ASSIGNMENT INSTRUCTIONS for TWO QUESTION PROJECTEnglish Literatu.docx

ASSIGNMENT INSTRUCTIONS for TWO QUESTION
PROJECT
English Literature
Instructions for Questions ONE & TWO Strict GUIDLINES
Compose a multi-paragraph essay that has an average length of
seven (7) typed, double-spaced pages, plus the works cited
page(s);
1. provide a clear and precise thesis that addresses and answers
the question;
2. use facts from the works selected to support your argument;
3. utilize standard English in the essay;
4.employ essay structure and essay map in composing essay;
5.use the MLA formatting where necessary;
6.demonstrate familiarity with the context of the works
selected; and
7. provide adequate details and explanation of ideas to support
your argument.
Question ONE
The Victorian world was fenced on all sides by strong barriers
of the patriarchal system. Use the likes of the works of Bernard
Shaw, Oscar Wilde, Robert Louis Stevenson, Emily Bronte,
Willian Morris and John Stuart Mill, all Victorian authors to
discuss this assertion. How this social and cultural system
(patriarchal society) impacted their creativity
Question TWO – follow steps 1-7
In FIVE (5) pages plus a works cites page;
Discuss how the title of Dickens’ Hard Times reflects the
content of the novel.

Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Copyright © 2013 F.A. Davis Company
Mexican Americans
Larry Purnell, PhD, RN, FAAN
*
4th Edition
Overview/HeritageMexican, Mexican American, Latino(a),
Chicano(a), la gente de la raza, Hispanic, etc. are commonly
used terms.Second largest Spanish speaking group in the
world500+ different dialects and ethnic groups in
MexicoMexico City is one of the largest cities in the world
*

4th Edition
Overview/Heritage Continued60% of the population is
mestizo—a blend of Spanish white and Indigenous IndianThe
majority of the Hispanic population in the United
StatesHispanic is the largest “minority” group in the United
States surpassing African Americans in 1999
*
4th Edition
Overview/Heritage ContinuedOriginal inhabitants, along with
Native American Indians, of southwest United StatesMajority of
newer immigrants come to the United States for economic
opportunities and are poorer than previous immigrantsLow
educational rates in the United StatesNinth-grade educational
level required in Mexico —mean is 5 years
*
4th Edition
CommunicationsDialect varies by region of Mexico, including
MayanRapid speech pattern with apocopation (e.g., como esta
usted = com-esta-sted)Idiomatic and slang expressions are
common—like English

*
4th Edition
Communications ContinuedConcepts of personalismo is
important.Touch between the men and between women is
acceptable. Men and women greet with a hug and kiss to the
cheek.Eye contact with staring is expected for peers.Many avoid
direct eye contact with superiors as a sign of respect.
*
4th Edition
Communications ContinuedIntense eye contact can cause the
“evil eye,” a folk illness common in all Hispanic and
Mediterranean cultures.Children are more susceptible to the evil
eye than are women who are more susceptible than
men.Healthcare provider should greet men with a firm
handshake.
*
4th Edition

Communications ContinuedTemporality varies via
socioeconomic level Clock time is not categorically imperative;
events begin when they begin and not until thenName format:
First name, middle name, father’s surname followed by
mother’s maiden name. A woman takes her husband’s last name
which is place before her maiden name..
*
4th Edition
Family RolesTraditional families are patriarchal but vary
greatly. Current research is dispelling the myth of machismo
and patriarchal decision-making.Children are closely protected
and are not expected to work or do many chores in middle-class
families—children are supposed to be allowed to be children.
*
4th Edition
Family Roles ContinuedChildren are taught to respect parents,
elders, and teachers, etc.Multigenerational families in Mexico,
less so in the United States.Children have comadres, compadres
(godparents).Single parenting somewhat stigmatized, severely
so in some groups.

*
4th Edition
Family Roles ContinuedSignificant number of Unido until at
which time the family has the money for a religious wedding
ceremony.Academic and professional degrees are highly
respected.A good education also means having good manners.
*
4th Edition
Family Roles ContinuedIf family and close friends are aware of
gay/lesbian relationships, they are not talked about.Stigma
continues to be a significant problem with many.Dignity, Hola,
and Ellas are support groups and they all have 800 numbers and
are located in Washington, DC.
*
4th Edition
Biocultural EcologyIntestinal parasites and diarrhea are major

health problem among immigrants; also tuberculosis, STIs, and
HIV/AIDS.Hypertension, cardiovascular disease, diabetes,
malaria, cholera, typhoid, dengue fever, and high suicide rates.
Incidence varies from point of migration and living conditions.
*
4th Edition
Biocultural Ecology ContinuedAlcohol metabolism is slowed,
especially among those with an Indigenous Indian
ancestry.Require lower doses of antidepressants and are poor
metabolizers of debrisoquinine.Greater toxicity from
tuberculosis drugs.
*
4th Edition
NutritionLarge percentage of women are overweight—seen as
positive and is a sign of health, fertility, wealth, and
beauty.Anytime is a time to celebrate with food.Food choices
vary by area of immigration—mountains, metropolitan areas,
seaports, etc.Staples include tacos and rice and plantains.
*

4th Edition
Nutrition ContinuedLactose intolerance, especially from adults
so calcium obtained from soups with bones and bone marrow,
leafy greens, and corn tortillas treated with calcium
carbonate.Many ascribe to the hot/cold theory of foods,
although they may not speak to it directly.
*
4th Edition
Nutrition ContinuedNot all foods are spicy! And Nachos are
American—not MexicanMeal times vary, but many continue
with the afternoon siesta if job permitsMany foods are deep
fried or fried in some manner—high-fat diet mostlyIron and
Vitamin A deficiency—especially among lower socioeconomic
groups
*
4th Edition
Childbearing FamilyBirth rate in Mexico and United States is
higher among Mexican Americans than among other United

States groups. Wide range of contraceptives when used, but not
always admitted.Condom use: used mostly with prostitutes for
infection prevention.
*
4th Edition
ClickerCheck
Many Hispanic Americans have lactose intolerance. A good
source of calcium if the diet is
Flour tortillas.
Corn tortillas.
Chicken
Pork.
*
4th Edition
Correct Answer
Correct answer: B
Corn tortillas are high in calcium because they are made with
calcium carbonate.
*

4th Edition
Childbearing Family ContinuedPregnancy is natural so why see
a healthcare provider for prenatal care?Many are not used to
prenatal care in their home country because it is not available—
thus, advice comes from older females in the family.Hot and
cold theory extends to foods and practices during pregnancy and
postpartum.
*
4th Edition
Childbearing Family ContinuedDo not walk in moonlight while
pregnant because it may cause a birth deformity.Man not to see
wife or baby until several hours after birth because harm can
come to the baby or mother.Do not reach over your head while
pregnant because it can cause the cord to wrap around the
baby’s neck.
*
4th Edition
Childbearing Family ContinuedSome do not bathe or wash hair

for 40 days postpartum – do take a sponge bath.Cutting the
baby’s nails before 3 months of age may cause blindness and/or
deafness.Umbilical belt and/or coin or key placed on abdomen
to keep it from protruding when crying.
*
4th Edition
Death RitualsDeath seen as a natural part of lifeSit vigil over
the dying and after death with the familyChildren are not
shielded from deathEl dia de muerte celebrated at the gravesite
of family membersVelorio—festive watch over the dead before
internment and may be a long procession
*
4th Edition
Death Rituals ContinuedEl ataque de nervios (nervous attack)
occurs with death and other strong emotionsA few may still hire
llorandos (criers) for the funeral
*

4th Edition
SpiritualityFamily is foremost among Mexicans and most other
Hispanic familiesTake great pride in their heritage and family
lineageReligiosity supports fatalism—it is God’s Will
*
4th Edition
Spirituality ContinuedMajority are Catholic with Indigenous
variation practices.Priests are major sources of support for the
individual and family and may be sought before seeking advice
from a healthcare professional.
*
4th Edition
Healthcare PracticesExternal focus of control works against
prevention measures.To express negative feelings is not
considered polite—therefore do not complain of health ailments
until symptoms are severe.Good health means being free of
pain.
*

4th Edition
ClickerCheck
Mrs. de la caza, 32 year old pregnant Mexican American, is
pregnant. The nurse recommends walking for exercise for
weight control. The patient works at a sedentary job during the
day and tells the nurse she cannot walk at night the baby will be
born
Too large.
Too small.
With a cleft-palate.
With a birth mark.
*
4th Edition
Correct Answer
Correct answer: C
Walking at night, especially in the moonlight, is believed to
cause the baby to have a cleft-lip or palate.
*

4th Edition
Healthcare Practices ContinuedMany do not protect themselves
from environmental hazards because they are not knowledgeable
about the hazards.Seek over-the-counter drugs and indigenous
healers before seeing a Western healthcare provider.All
socioeconomic levels seek traditional healthcare providers.
*
4th Edition
Hot and Cold IllnessesSee book chapter with hot and cold
illnesses and their treatments—varies greatly among families
because they are handed down within the family and
community—need to specifically ask! Barriers in the United
States include money, access, appropriateness, language,
limited knowledge, and gender.
*
4th Edition
Cultural ResponsesAccept and expect pain as a necessary part
of life.Obliged to endure pain in the performance of
duties.Ability to endure pain stoically is valued.Pain and
suffering may be due to immoral behavior.

*
4th Edition
Cultural Responses ContinuedPhysical and mental illnesses are
readily accepted but may keep family member at home to
protect others, not the patient. Can enter the sick role readily
without stigma.
*
4th Edition
Organ Donation and TransplantationNot morally averse to organ
donation.Hesitant to donate while alive because the body should
be buried whole.If abdominal surgery, bad air may enter the
body and increase the potential for cancer or other problems.
*
4th Edition

Traditional Hispanic Healthcare ProvidersCuranderos: folk
healersMasijistas: massage therapistsBrujos: witchesSobadoros:
manipulate bonesPadres: priestsEspiritistas—Espiritualistas—
Espiritus (spiritualists)Jerberos—yerberos: herbalists
*
4th Edition
Korean American Culture
Larry Purnell, PhD, RN, FAAN
*
4th Edition
Korean Overview/HeritageThis presentation focuses on the
commonalities among Koreans from the Republic of South
Korea, although some information may be congruent with North
Koreans..The first major immigration from Korea occurred
between 1903 and 1905, when more than 7,000 men arrived in
Hawaii.

*
4th Edition
Korean Overview/HeritageSouth Koreans immigrate to America
to increase socioeconomic opportunities and improve
educational opportunities.They place a high value on education.
Their reputation for hard work, independence, and self-
motivation has earned them the label of the “model minority.”
*
3rd Edition
Korean CommunicationThe dominant Korean language, han’gul,
was the first phonetic alphabet in East Asia.Most Koreans in
America can speak, read, write, and understand English to some
extent. Some Americans may have difficulty understanding their
English, especially those who learned English from Koreans
who spoke with their native intonations and pronunciations.
*
4th Edition

Korean CommunicationA high value is placed on harmony and
the maintenance of a peaceful environment. Most are
comfortable with silence. Small talk may appear senseless and
insincere. Most stand close when conversing.Touch in the realm
of health care is readily accepted.
*
4th Edition
Korean CommunicationTouching among friends and social
equals is common and does not carry a sexual connotation, as it
might in Western societies. Hugging and kissing are uncommon
among parents and children as well as among children and older
aunts or uncles.
*
4th Edition
Korean CommunicationAge, gender, and social status determine
the use of eye contact. Respect for those in senior positions is
shown by not looking them directly in the eye.Feelings are
infrequently communicated in facial expressions.

*
4th Edition
Korean CommunicationMore traditional Koreans are past-
oriented. Much attention is paid to the ancestry of a family.
Yearly, during the Harvest Moon in Korea, chusok (respect) is
paid to ancestors by bringing fresh fruits from the autumn
harvest, dry fish, and rice wine to gravesites.The younger and
more educated generation is more futuristic and achievement-
oriented.
*
4th Edition
Korean CommunicationPunctuality is the norm for keeping
important appointments, making transportation connections, and
reporting to work.The number of surnames in Korea is limited:
the most common ones are Kim, Lee, Park, Rhee or Yi, Choi or
Choe, and Chung or Jung.
*

4th Edition
Korean CommunicationKorean names contain two Chinese
characters, one of which describes the generation and the other
the person’s given name.The surname comes first.However,
because this may be confusing to many Americans, some
Koreans in the United States follow the Western tradition of
using the given name first, followed by the surname.
*
3rd Edition
Korean Family Roles and OrganizationMen are the primary
financial providers. Women are expected to stay home and care
for the children and domestic affairs unless they are
professionals.Women have long been degraded in Korean
society and seen as appendages of male family members.
*
3rd Edition
Korean Family Roles and OrganizationIn earlier times, a

woman’s identity was determined by her role as someone’s
daughter, wife, or mother. While many still practice these
gender relationships, more educated women and men no longer
adhere to these Confucian values.Parenting in Korea is
authoritative, although class differences play a more influential
role in determining parenting styles and family roles.
*
3rd Edition
Korean Family Roles & OrganizationChildren are expected to
be well behaved because the whole family is disgraced if a child
behaves in an embarrassing manner. Discussing domestic
violence violates Korean cultural norms. Dating is uncommon
among high school students, although it is gaining in the US.
*
3rd Edition
Korean Family Roles & OrganizationOnce young adults have
entered a university, they receive their freedom and are
permitted to make their own decisions about personal and study
time. With rapid acculturation, children often take on the values
of the dominant society or culture and challenge parents who
support traditional values and ideals.

*
3rd Edition
Korean Family Roles & OrganizationParents expect their
children to care for them in old age. Hyo (filial piety) is the
obligation to respect and obey parents, care for them in old age,
give them a good funeral, and worship them after death. The
obligation to care for one’s parents is written into civil code in
Korea.
*
3rd Edition
Korean Family Roles & OrganizationOlder people are
frequently consulted on important family matters as a sign of
respect for their life experiences.Old age begins when one
reaches the age of 60 years.Women who divorce may suffer
social stigma. Living together before marriage is not customary
in Korea.
*

3rd Edition
Korean Family Roles & OrganizationIf pregnancy occurs
outside marriage, it may be taken care of quietly and without
family and friends being aware of the situation.Lesbian and gay
relationships are frowned upon. Personal disclosure to friends
and family jeopardizes the family name and may lead to
ostracism.
*
3rd Edition
Korean Workforce IssuesThe skills and work experiences
Koreans bring from their home country are often not accepted in
the American workforce, forcing them to take jobs in which
they may be over skilled. A supervisor is treated with much
respect in work and in social settings. Informalities and small
talk may be difficult for Korean immigrants.
*
3rd Edition
ClickerCheck
An older adult Korean American man does not maintain eye
contact with the nurse who is teaching him insulin injection.
The nurse recognizes that lack of eye contact means he

Does not understand the instructions.
Does not care about the instructions.
Is demonstrating respect.
Is hard of hearing.
*
3rd Edition
Correct Answer
Correct answer: C
Many traditional Koreans do not maintain eye contact with
people in authoritative positions as a means of demonstrating
respect.
*
3rd Edition
Korean Workforce IssuesFor an employee to refuse a request of
an employer is unacceptable, even if the employee does not
want or feel qualified to complete the request. American slang
and colloquial language is difficult for Koreans to understand.
*

3rd Edition
Korean Biocultural EcologyCommon physical characteristics
include dark hair and dark eyes, with variations in skin color
and hair darkness. Skin color ranges from fair to light brown,
with those residing in the southern part of South Korea being
darker.Epicanthal skin folds create the distinctive appearance of
Asian eyes.
*
3rd Edition
Korean Biocultural EcologyCommon health conditions
occurring with Koreans include the following: schistosomiasis,
renal failure, asbestosis, hypertension, tuberculosis, hepatitis,
stomach cancer, lactase deficiency, osteoporosis, peptic ulcer
disease, and insulin autoimmune deficiency disease.
*
3rd Edition
Korean High-Risk Health BehaviorsKorea continues to
manufacture and use asbestos-containing productsSmoking by
women in public is taboo, but some women smoke at home.Men

have a high incidence of alcohol consumption.Seat belts are
worn infrequently in South Korea.
*
3rd Edition
Korean NutritionThe traditional Korean diet includes steamed
rice; hot soup; kimchee; and side dishes of fish, meat, or
vegetables served in some variation for breakfast, lunch, and
dinner. Breakfast is traditionally considered the most important
meal.Rice is served with 5 to 20 small side dishes of mostly
vegetables and some fish and meats.
*
3rd Edition
Korean NutritionFood is flavorful and spicy. Cooking includes a
variety of seasonings: red and black pepper, garlic, green onion,
ginger, soy sauce, and sesame seed oil.Most Korean Americans
are at high risk for calcium deficiencies due to lactose
intolerance. A cultural treatment for the common cold is soup
made from bean sprouts, anchovies, garlic, and other hot spices
*

3rd Edition
Korean Pregnancy & Childbearing PracticesPregnancy is a
highly protected time for women.Both pregnancy and the
postpartum period are ritualized.Once a woman is pregnant, she
starts practicing Tae-Kyo, which literally means “fetus
education.”
*
3rd Edition
Korean Pregnancy & Childbearing PracticesThe objective of
Tae-Kyo is to promote the health and well-being of the fetus
and mother by having the mother focus on art and beautiful
objects.
*
3rd Edition
Korean Death RitualsDeath and dying are fairly well accepted
in the Korean culture.Prolonging life may not be highly
regarded in the face of modern technology. Families are
expected to stay with family members and assist in feeding and

personal care around the clock.
*
3rd Edition
Korean Death RitualsMany believe that patients should not be
told they have a terminal illness. Crying and open displays of
grief are common and signify the utmost respect for the
dead.Relatives and friends pay respect by viewing photographs
of the deceased instead of viewing the body.
*
3rd Edition
Korean Death RitualsAn ancestral burial ceremony follows
death, with the body being placed in the ground facing south or
north. Rice wine is sprinkled around the gravesite.The eldest
son or male family member sits by the deceased, sometimes
holds a cane, and makes a moaning noise to display his grief.
The cane is a symbol of needing support.
*

3rd Edition
Korean SpiritualityOrganized religions include Christianity,
Buddhism, and Chondokyo. The church is a powerful social
support group for Korean immigrants.Christians believe the
spirit goes to heaven; Buddhists believe the spirit starts a new
life as a person or an animal. Family and education are central
themes that give meaning to life.
*
3rd Edition
Korean Health-care PracticesHerbal medicine may be used in
conjunction with Western biomedicine. Herbal remedies include
ginseng, seaweed soup, and haigefen (clamshell powder), which
has high levels of lead, causing abdominal colic, muscle pain,
and fatigue. Acupuncture, acumassage, acupressure, and
moxibustion therapy are commonly used.
*
3rd Edition
Korean Health-care PracticesSome Korean Americans are stoic
and are slow to express emotional distress from pain. Others are
expressive and discuss their smallest discomforts. Organ

donation and organ transplantation are rare, reflecting
traditional attitudes toward integrity and purity.
*
3rd Edition
Korean Health-care PracticesMental illness may be stigmatized.
Hwa-Byung, a traditional Korean illness, occurs from the
suppression of anger or other emotions. These emotions are
expressed as physical complaints, ranging from headaches and
poor appetite to insomnia and lack of energy.
*
3rd Edition
Korean Health-care PractitionersMore traditional individuals
frequently prefer health-care providers who speak Korean and
are older.Because of modesty, women prefer women health care
providers to perform Pap smears, mammography, and breast
examinations.
*

3rd Edition
ClickerCheck
Mrs. Kim brings her 15 year old daughter to the parish nurse
because she is having abdominal cramps and fatigue that have
worsened since she began giving her haigefen. The nurse should
request a blood test for
Iron levels.
Lead levels.
Calcium levels
Potassium levels.
*
3rd Edition
Correct Answer
Correct answer: B
Haigefen is an herbal compound that is made with clamshells
which has a high lead content.
*

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