Relationship between ischemia modified albumin (IMA) in Different Age Groups and Gender Variance

ischemia modified albumin

Abstract

The purpose of the study was to find the relationship between ischemia modified albumin (IMA) in different age groups and gender variance.IMA has been found to be present in high levels in cardiac ischemic patients. Many studies have been done on the relationship of other biomarkers such as troponin to gender and different age groups (Rodriguez-Ospina, 331; Wiviott et al, 1415).Therefore, further research need to be done to find out whether there exist differences in the levels of IMA between different age groups, and also in gender. The results of the study will be helpful in correct diagnosis of cardiac ischemia among patients, in addition to stratification of the patients that suffer from acute chest pains. Correct diagnosis means immediate treatment and management of the cardiac ischemia before it destroys the myocytes.

Introduction

Cardiac bio makers According to Rodriguez-Ospina et al (14) are substances released by the heart into the blood stream when it is stressed or damaged. Measurement of the released bio makers in the blood stream is helpful in diagnosis, monitoring, risk stratification and in management of people suspected to have cardiac ischemia and acute coronary syndrome (ACS). Cardiac ischemia results when blood supply that goes to the tissues of the heart is not enough to meet the needs of the heart. This results in a sudden blood decrease and oxygen that reaches the heart. Tousoulis et al (15) highlighted some of the different types of cardiac biomarkers tests but the most used and effective one is the troponin test. However, cardiac troponin is only specific and sensitive for detection of damage in myocardium, but sometimes may not rise in there is reversible myocardial ischemia. Further research is needed to clarify whether pathophysiological differences that are gender related exist in acute coronary syndromes presentation. The aim of the study was to find out the levels of IMA in different age groups and gender variance

Methods

Ninety six patients with acute chest pain between age group 30-60years admitted in ICCU of hospital participated in the study. Among these subjects, 40 were male and 56 were female.  Of the 96 patients, 16 of them had no evidence of myocardial ischemia. They were categorized as group II. The remaining 80 patients with evidence of myocardial ischemia were categorized into group I. About 41% of the patients of group I was between 50-60 years of age. The control group of healthy subjects was 28, of which 10 were males and 18 females.

Patients were evaluated as being non ischemic or potentially ischemic through standard coronary disease indicators [(CK), CK-MB, LDH and electrocardiography findings and were tested by a Co (II)-albumin binding assay for IMA. The patients of ischemic group (group 1) were further divided in to three groups based on their age &sex as follows; 30-40 years (M&F), 40-50 years (M&F), and 50-60 years (M&F).

 

Results

Table: Age wise distribution of cardiac markers in Ischemic group     

 

 

Age 30-40yrs 40-50yrs 50-60yrs
Sex Males (n=11) Females (n=13) Males (n=9) Females (n=14) Males (n=14) Females (n=19)
CK (IU/l)

Mean ± SD

102±18.0 80±22.0 96±28.0 94±26.0 115±48.0 124±36.0
CK-MB (IU/l)

Mean ± SD

10±1.26 12±2.6 18±1.0 24±1.6 52±6.0 56±4.8
LDH(IU/l)

Mean ± SD

210±6.0 160±5.0 156±4.8 166±6.5 198±10.6 225±6.4
IMA (ABSU)

Mean ± SD

0.31±0.06 0.28±0.04 0.30±0.02 0.36±0.05 0.48±0.06 0.51±0.06

 

Discussion

Many important findings regarding IMA in different age groups and gender variance in Ischemic patients presenting with Co (II)-albumin binding assay for IMA have emerged from the analysis. Similarly, Women had a higher likelihood of having IMA biomarker compared to men who were ischemic; this is in correlation to a study done by Kazanis et al (78). Further analysis indicated that, as age increases (from 40 to 60 years) IMA levels get elevated among the ischemic patients. The study also shows correlation to a study done by Bar-Or et al (12) where myocardial ischemic patients had elevated assay levels ((0.529±0.086)), and for the age group of 50 to 60 years which had higher levels of IMA. The clinical diagnosis was assigned and correlated with standard biomarker (CK, CK-MB, and LDH) test results which were high compared with group II (0.316±0.092) with no evidence of myocardial ischemia (Bar-Or et al, 12). High levels of the IMA in women and the elderly is an indication that the accuracy of diagnosis of coronary heart diseases such as cardiac ischemia has been increased. The application of IMA to detect ischemia before destruction of the myocardium muscles will be helpful in treating the elderly who mostly suffer from the cardiac diseases such as cardiac ischemia. Furthermore, it would be helpful in stratification of the patients who have cardiac ischemic and normal chest pains (radha et al, 225).  In the recent studies have indicated that Ischemia Modified Albumin (IMA) is very sensitive and effective biochemical marker of ischemia (Gaze, 337; Sinha et al, 209|).  During ischemic attack, IMA is produced and is present in blood in concentrations that is easily detectable. Recent studies have also indicated that there exist differences in the levels of biomarkers in gender but minimal differences in different age groups (Kazanis et al, 2; Mowafy et al, 146). Chawla et al (79) indicated that diagnosis of diseases of the coronary artery in women is more difficult. This is because of lower diagnostic accuracy of the non invasive tests and lower symptoms specificity. In their study, they found out that in patients with Non-ST-Elevation Myocardial Infarction (NSTEMI) and Unstable Angina (UA), there existed different patterns of biomarkers presentation. For instance, men had had a higher likelihood of elevated troponins and creatine kinase-MB. Women, on the other hand, had a higher likelihood of having elevated brain natriureitic peptide and C-reactive protein. Similarly, age differences exist in the level of bio makers. The levels of Brain Natriuretic peptide (BNP) are higher in older populations and women compared to men (Yakut et al, 173).

Conclusion

In conclusion, despite the gender and age differences, IMA were higher in women, and gets elevated as age increases in ischemic patients. This is a breakthrough for the elderly and the women who are ailing from cardiac ischemia or just experience chest pain. Correct diagnosis would enable them get people treatment on time.

 

Work Cited

Bar-Or, D, E Lau, and JV Winkler. “A Novel Assay for Cobalt-Albumin Binding and Its Potential As a Marker for Myocardial Ischemia-a Preliminary Report.” The Journal of Emergency Medicine. 19.4 (2012): 311-5. Print.

[email protected], Govender, Radha, De Greef, Jacques, Delport, Rhena, Becker, Piet J., & Vermaak, William J.H.”Biological Variation of Ischaemia-Modified Albumin in Healthy Subjects. Clinics Cardiv, 2009.” Internet resource.

Rodriguez-Ospina, LF, CP Rosales-Alvarez, and A Lopez-Mas. “Cardiac Biomakers for the Evaluation of Acute Coronary Syndrome.” Boletín De La Asociación Médica De Puerto Rico. 101.4 (2009). Print.

Sinha, M, Roy, D, Gaze, D, Collinson, P, & Kaski, J. “Role of “ischemia Modified Albumin”, a New Biochemical Marker of Myocardial Ischaemia, in the Early Diagnosis of Acute Coronary Syndromes.” BMJ Group, 2014. Print

Wiviott, Stephen D, Christopher P. Cannon, David A. Morrow, Kausik K. Ray, Marc A. Pfeffer, and Eugene Braunwald. ” Differential Expression of Cardiac Biomarkers by Gender in Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction.” Journal of the American College of Cardiology. 46.8 (2011): 1411-1416. Print.

Januzzi, James L. Cardiac Biomarkers in Clinical Practice. Sudbury, Mass: Jones and Bartlett Publishers, 2009. Print.

Tousoulis, Dimitris, and Christodoulos Stefanadis. Biomarkers in Cardiovascular Diseases. Boca Raton: CRC Press, 2013. Print.

Kazanis, K, M Dalamaga, C Nounopoulos, AS Manolis, N Sakellaris, G Jullien, and A Dionyssiou-Asteriou. “Ischemia Modified Albumin, High-Sensitivity C-Reactive Protein and Natriuretic Peptide in Patients with Coronary Atherosclerosis.” Clinica Chimica Acta; International Journal of Clinical Chemistry. 408 (2009): 1-2. Print.

Mowafy, H.H, M Hamdi, M Khaled, and M Ashraf. “The Role of Ima in Ruling Out Ischemia in Patients Presenting with Chest Pain, and Its Relation with the Extent of Coronary Artery Disease.” Egyptian Journal of Critical Care Medicine. 1.3 (2013): 145-149. Print.Chawla, R, N Goyal, R Calton, and S Goyal. “Ischemia Modified Albumin: a Novel Marker for Acute Coronary Syndrome.” Indian Journal of Clinical Biochemistry : Ijcb. 21.1 (2010): 77-82. Print.

Yakut, Ibrahim, Cüneyt Tayman, Osman Oztekin, Mehmet Namuslu, Fahri Karaca, and Aydın Kosus. “Ischemia-modified Albumin May Be a Novel Marker for the Diagnosis and Follow-Up of Necrotizing Enterocolitis.” Journal of Clinical Laboratory Analysis. 28.3 (2014): 170-177. Print.

Gaze, DC. “Ischemia Modified Albumin: a Novel Biomarker for the Detection of Cardiac Ischemia.” Drug Metabolism and Pharmacokinetics. 24.4 (2009): 333-41. Print.

Aparci, M, E Kardesoglu, N Ozmen, O Ozcan, BS Cebeci, BY Cingozbay, and M Dincturk. “Prognostic Significance of Ischemia-Modified Albumin in Patients with Acute Coronary Syndrome.” Coronary Artery Disease. 18.5 (2011): 367-73. Print.

Charpentier, Sandrine, Jean L. Ducassé, Maxime Cournot, Françoise Maupas-Schwalm, Meyer Elbaz, Cécile Baixas, Henri Juchet, Thierry Lang, and Dominique Lauque. “Clinical Assessment of Ischemia-Modified Albumin and Heart Fatty Acid-Binding Protein in the Early Diagnosis of Non-St-Elevation Acute Coronary Syndrome in the Emergency Department.” Academic Emergency Medicine. 17.1 (2010): 27-35. Print.

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Clinical Exploration and Experience Report on Aboriginal Health Services

aboriginal health services

Introduction

Orange Aboriginal Medical Service (OAMS) is an incorporated aboriginal health service that is an organization that is operated, owned and controlled by the community, and has been providing primary health care and medical services successfully to the local orange community since 2005 February (OAMS, 2014). OAMS is a nonprofit organization governed by seven members of board of directors who local people are skilled and independent. Five positions in the board including four executives posts are held by aboriginal people, while the two remaining are reserved for professionals who have relevant skills. The services provided at OAMS include women’s health, antenatal care, early childhood services, post natal care, immunizations, sexual health, lactating specific consultations, well persons check, Pathology collections, preventive advices and home visiting (OAMS, 2014).

Historical development of the aboriginal health service

In 1971 at Redfern saw the first establishment of Aboriginal medical service (AMS), after high pressure and agitation from the local service (Andrews et al, 2002). This was a part of self deterioration and aspirations of the aboriginal people in the melting-pot and intense environment of the intellectual life of Redfern. Moreover, this was a also a response to the urgent need of provision of accessible and decent health care services to the largely and swelling medically uninsured Redfern aboriginal populations.

The aboriginal medical services are separate from the state government controlled services, and are controlled by the aboriginal communities through their elected board of directors (Blais & Hayes, 2011). Rigby et al (2011) pointed out that the approach of primary health care that Redfern adopted as well as the early ACCHS’s mirrored international aspirations and was innovative for appropriate, effective, accessible need-based health care with social justice and prevention focus

The National Aboriginal and Islander Health Organization (NAIHO), a national umbrella organization was foreshadowed in 1974 in Albury during a national meeting on health of the aboriginal people, and in 1976 was established to promote the aboriginal community control principle in the health of the aboriginal people, to lobby for new service establishment and for holistic approach (Australia, 2009).

From 1970 to 1978 saw new establishment of ACCH in various parts of Australia to 12.however, this was halted for the next 15 years due to the minimal government financial support (Atwal & Jones, 2009). In 1992, NAIHO was replaced by the new national umbrella organization, national aboriginal community controlled health organization (NACCHO). The name change showed that the Torres Strait Islanders decided to campaign for themselves to establish their own organization (Australia, 1999).

There were 140 aboriginal health services funded by Australian government by 2003/2004 of which 127 ACCH were operating in remote, rural and urban areas (Blais & Hayes, 2011).

OAMS is a controlled health service by the aboriginal community providing primary and medical healthcare to the community. OAMS was established on 18th February 2005 and operates under one roof. In 2012, OAMS expanded its services to include outreach dental services to Cowra, Bathurst and Parkes aboriginal communities, and in 2013 to outreach to Forbes (OAMS, 2014).

Inter professional practice

The staff involved in OAMS center include general practitioners, midwifes, family and child health nurses, health workers, dentists and doctors. Inter-professional practice according to (Harding, B., & VEA, 2003) is when more professionals learn from, about and with each other to improve quality and collaboration in care. It is about creation of environments where health professionals can learn about and from each other, and the focus should be on the patient not the health professionals.

The inter-professional practice to indigenous health is very important because it is about preparing and modernizing the aboriginal health workforce in Australia for the challenges they will face in this 21st century. These include ageing population, chronic diseases and workforce trained on the acute care. Another importance to the inter-professional practice to the indigenous health is because it will keep the workforce be updated with changes in technology that they currently experience. This is all about the  organizational change of the entire aboriginal health systems, as well as the way the health professional think, manage, see and do (Andrews et al, 2002).

Cultural competent nursing care includes skills, attitudes and knowledge that support caring of people from different cultures and languages (Blais & Hayes, 2011). Culture influences the health practices and also how the patient and the health care practitioner perceive illness. According to Rigby et al (2011), it is important for the healthcare professionals to be cognizant to the aboriginal culture such as the shared values and traditions, common genetic elements of the aboriginal people. For instance, manifestation of disease, epidemiology and medication effects on the aboriginal people. Similarly, the health professionals should address attitudes, should be aware how individual thinking and behavior is influenced by culture, and be aware of how to interact with the aboriginal people.

Health promotion

The services offered at OAMS included general health checkups, primary health care, adult health checks, family and child health checks, antenatal care, dental services, mental, alcohol and drug health, home visits, transports services such as the ambulances, visiting specialists, and consultations (OAMS, 2014).

Community knowledge

The aboriginal cultures in Australia are diverse and complex. The aboriginal communities keep alive their cultural heritage  by passing rituals, arts, knowledge and performances  to new generations through teaching and speaking, protecting their  cultural materials, significant and sacred sites, and objects. There history spans between 40,000 to 45,000 years ago (Blainey, 2006). At the time of the European settlements, the population of the indigenous populations in Australia was estimated to be approximately 310,000 and 750,000 people (Australia, 2014). The aborigine society was organized into language groups of over hundred, with some containing sub groups and of varying sizes. According to Australia (2010), each language group was characterized by common culture, territory and language. Most of the groups also were semi-nomadic and traversed defined territorial areas of varying sizes from 500km2 to100, 000km2

Name

The aboriginal people call each other by their state (boundary name). Moreover, if an aboriginal person who is residing in a particular state may not be originally from that state, and will still retain his or her original state they came from (Blainey, 2006). The table below lists states and names

STATE NAME
New South Wales Koor/Goorie/Koorie/Coorie/Murrri
Victoria Koorie
South Wales Nunga/Nyungar/Nyoongah
Western Australia Nyungar/Nyoongar
Northern Territory Yolngu (Top End), Anangu (Central)
Queensland Murri
Tasmania Palawa/Koori

The aboriginal people also call themselves by their nation name. The table below lists the names by nation

NATION NAME AREAS
Bundjalung Grafton,Yamba,Gold Coast
Dunghutti/Thungutti Kempsey
Eora Sydney, La Perouse
Kamilaroi/Gamilaraay/Gomeroi Goondiwindi, Lightning Ridge, Tamworth
Tharawal/Dharawal Wollongong,Kiama
Wiradjuri Gilgandra, Dubbo, Wagga Wagga, Bathurts

Elders

Australia. (2014) indicated that certain male members who are senior of a traditional language group may be initiated to be elders. They are selected based on their personal abilities such as compassion and bravery to be ritual leaders and also on their knowledge on law. The elders’ roles are to provide leadership such as on education for the young, dispute resolution, and advising the marriage partners. Australia (2010) stated that in the traditional aboriginal communities, elders’ advice is usually unquestioned and heeded

Similarly, the elders have responsibility for spiritual matters, sacred objects and in ritual performance and spiritual performance. They are the custodians of the law and to pass it to the generations down the line.

 Customs

In the culture of the aboriginals, certain customs are performed by men and women separately. The aborigines have many different customs such ceremonies, dances, songs and music that were seen as central to the culture. For instance, performances of the dances, songs and the decorations of the body, painting and culture were seen as a way of preserving their culture and customs.

The aborigines also have rituals and ceremonies as part of their customs. some rituals according to Blainey (2006) are performed  to ensure continued existence of a species, and other for marking the life passage through important life stages such as puberty, marriage and even death. Moreover, almost all dreaming stories are associated to particular locations and also to sacred objects. For instance, Australia (2014) observed that each adult must perform every year the “increase ceremonies” for his or her totem at the sacred sites to enable release of the life force. This will make sure that the ongoing particular natural species supply which the individual is part.

Traditions and Beliefs

Land is the core of the aboriginal beliefs and their wellbeing. The land itself is not just minerals, rocks and soil, but the whole environment that is sustained and sustains culture and people (Australia, 2010). Blainey (2006) pointed out that for the aboriginals in Australia, the land is fundamental of all spirituality and this association and the “country’s” spirit is key to the issues that are essential to the aboriginals

According to Australia (2014), the aboriginals of Australia were gathers and semi nomadic, with each clan having designated territorial lands defined by geographic boundaries like lakes, rivers and mountains. Therefore, they cared and understood for their environments and are adapted to it. The national parks also contain important sites to the aboriginal communities like artworks and rock engravings.

Conclusion and personal reflection

The development of aboriginal health center has developed and has come a long way. From my essay, I have learnt that the aboriginal people are groups of people that embrace their culture, customs and beliefs.  As a person in the field of health, some of the strategies I can embrace and incorporate in my nursing practice are first, embracing inter professional practices where other health professionals can share ideas on heath matters for better service delivery to the patients. Secondly, another strategy is being competent on the aboriginal cultures and incorporates it in my nursing practice. This way, I will be able to understand my aboriginal patients, know how to handle them, understand their epidemiological trends and also care for them appropriately.

The essay discussed Orange Aboriginal Medical Service (OAMS) and their services they provide to the aboriginal community. Aboriginal health service has a long history as discussed and its development up to the current level has been through many challenges and dedication of the aboriginal community for better healthcare. Embracing of culture and inter-professional practice is beneficial for the health care providers for better nursing practice. Lastly, the essay explored the history of the aboriginal community.

References

Andrews, B., Simmons, P., Long, I., & Wilson, R. (August 01, 2002). Identifying and overcoming the barriers to Aboriginal access to General practitioner services in Rural New South Wales. Australian Journal of Rural Health, 10, 4, 196-201.

Atwal, A., & Jones, M. (2009). Preparing for professional practice in health and social care. Chichester, U.K: Wiley-Blackwell.

Australia. (1999). Inquiry into Indigenous Health: Discussion paper. Canberra: House of Representatives, Standing Committee on Family and Community Affairs.

Australia. (2009). A national Aboriginal health strategy. Canberra: Working Party.

Australia. (2010). Aboriginal people of New South Wales: Aboriginal Australia. Canberra: Published for the Aboriginal and Torres Strait Islander Commission by the Australian Govt. Pub. Service.

Australia. (2014). Indigenous Australia. Canberra: ATSIC.

Blainey, G. (2006). Triumph of the nomads: A history of aboriginal Australia. Woodstock, N.Y: Overlook Press.

Blais, K., & Hayes, J. S. (2011). Professional nursing practice: Concepts and perspectives. Boston: Pearson.

Harding, B., & Video Education Australasia. (2003). Indigenous health in Australia. Bendigo, Vic.: Video Education Australasia.

Orange Aboriginal Medical Service. (2014). Retrieved from http://www.oams.net.au/

Rigby, C. W., Rosen, A., Berry, H. L., & Hart, C. R. (October 01, 2011). If the land’s sick, we’re sick:* The impact of prolonged drought on the social and emotional well-being of Aboriginal communities in rural New South Wales. Australian Journal of Rural Health, 19, 5, 249-254.

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Business letter to Customers

Business letter to Customers

Dear Sir/Madam,

REF: INTRODUCTION OF FARM PRODUCTS AND EVENTS PLANNING

The importance of this letter is to familiarize our Supermarket, XYZ Supermarket Ltd, which has been active in the investment since 1990.  Here at XYZ, we have introduced a State of the Art Bakery and new methods of branding farm products. In our Bakery, we are we are manufacturing new range of products like breads, new designs of cakes that are customized to meet the customers needs, Dairy products and other meat products.  More so, we believe that great businesses are not  born, they are made, and this is why we have made XYZ as one of the best customer friendly venture that have received great reputation and connections to many customers needs and other organizations. We are happy to let you know we have established close relationship with leading clients distributed all across the cities and the neighboring countries. Since beginning, we have successfully provided customers with cost effective goods in our business that operates around the clock.

XYZ also, offers other services like events planning and decorations such as wedding setups/parties , transport services to customers that purchases bulky goods while delivering these goods to any customers location at little fee. We are guaranteed that our investment strategies remain the leading in these business environments. Part of this letter, you will find enclosed information pamphlets, documents and brochures about us. Our services are offered after thorough considerations of our client’s needs by charging normal fee.

We are fully aware that you are interested in the same options of company’s goods and services, and you must need time to think about. Through our great pleasure, we have stocked new range of products that we believe might best suit your needs. After meticulous field research and surveys, we came up with new products directly from new business people from the agricultural market, whereby, other products are manufactured or blend within our business venture. As we are all aware, the Government has provided farms supplies, loan and other incentives to our farmers, and, therefore, agricultural production and improved greatly while new farm produce is getting to our existing markets. More so, new entrepreneurs are offering new products that we are stocking and, therefore, these products will be essential for you.

The new ranges of farm produce are produced in modern ways of farming especially the incorporation of technology in the farms. They are, therefore, of higher quality than the average ones already in other shelves. The new products are cost effective, fast moving goods that everyone is after, well packaged and more so, beneficial to our health especially in preventing and curing of common diseases. For instance, we are blending and manufacturing new range of breads from a wide variety of balanced protein, vitamin and vital fats’ collected from the new farm produce. These breads are so enriched “you might be tempted to skip some meals” for their balanced and satisfying characteristics. Their packaging is so modern and attractive that everyone will be interested in looking or tasting. Brochures furnishing the details of each product have been enclosed with this letter. Being our esteemed customer, we would like to offer you a range of free products in our shelves before the current stock runs out. We are working with highly qualified staffs that assures every customer detail is handled and taken care of physically or through our business contacts 24/7.

Please note that we are working with new top sales representative, Mr. George Brown, as a Business Manager and being a former sales staff from Amazon Ventures Ltd in Paris.  Mr. George has 21 years of experience in sales and marketing and was formally working in other great business companies like Virginia Green Garden, one of the largest importer and manufacturer of farm Produce in Europe.  He is a graduate from Oxford University and recently completed his management studies from Michigan University. Through the combined experiences and expertise within our staffs, we have been ranked one of the best business investments and that we have developed close ties with staffs (clients) from IBM. We sometimes ask ourselves, if IBM staffs are interested with the Farm Products in our shelves, who else can’t buy from us? We, therefore, introduce and welcome all of our esteemed customers including you to these new ranges of products.

Finally, we acknowledge your time and effort in reading this letter and hopeful that you may share our good news to your close colleagues especially by showing them some of the attached business brochures accompanying this letter.

Mr. George is available to ascertain the prior commitments and orders. Incase of any special arrangements or enquiries, our lines, are open and can also reach our Manager at 07-05-123456 anytime between 9 A.M to 8 P.M. Further contact details can be referenced from one of the brochures.

We are grateful for your concern in our Business.

Sincerely

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ReferencesCommunications and media. (1974). Sydney: London : Angus & Robertson.

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Victimologist’s Report-caralyn king

Victimologist’s Report-caralyn king

Is the deceased a victim or an offender? Why do you think so?

The deceased from the point of a victimologist was a victim. The deceased, Caralyn king, since her childhood through her teenage life, until her adulthood had been faced by many social challenges. Some of her decisions she made until her death were made when she was still underage, under the influence of drugs or through mental disorder. Therefore, lawfully, it cannot be wholly accepted that she did them by her own will as an adult. One social factor after the other had led to Caralyn king’s problematic life. To begin, the victim had a learning disability and this affected her leaning in school and finally resulted to her failure to excel in school.  Her dismissal performance in school further affected her self esteem and this contributed majorly to abuse of drugs at an early age. Evidence points out that at her teenage years she had started using drugs and taking of alcohol and she eventually dropped out of high school prematurely.

Given that she dropped out of school, was unemployed and had ran away from her home, she had to find alternative means of finding a shelter, feeding herself and to sustain her new lifestyle. By that time, her neighborhood was a den of prostitution from young girls and the moral social fabric of her community was being torn apart. Sex in the streets was the order of the day. Being a victim to immoral social vices comes out because of her vulnerability to pimps, gangs and men in her community because of her tender age, mental illness and being an addict to drugs.

Similarly, evidence pointed out that Caralyn king was suffering from psychosis, a mental disease that is induced by drugs. Furthermore, she turned to prostitution at some point in life. Professionally, it cannot be ruled that she willingly engaged in prostitution, but she may have been forced due to the prevailing financial problems she was facing in the streets. From police evidence, prostitution in the Edmonton community was rampant because young were girls had to fend for themselves, or they were easily duped into prostitution by pimps.

Who are the other victims in this case?

The case of the death of Caralyn king unraveled the deep rot in the community. There were also other victims apart from Caralyn king. Evidence from different experts pointed out that there were other lost young women in the community who were also victims of the factors Caralyn king was a victim of. To begin, statistics indicated that since the year 1988, 12 bodies of women that lived in similar lifestyles of high risks have been found in the area of Edmonton.

Evidence from the undercover law enforcers brought to light the other victims.  The other victims are teenage girls in the streets who are abusing drugs, lack positive parenting from their parents or even suffer from mental problems. The teenagers are not good in making right decisions, and some are even underage girls and therefore they end up being sexually assaulted or sexually abused. Therefore, they can easily fall prey to the unsuspecting pimps, gangs or the customers who might have hidden agendas, or just see them as machines of making money. Therefore, from the victimologist angle, the young girls are not criminals rather victims of different forms of exploitation.

These young girls who are victims have been set from their tender ages to willingly agree to sex to support themselves whenever they are broke, are in streets, desperate or in trouble. Similarly, a scenario where a young woman is single mother of a young baby and has no way of feeding the child, they willingly opt for prostitution to survive. On the other hand, the victims also engage in prostitution to support their drug addiction, and to pay for their drugs which they started using at a younger age.

From the victimologists point of view, the victims are not perpetrators by buying the banned illegal drugs, but they are just merely survivors. They are trying with their own means to cope with the situations they have found themselves in, and are also stuck in.

What are the needs of these other victims? How should they be addressed?

The other victims have many needs that force then into drugs and even prostitution. To begin, the victims have no meaningful source of income. They are unemployed and therefore faced with the hard economic times; they opt for prostitution to make ends meet.

The victims also suffer from torn social fabric. There are no organizations that assist in steering the community moral values. Positive parenting is lacking also in the community. The teenagers engage in drugs and prostitution from a tender age and it is deemed ok in the community. Therefore, leadership and positive role models is needed in the community.

To address the discussed needs of the victims, the community where the victims hail from should come together and talk as one entity to address the problems that face them as a community. Many positive things can be achieved if people come together and discuss the way forward for their children and the teenagers who have gone astray. The discussion should not be focused between “us” and “them,” but it should be centered as “we,” the people of Edmonton community and the changes needed for the betterment of the community.

Another way in which the problems can be addressed is though formation community based nonprofit organizations that address the problems of the community. For instance, formation of organizations that sensitizes the victims on the negative effects of drugs, sexual assaults, prostitution and importance of positive parenting. The programs should be attended by both the victims, the young community teenagers, professionals and the parents.

Economic empowerment programs should also be started to offer alternatives to the victims to hinder them from engaging in dangerous activities such as usage of drugs and prostitution. This could be done by the state government starting business programs for the community, inviting investors and encouraging other forms of economic activities.

The law enforcers should also play their part by conducting investigations who are the pimps, the clientele of the young teenage prostitutes, investigate the sexual assaults among the young women too. Solutions to these problems should also be researched to address the social problem in the community.

Do you advise the judge to recommend legalization and regulation of prostitution? Explain your reasoning.

I would advise the judge to recommend that prostitution should not be legalized. This is because the vice of prostitution comes with many wrongs such as teenage sex, drugs and murder as in the case of Caralyn King. Sex should not be done in strangers’ cars, streets, in open public places and parks, but comfortably in private houses (Gerdes, 2006).

Similarly, legalizing prostitution in a society will encourage rot of the moral society’s fabric. The community organizations are playing their part by ensuring dignity is restored in communities. Therefore, by legalizing prostitution, the gains made by community organizations will go waste. Furthermore, the married couples would not have to worry about their partners cheating, or maybe the young teenage girls to think prostitution is a profession (Roleff, 2006).

I also believe that by legalizing the vice of prostitution, the government will be agreeing to use of young girls and women as merchandise. Similarly, prostitution will increase the street crimes incidences, in addition to violence, mental trauma and health hazards.

Many studies (Weitzer, 2011; Roleff, 2006) pointed out that most prostitutes are runaway teens, and the prostitutes end up in the streets because of maybe a sexual assault committed to them when they were still children or were beaten. Given that the prostitutes trade in their bodies, they do it not because they are willing but because of situations they have found themselves in. For instance, Gerdes (2006) indicated that prostitutes have to put their thinking and minds away to assume that they are not doing sex. Moreover, they are at high risks of being sexually assaulted or beaten by their clients. Therefore, even legalizing of prostitution does not guarantee that violence to the prostitutes will end.

According to Roleff (2006), tax payers incur million of dollars for incarceration the prostitutes, but even by legalizing them will even be more costly since checking of all prostitutes monthly for STDs is very costly. Moreover, prostitution comes with emotional turmoil and low self esteem after a woman having sex with many different men.

In summary, prostitution should not be legalized because it the risk of contracting and spreading STIs increases like HIV/AIDs. Moreover, it is also wrong for any woman to sell her body, increased chances of rape, shameful, lack of alternative source of income for the women when they age, and lastly high chances of the prostitutes becoming drug addicts (Weitzer, 2011). 

Does your review of this testimony suggest any other recommendations the judge might make to prevent similar deaths?

  1. The parents should be engaged closely with their children’s lives and to understand them better. If the child tends to be performing dismissal in school, it should not be taken lightly. Diagnostic testing should be done on the children to determine their IQ level to help them in reasoning and making of best decisions. This would prevent them from falling prey to gangs who perceive them as adults while their reasoning capacity is still low.
  2. Intervention services should be provided to children who symptoms or behaviors such as moodiness, tantrums, impulsiveness, delays in development, learning difficulties, poor judgment, attention disorders, delinquency and aggression. These could be because of neurological disorders or Fetal Alcoholic Spectrum Disorder.
  3. The teenagers in their adolescent age should be assisted by their teachers, counselors and parents to find their identity and for them to have self esteem. This would prevent social deficits that would make it difficult for a teenager to fit well in the world, understand things well and find a community where they are accepted.
  4. Make regulations on consumption of alcohol and usage of drugs. There should be a minimum set age limit where people can consume alcohol. This will control the alcohol consumption in the name of recreation which can slip and over to addition level. Addiction to drugs and alcohol especially to young people leads to self destruction of life.
  5. Establishment under law for minimum number of community support groups to assist the people with mental illness. This can help the teenagers who have been diagnosed with mental illness problems.
  6. Establishment of government homes for the homeless teenagers who wonder in the streets. The homes could be under the government, Non-governments organizations, community organizations and even churches. This could offer alternatives to the homeless street  children
  7. Prevent incarceration of young adults who did not have juvenile crime records, or give alternative sentences like community work instead of jail terms. Courts should also consider deferment of court cases for treatment suggestions to the charged teenagers. Furthermore, determining mental state of the teenagers when crime was committed should also be determined before sentencing the charged teenagers or young adults to jail.

References

Gerdes, L. I. (2006). Prostitution and sex trafficking: Opposing viewpoints. Detroit: Greenhaven Press.

Roleff, T. L. (2006). Prostitution. Detroit: Greenhaven Press.

Weitzer, R. J. (2011). Legalizing prostitution: From illicit vice to lawful business. New York: NYU Press.

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