Effects of Hydroxyurea Therapy


Institutional Affiliation

Conceptual Framework Design/

Sample/ Setting
Major Variables Studied and
Their Definitions

Measurement of Major Variables

Study Findings
Strength of the Evidence (i.e., level of evidence + quality [study strengths and weaknesses])
Author, Year, Title


Platt, O. (2008). Hudroxyurea for the treatment of sickle cell anemia. The new England Journal of medicine, 1362-1369.


RCT N=299

Age=18 years and above


Delivery; doses of 15-20 mg/kg/day with the possibility of increasing it to 35 mg/kg/day

IG; administration of placebo and hydroxyurea to adults who had experienced three painful crises at least. Follow to a maximum of 9 years for qualified correspondents.



IV= Hydroxyurea treatment


DV= sickle cell disease, prescription of myelosuppressive drugs.

Observation of responses or side effects from the initial dose of Hu of 10-12 mg/kg/day.

Patients divided into two different groups based on the 10-15.9 mg/kg/day and 16 to 26 mg/kg/day doses of HU.


Chi-square test



Incidence of painful crises reduced on average from 4.5 to 2.5 per annum.

Reduction in mortality for patients receiving hydroxyurea by 40%

Level of evidence: III


Limitation: the lack ofinformation on the effect of the drug on children is lacking


Strength: indicatesa dependable attempt to study the reduction of side effects of drug.


↑ Applicability: can be used to reduce splenic dysfunction, secondary stroke and even cerebral artery stroke

Author, Year, Title


Segal, J., Stouse, J., Beach, M., & Haywood, C. (2008). Hdroxyurea for the treatment of Sickle cell disease. AHRQ Publication.
No Observational study  IG: analysis of articles that are included and used by MEDLINE, EMBASE, TOXLine and Cinahl up until the 30thJune 2007.



IV: Hydroxyirea therapy


DV: Sickle cell disease


The research team was paired into reviews of two who compared every article’s abstract and title as the best means of establishing eligibility for the program. Information and datawas abstracted in a sequential format with each being independently graded based on the evidence. Grading scheme provided by the GRADE WORKING group

The WHO Collaborating Centre for Drug Monitoring

In a small randomised exercise, children who were hospitalised with HY was lower than placebo, at 1.1 and 2.8 respectively with p=0.02

A lager randomized exercise studying the efficacy of HU in adults posted an increase of HbF% in the first two years by 3.2%.

The median number of painful side effects was lowerthan that of successful treatments as they constituted 44% with p<0.001

Level of evidence: I


Strength: Positive outcome of results.


Limitation: information is sourced from other research exercises.


↓applicable to research programs on sickle cell disease.



Author, Year, Title


McIntyre, B. (2010). NTP research concept; Hydroxyurea. NTP toxology branch.
No Cross sectional study  

IG: exposing rodents to hydroxyurea and observing the neonatal and prenatal developmental periods for the adverse effects of the drug.

IV: Hydrocabamide therapy



DV: Malformation, Neural behaviouralobservations, immunity, carcinogenicity, exposure.

Provide dosages for pregnant rat during the last phase of gestation as earlier administration is seen to result in resorptions with direct dosages of subsequent offspring.

The execution of perinatal carcinogenesis study in the rat as well as a 2-year bioassay on the sampled animal.

t-tests The establishment of long term effects of exposure to postnatal and prenatal hydroxyurea as well as effects on post-natal development.

Effects of hydrourea on neurotoxicity, carinogenirs and reproductive function.


Level of evidence: I


Limitation: studies on the effects of hydroxyurea are arguably at the human testing phase.


Provide insight to the long term effects of the drug as well as the consequences of its use on infants and pregnant mothers.

Applicability; to further research on the prevention of the spread of sickle cell disease from mother to child.




Author, Year, Title


EPR. (2014). Evidence based management of sickle cell disease. Washington: U.S department of health and Human Services.
No Observational study N=54

IG: analysis of human studies that were published from 2007 to May 2010 in English that addressed in PICOS Query.

IG(B); Analysis of Publications from The 2008 National Institutes’ OF Heath Consensus Conference on Hydroxyurea


IV: Hydroxyurea

DV: sickle cell disease

Systematicreview of effectiveness, harms,barriers and effaces of using hydroxyurea as SCD treatment.

Three different trials on case studies.




Lower annual rates of pain crises with median at 2.5 per year as opposed to 4.5 of no pain full treatment)

Longer time to accomplishinitial study at 3 months.

Second crisis on study took even longer at a mean of 8.8 moths.

There was a reduction of need for blood transfusions at 48 patients to 73.

There was an increase in HbF from 5.0 to 8.6 %.

An increase in total haemoglobin at 0.6 g/Dl.

Level of the evidence: II


Limitation: there was a limited number of correspondents.


Strength: Information indicated a positive outcome in the studies.


Author, Year, Title


Wang WC, O. S. (2013). Hydroxyurea is associated with lower costs of care of young children with sickle cell anemia. Pediatrics.
No Cohort study AGE= 1-3 years

IG; The research team collect information from the BABY HUG study as well as insurance claims data and applied that information as a means of understanding the healthcare expenditure that is associated with HU treatment for infants with sickle cell anaemia.

IV: hydroxyurea.

DV: sickle cell disease, medical costs, insurance, infants

Analysis of information from seven states involved in the Registry and surveillance for Hemoglobionpathies project.

Execution of the Public HealthResearch Epidemiology and Surveillance for Hemoglobinopathiers project in Mississippi, Georgia and California.

SPSS software

Paired samples t-test

Independent sample t-test



Infants receiging treatment have lesser hospital stays making a 305 of all patinets receiving care.

The average Medicaid riembursements for admissions based the total cost of hospital care with $1.8 million forthose receing treatment in two yers and $2.5 million for those on a diferent tretment. The annual hospital bill averaged $9,450 and $13,716 respectively. Pioutpatient costs were $1,622 and $246 respectively.

Children receign treament has a total reduction cost avaraging at 21%.

Level of evidence: III


Limitation: limited to cost of treatment information.

Strengths; promotes advocacy for the treatment as the best cost effective means of addressing the problem.




EPR. (2014). Evidence based management of sickle cell disease. Washington: U.S department of health and Human Services.

McIntyre, B. (2010). NTP research concept; Hydroxyurea. NTP toxology branch.

Platt, O. (2008). Hudroxyurea for the treatment of sickle cell anemia. The new England Journal of medicine, 1362-1369.

Segal, J., Stouse, J., Beach, M., & Haywood, C. (2008). Hdroxyurea for the treatment of Sickle cell disease. AHRQ Publication.

Wang WC, O. S. (2013). Hydroxyurea is associated with lower costs of care of young children with sickle cell anemia. Pediatrics.
































Social Cohesion as the Basis of Morality

Social cohesion or integration can be described as a set of characteristics that hold a group or community closer together, enabling it to function as a single unit. Among these characteristics include shared values and culture among others[1]. From a sociological point of view, social cohesion is seen as a structural issue describing how the different parts or sub-groups within the larger group interact with each other to function as a whole. Communities are made up of different individuals, families, social institutions, and different age groups, who interact with each other effectively to promote their culture and shared values[2]. Morality refers to a system or doctrine of principles that distinguish between right and wrong behavior. Individuals are expected to conform to established guidelines and principles of morality in their groups or communities[3]. Of note, however, is the fact that different groups have different sets of moral principles. Thus, morality standards for one group may vary with those of another group. Besides, conformity to the moral standards is seen as one of the crucial aspects of social cohesion. Therefore, this paper asserts that social cohesion is the basis for morality.

For a long time, sociologists have theorized that social cohesion is the basis or foundation for morality in a society. This argument has been expounded and explained through various theories and models in sociology over the years. Among the most notable sociologists who have promoted the notion of social cohesion as the basis for morality include Emile Durkheim, Henri Bergeson, and Adam Smith.

In general terms, communities or groups are able to regulate the morality of their individuals if they are held closely together. The more tight the group is, the easier it will be for it to regulate morality. Essentially, morality of individuals within a group can be regulated and monitored through different approaches including social norms and incentives.These are the two main motivations that drive individuals to act morally[4]. Social norms are the specific standards that a community accepts as the ideal measures of desirable and acceptable behavior. The norms can be conventional or explicit and could range from dress codes to how an individual ought to conduct himself or herself within the community. Ignoring the norms can result in disciplinary actions.

Incentives are rewards that individuals receive for performing something or doing some desirable acts. On the other hand, if people act in a manner that is not remarkable and contravenes the rules, regulations, and conventions within the community, they will be punished. Each society has its system of incentives and punishments to help motivate people to act in a certain way[5]. For example, good people who exemplify the community’s values will be praised, given leadership roles, and more responsibilities in the community. On the other hand, those who contravene the acceptable standards in the community will be rebuked.

According to Emile Durkheim, the society is the sole determinant of the moral phenomena. He argues that morality is a collective element which characterizes the society as a whole. In his moral theory, Durkheim introduces the concept of social facts to describe the various aspects of the collective life of a group or community, which influence the behavior of individual members within the group.  He also criticizes the belief in a priori moral standards, which rely on logical or abstract reasoning to create ethical or moral standards[6]. Rather, he recommends treating the moral phenomena as a concept conditioned by both social and historical factors. With time, each society or community is able to create its   sets of moral principles, which may vary in different degrees to those of other communities. Therefore, a society’s moral principles are based on its existential needs, which make its code of ethical or moral principles unique. Therefore, Durkheim states that in order to for one to understand the moral values of a particular community, it is important to understand its socio-historical development.

Durkheim’s moral theory also distinguishes between moral rules and other sets of rules that may be found within a community. Morality has unique qualities such as desirability and its obligatory nature, unlike other rules in the community[7]. Community leaders act as the central source of authority for enforcing morality within the community, thereby creating an external force demanding individuals to behave in a certain way[8]. Therefore, obligation is seen as one of the most crucial aspects of morality. Similarly, individuals often willingly accept the obligatory nature of the moral principles in their community as they view the moral principles as being beneficial to them in the long run. Durkheim also sees a close relationship between mo0rality and religion.

Therefore, based on these arguments, Durkheim is able to show that the society, as a whole, plays a very vital role in creating and enforcing morality[9]. This morality is often based on the society’s socio-historical developments over the years, which result in the community becoming more integrates in terms of its leadership structure, division of labor, and specialization where each person depends on each other for their own survival as well as the survival of the community at large[10]. Thus, the closer the community is held together, the more influential their moral principles will be on individual members.

In conclusion, social cohesion is relevant matter of discussion in the world today. The argument that can be used to support such intuition is that many of the world’s societies thrive on social relationships and bonds. Evidence presented in the course of discussion show that social cohesion highly impacts the notion of morality. In simple terms, the concept of morality is instrumented by the way people maintain certain bonds in the society. Subsequently, morality guides the way people behave and reason within the society. Thus, social cohesion is the defining element of the concept of morality in the modern world. The relationship between social cohesion and morality is that the social cohesion generates the latter by formulating the platform of existence. The argument on such a matter is that when there is the understanding of group or societal bonds, there is the willingness to meet the moral obligations.























Pickering, Sharon, Jude McCulloch, and David P. Wright-Neville. 2008. Counter-terrorism policing community, cohesion and security. New York: Springer.

Herbert, David. 2013. Creating community cohesion: religion, media and multiculturalism. Basingstoke: Palgrave Macmillan.

Shin ,Hyesun, and Margaret Jane Wyszomirski. 2015. Promoting trust building in a unified Korean society: the arts-based policy strategy for social cohesion. Columbus: Ohio State University.






[1]Shin ,Hyesun, and Margaret Jane Wyszomirski. 2015. Promoting trust building in a unified Korean society: the arts-based policy strategy for social cohesion. Columbus: Ohio State University.

[2]Pickering, Sharon, Jude McCulloch, and David P. Wright-Neville. 2008. Counter-terrorism policing community, cohesion and security. New York: Springer.

[3]Pickering, Sharon, Jude McCulloch, and David P. Wright-Neville. 2008. Counter-terrorism policing community, cohesion and security. New York: Springer.

[4]Pickering, Sharon, Jude McCulloch, and David P. Wright-Neville. 2008. Counter-terrorism policing community, cohesion and security. New York: Springer.

[5]Herbert, David. 2013. Creating community cohesion: religion, media and multiculturalism. Basingstoke: Palgrave Macmillan.

[6]Shin ,Hyesun, and Margaret Jane Wyszomirski. 2015. Promoting trust building in a unified Korean society: the arts-based policy strategy for social cohesion. Columbus: Ohio State University.

[7]Shin ,Hyesun, and Margaret Jane Wyszomirski. 2015. Promoting trust building in a unified Korean society: the arts-based policy strategy for social cohesion. Columbus: Ohio State University.

[8]Herbert, David. 2013. Creating community cohesion: religion, media and multiculturalism. Basingstoke: Palgrave Macmillan.

[9]Herbert, David. 2013. Creating community cohesion: religion, media and multiculturalism. Basingstoke: Palgrave Macmillan.

[10]Herbert, David. 2013. Creating community cohesion: religion, media and multiculturalism. Basingstoke: Palgrave Macmillan.


Community Health Nursing




Community Health Nursing.





Institution Affiliation:












Community health nursing refers to the creation and establishment of public health practices as well as nursing to endorse and protect the health status of the community at large (Gauwitz, 2007). It entails combination of all the elementary fundamentals of clinical expertise, nursing with public health and community practices. This implies that community health nursing is a fusion of both primary healthcare and nursing practices in line with public health nursing. Community health nurses endeavor to ensure continuous and comprehensive practices that are deemed preventive, curative as well as rehabilitative holding onto the belief that concentrated care on an individual, family or group results to a healthy community. In addition, it is notable that community health nurses are supposed to execute their duties remarkably to all members of the community explicitly without favor or discrimination. Through working with the entire community, the nurses are able to enlighten people on health issues thereby elevating community health, safety as well as accessibility to care.


Community health nursing is a population focused practice which requires unique knowhow, skills as well as competencies. It encompasses working with communities and the demography as equal partners in focusing on primary prevention as well as health promotion. Thus, the public health nurses work industriously to improve a community’s health and prevent diseases since they believe that a person’s health is affected by elements such as genetic makeup, environment and lifestyle. In this regard, they avail screening services, preventive care, direct health care services and above all health education. Relaying useful and informative information to the community on how to improve their health status forms their core agenda. Thus community health nursing is very crucial for every community in order to ensure elevated health standards which in turn increases their productivity thus, improving their living standards (Harkness & DeMarco, 2012).

Notably, there are numerous shortcomings that influences the overall health status of a community. Therefore, the community health nurses are entitled to identify these challenges and devise effective models of educating the community on ways to avoid them and also provide care to affected persons. This information is relayed via organization of demonstrations in schools, senior centers, local groups, and community groups. The nurses explain proper nutrition, early detection of prevalent ailments, risk factors, safety practices and above all how to care for the disabled persons in the community. Moreover, the nurses educate the community on simple first aid practices that they can offer to anyone suffering from maladies such as nose bleeding, fainting, and poison consumption just to mention a few.

It is notable that infectious diseases such as tuberculosis are likely to spiral out of control mostly in urban areas due to overcrowding. Health status of children is also under great threat of preventable diseases, violence, accidents, and environmental toxins. In this case, community health nursing is very crucial to ensure improved health conditions for children via educating the community on provision of conducive environment for children growth (Harkness & DeMarco, 2012). Additionally, they inform parents regarding the importance of vaccination for their children. Notably, community health nurses are mandated to move door to door in a community providing vaccination to all liable children so as to ensure a healthy community. This activity plays a great role in eradicating the menace of unequal access to health care services. Unequal access to health care services as well as insurance coverage which are crucial in a community to bolster the health standards lead to elevated instances of morbidity amongst infants, expectant women and other vulnerable members of a community.

Working as a community health nurse is excellent since one is able to combine their love for nursing and that of their community thus reducing morbidity rates. The community health nurse is supposed to keep the health standards of the community in question under control. The primary duty of a community health nurse is to provide treatment and education to the members. They often provide affordable care to all members inclusive in a community. These nurses work together with other health professionals such as highly qualified doctors to ensure improved health care for the citizens. Noticeably, healthcare nurses in a community also focus on preventing an outbreak from sweeping over the whole community (Gauwitz, 2007). Some exemplary examples of maladies that would affect a community at large includes influenza, HIV and AIDs, teenage pregnancy, substance abuse, obesity, and many more.

In order to prevent the tremendous impacts of these ailments, the community health nurses circulate throughout the whole community interacting directly with community members, handing out informational fliers to the members to educate them on the diseases and how they can be prevented and  also spreading a word about the common means of avoiding and preventing certain health issues. In some instances, the nurses are required to distribute health related items such as mosquito nets to reduce the number of malaria patients, free condoms to prevent increased teen pregnancies and sexually transmitted diseases (STDs), as well as medication to already infected persons (Harkness & DeMarco, 2012). It is also notable that the community health nurses administer vaccinations and immunizations to all pertinent individuals in a community in order to protect them from contagious diseases. The community health nurses are normally concerned about the health of the whole community in general rather than that of individuals.

Community health nursing also plays a very significant role of advocacy in a community. Through community health nursing, a community is able to present its grievances to both the political leaders and health providers. The community health nurses play this role by writing proposals, for example, to the government requesting for funding of health facilities thus ensuring free or affordable health care services for a community consisting of low income earners. In addition, they make it easy for the members of community to access high standard healthcare for those with critical conditions through being the link between the patients and the highly competent practitioners (Holzemer & Klainberg, 2012). Community health nurses also book appointments and recommend the critically ill patients in the big hospitals in order to acquire quality medical attention the soonest possible. Thus, it is notable that the community health nurses aid a great deal in reducing mortality rate which is prevalent with infants, pregnant women, and the aged.

Through community health nursing, root causes of particular ailments affecting members of a community are pinpointed subsequent to critical analysis and interpretation of research findings. The community health nurses conduct thorough research leaving no stone unturned in their endeavor to discover risk factors causing particular maladies associated with a community. Unravelling of such risk factors is important since it leads to implementation of measures which controls or completely eliminates them. In addition, loopholes affecting the health standards of the community are identified during research and means of mending them are developed thus improving health status. A healthy community results to a productive community thus reduced death rates. Research also aids in identification of the best lifestyle to be adopted in a community to prevent instances of increased health complications.

Community health nurses participate in improvement of health outcomes of a society via promoting expansion and improvement of healthcare facilities and infrastructures for monitoring as well as managing ailments (Holzemer & Klainberg, 2012). They also organize programs such as Special Supplemental Nutrition Program for Women, Infants and Children (WIC). Such programs facilitate administration of effective baby assessments, newborn screenings and vaccinations which considerably improves community health. Notably, the community health nurses also bear high adaptability as well as willingness to offer health care services in almost all kinds of a community setting such as in community health clinics, schools, churches, homeless shelters, and individual homes.

Communities are dynamic with diverse needs and thus flexibility and adaptability are crucial attributes that public or community health nurses should have.Additionally, they offer comprehensive care at organized events such as health fairs and exhibitions, at agencies and institutions providing medical services, to patients ailing from specific diseases. It is notable that community health nursing provides corporate wellness programs thus, supporting health and productivity of a community. Community health nursing also facilitates partnership amongst diverse partners which fosters addressing of complex health challenges faced by a community.

In the contemporary health care sectors, community health nursing is catapulted in the middle of emergency response plans unlike in the traditional set up where the law enforcers and emergency response professionals are responsible for emergencies. Currently, community/public health nurses are considered as the first persons to respond to emergencies. They are required to offer first aid before the patients get to hospitals in order to control issues such as excessive bleeding. This implies that community health nursing is deemed important in preventing increased death rates or worsened conditions in case of an emergency (Holzemer & Klainberg, 2012). However, it is unfair that the community health nurses are not paid as much as their counterparts in the healthcare institutions despite them executing numerous mandates for a community to ensure high health standards.


Community health nursing is crucial in ensuring improved health standards for all the members. It also facilitates cooperation and participation of all the members in adopting recommendable lifestyle that results to improved community health and productivity. Notably, community health nursing both at generalist and advanced level is based on competence. The public health nurses are required to be highly qualified bearing essential skills to handle any health issues that may arise in a community. Additionally, they are supposed to bear adaptability and flexibility since communities are dynamic and diverse with people bearing different needs and preferences. The core mandate of a community health nurse is to provide affordable treatment to community members at convenient places and information dissemination regarding prevalent ailments as well as how they can be avoided. Notably, roles of the contemporary public health nurses evolve from the Patient Protection Affordable Care Act (PPACA)which denotes thatit’s essential to stress collaboration as well as partnership with communities and populations. It is also notable that the community health nurses play advocacy roles to ensure funding of health care services for low income earners in a community.  Therefore, it can be concluded that community health nurses act as advocates, educators, partners, collaborators, policymakers and researchers in a community in order to ensure improved community health.





Gauwitz, D. F. (2007). Community Health Nursing. Clifton Park, NY: Thomson Delmar Learning. Print.

Harkness, G. A., & DeMarco, R. (2012). Community and Public Health Nursing: Evidence for Practice. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Holzemer, S. P., & Klainberg, M. (2012). Community Health Nursing. Sudbury: Jones & Bartlett Learning. Print.






Homosexuality in China





Homosexuality in China

Homosexuality has for long been a taboo in China. However, this standpoint has changed dramatically over the recent past. Homosexuals have been coming out publicly to demand for their right to marry and get married. Homosexuality has been defended as being a new way of life. As the society changes, so does the perception on fundamental societal issues such as marriage. In the current Chinese generation, homosexual is common social phenomenon. The modern Chinese generation can accept gay, lesbian or bisexual in their daily life. However, this is not the case with the older generation.  Indeed, it is because of the fear of the older generations that most gays and lesbians are not free in the Chinese society.  For example, fake marriage is the normal problem in nowadays. Most of the homosexual are still afraid to tell their family that they are not straight. So they pretend to marry with a straight person. This marriage will hurt both sides. China’s attitude toward homosexuality is beginning to shift. More and more people will not discriminate homosexual but still cannot accept it. This paper will show how the homosexuality lived before 1997; how do they face to the discrimination and fight for their rights; how do heterosexuality treat or think homosexuality nowadays.

Although there has been asexual revolution in China, homosexuality was not accepted in China before it was not made legal in 1997. Majority of the people perceived homosexuals as being a burden to the society (O’Connor). To this end, gays and lesbians in China faced immense discrimination because of their sexual orientation. They were perceived as going against the societal norm where individuals are expected to be sexual straight.  To most people, sex refers to biology, to anatomical parts, and, with the exception of those who are born as hermaphrodites or with ambiguous genitalia, is either male or female. However, the term gender itself does not mean male or female, it means feminine, masculine, or neutral, and is created by which characteristics, behaviors, and expressions society and culture choose to put under each of those categories. In psychology one would frequently refer to “gender differences” rather than “sex differences” (Galli 34).

Before 1997, homosexuality did not have a place in China. For most parents, homosexuality was restricted because of the effect that the acceptance of gay marriage as a form of marriage will have on their children.  To them, the main concern was that if the lobbying for the recognition of homosexuality succeeded it will become legally accepted just like heterosexual marriages. This means that many aspects of marriage will change. In school, the definition of the family will have to change (Outright International). Children will be taught o treat heterosexual relationships as equal to gay relationships.  Obviously, not many parents were willing to get that low. Most parents would desired to take their children to school knowing that the school will not teach them to accept gay or any other forms of non-straight relationships.

In china, homosexuality has been forced on to the society by the insufficiency of bisexual partners in China. With the government of China implementing the “one child” policy, the sex ratio in China was massively interfered with. Because of the “One Child” policy many families that had found their first born being a female Child have had to give birth for the second child in the hopes of getting a male child. By 1892, barely 4 years after the “One Child” policy took effect, the sex ratio at birth was found to be 100 girls for 108.5 boys (Dodge and Elizabeth 22). By the early 1990s, the figure has risen to 117 boys for 100 girls (Dodge and Elizabeth 14). In various ways, the “One Child” policy creates in imbalance in the sex ratio. Because the policy required couples to have one child and because the male child in preferred in the Chinese society, many couples has had go through selective abortion in order to get children of their desired sex (Zhou 487). Besides, some parent have had to hide their female children from the census official and so the numbers of female children is not well recorded in China. Over the years, the numbers of orphaned and abandoned children have been on the rise, with most abandonment attributed to the “One Child” policy. Because of female infant neglect and infanticide, the number of brides in China has been on the decline and many Chinese men have had to spend their lives as bachelors.

China has been suffering an acute shortage of females. The preference of male children let too many girl children being killed or abandoned at young age.  Most females are killed when they are still young to pave way for the birth of boys.  As has been indicated, this has impacted on the sex ration in the Chinese society. Besides it has created new problems. Many men have been left without wives. This situation has led to an increase in human trafficking. Bride abduction has become almost a norm in various provinces in China. Crackdowns in human trafficking have freed thousands of brides who had been abducted (Outright International). Males who are not able to find mates have also been pushed to satisfy their sexual urges through other means. Smuggling of prostitutes in China has been on the rise in the recent past. This has provided the space for the development of a sex industry that is controlled by criminal gangs. Most of the females who are used in this racked are drawn from other Asian countries, such as Philippines.  The girls are used to meet the sexual demands of many men who have been unfortunate to miss out on marriage partners. Besides, this trend has led to the expansion of pornography industry in China. Further, gay relationships have also been shown to be on the rise.

In conclusion, homosexuality has had a relatively rough relationship with the Chinese society. While it might be legally accepted for people of same sex to get into relationship, homosexuality is still considered to be out of touch with the Chinese culture. Many people, especially of the old generation, still consider it to be an erosion of the Chinese culture.  However, the current generation if open about homosexuality and consider it to be a personal decision rather than going against the culture. As such, gays and lesbians have found some reprieve, although they still have to conduct their affairs in secrete.











Works Cited

Dodge, Patrick Shaou-Whea, and Elizabeth A. Suter. “It’s Okay To Have A Girl”: Patronymy And China’s One Child Policy.” Women & Language 31.1 (2008): 13-22.

Galli, Moly. “Is they gay marriage debate over?.” Christianity Today, (2009)53:7, 30-33.

O’Connor, Andrew. “The Rise of China.” 12 Mar. 2012 Web. 11 Aprl. 2016. <http://www.rba.gov.au/econ- compet/2012/pdf/second-prize.pdf>

Outright International. “China: the legal position and status of lesbian, gay, bisexual and transgender people in the people’s republic of china”. 2016. Web. 10 Aprl. 2016 <,https://www.outrightinternational.org/content/china-legal-position-and-status-lesbian-gay-bisexual-and-transgender-people-people’s&gt;

Owell, Bill. “China’s Big Closet.” Newsweek Global 163.12 (2014): 18-20.

Zhou, Yanqiu Rachel. “Homosexuality, Seropositivity, And Family Obligations: Perspectives Of HIV-Infected Men Who Have Sex With Men In China.” Culture, Health & Sexuality 8.6 (2006): 487-500.





















Question 1

The Divine Command Theory defines morality as being in accordance with God’s command. Moral obligatory actions are justifiable before God. This Divine Command Theory is, therefore, ethical in itself. Divine believers of both monotheistic and polytheistic paths of faith acknowledge God’s significance of restoring morality in the past and present generations. The theory further suggests that moral uprightness does not entirely rely on God but is supported by divine rules. Although this theory has been challenged by several philosophers in the past, it still holds that moral obligation is regarding obedience to Gods requirements.

The opposite is quite true in that immoral actions are termed immoral since they are against God’s command. The major question that helps identify the position of the Divine Command theorists is widely known as the Euthyphro dilemma that is contained in the dialogue Plato; a well-respected philosopher (Engel 56). In simple terms, the question is presented as “Is what is morally good commanded by God because it is morally good, or is it morally good because it is commanded by God?” This question continues to feature in theological and philosophical arguments up to date. Several responses by theorists emerged under the dilemma.

Firstly, some responded by accepting that if God does not command evil such as cruelty, then inflicting it upon fellow men would be morally obligatory. Thomas Aquinas responded by arguing basing on human nature. He says that people are made in the nature they possess and are required to live according to God’s love and other people so as to be fulfilled as human beings. Nonetheless, the Divine Command Theory has been criticized in many ways. The         Bible has been blamed for dictating harsh punishment to errant children, the mentally ill, animals, the divorced, non-believers. This is evident in scriptures such as Exodus 22:18. Sin is evil. This has manifested in children and young people during historical times but was condoned. Torture in this theory is seen through the kind of slavery while theorists firmly believed that God has no problem with the act. A story told of a clergy who impregnated his wife despite being warned by a physician. The moral behind this is temptation. Later on, his wife passed on, and no one condemned him. This can be seen as silent praiseworthy which is totally wrong.

Question 2

Ethical Egoism states that it is necessary and sufficient for an action to be regarded as morally correct if it brings fulfillment of oneself. Ethical egoism does not only talk about the human achievement of self-interest but also relates to qualities. It argues that one must interact with others in a positive way to gain friendship and protection. How one acts regarding others determines how people around will act in return (Engel 60). Ethical egoism faces some challenges in that it is viewed as a violation of other moral theories particularly in what psychological theology believe I cannot aim at what I cannot do. Other problem includes the fact that one could want to see morality being practical which is not a necessity.

Moral judgments are meant to keep people free from irrational ideas. The issue of duty comes in ethical egoism in that one has a duty of helping others so as to make the world a better place. However, it does not mean one is good enough by helping others. Moore’s argues that ethical egoism is inconsistent since one can recommend other people to try what him /her objects just to be seen morally upright. Rachel goes on to add that we need to have more foresight on what we do since our interests should reflect what we want for our society to experience. The other problem with this Ethical Theory is the fact that most ethicians think that it is a public guide to behavior yet it is not  (Hirst 43). Moral theories are expected to flourish human beings which are not the case of ethical egoism, which causes a man to prevent others from succeeding. The theory suggests that recreational torture is immoral. Ethical egoism goes against considered moral intuitions that are condemned by the society.

Question 3

In his article of Immorality in Eating Meat, Engel is trying to show that a morally upright man would never eat. He argues that man should take steps by avoiding meat to make the world a better place for animals. Basing on religion; it is immoral for anyone to eat meat. This reasoning is not regarded on any moral theory since it is morally wrong to eat meat as presumed by Engel. The five number examples given by Engel aim at projecting his argument that animal farming is insignificant and wastes the environment in a bid to produce food. In his case of energy intensive, he argues that to acquire 1kcal of animal protein, 28 kilocalories of fuel is needed while it only takes 3.3 kilocalories of energy to get 1kcal of plant protein.

Animal farming is considered inefficient compared to crop planting since it wastes several litres of fresh water. He further goes on to suggest that keeping animals is nutrient inefficient because nearly all grain fed on livestock is never regenerated. In the U.S, for instance, oats and corn are fed to livestock. Increasing demand for the crops results in over cultivation thus soil erosion is due to occur. Livestock produces quite large excretions that amount to 1 billion tons a year. Water from streams, rivers and lakes are continually used to appoint that the structure of underground water is affected and water bodies impaired.

Question 4

Engels evaluation of “Free Range” Fantasy and Consistency in the Utilitarian Gambit is exclusive. Following Engel’s argument that eating meat from farming is immoral and is bound to cause pain, the following objection emerged. This complaint states that there is no reason for our beliefs to entitle us to immorality just because of consuming meat from animals raised in a free range and killed painlessly. Engel replies to the objection of Utilitarian Gambit of thugs and gustatory by pronouncing that people do not take into consideration the human acts of pleasure that cause suffering to animals (Hirst 33). An example of thugs getting away with the evil act of burning a cat and the case of skinning a live dog for meat are considered satanic.

Despite the fact that gustatory benefits are obtained, still the act is bad.  In both cases, the animals would have escaped suffering had it not been the immoral act of man. Free range birds and animals consistently get killed illegally and eaten as food. He further goes on to convince that man’s actions of eating factory meat makes them immoral following the fact that they admit that 90% of meat people eat is not good for their health.

The Two-Edged Sword argues that consistency does not demand one to stop eating meat. Engel comes in to say that if beliefs dictate that eating meat is immoral, then by eating animal meat human beings become immoral. Engel responds to this by arguing that it is worse to kill a sensual animal compared to killing plants for food since plants have more nutritious value. Engel disputes that meat is not a necessity citing an example of world class vegetarian athletes who seem totally healthy.


Question 5

James Rachel has had a great contribution towards the safeguarding of animal right. In the article; “Do Animals Have Rights” James Rachel is trying to say that animals though non-human are to be treated right. Following the case of chimpanzee, Rachel states that smart intelligence should be allowed through education.

Fundamentally, he is trying to make people understand that to determine how an individual is to be treated; one should consider the features of those treating the person. According to James Rachel Human Rights are the freedoms accorded to human beings in a way that they restore their moral status in the society and to be allowed to do what does not bring significant harm to them. Animals are referred to as human beings since they also have moral standing. The right of not to be tortured is accorded to both mankind and animals. This is simply because both parties are very much similar in that they feel pain if harmed in any way. The right to worship by Rachel suggests that if truly God exists, then he deserves to be worshipped. Worship of any other being is blasphemy. In explaining the right to property, Rachel uses the example given by Locke. The man is said to own labor and work of his hands making labor appear as property.

The right to liberty is imperative in the history of manifestos. In the same way, animals are entitled to liberty. A good example of humans harming animals’ right to liberty denies them their natural right by taking them to captivity in zoos. Animals here will not function as they would be in their natural setting. The rhesus monkeys, for instance, have been found to have compassion. This means man just like the monkeys has moral virtues. Unfortunately, this feature has not been preserved by humanity. Squirrels also had been partly denied liberty because when it collects nuts, man goes to pick the nuts where the animal placed. Another vital example is that of the baboon colony in the zoo. Their numbers have been limited in London, for example, by destroying the female baboons. In Africa, they are observed to live peacefully in colonies.

Question 6

The principle of utility is considered as an analysis of action on account of whether it instills happiness on those affected by the action. In section 1 Bentham argues that nature has contributed to the governing of mankind through pain and pleasure. The principle acknowledges that the two forces dictate what people think, do, say. Section 2 goes on to say that moral science is to be modified but not without use of metaphor and declamation. This chapter also explains that this principle is responsible for approving or disapproving actions about how it impacts on others (Hirst 46). It is seen that property in any object whether the whole community or a single person is responsible for happiness or unhappiness in that particular purpose. The general interest of the community is what each member of that community feels thus; this can be viewed regarding morals. To get the clear view of the community, one must evaluate each person. An action is then said to be according to utility if it fulfills the community.

Chapter of Value of a Lot of Pleasure or Pain, How to be Measured concentrates on analysis on measurement of pain and pleasure. This aims at how non-human animals should be treated whose utility is a challenge to estimate. Pleasure or pain for a person is determined by intensity, duration, certainty and propinquity of the accompanying events. For proper analysis to be completed, purity and fecundity are included in the assessment tools. Bentham however, insists that these approaches are not always practical. He adds that moral judgment can be obtained by determining whether the action is good or bad. This theory is not as good to be considered perfect. The aspect of purity and fecundity are only keen on the properties of the act but not the feeling of pain or pleasure. The occurrence of pain or pleasure is never certain regardless of whether the event happened or not.















Works Cited

Engel, Morris. Engel. New York: M. Engel, 1986. Print.

Hirst, Paul Q. “Marx and Engels on law, crime and morality.” Economy and Society 1.1 (1972): 28-56. Print.



Regression Analysis


















This study aims to determine what possible factors may be associated with the level of carbon dioxide emissions seen in various countries. This topic was chosen because of the constant change that is happening in the environment and its significant threat to humans. It is a known fact that the level of carbon dioxide is not the same as compared to how it was before given its 40% increase at the start of the Industrial Revolution (Think Global Green, 2008). The researcher aims to find out what factors can be considered as significant contributors to the potential increase or decrease in the level of carbon dioxide emission (in kt) measured in the environment. The three factors considered were the following: total population, energy use (kg of oil equivalent per capita) and GDP growth (annual %).


Data Gathering

The data used to conduct this research was taken from the website of Worldbank for the year 2011. This includes 160 randomly selected countries from different parts of the world.



Prior to seeing the results, the initial prediction of the researcher was that the level of carbon dioxide emissions seen in a country is positively affected by the three factors, namely, GDP, total population, and energy use. This means that an increase in any of these three variables would result to an increase in the level of carbon dioxide emission. These variables are also known as coefficient parameters (b’s) because they may or may not explain the variations seen in the dependent variable, level of carbon dioxide.



The table below shows the descriptive statistics of the variables. The mean carbon dioxide emission is 0.030 with a standard deviation of 0.944. The average energy use is -.005 with a standard deviation of 1.010 while population is 0.009 with a standard deviation of 1.050. Lastly, mean GDP growth is 3.573 with a standard deviation of 6.517.


Table 1 Descriptive Statistics

CO2 emissions Energy Use Population GDP growth
Mean 0.030 -0.005 0.009 3.573
Standard Error 0.075 0.080 0.083 0.515
Median -0.022 0.070 -0.024 3.861
Standard Deviation 0.944 1.010 1.050 6.517
Sample Variance 0.891 1.020 1.103 42.468
Kurtosis -0.285 0.275 -0.532 65.216
Skewness 0.032 0.125 0.045 -6.573
Range 4.643 6.120 4.375 79.367
Minimum -2.485 -3.060 -2.015 -62.076
Maximum 2.158 3.060 2.360 17.291
Sum 4.842 -0.768 1.467 571.611
Count 160.000 160.000 160.000 160.000
Confidence Level(95.0%) 0.147 0.158 0.164 1.018


Hypothesis Testing

The null hypothesis states that there is no relationship seen between the independent and dependent variables wherein slope is equal to zero while the alternative hypothesis states that there is a significant relationship seen between the independent and dependent variables wherein slope is not equal to zero. Using a significance level of 0.05, the regression test was done.



Normal Probability Plot

The normal probability plot gives a deeper understanding of the distribution of the data. It is evident that a normal distribution is applicable here since the data follows an almost linearly straight line with no significant outliers seen. Following it is the multiple linear regression result generated by the statistical software. There are three predictors considered and these are GDP, Energy use, and Population. The hypothesis being tested is aimed to check whether the predictor variables (GDP, Energy use, and Population) are able to affect the changes seen in the dependent variable (CO2 emission).


Figure 1 Normal Probability Plot



Assumptions for this statistical test are as follows. Variables are normally distributed and this is seen from the normal probability plot. There is a linear relationship between dependent and independent variables, which is justified through the scattered data points illustrated in the residual plots. Furthermore, homoscedasticity was checked using the standardized residual plots.


Using Excel data analysis, the regression output is shown in Table. The significance of F is very small (<0.0) which shows that this is the probability that the regression output was obtained by chance. This means that the model is significant to the study. The p-value of GDP (p<0.00) and Energy (p<0.00) use are both less than alpha = 0.05 which means that the null hypothesis should be rejected because there is a significant relationship seen between the independent and dependent variables.


The R square value or the coefficient of determination is 0.891. This means that 89% of the variability seen in the level of carbon dioxide emission is explained by the variables: GDP, Energy Use, and Total Population. In addition, the Significance F value is less than the chosen significance level of 0.05 which shows that the results are reliable.


Looking at the coefficients table, the p-value of GDP growth is 0.47> alpha = 0.05 makes it insignificant to the model. On the other hand, the p-value of Energy use is 0.00 as well as the p-value of Population < 0.000 are both less than alpha = 0.05. This shows that these two variables give valuable information to the model.


Table 2RegressionOutput

Regression Statistics
Multiple R 0.94
R Square 0.89
Adjusted R Square 0.88
Standard Error 0.32
Observations 160.00
  df SS MS F Significance F
Regression 3.00 125.49 41.83 402.08 0.00
Residual 156.00 16.23 0.10
Total 159.00 141.72      
  Coefficients Standard Error t Stat P-value Lower 95% Upper 95%
Intercept 0.04 0.03 1.22 0.22 -0.02 0.09
Energy Use 0.49 0.03 19.05 0.00 0.44 0.54
Population 0.79 0.02 32.01 0.00 0.74 0.84
GDP growth 0.00 0.00 -0.73 0.47 -0.01 0.00



The residuals are presented in the figures below and it can be seen that there is no obvious pattern followed by the data points. This indicates the assumption of normally distributed data is valid.

Figure 2 Residual Plot for Energy Use


Figure 3 Residual Plot for Population

Figure 4 Residual Plot for GDP growth


Regression Equation

Based on the model, the regression equation is as follows: CO2 level = 0.49*Energy use + 0.79*Population. The variable, GDP growth, was not included because it is not significant to the study based on the computed p-value. The line fit plots presented in the figures below show the “best-fit” line for each independent variable. Energy use is positively correlated to CO2 emission as well as Population while GDP is negatively correlated based on the trend line seen.


Figure 5 Energy Use Line Fit Plot

Figure 6Population Line Fit Plot


Figure 7GDP Growth Line Fit Plot



Based on the results of the analysis, only Population and Energy use were significant because they have a major effect on the level of carbon dioxide emission seen in a country. The number of people seen in a country can be considered as a contributor especially if there are high economic activities seen per person. Furthermore, the widespread use of energy is a significant contributor to the socio economic development of a country which eventually creates a long term impact to the environment in terms of CO2 levels. Despite the on-going programs geared towards improving awareness to the community, there is still a lot more to do in order to decrease the increasing rate of carbon dioxide emissions across different countries. This model can be improved by adding another potential factor such as level of industrialization, because it considers fossil fuels and manufacturing productions in the country. Lastly, this research will be more significant by reviewing previous studies related to the topic and constantly updating the data used.


EIA. (2015, November 23). U.S. Energy Information Administration – EIA – Independent Statistics and Analysis. Retrieved April 09, 2016, from https://www.eia.gov/environment/emissions/carbon/

The World Bank, World Development Indicators (2011). Population, total [Data file]. Retrieved from http://data.worldbank.org/indicator/SP.POP.TOTL

The World Bank, World Development Indicators (2011). CO2 emissions (kt) [Data file]. Retrieved from http://data.worldbank.org/indicator/EN.ATM.CO2E.KT/countries

The World Bank, World Development Indicators (2011). Energy use (kg of oil equivalent per capita) [Data file]. Retrieved from http://data.worldbank.org/indicator/EG.USE.PCAP.KG.OE/countries

The World Bank, World Development Indicators (2011). GDP growth (annual %) [Data file]. Retrieved from http://data.worldbank.org/indicator/NY.GDP.MKTP.KD.ZG

Think Global Green. (2008). Carbon Dioxide. Retrieved April 09, 2016, from http://www.thinkglobalgreen.org/carbondioxide.html


Empowering leadership and motivation as a mediator

Empowering leadership and motivation as a mediator

In prior studies, empowering leadership and motivation are all believed to act as a mediator towards employees performances. According to Brend (2016), empowering leadership refers to a way of leadership that involves helping subordinates discover their purpose through fair treatment, listening actively, sharing experiences, and aligning around the organization mission to deliver superior results. Motivation is also defined as the driving force behind the employee’s behavior and actions (Marylene, 2014). It results in individuals taking action to fulfill an expectation or need as well as achieving a goal.  Previous studies have focused on describing the relationship between empowering leadership as well as motivation and employees performance. However, there is less focus on how it mediates towards improving their performance.

Literature has proven that there is a direct positive relationship between subordinate empowerment and empowering leadership. However, in the current literature the leader’s relationship-building with the employees in an organization is more complex than understood (Cameron, 2013). The empowerment role of mediating in the model of leadership management is consistent with studies on transformational leadership. The intellectual stimulation together with individualized consideration maximizes service quality in an organization.

According to Mendes & Stander (2011), empowerment leadership and motivation gain strong support from leadership theories notions. Transformational leadership indicates that mutual understanding between the subordinates and leaders when managing functions of an organization increases service quality through moderating their moralities. Transformational leadership theory claims that empowering interaction between the leaders and workers inspires and motivates subordinates beyond their self-interests towards supporting the interest of the organization (Bakker & Schaufeli, 2008). Therefore, empowerment leadership and motivation develop subordinates concern and moralities about organization interests through stimulation of their potentials in managing the firm’s functions. As a result, this may lead to enhanced service quality in the unit or organization.

Motivation accounts for individual’s persistence, intensity, and direction of effort towards achieving a goal (Albrecht & Andreetta, 2011). Self-determination theory differentiates between three motivation types depending on the reasons that lead to the action: motivation, extrinsic motivation, and intrinsic motivation. Motivation mediates through different internal factors, such as energy, the locus of control, effectively, impulsiveness and self-esteem, and external actors, which comprise locking-in effect and empowering leadership (Zhang & Hailong, 2010). Motivation learning psychologists see excellence level as the desire of succeeding. Thus, the achievement motivation concept in current studies claims that the three intrinsic achievement motivation factors include mastery, job ethic, and excellence. Zhang & Hailong (2010) add that motivation moderates employees’ engagement by making the workers feel satisfied with, enthusiastic for, and involved with their work.

According to the prior studies on empowerment leadership and motivation as a mediator, it is evident that there is less focus on understanding the individual level of empowering and motivational developmental readiness. The studies carry a generalized view that every individual can be motivated and empowered towards their full potential. There is an immense interest and energy in the literature of leadership development; thus, there are more activities in trying to discover the genuine empowerment leadership and motivation impact as a mediator at multiple analysis levels from organizational through to cognitive climates. Therefore, this study will help to link to cognitive psychology literature and individual and well as lifespan development to encourage further study on motivation and empowerment leadership.


















Albrecht, S. L., & Andreetta, M. (2011). The influence of empowering leadership, empowerment

and engagement on affective commitment and turnover intentions in community health service workers. Leadership in Health Services, 24(3), 228-237. Retrieved from https://www.researchgate.net/publication/241675274_The_Influences_of_Empowering_Leadership_Empowerment_and_Engagement_on_Affective_Commitment_and_Turnover_Intentions_in_Community_Health_Service_Workers_Test_of_A_Model Date of Access 22nd June 2016

Bakker, A. B., & Schaufeli, W. B. (2008). Positive organizational behavior: engaged employees

in flourishing organizations. Journal of Organizational Behavior, 29(2), 147-154. doi:10.1002/job.515

Brend, B. (2016). Leading & Managing Occupational Therapy Services: An Evidence-Based

Approach. United States: F.A. Davis.

Cameron, K. (2013). Practicing positive leadership: Tools and techniques that create

extraordinary results. Berrett-Koehler, Inc.: San Francisco, CA.

David, D. (2014). The Oxford Handbook of Leadership and Organizations. United Kingdom:

Oxford University Press.

Mendes, F., & Stander, M. W. (2011). Positive organisation: The role of leader behaviour in

work engagement and retention. SA Journal of Industrial Psychology, 37(1). doi:10.4102/sajip.v37i1.900

Zhang, D., & He, H. (2010). Personality traits and life satisfaction: a chinese case study. Social

Behavior and Personality: an international journal, 38(8), 1119-1122. doi:10.2224/sbp.2010.38.8.1119

Marylene, G. (2014). The Oxford Handbook of Work Engagement, Motivation, and Self

-determination Theory. United Kingdom: Oxford University Press.