Ensuring Effectiveness Of Critical Reflection With Reflection Models

Ensuring Effectiveness Of Critical Reflection With Reflection Models The NMC (2008) requires nurses to maintain competence in all areas of practice (Meretoja et al, 2004). Nurses can contribute to the ongoing maintenance and development of clinical competence and ongoing professional development through reflection (Gustafson and Fagerberg, 2004). Reflection supports clinical reasoning, critical thinking and review of clinical actions and knowledge, contributing to ongoing evaluation of practice, for self and others (Bowden, 2003). However, reflection can be challenged as a pointless or limited process (Jones, 1995), and therefore, to ensure reflection is effective, and contributes to knowledge, understanding, learning and development (Rolfe, 2005), it is best to use one of the many models of critical reflection that have been developed within the theoretical domain. As part of a process of critical reflection, I shall use Gibbs (1988) model of structured reflection, to structure and define the process of reflection and critical analysis involved in this scenario. Description (What Happened) I was involved in the care of a fifty two year old gentleman who has been under my care for some time in relation to monitoring of blood pressure. After initial tests were carried out, the gentleman was assessed according to standard definitions of hypertension. The gentleman, who shall be called Mr J for the purposes of this reflection, and to maintain confidentiality in accordance with the NMC Code of Conduct (NMC, 2008), had been complaining of some intermittent headaches, occasional dizziness, and blood tests were taken: full blood count, urea and electrolytes (to rule out any renal involvement), and creatinine. Blood pressure measurements were one week apart, and his blood pressure was found to be 150/100 mmhg and 150/98 mmHg respectively. I carried out a further blood pressure measurements on three subsequent days and found the blood pressure to be within these two ranges on several occasions. There was no abnormality detected in the blood test results, and therefore, the decis ion was made to commence the patient on antihypertensive medication. I also carried out tests for diabetes and referred him to the GP for further assessment of cardiovascular risk. In order to make this decision, I consulted not only reference books such as the British National Formulary, and the guidance on nurse prescribing, but the guidelines provided by the National Institute for Health and Clinical Excellence (NICE, 2006). In this guideline, NICE (2006, p 2) clearly state that: Treatment and care should take into account patients individual needs and preferences. Good communication is essential, supported by evidence-based information, to allow patients to reach informed decisions about their care. Carers and relatives should have the chance to be involved in discussions unless the patient thinks it inappropriate Therefore, having explained the findings to the patient, I discussed with him the issues surrounding the diagnosis of hypertension, and what the consequence of this condition could be for his long term health. I also discussed the type of medication that was used, in order to make sure that he understood how this would affect him and how important it was to maintain a good treatment regimen and not to miss his medication. This allowed me to assess his ability to self-medicate and also monitor his own condition and any effects of side effects of the medication. I also discussed with him the need to inform his family or next of kin of his condition and its treatment, as this would allow him to have support and help in adjusting to a chronic condition, and also other people who would assess symptoms and side effects during the treatment process. This is important as it can take time to adjust to the use of anti-hypertensive medication and sometimes the regimen needs to be altered in ord er to suit the individual patient (NICE, 2006). Feelings (What were you thinking and feeling) My thoughts during this process were focused on the need to properly diagnose this patients condition, and to ensure that the prescribing process was correct, within the guidelines laid down for nurses by the NMC. I was concerned with getting the right dosage and frequency, choosing the right medication within the boundaries of my prescribing role, and also, ensuring that the patient was fully aware of the implications of his condition. However, more challenging to my current role was the realisation that my concern for the patient, and for his adjustment to being told he had a chronic illness that needed treatment, was overshadowed by my focus on the prescribing process, and therefore, on reflection, I realised that there was a degree of dissatisfaction, in that I could feel that I was finding it more difficult to focus on his psychological and emotional needs because of the prescribing role. Evaluation (What was good and bad about the expereince) The positives of this experience relate to the ability to apply the principles of the NICE Guidance (NICE, 2006), whilst at the same time being able to provide continuity of care, quality of care, and holistic nursing care to an individual based on his own needs and reactions. While I became aware of the way in which the process of diagnosis and prescription started to eclipse the more holistic and humanistic elements of my nursing care for this patient, I did identify this and so was able to redress this during the consultations and to develop a more holistic approach. Thus, identifying my own feelings allowed me to take immediate action and to spend time with the patient discussing the impact of the diagnosis and his own feelings, particularly in relation to his social life and family life. As an active individual, he was concerned about the impact on his lifestyle, and the NICE guidance (NICE, 2006) does suggest that lifestyle advice should be provided at appropriate moments durin g care, so it was also good to be able to both meet the individual needs of the client and ensure I was taking the optimal approach to his monitoring, treatment, support and health education. Analysis (What sense can you make of the situation) The literature suggests that decision making in nursing is focused on optimal treatment and management for the best possible outcomes, and the first stage of this is assessing and observing all features of the patient, ie their condition, clinical signs and symptoms, and their holistic state of being (Hedberg and Satterlund, 2003). In this case, the decision making process began with the assessment of the blood pressure measurements, and these were the first indication that there was a need to intervene, as the readings were above the diagnostic line on more than two separate occasions (NICE, 2006). Thus, I knew that I would need to intervene, and that there was a need to prescribe medication appropriate to the clients needs, within the guidelines set out locally (Latter and Courtenay, 2004). My competence in the diagnostic and prescribing processes was confirmed by my recognition of patient need and the ability to also carry out further tests, or refer the patient for further tests relating to their condition (Meretoja et al, 2004; Ashworth and Saxton, 1990). The NICE (2006) guidelines clearly state that in the absence of established cardiovascular disease, when raised blood pressure persists, they need further testing to identify cardiovascular risk, and further tests specifically in relation to diabetes and renal disease, due to the connections between these two chronic conditions and hypertension. A key feature of this diagnostic process however was the intersection of advanced nursing competence in relation to diagnostic and prescribing practice, and general holistic nursing care principles, including person-centred care (Price, 2006). The management of the complex clinical knowledge required in a situation like this, and the more interpersonal and humanistic side of nursing practice, is almost second nature to many nurses, but I became conscious of it during this encounter, and it was an important learning point for me. Older clients have complex personal and social lives, and complex histories, and therefore it is important to see and understand them as individuals in the light of that complexity, rather than falling into the bad habit of reducing them to their signs, symptoms, and disease (Redfern and Ross, 2001). Thus it was possible to view the clinical decision making process from multiple angles: from the clinical and objective angle and from the holistic viewpoint (Ha rbison, 1991). Critical thinking processes were involved, in assessing the need to take action, in assessing the patient as a person, and in assessing their self care ability and their ability to cope with this new medication regime and its likely effects, all part of ensuring that they are being monitored appropriately after the introduction of the anti-hypertensive medication (Department of Health, 2004). It was also apparent that this was an appropriate time to discuss health promotion and lifestyle changes to improve patient health and wellbeing (Croghan, 2005), and taking a positive and patient centred approach, focusing on patient empowerment during the transition to acceptance of their condition (Funnell, 2004). Thus it is possible to see how the process of diagnosis and prescribing fits into the overall assessment and decision making processes of clinical nursing practice, in the context of an effectively developed nurse-patient relationship (Luker et al, 1998). Conclusion (What else could you have done?) On reflection, I could argue that there is always scope for improvement within nursing practice. Therefore, I could have perhaps considered earlier on in the process what the full implications of this diagnosis were. I did consult the NICE guidelines, the local guidelines, and worked within the rules laid down by the NMC, but perhaps I should have been considering the patient holistically first, and considered lifestyle factors and changes earlier on in the process (NICE, 2006). I could have also perhaps asked if he would like to bring his wife/primary carer with him to an appointment so I could have involved her, with his permission, in discussions of his condition, and in the explanation about his medication and its potential effects. Action Plan (If it arose again, what would you do?) If this occurred in the future, I would focus on the nurse patient relationship immediately, and would consider the holistic view more consciously earlier on in the diagnosis, assessment, and prescribing process. This might allow the patient to come to terms more effectively with their condition, and would also allow them to get carers involved if necessary. However, the adherence to the NICE guidelines is also something I would repeat in future, as this has provided a useful source for supporting practice, decision making, and prescribing.

Chapter 8 Microbial Genetics

Microbiology: An Introduction, 11e (Tortora/Case)Chapter 8 Microbial Genetics8. 1 Multiple Choice Questions 1) A gene is best defined as A) a segment of DNA. B) three nucleotides that code for an amino acid. C) a sequence of nucleotides in DNA that codes for a functional product. D) a sequence of nucleotides in RNA that codes for a functional product. E) a transcribed unit of DNA. Answer: C Skill: Recall 2) Which of the following pairs is mismatched? A) DNA polymerase — makes a molecule of DNA from a DNA template B) RNA polymerase — makes a molecule of RNA from an RNA template C) DNA ligase — joins segments of DNA D) transposase — insertion of DNA segments into DNA E) DNA gyrase — coils and twists DNA Answer: B Skill: Recall 3) Which of the following statements is FALSE? A) DNA polymerase joins nucleotides in one direction only. B) The leading strand of DNA is made continuously. C) The lagging strand of DNA is started by an RNA primer. D) DNA replication proceeds in one direction around the bacterial chromosome. E) Multiple replication forks are possible on a bacterial chromosome. Answer: D Skill: Understanding 4) DNA is constructed of A) a single strand of nucleotides with internal hydrogen bonding. B) two complementary strands of nucleotides bonded A—C and G—T. C) two strands of nucleotides running antiparallel. D) two strands of identical nucleotides with hydrogen bonds between them. E) None of the answers is correct. Answer: C Skill: Understanding 5) Which of the following is NOT a product of transcription? A) a new strand of DNA B) rRNA C) tRNA D) mRNA E) None of the answers are correct; all of these are products of transcription. Answer: A Skill: Understanding 6) Which of the following statements about bacteriocins is FALSE? A) The genes coding for them are on plasmids. B) They cause food-poisoning symptoms. C) Nisin is a bacteriocin used as a food preservative. D) They can be used to identify certain bacteria. E) Bacteriocins kill bacteria. Answer: B Skill: Understanding Figure 8. 1 7) In Figure 8. 1, which colonies are streptomycin-resistant and leucine-requiring? A) 1, 2, 3, and 9 B) 3 and 9 C) 4, 6, and 8 D) 4 and 8 E) 5 and 6 Answer: D Skill: Analysis Table 8. 1 Culture 1: F+, leucine+, histidine+ Culture 2: F-, leucine-, histidine- 8) In Table 8. 1, what will be the result of conjugation between cultures 1 and 2? A) 1 will remain the same; 2 will become F+, leucine-, histidine- B) 1 will become F-, leu+, his+; will become F+, leu-, his- C) 1 will become F-, leu-, his-; 2 will remain the same D) 1 will remain the same; 2 will become F+, leu+, his+ E) 1 will remain the same; 2 will become F+ and recombination may occur Answer: A Skill: Analysis 9) In Table 8. 1, if culture 1 mutates to Hfr, what will be the result of conjugation between the two cultures? A) They will both remain the same. B) 1 will become F+, leu+, his+; 2 will become F+, leu+, his+ C) 1 will remain the same; recombination will occur in 2 D) 1 will become F-, leu+, his+; 2 will become Hfr, leu+, his+ E) The answer cannot be determined based on the information provided. Answer: C Skill: Analysis 10) An enzyme produced in response to the presence of a substrate is called a(n) A) inducible enzyme. B) repressible enzyme. C) restriction enzyme. D) operator. E) promoter. Answer: A Skill: Recall 11) When glucose is high, cAMP is _____ : CAP _____ bind the lac operator, and RNA polymerase _____ bind the lac promoter. A) high; does; does B) low; does not; does not C) high; does not; does D) low; does not; does E) None of the answers is correct. Answer: B Skill: Understanding 12) Transformation is the transfer of DNA from a donor to a recipient cell A) by a bacteriophage. B) as naked DNA in solution. C) by cell-to-cell contact. D) by crossing over. E) by sexual reproduction. Answer: B Skill: Recall 13) Genetic change in bacteria can be brought about by A) mutation. B) conjugation. C) transduction. D) transformation. E) All of the answers are correct. Answer: E Skill: Understanding 14) Which of the following statements regarding a bacterium that is R+ is FALSE? A) It possesses a plasmid. B) R+ can be transferred to a cell of the same species. C) It is resistant to certain drugs and heavy metals. D) It is F+. E) R+ can be transferred to a different species. Answer: D Skill: Understanding 15) The initial effect of ionizing radiation on a cell is that it causes A) DNA to break. B) bonding between adjacent thymines. C) base substitutions. D) the formation of highly reactive ions. E) the cells to get hot. Answer: D Skill: Recall 16) According to the operon model, for the synthesis of an inducible enzyme to occur, the A) end-product must not be in excess. B) substrate must bind to the enzyme. C) substrate must bind to the repressor. D) repressor must bind to the operator. E) repressor must not be synthesized. Answer: C Skill: Understanding 17) Synthesis of a repressible enzyme is stopped by the A) allosteric transition. B) substrate binding to the repressor. C) corepressor binding to the operator. D) corepressor-repressor complex binding to the operator. E) end product binding to the promoter. Answer: D Skill: Understanding Figure 8. 2REPLICATION FORK18) In Figure 8. 2, if base 4 is thymine, what is base 4†²? A) adenine B) thymine C) cytosine D) guanine E) uracil Answer: A Skill: Analysis 19) In Figure 8. 2, if base 4 is thymine, what is base 11†²? A) adenine B) thymine C) cytosine D) guanine E) uracil Answer: B Skill: Analysis 20) In Figure 8. 2, base 2 is attached to A) ribose. B) phosphate. C) deoxyribose. D) thymine. E) The answer cannot be determined based on the information provided. Answer: C Skill: Recall 21) The damage caused by ultraviolet radiation is A) never repaired. B) repaired during transcription. C) repaired during translation. D) cut out and replaced. E) repaired by DNA replication. Answer: D Skill: Recall Table 8. 2 Codon on mRNA and corresponding amino acid |UUA |leucine |UAA |nonsense | |GCA |alanine |AAU |sparagine | |AAG |lysine |UGC |cysteine | |GUU |valine |UCG, UCU |serine | 22) Refer to Table 8. 2. If the sequence of amino acids encoded by a strand of DNA is serine-alanine-lysine-leucine, what is the order of bases in the sense strand of DNA? A) 3†² UGUGCAAAGUUA B) 3†² AGACGTTTCAAT C) 3†² TCTCGTTTGTTA D) 5†² TGTGCTTTCTTA E) 5†² AGAGCTTTGAAT Answer: B Skill: Analysis 23) Refer to Table 8. 2. If the sequence of amino acids encoded by a strand of DNA is serine-alanine-lysine-leucine, the coding for the antisense strand of DNA is A) 5’ ACAGTTTCAAT. B) 5’ TCTGCAAAGTTA. C) 3’ UGUGCAAAGUUA. D) 3’ UCUCGAAAGUUA. E) 3’ TCACGUUUCAAU. Answer: B Skill: Analysis 24) Refer to Table 8. 2 The anticodon for valine is A) GUU. B) CUU. C) CTT. D) CAA. E) GTA. Answer: D Skill: Understanding 25) Refer to Table 8. 2. What is the sequence of amino acids encoded by the following sequence of bases in a strand of DNA? 3’ ATTACGCTTTGC A) leucine-arginine-lysine-alanine B) asparagine-arginine-lysine-alanine C) asparagine-cysteine-valine-serine D) Translation would stop at the first codon. E) The answer cannot be determined based on the information provided. Answer: D Skill: Analysis 26) Refer to Table 8. 2. If a frameshift mutation occurred in the sequence of bases shown below, what would be the sequence of amino acids coded for? ’ ATTACGCTTTGC A) leucine-arginine-lysine-alanine B) asparagine-arginine-lysine-alanine C) asparagine-cysteine-valine-serine D) Translation would stop at the first codon. E) The answer cannot be determined based on the information provided. Answer: E Skill: Understanding [ 27) In Figure 8. 3, if compound C reacts with the allosteric site of enzyme A, this would exemplify A) a mutation. B) repression. C) feedback inhibition. D) competitive inhibition. E) transcription. Answer: C Skill: Understanding 28) In Figure 8. 3, if enzyme A is a repressible enzyme, compound C would A) always be in excess. B) bind to the enzyme. C) bind to the corepressor. D) bind to RNA polymerase. E) bind to gene a. Answer: C Skill: Understanding 29) In Figure 8. 3, if enzyme A is an inducible enzyme, A) compound C would bind to the repressor. B) compound A would bind to the repressor. C) compound B would bind to enzyme A. D) compound A would react with enzyme B. E) compound C would react with gene a. Answer: B Skill: Understanding 30) Conjugation differs from reproduction because conjugation A) replicates DNA. B) transfers DNA vertically, to new cells. C) transfers DNA horizontally, to cells in the same generation. D) transcribes DNA to RNA. E) copies RNA to make DNA. Answer: C Skill: Understanding 31) The necessary ingredients for DNA synthesis can be mixed together in a test tube. The DNA polymerase is from Thermus aquaticus, and the template is from a human cell. The DNA synthesized would be most similar to A) human DNA. B) T. aquaticus DNA. C) a mixture of human and T. aquaticus DNA. D) human RNA. E) T. aquaticus RNA. Answer: A Skill: Understanding Table 8. 3 Amino Acids Encoded by the Human p53 Gene [pic] 32) Based on the information in Table 8. 3, prostate cancer is probably the result of which kind of mutation? A) analog B) frameshift C) missense D) nonsense E) None of the answers is correct. Answer: D Skill: Analysis Figure 8. 4 33) In Figure 8. 4, the antibiotic chloramphenicol binds the 50S ribosome as shown. From this information you can conclude that chloramphenicol A) prevents transcription in eukaryotes. B) prevents translation in eukaryotes. C) prevents transcription in prokaryotes. D) prevents translation in prokaryotes. E) prevents mRNA-ribosome binding. Answer: D Skill: Analysis 34) The mechanism by which the presence of glucose inhibits the arabinose operon is A) catabolite repression. B) translation. C) DNA polymerase. D) repression. E) induction. Answer: A Skill: Recall 35) The mechanism by which the presence of arabinose controls the arabinose operon is A) catabolite repression. B) translation. C) DNA polymerase. D) repression. E) induction. Answer: E Skill: Recall 36) If you knew the sequence of nucleotides within a gene, which one of the following could you determine with the most accuracy? A) the primary structure of the protein B) the secondary structure of the protein C) the tertiary structure of the protein D) the quaternary structure of the protein E) The answer cannot be determined based on the information provided. Answer: A Skill: Understanding 37) An enzyme that makes covalent bonds between nucleotide sequences in DNA is A) RNA polymerase. B) DNA ligase C) DNA helicase. D) transposase. E) DNA polymerase. Answer: B Skill: Recall 38) An enzyme that copies DNA to make a molecule of RNA is A) RNA polymerase. B) DNA ligase. C) DNA helicase. D) transposase. E) DNA polymerase. Answer: A Skill: Recall 39) An enzyme that catalyzes the cutting and resealing of DNA, and is translated from insertion sequences, is A) RNA polymerase. B) DNA ligase. C) DNA helicase. D) transposase. E) DNA polymerase. Answer: D Skill: Recall 40) Repair of damaged DNA might be viewed as a race between an endonuclease and A) DNA ligase. B) DNA polymerase. C) helicase. D) methylase. E) primase. Answer: D Skill: Understanding 41) The cancer gene ras produces mRNA containing an extra exon that includes a number of UAA codons. Cancer cells produce ras mRNA missing this exon. This mistake most likely is due to a mistake by A) a chemical mutagen. B) DNA polymerase. C) photolyases. D) snRNPs. E) UV radiation. Answer: D Skill: Understanding Figure 8. 5 42) In Figure 8. 5, which model of the lac operon correctly shows RNA polymerase, lactose, and repressor protein when the structural genes are being transcribed? A) a B) b C) c D) d E) e Answer: D Skill: Analysis 43) The miRNAs in a cell A) are found in prokaryotic cells. B) are a part of the prokaryotic ribosome. C) are a part of the eukaryotic ribosome. D) allow different cells to produce different proteins. E) are responsible for inducing operons. Answer: D Skill: Recall 44) Assume the two E. coli strains shown below are allowed to conjugate. Hfr:pro+, arg+, his+, lys+, met+, ampicillin-sensitive F:pro-, arg-, his-, lys-, met-, ampicillin-resistant What supplements would you add to glucose minimal salts agar to select for a recombinant cell that is lys+, arg+, amp-resistant? A) ampicillin, lysine, arginine B) lysine, arginine C) ampicillin, proline, histidine, methionine D) proline, histidine, methionine E) ampicillin, prolein, histidine, lysine Answer: C Skill: Analysis 45) Protein synthesis in eukaryotes is similar to the process in prokaryotes in that both eukaryotes and prokaryotes A) have exons. B) have introns. C) require snRNPS. D) use methionine as the â€Å"start† amino acid. E) use codons to determine polypeptide sequences. Answer: E Skill: Understanding 8. 2True/FalseQuestions1) Recombination will always alter a cell’s genotype. Answer: TRUE Skill: Understanding2) Open-reading frames are segments of DNA in which both start and stop codons are found. Answer: TRUE Skill: Understanding3) Bacteria typically contain multiple chromosomes. Answer: FALSE Skill: Recall4) Mutations that are harmful to cells occur more frequently than those that benefit cells. Answer: TRUE Skill: Recall5) The miRNAs in a cell inhibit protein synthesis by forming complementary bonds with rRNA. Answer: FALSE Skill: Recall6) Some organisms may contain multiple genomes. Answer: FALSE Skill: Recall7) Both base substitution and frameshift mutations can result in the formation of premature stop codons. Answer: TRUE Skill: Recall8) In the Ames test, any colonies that form on the control should be the result of spontaneous mutations. Answer: TRUE Skill: Recall9) Transposition results in the formation of base substitution mutations in a cell’s DNA. Answer: FALSE Skill: Recall 10) Cell-to-cell contact is required for transduction to occur. Answer: FALSE Skill: Understanding 8. 3Essay Questions1) What is the survival value of the semiconservative replication of DNA?2) Scientists are concerned that bacteria will be resistant to all antibiotics within the next decade. Using your knowledge of genetics, describe how bacterial populations can develop drug resistance in such a short time frame.3) Explain why the following statement is false: Sexual reproduction is the only mechanism for genetic change.4) Why must the cultures used in the Ames test be auxotrophic? Explain the necessity of using a strain that is mutated in this experiment.5) W hat is the survival value of the degeneracy of the genetic code?

Foreclosure Crisis A Lack of Knowledge - 1106 Words

The foreclosure crisis all boils down to lack of knowledge. Real Estate as any other investment entails risk and uncertainty. No one can foretell how much return an investment will make, or even if there will be a return at all. Risk is only matched by the size of the investment, where higher risks are taken for investments that have a higher possible return. That said, as Real Estate will undoubtedly be the largest investment for most of the population, it will definitely have the highest level of risk for most people in the population. Risk will be inherent in any investment as no one can be certain about the future; however risk is maximized by ignorance and minimized by knowledge. It is ignorance that has led to ill-advised home†¦show more content†¦Such payment structures lead to families overestimating what they could actually afford and only finding that reality of affordability had floated beyond their reach in foreclosure. The fundamental principle that must be realized is that foreclosure only happens when one cannot make timely monthly payments. The monthly payment is largest focal point of affordability in real estate. One must answer this: â€Å"Can I afford the monthly payment on this loan for the duration of the assigned term even when the loan adjusts?† If the answer is yes, then that will reduce the risk of foreclosure. Many people during the crisis tried to squeeze into loans that eventually adjusted above their affordability level. Some tried to refinance finding that since the value of their home decreased, they were stuck with their current payment. However, if they understood again, personal finance, and the structure of debt, they would understand that a high adjustment in interest rate would push them into a payment that was well above their means. 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The Frontiers of American History in Last Child of the...

In the second chapter of Last Child of the Woods, Richard Louv makes the claim that there have been three frontiers in the course of American history. The first phase was the original frontier, before the Industrial Revolution. This was the time of the prairie schooner, the cowboy, the herds of bison that were thousands strong. This was a rough, hard time, when man and nature were constantly thrown together. There was wilderness to spare, and people were willing to move West to get to it. The second phase came into being after the Industrial Revolution. Land that was available to homesteaders had run out. Yet the American people still considered themselves frontier explorers. Times had been trying during the Westward Expansion,†¦show more content†¦Not only are they taught that building things outside are bad, but because of the disappearance of natural spaces within cities, nature is not as accessible to kids. This leads to what Louv calls, Nature Deficit Disorder, the lack of relationship between children and nature. Richard Louv uses Logos in several different ways throughout this selection. He collects research from many different studies, interviews parents, and finds sources from history. In his second chapter especially, he uses numerous examples of scientific experiments to back his point that people really do not have an adequate realization of the difference between humans and animals. In his third chapter, he conducted an interview with a parent who had moved to a certain neighborhood because of the abundance of outdoor areas. Louv uses this interview to illustrate his point that even if nature is available, it really is not supposed to be used for unstructured recreation. In his second chapter, he draws on U.S. Census Bureau reports to illustrate the decline of the family farm. He uses historical events and ideas to show his idea of the romanticizing of the American frontier. Through these concrete examples, he is able to persuade the reader that his ideas and theories are vali d. I think that Louv is right in his opinion that kids are losing touch with nature. This epidemic is not just in big cities, but wherever technology has a hold. Technology has become