- to late 1930s, Stalin collectivized the Soviet labor force by means of forced-draft or conscript labor. Work units were structured and regimented along military lines. This policy gave birth to the so-called gulag archipelago, a network of draconian slave-labor camps maintained and operated by the Soviet secret police where social and political undesirables were forced to live. Through the gulag system, railroads, canals, and dams were constructed in remote and inaccessible areas where workers would not voluntarily go. Aleksandr Solzhenitsyn, the celebrated dissident writer who chronicled life in the labor camps, estimated that they held as many as twelve million prisoners at any given time, perhaps half of them political prisoners. “As some departed beneath the sod,” he noted, “the Machine kept bringing in replacements.”*

    At the close of 1938, Stalin stood alone at the top. Industrial development had been spurred, but the Soviet Union was anything but a worker’s paradise. Terror had brought about great political changes, with many luminaries from the pages of Soviet Communist Party history uncovered as traitors and placed on public trial. The list of the accused read like an honor roll of the October Revolution. The military high command had been sacked, the party rank and file cleansed of all political impurities, and the “toiling masses” reduced to a new level of industrial serfdom. Although he ruled until his death in 1953, Stalin (and the legacy of Stalinism) would be identified, above all, with the bloody purges of the 1930s.

    Germany under Hitler

    The overriding theme of National Socialist (Nazi) Party ideology during the Third Reich (1933–1945) was the elimination of the Jews and other “social undesirables” and the ascendency of the “Aryan” race—a fiction that nonetheless obsessed Hitler and his followers. Through Nazi ideology and propaganda, the German people came to accept the persecution of the Jews, the necessity of eventual war, and the radical transformation of society. Every aspect of German life became politicized. Dissident artists, journalists, and academicians were silenced. New state organs, including the Reich chambers for literature, press, broadcasting, theater, music, and fine arts, were created for the primary purpose of censoring or quelling potentially “dangerous” forms of written or artistic expression.

    In the realm of music, German folk tunes were exalted over “decadent” modern music and classical music written by composers of Jewish lineage, such as Felix Mendelssohn and Gustav Mahler. Modern art was likewise condemned, and the works of virtually every well-known contemporary artist were banned. Literature under the Nazi regime fared no better. According to one chronicler of the Third Reich, “Blacklists were compiled ceaselessly and literary histories were revised…. The ‘cleansing’ of libraries and bookstores presented some problems, but the destruction and self-destruction of German literature was achieved within a matter of months through the substitution of second- and third-rate scribblers for first-rate writers and by inhibiting contacts with the outside.”*

    The Nazi attack on the arts was indicative of the lengths to which Hitler would go to ensure that Nazi values were propagated. But perhaps no part of German life more vividly demonstrated Hitler’s commitment to a new future than the Nazi school system. As Bracher pointed out, “While National Socialism could substitute little more than ideology and second-rate imitators for the literature and art it expelled or destroyed, its main efforts from the very outset were directed toward the most important instruments of totalitarian policy: propaganda and education.”*

    Nazi educational policy was implemented in three principal ways. To begin with, educators and school administrators who were suspected of opposing Hitler, Nazism, or Nazi educational “reform” were promptly removed from their positions. Then all academic subjects were infused with ideological content reflecting Hitler’s anti-Semitic racial theories. History became “racial history,” biology was transformed into “racial biology,” and so on. Finally, the Nazis established special schools to train a future party elite, including military leaders, party officials, and government administrators. Students were assigned to these schools according to age group and career orientation. The Adolf Hitler Schools, to cite one example, taught 12- to 18-year-old students who wished to become high party functionaries. In general, all special schools taught certain basic core courses (such as racial history and biology) and emphasized military drill (for example, the training of the infamous Hitler Youth).

    The Nazi educational program turned out to be all too successful. In the judgment of one authority, “Just as teachers and parents capitulated to the pressures of the regime, so on the whole did the indoctrination of the young succeed. The young, who were receptive to heroic legends and black-and-white oversimplifications, were handed over to the stupendous shows of the regime.”* Education of the young was reinforced by carefully planned pomp and ceremony: “From earliest childhood, they were exposed to flag raisings, parades, nationwide broadcasts in the schools, hikes, and camps.”* Indoctrination and propaganda, not terror, became the instruments by which the children of the Third Reich were initiated into the new order.

    The overriding theme of Nazi Party ideology was the elimination of the Jews and other “social undesirables” and the subsequent creation of a “racially pure” Aryan nation. Between 1933 and 1945, at least six million European Jews plus countless others perished in Nazi death camps. The entrance to the infamous Auschwitz death camp is pictured here. The sign above the gate reads, “Work makes you free.”

    Mass indoctrination combined with a preexisting anti-Semitism made it possible for Hitler to carry out the murderous racial policies that culminated in the Holocaust. After seizing power, Hitler implemented his anti-Jewish policy in stages, each more radical than the one before.* First came the attempt to define who precisely was and was not a Jew. Then the regime launched a systematic campaign to isolate Jews from the mainstream of German life and to expropriate their property. Next all Jews who had not fled the country between 1933 and 1938 were forcibly removed from German society and sent to the infamous concentration camps. This mass deportation presaged the fourth and final step—genocide.

    Hitler’s maniacal obsession was ultimately his undoing. Even on the brink of defeat, Hitler continued to divert resources needed to prosecute the war to the Final Solution (the liquidation of the Jews). In the end, some six million European Jews plus countless others, including the mentally ill, physically disabled, Soviet prisoners of war, gay men, Gypsies, Jehovah’s Witness members, and Polish intellectuals, as well as many Polish Roman Catholics, were annihilated.

    China under Mao

    Mao Zedong’s rise to power in China is an epic example of revolutionary struggle—a true mass movement in a poor, peasant-dominated society. For more than twenty years (1927–1949), Mao waged a bitter “war of national liberation” against the Kuomintang, headed by Chiang Kai-shek, as well as against the Japanese during World War II. In the mid-1930s, Mao was one of the leaders of the legendary Long March, a 6,000-mile trek, during which his ragtag band of guerrillas repeatedly evaded capture or annihilation by the numerically superior and better-equipped forces of Chiang’s Nationalist army. By 1949, when Mao finally won the last decisive battle and assumed command of the Chinese nation, Mao had been waging class war in the name of the Chinese masses for more than two decades.

    Mao prided himself not only on his revolutionary exploits but also on his political thought. In time, the “thoughts of Chairman Mao,” compiled in his pocket-sized little Red Book, of which millions of copies were printed and mass distributed, attained the status of holy scripture in Chinese society. His vision of a new, classless state and of the exemplary communist cadres and comrades who would typify this morally reeducated society inspired the radical policies that have become known collectively as Maoism.

    Although Mao’s worldview was undoubtedly shaped by the basic tenets of Marxism, 1920s China was a preindustrial society without a true proletarian (industrial-worker) class or a “monopoly capitalist” class of the kind Marx had described in Das Kapital. The bane of China’s peasant masses was not factory bosses but greedy landlords and bureaucratic officials preoccupied with the preservation of the status quo and of their own power and privilege. If the oppressed majority were to be liberated, those in power would have to be overthrown. To accomplish such a historic mission, Mao believed, violent revolution “from below” was an unavoidable necessity. “Political power,” he wrote, “grows out of the barrel of a gun.”*

    As part of his adaptation of Marxism, Mao glorified the Chinese peasants—whom he described as “poor and blank”—as models of communist virtue because they had never been corrupted by “bourgeois materialism” and big-city decadence. Mao thus made the peasantry (not the proletariat) the cornerstone of his visionary utopian society.

    Once in power, Mao turned China into a kind of social laboratory. The first step included campaigns to eradicate specific evils such as individualism and bourgeois materialism by “reeducating” the masses or exterminating undesirable social elements (landlords, counterrevolutionaries, and “bandits”). Accompanying mass reeducation was a sweeping land reform program culminating in the wholesale collectivization of Chinese agriculture. This bitter pill was administered with massive doses of propaganda, as well as brute force. In the early 1950s, a major push to industrialize China along Stalinist lines was also launched.

    Alternating periods of freedom and repression marked Mao’s rule. In 1956, for example, he announced the beginning of the Hundred Flowers campaign, which promised a relaxation of strict social discipline. As a high-ranking party official put it at the time, “The Chinese Communist party advocates [that] one hundred flowers bloom for literary works and one hundred schools contend in the scientific field . . . to promote the freedom of independent thinking, freedom of debate, freedom of creation and criticism, freedom of expressing one’s own opinions.”* What followed probably caught Mao by surprise. Public protests and anti-party demonstrations occurred at Beijing University and other campuses. Strikes and scattered riots, even isolated physical attacks on party officials, occurred in various parts of the country.

    Instead of a hundred flowers, thousands of “poisonous weeds” had grown in the Chinese garden. The incipient rebellion was rapidly suppressed in a brutal “anti-rightist” crackdown. The official party newspaper, People’s Daily, announced the whole Hundred Flowers campaign had been a ploy to lure the enemies of the state into the open.

    In retrospect, the Hundred Flowers episode was a mere warm-up for Mao’s Great Leap Forward (1957–1960)—a spectacular but ill-conceived attempt to catapult China onto the stage of “full communism” by means of mass mobilization. Mao set out to prove that anything is possible, and that subjective factors like human will can triumph over objective conditions such as poverty, illiteracy, and external dependency. Put differently, the idea “was to take advantage of China’s rural backwardness and manpower surplus by realizing the Maoist faith that ideological incentives could get economic results, that a new spirit could unlock hitherto untapped sources of human energy without the use of material incentives.”* Thus did Mao’s brand of “Marxism” stand Marx on his head.

    es could get economic results, that a new spirit could unlock hitherto untapped sources of human energy without the use of material incentives.”* Thus did Mao’s brand of “Marxism” stand Marx on his head.

    Many peasants for a time ate in large mess halls. All labor was to be controlled. Everyone was to work twenty-eight days of the month, while children went into day nurseries. This would bring large-scale efficiency to the village and get all its labor, including its womanpower, into full employment.*

    Why were the unprecedented measures associated with Mao’s grandiose concept instituted? According to China scholar John King Fairbank, “The result, it was hoped, would be agricultural cities with the peasants proletarianized and uprooted from their own land”—with an overall view toward giving the state increased control over labor resources and changing the peasants’ attitudes.*

    The Great Leap Forward was a colossal failure with disastrous consequences for the Chinese people, including severe crop failures and food shortages. But Mao was undeterred. After a brief period of retrenchment, he launched a second “revolution from above.” From 1966 to 1969, the Great Proletarian Cultural Revolution shook Chinese society to its very foundations. In the first stage, designed to wash away all that was “decadent” in Chinese life, Mao closed all schools and urged his youthful followers, called the Red Guards, to storm the bastions of entrenched privilege and bureaucratic authority. Millions of Maoist youths obligingly went on a rampage throughout the country for many weeks. This phase of the revolution accomplished its intended purpose, as the Red Guards “smashed most of the Republic’s bureaucratic institutions” and “invalidated [the government’s] authority and expertise.”* Officials were dragged out and put on public display to be ridiculed and humiliated, accompanied by purges and summary executions; temples and historical treasures lay in ruins, as did the party, government, and armed forces.

    The second stage of the Cultural Revolution called for positive action to replace the previous order with a new and better one. Unfortunately, the economy and society, especially in urban areas, had been severely disrupted. Factories and schools, shut down by marauding Red Guards, did not reopen for months or even years.

    The ultimate cost of the Cultural Revolution is incalculable. One fact, however, is clear: Mao’s unrelenting efforts to prove that human nature is infinitely malleable—and society, therefore, infinitely perfectible—foundered on the rocky shores of political reality, not to mention the folly of eliminating a whole generation of educated citizens. His death in 1976 closed a unique chapter in the political history of the modern world.

    The Human Cost of Totalitarianism

    Totalitarian regimes present a stark contrast between ends and means—diabolical deeds in pursuit of utopian dreams. The death camps of Nazi Germany and the labor camps of Stalinist Russia stand as the essence of twentieth-century totalitarianism.

    All told, the three revolutions featured in this chapter—Nazi Germany, Stalinist Russia, and Maoist China—caused at least one hundred million civilian deaths by most estimates.* The number defies imagination; but these estimates, which include World War II casualties, are quite plausible and may actually be low.* War-related deaths in the European theater during World War II numbered “about six million for Germany and Austria, 20 million for the Soviet Union, and about 10 million for all other European countries, for a total of about 36 million.”* Hitler’s Final Solution was estimated to have resulted in the deaths of an estimated five to six million European Jews, not to mention an indeterminate number of non-Jews whom Hitler considered “social undesirables.” All in all, perhaps forty-two million people died directly or indirectly as a result of Hitler’s policies.

    The Russian Revolution of 1917 and its aftermath were hardly less costly in terms of human life. Between 1918 and 1923, approximately three million Soviet citizens died of typhus, typhoid, dysentery, and cholera, and about nine million more disappeared, probably victims of the terrible famine that scourged the country in the early 1920s. Many perished in a severe drought in 1920–1921, but others died of direct or indirect political causes.

    In the late 1920s, during Stalin’s titanic industrialization drive, the kulaks were annihilated as a class. In addition, another killer famine—at least partially self-inflicted—occurred in the early 1930s. When deaths associated with the early stages of collectivization are combined with deaths brought on by famine, the mortality figures range in the millions for the period from 1929 to 1934.

    But the worst was yet to come. After 1934, Stalin’s purges directly claimed hundreds of thousands of lives and led to the premature deaths of some two million “class enemies” in Siberian forced-labor camps. Nor did the end of the great purges in 1938 stop the political hemorrhaging that, together with World War II, drained Soviet society of so much of its vitality. Millions of labor camp inmates died between 1938 and 1950 due to the inhumane treatment and harsh conditions they had to endure on a daily basis.

    The human cost of the revolution in Maoist China exceeds that of Stalinist Russia. Between the time of the communist takeover in 1949 and the Great Leap Forward in 1957, several mass campaigns were launched to combat allegedly counterrevolutionary forces. After the Chinese Communist takeover, the land reform program cost the lives of several million “landlords” and rich peasants between 1949 and 1952. Other campaigns against counterrevolutionaries in the early 1950s cost another million and a half lives. Periodic anti-rightist campaigns and collectivization of agriculture after 1953 also took a toll.* According to scholar C. W. Cassinelli,

    Accurate information is not available—and often even informed guesses are lacking—on the cost of the first decade [emphasis supplied] of the People’s Republic. An estimate of twelve million lives is modest but reasonable.*

    These figures do not include deaths caused by hardship and privation, most notably those traceable to the dislocations that accompanied the Great Leap Forward in the late 1950s.

    The Cultural Revolution (1966–1969) was another bloody episode in Chinese history, although firm estimates of the number of casualties are impossible to make. A much heavier toll was probably taken by the Chinese gulag system. As many as fifteen million may have perished as a direct result of inhumanly harsh labor camp conditions. When Cassinelli tallied the total number of politically related deaths, including “another million from miscellaneous causes,” he arrived at the astonishing figure of “about 33.5 million.”* Though unverifiable, this number is consistent with the available evidence. The mere fact that it is not implausible speaks volumes.

    Totalitarian regimes typically refuse to concede that any goal, no matter how visionary or perverse, is beyond political reach. The compulsion to validate this gross misconception may help explain the pathological violence that marks totalitarian rule.

    The Sanguinary Imitators

    Stalin’s Russia, Hitler’s Germany, and Mao’s China are the best-known examples of totalitarianism, but not the only ones. A surprising number of dictatorships have tried to copy or imitate totalitarianism’s Big Three. Incredibly, one went to even greater extremes to purge society than either Stalin or Mao did, and in this case, to which we now turn, the tyrant committed genocide against his own nation.

    Pol Pot governed Cambodia (renamed Kampuchea) from 1975 to 1979.* He and his followers sought to create a radically new society, based on the rustic and Spartan life of peasant cadres. All vestiges of the old order—everything from the calendar to the family—were eradicated. Pol Pot proclaimed 1978 “Year Zero,” which turned out to be grotesquely appropriate, for at the end of his brief rule, some two million Cambodians (of a population of 7.5 million) would be dead—the victims of purges, starvation, or persecution.

    Another example of totalitarian rulers is Ethiopia’s Colonel Mengistu, who ruled from the mid-1970s until 1991.* Mengistu attempted to reorganize the nation by physically relocating its people into regimented population and refugee centers for the purposes of permitting intensive governmental surveillance as well as encouraging systematic propaganda and indoctrination. His efforts destroyed the nation’s agriculture, and a killer famine resulted. Although the West made efforts to feed the starving children of Ethiopia, their government appeared curiously detached. While his people went hungry, Mengistu staged lavish military parades, sold wheat to neighboring nations, and used the money he received to buy weapons. In May 1991, with his regime under siege by a coalition of rebel forces, Mengistu fled the country.

    North Korea is the last Soviet-style totalitarian state still in existence. Kim Il-sung ruled over the Hermit Kingdom (so named for the nation’s self-imposed isolation from the outside world) until his death in July 1994. He was succeeded by his son, Kim Jong-il, who ruled from 1994 to 2011 as a brutal and lunatic tyrant bent on building nuclear weapons and indifferent to the suffering and starvation of his own people. The second Kim’s claim to rule was hereditary—his father not only founded North Korea’s totalitarian dictatorship after World War II but also established a ruling dynasty.

    Kim Jong-il ruled North Korea the same way his father did—by perpetuating a personality cult similar to those once perpetrated in Russia by Joseph Stalin or in China by Mao Zedong. In a bizarre twist, when his father died, Kim Jong-il made him (the father) president for eternity. North Korean propagandists ascribe to Kim (the son) the authorship of a thousand books while he was a college student. When Kim Jong-il died in 2011, he was succeeded by (guess who) his son, Kim Jong-un.

    North Korea maintains a huge army, entrenched along the 38th parallel that divides Korea, and poses a standing threat to South Korea, a close ally of the United States since the Korean War (1950–1953). That major war was started when northern Korea invaded the south, a fact that continues to shape Western perceptions of North Korea today. The war ended in a draw and without a peace treaty.

    In stark contrast to the prosperous south, North Korea remains one of the poorest countries on earth. Malnutrition and even starvation threaten the population—children in North Korea are, on average, considerably shorter and weigh less than children of the same age in South Korea. North Koreans are not allowed to have contact with South Koreans, including family members.

    After 9/11, President Bush declared North Korea to be part of an “axis of evil” along with Iraq and Iran. North Korea again found itself in the international spotlight when the late Kim Jong Il Jong-il defied the Bush administration’s demand for a “complete, verifiable, and irreversible” halt to its nuclear weapons program. U.S. relations with North Korea did not greatly improve in the ensuing years. A preoccupation with the wars in Iraq and Afghanistan, as well as a deepening recession in the wake of the U.S. financial crisis in 2008–2009, led President Obama, like his predecessor, to seek an accommodation with Pyongyang (the capital).

    North Korea conducted a nuclear test in 2006 and in April 2009 attempted to launch a long-range missile, but the test failed. Pyongyang is also thought to have stockpiles of chemical and biological weapons. North Korea’s extreme self-isolation and secrecy make it impossible for the outside world to know where the country is headed, what the leadership is thinking, or even who’s in charge. So if the Hermit Kingdom does have a nuclear “gun,” nobody knows for sure whose finger is on the trigger.

    Under the regime of Ayatollah Khomeini (1979–1989), Iran displayed most of the elements associated with totalitarian rule: an attempt to transform society; a dictatorship that demanded abject loyalty, obedience, and self-sacrifice; an all-encompassing creed that rationalized, explained, and justified arbitrary rule; press censorship; and secret police, show trials, summary executions, and holy wars.

    Eventually, no aspect of life in Iran lay outside governmental control. Teachers, textbooks, education, entertainment, the legal system, even courtship and sexual mores were made to conform to fundamental Islamic beliefs. The regime declared war on civil servants, intellectuals, professional and entrepreneurial elements of the middle class, and all others who had endorsed modern Western ways and culture.

    After Khomeini’s death, his successors relaxed some of the strict moral and social controls but maintained a rigidly theocratic police state fiercely opposed to the West and, in particular, to the U.S. presence in neighboring Iraq and the Persian Gulf. In addition, Tehran launched a major nuclear research and development program, raising a general alarm in the international community and causing the United States to orchestrate a global campaign to stop Iran from building nuclear weapons.

    When President Obama assumed office, he quickly attempted to break the diplomatic impasse with Iran. During the 2008 presidential campaign, Obama had roundly criticized President Bush for refusing to engage in direct talks with Tehran. In early 2009, the new administration expressed a willingness to meet with Iran “without preconditions.” In April 2009, then President Mahmoud Ahmadinejad declared in a televised speech, “We have prepared a package that can be the basis to resolve Iran’s nuclear problem. It will be offered to the West soon.”* In 2015, the world was still waiting—and hoping—for that promise to bear fruit.

    The Iranian case demonstrates three important points. First, totalitarian regimes, like democracies and traditional dictatorships, can share a single essence and assume many different guises. Second, although totalitarian regimes appear to be rigid and unchanging on the outside, they are, in fact, not impervious to change on the inside. Third, in the modern world of the twenty-first century, totalitarian regimes cannot succeed economically in isolation—that is, without access to global markets, the latest technological advances, and sources of investment capital.

    Ironically, as totalitarianism disappeared in Russia and Eastern Europe, it reared its ugly head in Afghanistan—a country the Soviet Union had invaded in 1979. It is generally accepted that the protracted and costly conflict in Afghanistan hastened the demise of the totalitarian Soviet state. It turned out to be Moscow’s Vietnam, but with more dire consequences.

    In the 1990s, totalitarianism in a different guise arose from the ashes of the war that had ravaged Afghanistan during the previous decade. That regime—the Taliban—captured the world’s attention after September 2001 because the mastermind behind the 9/11 operation, the actual perpetrators, and the organization that carried it out were all based in Afghanistan. The Taliban was providing sanctuary for Osama bin Laden, who had set up training camps for his stateless “army.”

    But the Taliban was not just harboring a terrorist organization; it was itself a terrorist organization—a full-blown totalitarian regime complete with a single all-powerful ruling clique, harsh and arbitrary laws, kangaroo courts, predictable (guilty) verdicts, summary executions turned into public spectacles, severely restricted personal freedoms, closed borders, and a captive population. Afghans were not allowed to emigrate or travel abroad. Girls were not allowed to go to school. Boys were not allowed to fly kites. Women had no rights, had to be completely covered in public, and could not work outside the home. Wife beating, no matter how severe, was not a crime—not even when the victim died.

    After more than three decades of political upheaval, economic paralysis, and inconclusive civil war, Afghanistan remains one of the poorest of the least developed states in the world. None of the turmoil, however, has fundamentally changed the traditional structure and culture of Afghan society, which raises a serious question about outside intervention and whether revolutionary change is ever possible unless it comes from within.

    Twilight of Totalitarianism?

    Hitler boasted that his would be a thousand-year empire, but it lasted less than a decade. In fact, in stark contrast to the great autocratic empires of ancient history, totalitarian regimes are short-lived. They tend to burst on the scene like a meteor and burn out. Why might that be?

    Fatal wars with other nations, such as Hitler’s defeat by the Allies in World War II, can bring a sudden end to totalitarian states. The death of a particularly charismatic or successful ruler—Mao or Stalin, for instance—can precipitate an extended downward spiral. Drab, indistinguishable successors who rule by coercion and terror rather than by consent may undermine the economic efficiency, moral vitality, and political idealism on which legitimate political power ultimately rests. Thus, the collapse of the Soviet Union was preceded by both a prolonged period of economic disintegration and a widespread loss of faith in the regime and its political ideals; a period of “totalitarianism in decline.”*

    The Peoples’ Republic of China, to cite a key example, has morphed into a one-party authoritarian system with a transitional economy falling somewhere between a Soviet-style command economy and a Western-style market economy—a hybrid form sometimes called state capitalism. Iran after Khomeini remains a theocracy with limited personal freedoms, but it cannot in fairness be called totalitarian. North Korea alone still qualifies as unambiguously totalitarian. The totalitarian regimes in Kampuchea and Ethiopia are long gone—only the scars and bitter legacies remain.

    In sum, the best thing about the worst regimes in today’s world is that they tend to be short-lived. Unfortunately, totalitarian tyrants need only a little time to do a lot of damage.

    Summary

What Students Are Saying About Us

.......... Customer ID: 12*** | Rating: ⭐⭐⭐⭐⭐
"Honestly, I was afraid to send my paper to you, but splendidwritings.com proved they are a trustworthy service. My essay was done in less than a day, and I received a brilliant piece. I didn’t even believe it was my essay at first 🙂 Great job, thank you!"

.......... Customer ID: 14***| Rating: ⭐⭐⭐⭐⭐
"The company has some nice prices and good content. I ordered a term paper here and got a very good one. I'll keep ordering from this website."

"Order a Custom Paper on Similar Assignment! No Plagiarism! Enjoy 20% Discount"

Ethical And Legal Implications Of Prescribing Drugs

By Day 7 of Week 1

Write a 2- to 3-page paper that addresses the following:

 

The Assignment (case) for week one is listed below.

A friend calls and asks you to prescribe a medication for her. You have this autonomy, but you don’t have your friend’s medical history. You write the prescription anyway.

  • Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
  • Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
  • Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
  • Explain the process of writing prescriptions, including strategies to minimize medication errors.

 

To Prepare
  • Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
  • Review the scenario assigned by your Instructor for this Assignment.
  • Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor.
  • Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
  • Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors

What Students Are Saying About Us

.......... Customer ID: 12*** | Rating: ⭐⭐⭐⭐⭐
"Honestly, I was afraid to send my paper to you, but splendidwritings.com proved they are a trustworthy service. My essay was done in less than a day, and I received a brilliant piece. I didn’t even believe it was my essay at first 🙂 Great job, thank you!"

.......... Customer ID: 14***| Rating: ⭐⭐⭐⭐⭐
"The company has some nice prices and good content. I ordered a term paper here and got a very good one. I'll keep ordering from this website."

"Order a Custom Paper on Similar Assignment! No Plagiarism! Enjoy 20% Discount"

Cultural Factors And Their Influence On Medications

Cultural Factors And Their Influence On Medications

In this written assignment, select one cultural factor such as health beliefs, language, perception of time, environment control, etc. (see textbook reading) and apply it to a selected ethnic group. The paper will include the following:

  1. One impact on medication preparation. Explain.
  2. Two impacts on medication administration. Explain.
  3. Two potential adverse reactions. Explain with rationale.
  4. One possible issue in adherence to medication regimen. Explain how this can be overcome.

The paper should be no more than 3 pages. Use APA Editorial Format for all citations and references used

What Students Are Saying About Us

.......... Customer ID: 12*** | Rating: ⭐⭐⭐⭐⭐
"Honestly, I was afraid to send my paper to you, but splendidwritings.com proved they are a trustworthy service. My essay was done in less than a day, and I received a brilliant piece. I didn’t even believe it was my essay at first 🙂 Great job, thank you!"

.......... Customer ID: 14***| Rating: ⭐⭐⭐⭐⭐
"The company has some nice prices and good content. I ordered a term paper here and got a very good one. I'll keep ordering from this website."

"Order a Custom Paper on Similar Assignment! No Plagiarism! Enjoy 20% Discount"

Community Assessment and Analysis Presentation

Community Assessment and Analysis Presentation

The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by the Commission on Collegiate Nursing Education (CCNE) and the American Association of Colleges of Nursing (AACN), using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, specific care discipline, and local communities.

This assignment consists of both an interview and a PowerPoint (PPT) presentation.

Assessment/Interview

Select a community of interest in your region. Perform a physical assessment of the community.

  1. Perform a direct assessment of a community of interest using the “Functional Health Patterns Community Assessment Guide.”
  2. Interview a community health and public health provider regarding that person’s role and experiences within the community.

Interview Guidelines

Interviews can take place in-person, by phone, or by Skype.

Develop interview questions to gather information about the role of the provider in the community and the health issues faced by the chosen community.

Complete the “Provider Interview Acknowledgement Form” prior to conducting the interview. Submit this document separately in its respective drop box.

Compile key findings from the interview, including the interview questions used, and submit these with the presentation.

PowerPoint Presentation

Create a PowerPoint presentation of 15-20 slides (slide count does not include title and references slide) describing the chosen community interest.

Include the following in your presentation:

  1. Description of community and community boundaries: the people and the geographic, geopolitical, financial, educational level; ethnic and phenomenological features of the community, as well as types of social interactions; common goals and interests; and barriers, and challenges, including any identified social determinates of health.
  2. Summary of community assessment: (a) funding sources and (b) partnerships.
  3. Summary of interview with community health/public health provider.
  4. Identification of an issue that is lacking or an opportunity for health promotion.
  5. A conclusion summarizing your key findings and a discussion of your impressions of the general health of the community.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA format ting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Functional Health Patterns Community Assessment Guide

Functional Health Pattern (FHP) Template Directions:

This FHP template is to be used for organizing community assessment data in preparation for completion of the topic assignment. Address every bulleted statement in each section with data or rationale for deferral. You may also add additional bullet points if applicable to your community.

Value/Belief Pattern

· Predominant ethnic and cultural groups along with beliefs related to health.

· Predominant spiritual beliefs in the community that may influence health.

· Availability of spiritual resources within or near the community (churches/chapels, synagogues, chaplains, Bible studies, sacraments, self-help groups, support groups, etc.).

· Do the community members value health promotion measures? What is the evidence that they do or do not (e.g., involvement in education, fundraising events, etc.)?

· What does the community value? How is this evident?

· On what do the community members spend their money? Are funds adequate?

Health Perception/Management

· Predominant health problems: Compare at least one health problem to a credible statistic (CDC, county, or state).

· Immunization rates (age appropriate).

· Appropriate death rates and causes, if applicable.

· Prevention programs (dental, fire, fitness, safety, etc.): Does the community think these are sufficient?

· Available health professionals, health resources within the community, and usage.

· Common referrals to outside agencies.

Nutrition/Metabolic

· Indicators of nutrient deficiencies.

· Obesity rates or percentages: Compare to CDC statistics.

· Affordability of food/available discounts or food programs and usage (e.g., WIC, food boxes, soup kitchens, meals-on-wheels, food stamps, senior discounts, employee discounts, etc.).

· Availability of water (e.g., number and quality of drinking fountains).

· Fast food and junk food accessibility (vending machines).

· Evidence of healthy food consumption or unhealthy food consumption (trash, long lines, observations, etc.).

· Provisions for special diets, if applicable.

· For schools (in addition to above):

· Nutritional content of food in cafeteria and vending machines: Compare to ARS 15-242/The Arizona Nutrition Standards (or other state standards based on residence)

· Amount of free or reduced lunch

Elimination (Environmental Health Concerns)

· Common air contaminants’ impact on the community.

· Noise.

· Waste disposal.

· Pest control: Is the community notified of pesticides usage?

· Hygiene practices (laundry services, hand washing, etc.).

· Bathrooms: Number of bathrooms; inspect for cleanliness, supplies, if possible.

· Universal precaution practices of health providers, teachers, members (if applicable).

· Temperature controls (e.g., within buildings, outside shade structures).

· Safety (committee, security guards, crossing guards, badges, locked campuses).

Activity/Exercise

· Community fitness programs (gym discounts, P.E., recess, sports, access to YMCA, etc.).

· Recreational facilities and usage (gym, playgrounds, bike paths, hiking trails, courts, pools, etc.).

· Safety programs (rules and regulations, safety training, incentives, athletic trainers, etc.).

· Injury statistics or most common injuries.

· Evidence of sedentary leisure activities (amount of time watching TV, videos, and computer).

· Means of transportation.

Sleep/Rest

· Sleep routines/hours of your community: Compare with sleep hour standards (from National Institutes of Health [NIH]).

· Indicators of general “restedness” and energy levels.

· Factors affecting sleep:

· Shift work prevalence of community members

· Environment (noise, lights, crowding, etc.)

· Consumption of caffeine, nicotine, alcohol, and drugs

· Homework/Extracurricular activities

· Health issues

Cognitive/Perceptual

· Primary language: Is this a communication barrier?

· Educational levels: For geopolitical communities, use http://www.census.gov and compare the city in which your community belongs with the national statistics.

· Opportunities/Programs:

· Educational offerings (in-services, continuing education, GED, etc.)

· Educational mandates (yearly in-services, continuing education, English learners, etc.)

· Special education programs (e.g., learning disabled, emotionally disabled, physically disabled, and gifted)

· Library or computer/Internet resources and usage.

· Funding resources (tuition reimbursement, scholarships, etc.).

Self-Perception/Self-Concept

· Age levels.

· Programs and activities related to community building (strengthening the community).

· Community history.

· Pride indicators: Self-esteem or caring behaviors.

· Published description (pamphlets, Web sites, etc.).

Role/Relationship

· Interaction of community members (e.g., friendliness, openness, bullying, prejudices, etc.).

· Vulnerable populations:

· Why are they vulnerable?

· How does this impact health?

· Power groups (church council, student council, administration, PTA, and gangs):

· How do they hold power?

· Positive or negative influence on community?

· Harassment policies/discrimination policies.

· Relationship with broader community:

· Police

· Fire/EMS (response time)

· Other (food drives, blood drives, missions, etc.)

Sexuality/Reproductive

· Relationships and behavior among community members.

· Educational offerings/programs (e.g., growth and development, STD/AIDS education, contraception, abstinence, etc.).

· Access to birth control.

· Birth rates, abortions, and miscarriages (if applicable).

· Access to maternal child health programs and services (crisis pregnancy center, support groups, prenatal care, maternity leave, etc.).

Coping/Stress

· Delinquency/violence issues.

· Crime issues/indicators.

· Poverty issues/indicators.

· CPS or APS abuse referrals: Compare with previous years.

· Drug abuse rates, alcohol use, and abuse: Compare with previous years.

· Stressors.

· Stress management resources (e.g., hotlines, support groups, etc.).

· Prevalent mental health issues/concerns:

· How does the community deal with mental health issues

· Mental health professionals within community and usage

· Disaster planning:

· Past disasters

· Drills (what, how often)

· Planning committee (members, roles)

· Policies

· Crisis intervention plan

PAGE

© 2011. Grand Canyon University. All Rights Reserved.

image1.jpg

What Students Are Saying About Us

.......... Customer ID: 12*** | Rating: ⭐⭐⭐⭐⭐
"Honestly, I was afraid to send my paper to you, but splendidwritings.com proved they are a trustworthy service. My essay was done in less than a day, and I received a brilliant piece. I didn’t even believe it was my essay at first 🙂 Great job, thank you!"

.......... Customer ID: 14***| Rating: ⭐⭐⭐⭐⭐
"The company has some nice prices and good content. I ordered a term paper here and got a very good one. I'll keep ordering from this website."

"Order a Custom Paper on Similar Assignment! No Plagiarism! Enjoy 20% Discount"

Review the healthcare agenda priorities of the current/sitting U.S. president and the two previous presidential administrations

To Prepare:

  • Review the agenda priorities of the current/sitting U.S. president and the two previous presidential administrations.
  • Select an issue related to healthcare that was addressed by each of the last three U.S. presidential administrations.
  • Reflect on the focus of their respective agendas, including the allocation of financial resources for addressing the healthcare issue you selected.
  • Consider how you would communicate the importance of a healthcare issue to a legislator/policymaker or a member of their staff for inclusion on an agenda.

The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page Fact Sheet)

Part 1: Agenda Comparison Grid

Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the two previous presidential administrations and their agendas related to the public health concern you selected. Be sure to address the following:

  • Identify and provide a brief description of the population health concern you selected and the factors that contribute to it.
  • Describe the administrative agenda focus related to the issue you selected.
  • Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.
  • Explain how each of the presidential administrations approached the issue.

(A draft of Part 1: Agenda Comparison Grid should be posted to the Module 1 Discussion Board by Day 3 of Week 1.)

Part 2: Agenda Comparison Grid Analysis

Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following:

  • Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?
  • How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there?
  • Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?

Part 3: Fact Sheet or Talking Points Brief

Based on the feedback that you received from your colleagues in the Discussion, revise Part 1: Agenda Comparison Grid and Part 2: Agenda Comparison Grid Analysis.

Then, using the information recorded on the template in Parts 1 and 2, develop a 1-page Fact Sheet or Talking Points Brief that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. You can use Microsoft Word or PowerPoint to create your Fact Sheet or Talking Point Brief. Be sure to address the following:

  • Summarize why this healthcare issue is important and should be included in the agenda for legislation.
  • Justify the role of the nurse in agenda setting for healthcare issues.

Agenda Comparison Grid and Fact Sheet or Talking Points Brief Assignment Template for Part 1 and Part 2

Part 1: Agenda Comparison Grid

Use this Agenda Comparison Grid to document information about the population health/healthcare issue your selected and the presidential agendas. By completing this grid, you will develop a more in depth understanding of your selected issue and how you might position it politically based on the presidential agendas.

You will use the information in the Part 1: Agenda Comparison Grid to complete the remaining Part 2 and Part 3 of your Assignment.

Identify the Population Health concern you selected.
Describe the Population Health concern you selected and the factors that contribute to it.
Administration (President Name) (Current President) (Previous President) (Previous President)
Describe the administrative agenda focus related to this issue for the current and two previous presidents.
Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.
Explain how each of the presidential administrations approached the issue.

Part 2: Agenda Comparison Grid Analysis

Using the information you recorded in Part 1: Agenda Comparison Grid, complete the following to document information about the population health/healthcare issue your selected

Administration (President Name) (Current President) (Previous President) (Previous President)
Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?
How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there?
Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?
Note: Part 3: of the Module 1: Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief is a 1-page Fact Sheet or Talking Points Brief the you will create in a separate document.

Agenda Comparison Grid Template

What Students Are Saying About Us

.......... Customer ID: 12*** | Rating: ⭐⭐⭐⭐⭐
"Honestly, I was afraid to send my paper to you, but splendidwritings.com proved they are a trustworthy service. My essay was done in less than a day, and I received a brilliant piece. I didn’t even believe it was my essay at first 🙂 Great job, thank you!"

.......... Customer ID: 14***| Rating: ⭐⭐⭐⭐⭐
"The company has some nice prices and good content. I ordered a term paper here and got a very good one. I'll keep ordering from this website."

"Order a Custom Paper on Similar Assignment! No Plagiarism! Enjoy 20% Discount"

Knowledge Worker And Nursing Informatics

The term “knowledge worker” was first coined by management consultant and author Peter Drucker in his book, The Landmarks of Tomorrow (1959). Drucker defined knowledge workers as high-level workers who apply theoretical and analytical knowledge, acquired through formal training, to develop products and services. Does this sound familiar?

Nurses are very much knowledge workers. What has changed since Drucker’s time are the ways that knowledge can be acquired. The volume of data that can now be generated and the tools used to access this data have evolved significantly in recent years and helped healthcare professionals (among many others) to assume the role of knowledge worker in new and powerful ways.

In this Assignment, you will consider the evolving role of the nurse leader and how this evolution has led nurse leaders to assume the role of knowledge worker. You will prepare a PowerPoint presentation with an infographic (graphic that visually represents information, data, or knowledge. Infographics are intended to present information quickly and clearly.) to educate others on the role of nurse as knowledge worker.

Reference: Drucker, P. (1959). The landmarks of tomorrow. New York, NY: HarperCollins Publishers.

To Prepare:

  • Review the concepts of informatics as presented in the Resources.
  • Reflect on the role of a nurse leader as a knowledge worker.
  • Consider how knowledge may be informed by data that is collected/accessed.

The Assignment:

  • Explain the concept of a knowledge worker.
  • Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker.
  • Develop a simple infographic to help explain these concepts.

    NOTE: For guidance on infographics, including how to create one in PowerPoint, see “How to Make an Infographic in PowerPoint” presented in the Resources.

  • Your PowerPoint should Include the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data that you could use, how the data might be accessed/collected, and what knowledge might be derived from that data. Be sure to incorporate feedback received from your colleagues’ responses.

A good example of a scenario that would benefit from access to data is a case where a healthcare centre wants to know the number of patients visiting on a daily basis so as to establish whether the available staff is enough.  Data of this nature can be collected by registering all the patients that come to seek medical services on a daily basis for a period of one month. Upon registering the patient, the data might be stored in the computer and retrieved when needed. The only people that will be allowed to access such information are the staff members (McGonigle, 2017).

The specific knowledge that will be derived from the data on a number of the patient visit is information on whether there is a shortage of labour force. In any case, the health facility will, for instance, establish that the number of patients visiting the facility is too high when compared to the available number of nurses; this will be taken to mean that there is a staff shortage. It will also be interpreted to mean that the current staff is being overworked and so the quality of health services being provided is more likely to be compromised (Sweeney, 2017).

A nurse leader can use clinical reasoning and judgment in the formation of knowledge from this experience to approximate the overall performance of the health facility being managed. The nurse leader could for example reason that since the health facility is understaffed, it may not be performing well. The nurse leader could judge that the patient feedback is more likely to be negative suggesting poor performance. This is due to the fact that feedback from the patients is one of the tools used to tell whether a health facility is performing well or not (McGonigle, 2017).

References

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1).

**Attached is an example of one presentation**

(8 to 10 slides)

What Students Are Saying About Us

.......... Customer ID: 12*** | Rating: ⭐⭐⭐⭐⭐
"Honestly, I was afraid to send my paper to you, but splendidwritings.com proved they are a trustworthy service. My essay was done in less than a day, and I received a brilliant piece. I didn’t even believe it was my essay at first 🙂 Great job, thank you!"

.......... Customer ID: 14***| Rating: ⭐⭐⭐⭐⭐
"The company has some nice prices and good content. I ordered a term paper here and got a very good one. I'll keep ordering from this website."

"Order a Custom Paper on Similar Assignment! No Plagiarism! Enjoy 20% Discount"