Analysis of Orthopeadic Theatre Time Utilization

Analysis of Orthopeadic Theatre Time Utilization ANALYSIS OF ORTHOPEADIC THEATRE TIME UTILIZATION AT KENYATTA NATIONAL HOSPITAL Trauma is the leading causes of admission in Kenyatta National Hospital and often these patients require surgery. The trauma burden unpredictability usually mismatches demand and supply of the hospital thus posing challenge for systems improvement and streamlining. Utilization is defined as the ratio of time that an asset is used, against its capacity. For uniformity among the OR team, it is extremely important to developing a precise definition of turnaround time. For the purpose of this paper, turnaround time is defined as the time between incision close of patient n and incision open of patient n+1. This definition captures the surgeon’s, anaesthetist and nurse perspective of turnaround time and allows us to see the delay between the most expensive value-added times in the theatre. Previous study from KNH reported high rate of cancellation of elective list on the day of surgeries (20.6%)1. One of the causes attributed to these delays was inefficient utilization of OR time, mainly due to delay in starting time and long turnaround time within the OR. It was noted that 70.9% of non clinical cancellation was due to list overrun/lack of time. It was also the leading cause of cancellation in KNH at (43.8%). Three specialty were identified to have recorded the highest cancellation rate were Cardiothoracic surgeries 38%, Neurosurgeries 37.8% and Orthopedic surgeries 32.6%1. Cancellation generally increases waiting list and the risk of further cancellation, which may cause patient dissatisfaction and compromise patient’s safety2. Poor scheduling of operations can result in cancellation of operation which is costly to both the patient and the hospital3. With the escalating cost of healthcare, quality of care fails to meet expectation of our patients and therefore, the health care organization should look on strategies to improve quality while reducing cost of running hospitals. The efficiency of operating room can be measured in variety of ways4. Efficiency is defined in term of ability to translate available time into earning5–8. Computer simulation and mathematical models, both of which essentially idealizations that the practical capacity for OR to be between 80-90%9. Justification Theatre complex is a high cost department with the hospital and therefore considerable resources are wasted if operating room if not used effectively. Improving the performance of operating room is key to achieving shorter waiting time for surgery, reducing cancellation for operations and more so achieving the implementation of booking of elective surgery in our hospital. Increased utilization of operating room improves patients flow and reduces the waiting list time. Improving theatre utilization would lead to a reduction in cost recovery from each patients10. 4 in their study in South African concluded that private operation theatre utilization rates were higher than public operation theatres due to commercial nature of private healthcare and absent consequent cost drivers in public health sector10. Utilization rate in South Africa was found to be 48% which was significantly lower than the globally bench mark of between 70-80%4. 11 concluded that the delay in starting list, under s chedule, interruption due to emergency surgeries, administrative reasons, induction of anesthesia and recovery police are the main factor that account for inefficient use of operating room facilities in India hospitals Operating room utilization rate is usually an indicator used in measuring efficiency in use of hospital resources. It is argued that high utilization is cost effective and improves quality of care10,12–15. Brief Description of KNH Main Theatre KNH Main theatre is located in the first floor of the tower block adjacent to Critical Care Unit (CCU), Renal and Burns Unit. It has twelve operating rooms out of which two are allocated to Prime Care Center; one is dedicated for emergency surgeries 24 hours a day. The remaining nine are allocated to different specialty in a week. The specialties are General surgery, Urology surgery, Maxillofacial surgery, ENT surgery, Pediatrics surgery, Plastic surgery, Ophthalmology surgery, Orthopedic surgery, Cardiothoracic surgery, Neurosurgical and Obstetrics and Gynecology surgery. Within the OR the following equipments are found, Operating table in the center of the room, Operating lights directly over the table to provide bright light during surgery, Anaesthesia machine is at the head of the operating table equipped with Electronic monitor machine which records the heart rate and respiratory rate by adhesive patches called chest leads placed on patient’s chest, it has also the Pulse oximeter which is attached to the patient’s finger with an elastic band aid. Pulse oximeter measures the amount of oxygen contained in the blood, an automated blood pressure measuring machine that automatically inflates the blood pressure cuff on patient’s arm continuously recording blood pressure, there is the diathermy machine which uses high frequency electrical signals to cauterize blood vessels and cut through tissue with a minimal amount of bleeding. Other specialized machines may be brought in depending on the nature of surgery. In a week there are 45 theatre space slot allocated to different specialty, out of which orthopedic surgeries have 12 slots and the remaining 33 slot are allocated among the remaining 10 specialty. The orthopedic department is located on the sixth floor of the tower block and has four wards namely 6A, 6B, 6C and 6D. Ward 6B serves as a joint admission for all pediatric cases from 6A, 6C and 6D. Each ward has four days in a week to do the elective surgeries. Theatre procedure Each ward is expected to submit its operation list to main theatre reception before 15:00 hours on the day before its as ­signed operation day. In the evening before the surgery, anaesthetists visit the wards to do a pre-anesthetic assessment on patients who had been scheduled for surgery. They are expected to re-assure these patients, assess their fitness for surgery, and also confirm the necessary investigation are done which they document in the pre-anesthetic check list. On the day of surgery porters are sent to the ward to bring the patients who are then received by a designated theatre nurse at the receiving area, the Receiving Area nurse check to confirm the identity of the patient, see that consent for the surgery had been given and all necessary investigation have been done. Thereafter, the patient is wheeled to waiting bay where he/she is kept on-hold until the theatre room is ready. All other procedures like intravenous access and induction of anaesthesia are done in theatre. After surgery, the patient is taken to Post Anesthesia Care Unit (PACU) while the oper ­ating room is cleaned in preparation for the next patient. Economic considerations also suggest that it is desirable to keep operat ­ing rooms fully used. Thus, it is imperative that areas of time wastage in the theatre time flow be recognized and their causes identified. This will assist theatre managers take necessary steps to correct the problem14. Objective To identify areas of, and causes of operating room time delay, and suggest solution based on the identified deficiencies. Operating theatre represents an area of considerable expenditure in a hospital budget. Consequently, hospital administrators are so concerned with maximizing utilization of OR. This can only be made possible by knowing how much time is spent on which activity and there by identify the factors resulting in under utilization of OR16. Staffing KNH theatre complex is being managed by Assistant Chief Nurse (ACN) with the help of Administrative Officer. The two are answerable to the Head of Department (HOD) Theatre, TSSU and CSSD. The staff within each OR includes Surgeons, Anesthetist, 1- circulating nurse , 1- scrub nurse and 1- theatre sterile assistant (TSA). The general theatre activities are overseen by a Theatre Users Committee (TUC), with HOD as the chairperson. Other members are from Nursing, Surgery, Anaesthesia, Administration and Technical departments. Data Collection I will survey the timing of events in the Orthopedic OR using their elective operating lists available from Monday to Friday at theatre front office desk for a period of one month. I will use a designed proforma based on established oper ­ating theatre process steps to record the following; Patient sent-for (PS): Time when porter leave R/A to the ward for the patient Patient available (PA): Time the patient arrives at theatre R/A Patient in room (PIR): time when patient enters OR Anesthesia/Induction start time (AIT): time induction of anesthesia starts Surgery start time (ST): time cleaning of surgical area Surgery finish (SF): time dressing is put on the incision site Patient out OR (POR): Time at which patient leaves the OR From the above times, I will derive the following: Ward to theatre transfer interval: the interval between PS and PA (b-a). This interval is prolonged when it is greater than 20 minutes. R/A waiting time: It is the interval be ­tween patient available (PA) and when patient is transferred to OR (c-b). It is prolonged if it is greater than 10 minutes. Pre-anesthetic waiting time: the difference between patient’s in room (PIR) and anesthesia/induction start time (AIT) (d-c). It is prolonged when it is greater than 20 minutes. Anaesthesia admission time (AAT): the interval between AIT and ST (e-d) and it is prolonged when it is greater than 20 minutes. Surgery duration: the interval between ST and SF (f-e). Anesthesia reversal time (ART): the interval between SF and POR (g-f) Turnaround time (TAT): the interval between incision close of patient n and incision open of patient n+1. There will be a one week pilot study to set the cut-off point for the intervals between normal and delayed time. This will be based on the mean time observed in the pilot study and for convenience it will be rounded-up to the nearest number divisible by five. In case of delay outside theatre the officer involved will be interviewed to determine the cause of the delay. However, delays that occures in the theatre will be observed directly by the research assistant filling the proforma. The data was entered into SPSS 11.5 which was used to calculate the time intervals and for statistical analysis Efficiency means the management of theatre time, costs resources and staff to undertake as many procedures as possible within given levels of resources, or doing the same number of procedures using a lesser amount of resources .

Sectionalism Due to Western Expansion

The Antebellum period from 1800 to 1850 marked a time of sectionalism in American history. Furthermore, new territories gained during western expansion added to this conflict between different sections of America. Southern states wanted new slave territories, while the North wanted to contain the spread of slavery. While Western expansion contributed to growing sectional tensions between the North and South from 1800-1820, sectionalism intensified significantly from 1820-1850. Since the turn of the nineteenth century, Western territorial expansion started to increase a sense of sectionalism throughout America.President Jefferson obtained the Louisiana purchase from Napoleon in 1803, gaining unfamiliar territory West of the Mississippi River. As Lewis and Clark explored the area, others began to populate it, slowly leading to increased tensions between the North and the South. Soon an act was passed stating that territories with a certain number of inhabitants would be added to the un ion as newly developed states. Furthermore, During the Adams-Onis treaty with Spain, Florida was peacefully acquired as a state in America, which also increased tension.Eli Whitney’s cotton gin, and King Cotton increased the South’s dependence on slaves to sustain the supply and demand of cotton, while the North favored the containment of slavery; This difference between the territories regarding slavery directly contributed to the sense of sectionalism shared throughout the nation. However the issue of slavery would be postponed due to the War of 1812, and for a while afterwards, America’s shared sense of nationalism overpowered their shared sense of sectionalism.Around the time of 1820, America’s pride in their victory in the war of 1812 was wearing off, and the balance of nationalism and sectionalism among the nation shifted primarily due to Westward expansion. The Missouri Compromise of 1820, introduced by Henry Clay, allowed for both Maine and Missou ri to be admitted into the union on condition that Missouri became a slave state, as well as banning slavery above the thirty-sixth parallel. Any state admitted into the Union bellow this line would decide the legality of slavery for their new state, by popular sovereignty.This temporarily maintained the balance of slave states and free states in the Union, while increasing sectionalism throughout America. Neither the North or South wanted the other section to have more states favoring their own slavery ideals, in fear of biased representation in the Senate. Furthermore, sectionalism was demonstrated by the fact that congress felt the need to implement â€Å"The Gag rule†; This disallowed congress from discussing the issue of slavery for the next thirty years (while only lasting a decade).Though members of the house tried to pass the Wilmot proviso, which would ban slavery in newly acquired Mexican territories, Southerners naturally opposed this. Disagreements over how to dec ide the newly acquired land’s position on slavery, further intensified sectionalism between the North and South. At one point the South even tried to pass the Ostend Manifesto in an attempt to purchase Cuba from Spain, and admit it into the Union as a slave state.Although this effort failed, it strongly represents the intense sectionalism during the time: As an entire portion of the country acted autonomously to secure an additional state to gain power over their Northern neighbors. Finally, the compromise of 1850 was passed, declaring popular sovereignty as the determining factor of the position of slavery among the land gained from Mexico. Moreover, this compromise enforced a fugitive slave law, allowing the South to collect runaway slaves, abolished the slave trade in Washington D. C. , and admitted California as a free state.Although Congress implemented countless compromises to secure the unionization of America, their efforts proved futile, as sectionalism prevailed and the United States grew closer to an inevitable Civil War. Western expansion during the first half of the nineteenth century, along with increased tensions between the North and South due to slavery, directly increased the sense of sectionalism between the two regions. The controversy over controlled land transformed the nation’s intense sense of nationalism into an even more intense sense of sectionalism, leading to a Civil War only fifty years later.

Media Influence and Ethnic Identity

This paper gives a critical review of the literature on media depictions of minorities in Canada. I propose that the research tends to center on tabularize the under-representation and misrepresentation of ethnic minorities. Media Influence and Ethnic Identity The depiction of ethnic minorities in Canadian media serves to play an alarming part in determining the structure of Canadian minority identities. Researchers have insisted that it is imperative to research media-minority relations because the media play a crucial part in the creation of social identities (Henry). The media gives a vital source of data through which people gain information about their country, and our approaches and viewpoints are formed by what the media distinguishes as public information. The media is directly accountable for how Canada, in all its multiplicity, is interpreted among its people. Simply put, the media is accountable for the ways that Canadian society is interpreted, considered, and assessed among its habitants. The media influences attitudes in Canada by siphoning and selecting the data we receive to make choices about our day-to-day realities. Though, this selection procedure is governed by a series of vitals. Media images of Canadian ethnic minorities are not just a random panoply of depictions. Verdicts about depictions of cultural multiplicity must be envisaged within a series of opposing discourses taking place within media institutions. In spite of what we would like to consider, Canadian media is not just and democratic, nor objective in nature (Hackett, Gruneau, Gutstein, Gibson and NewsWatch). Ethnic Minority groups are regularly disqualified and marginalized, and the leading culture is reinforced as the custom. As researchers have established (Fleras and Kunz; Henry) the media push certain traits, most often negative, about ethnic minorities into the limelight, at the same time as others are downplayed or totally absent from depictions. How does this influence identity creation among ethnic Minority groups? Negative depictions of ethnic minorities teach ethnic minorities in Canada that they are hostile, abnormal, and inappropriate to country-building. Canadian media persist to transmit negative and conventional images that only serve to degrade ethnic Minority Canadians. In other words, ethnic minorities do not see themselves precisely mirrored in Canadian media, and that marginalization effects feelings of segregation. In Canada, questions adjoining the association between identity development among ethnic minorities and media are mainly weighed down because of multicultural policy. It has been recommended that in countries where official multiculturalism is legislated, multifaceted forms of racial discrimination can materialize through a variety of media depictions of ethnic minorities (Dunn and Mahtani, 163-171). Ethnic Minority Depiction: Under-representation And Mis-representation Since its beginning in the late 1960s to the 1980s, research on media-ethnic minority relationships was largely distant with probing the two main ways in which ethnic minorities are problematically treated in media accounts. First is the under-representation (or absence) of ethnic minorities. The second refers to the misrepresentation (or negative depiction) of ethnic minorities A) Under-representation The under-representation of a variety of cultural groups in Canadian media has been evocative of their insignificance or their nothingness. Most of the early research on ethnic depiction was concerned with inducting their nonexistence in the media sequentially to exhibit this argue. Different researchers have found that regardless of the culturally miscellaneous nature of Canadian society, that very multiplicity is frequently missing from media depictions (Fleras and Kunz 2001; Fleras 267-292). As Fleras (1995) spots out, the lack of ethnic minorities in the Canadian media is the law, rather than the exemption. In Canada, interracial relationships in spectacular series are rare. This efficiently reveals that the media is not exactly providing a mirror in which ethnic minority Canadians can see themselves — and their dating models — mirrored. In a study of ethnic minorities' depiction in Canadian amusement programs, MediaWatch scrutinized eight made-in-Canada dramatic series and exposed that only 4 percent of the female characters and 12 percent of the male characters were from diverse ethnic or racial locale (MediaWatch). This exposes that ethnic minorities (and in particular ethnic minority women) are relentlessly underrepresented in equally dramatic series and in news. Miller and Prince (1994) gave a comparable assessment from a news point of view by looking at the photos and news stories printed in six foremost Canadian newspapers. They concluded that out of the 2,141 photos printed, ethnic minorities were presented in only 420 images. Media researchers have specified that the impact of ethnic Minority eccentricity in the media merely serves to more embed the invisibility of ethnic minorities in the general public (Fleras 1995). Ethnic minorities in Canada do not see themselves mirrored in the media, and this effects feelings of refusal, belittles their assistance, and lessens their part as people in their nations (Jiwani 1995). For example, in their paper â€Å"Media (Mis)Depictions: Muslim Women in the Canadian Country,† Bullock and Jafri give extracts from their focus groups where Muslim women met to talk about the representation of Muslim women in the media. (35-40) B) Mis-representation A helpful result of these before time studies was that it gave a momentum for media researchers to examine how the media portrays ethnic minorities when they are actually represented. Researchers have recommended that the depiction of non-prevailing cultures normally prolonged in recent decades (Fleras 1995). One of the means in which Eurocentric domination is maintained is by restraining the kinds of depictions of ethnic minorities in the media to unconstructive or striking stereotypes. Ethnic minorities have persisted that media images of their elements disclose a remorseless pessimism in their description. Media researchers have pointed to the negative depictions of ethnic minorities in a variety of studies. In studies emerging in the 1970s, researchers in Canada have time after time pointed out that the media â€Å"rot †¦ on race-specific and culture cognizant characterizations of people†. Canadian media keep it up to rely on both negative and conservative depictions of ethnic minorities (Roth 1996; MediaWatch 1994; Fleras 1994; Zolf 13-26). Fleras (1994) has explained how ethnic minority images in Canadian media are constantly conservative ones, â€Å"steeped in groundless simplifications that swerve towards the comical or bizarre† (Fleras 1994:273), where the examples of ethnic minorities as â€Å"social problems† are regularly employed: namely, as pimps, high-school dropouts, homeless teens, or drug pushers in Canadian dramatic series. Fleras argues a modicum of media depictions of First Nations people, counting â€Å"the noble savage,† â€Å"the savage Indian,† â€Å"blood-thirsty barbarians,† and â€Å"the drunken Native,† among other damaging stereotypes (Fleras 1994; see also Fleras and Kunz 2001). In television and newsprint and political cartoons, media's fighters were altered primitives, colossal depictions of Indian activists† (Valaskakis 224-234). Gender is a relatively unfamiliar feature of studies about ethnic Minority depiction, as Jiwani (1995) has designated. Several actors and news anchors have spoken out candidly about their apprehensions about ethnic falsification in the media. Rita Deverell, senior producer of Vision TV, has expressed her views about the awkward interpretation of ethnic minorities in television. Deverell has pointed out that, compared to American images, â€Å"we have very few negative, wicked depictions of women of color. Undoubtedly, many researchers be in agreement that in typical media in Canada, ethnic minorities are offered as intimidation, with explicit positionings of â€Å"us† and â€Å"them† in which the former is an understood mainstream audience, and the latter is the ethnic minority (Fleras and Kunz 2001). This occurrence is unhappily not restricted to television dramas — it happens in newspapers and television news too. In a study of ethnic minorities and First Nations peoples' depiction in two major Winnipeg papers, a report conducted by the Social Planning Council of Winnipeg (1996) found that ethnic minorities are often shorn of admittance to the media and quote the problematical reportage of ethnicity when it is inappropriate to the event or incident. Tator (1995) has established that ethnic minorities are continuously being â€Å"singled out† and identified as the cause of a â€Å"social problem† in media depictions. Using the example of the â€Å"Writing Through Race† Conference held in Vancouver of 1994, she explains that the media continually misrepresents and distorts issues of importance to ethnic minorities. A few of the most inquisitive work on the continuation of typecasts has discovered the ways ethnic minorities have been normalized in Canadian news reports. Numerous government reports furnished through official multiculturalism have scrutinized the reporting of variety in the media, closing that stereotypes and negative images flourish (see Karim 1995). Ducharme (1986, 6-11) scrutinized national newspaper reporting of the Canadian immigration policy for a five-year period. Through the early 1990s, researchers gave a helpful Canadian equivalent to U.S. studies that were worried with anti-Islamic images reproducing in American news. Support groups have also added toward this discussion — a working example includes the report created by the Afghan Women's Organization, which appraises research, local activism, and community viewpoints on the portrayal of Muslim women in Canadian media. Supported on a six-month assessment of coverage of numerous Canadian newspapers, the MediaWatch Group of the Canadian Islamic Congress carried out a study of anti-Islamic media exposure, advocating results to the media industry (Canadian Islamic Congress 1998, 51). Henry et al. (1995) propose that this type of racism remains acutely surrounded within media institutions, where structuralist racism still permeates depictions, and regular patterns of under- and misrepresentation continue to strengthen uneven power relations. The tapered range of images of ethnic minorities has successfully reduced the aptitude of ethnic minorities to be distinguished as optimistic providers to Canadian society. Media researchers have pointed out that these unconstructive stereotypes are reason for concern because it creates a divide between ethnic minorities and so-called â€Å"real† Canadians — visible ethnic Minority Canadians are seen as â€Å"others† or â€Å"foreigners† who potentially have the power to threaten the country (Fleras 1995). The reinforcement of negative stereotypes ethnically pathologizes ethnic minorities, advancing racial divides. †¦Through examining the depictions of people of color in the media †¦ [it seems clear that the] dominant culture continues to establish its power and protect its supremacy by inculcating negative and conservative images of ethnic minorities †¦ generating a indistinct awareness on the part of the conventional of ethnic minorities. (Henry, 1999:135-136) Conclusion This paper maintains that the ways the media expose and account on ethnic minority groups in Canada very much affects the ways the public distinguishes ethnic Minority groups in Canadian society. Wide-ranging research crossways disciplines show that ethnic minorities are frequently typecasted in mass media. Media images can promote manners of acceptance and agreement or of fear and pessimism. When media representations fail to represent Canada's ethnic minorities with compassion, the entire country undergoes the consequences. Media workers require believing and creating substitute depictions of ethnic minorities and it may well be our duty to build up coalitions with them to give confidence other sorts of images. Works Cited Bullock, K., and G. Jafri. 2001. â€Å"Media (Mis)Depictions: Muslim Women in the Canadian Country.† Canadian Woman Studies 20 (2): 35-40 Ducharme, M. 1986. â€Å"The Coverage of Canadian Immigration Policy in the Globe and Mail (1980-1985).† Currents Spring: 6-11 Dunn, K., and M. Mahtani. 2001. â€Å"Media Depiction of Ethnic minorities.† In Progress and Planning 55 (3): 163-171. For a web version see Fleras, A. 1995. â€Å"Please Adjust Your Set: Media and Ethnic minorities in a Multicultural Society.† Communications in Canadian Society, 4th Edition. Toronto: Nelson Canada Fleras, A., and J. Kunz. 2001. Media and Ethnic minorities: Representing Multiplicity in a Multicultural Canada. Toronto: Thompson Educational Publishing, Inc. Fleras, A.1994. â€Å"Media and Ethnic minorities in a Post-Multicultural Society: Overview and Appraisal.† in Ethnicity and Culture in Canada: The Research Landscape, edited by J. W. Berry and J. A. LaPonce, Toronto: University of Toronto Press, 267-292 Hackett, R., R. Gruneau, D. Gutstein, T. Gibson, and NewsWatch. 2001. The Missing News: Filters and Blind Spots in Canada's Press. Aurora: Canadian Center for Policy Alternatives/Garamond Press Henry, F. 1999. The Racialization of Crime in Toronto's Print Media: A Research Project. Toronto: School of Journalism, Ryerson Polytechnic University Jiwani, Y. 1995. â€Å"The Media, ‘Race' and Multiculturalism.† A Presentation to the BC Advisory Council on Multiculturalism. March 17. See web site: http://www.harbour.sfu.ca/freda/articles/media.html Karim, K. 1995. Women, Ethnicity and the Media. SRA Reports. Ottawa: Canadian Heritage MediaWatch. 1994. â€Å"Front and Center: Ethnic Minority Depiction on Television.† Media Watch Research Series, Volume 1. Toronto: MediaWatch Miller J. and K. Prince. 1994. â€Å"The Imperfect Mirror: Analysis of Ethnic Minority Pictures and News in Six Canadian Newspapers.† A Report available from the Authors, Toronto: The School of Journalism, Ryerson Polytechnic University Roth, L. 1996. â€Å"Cultural and Racial Multiplicity in Canadian Transmit Journalism.† In Deadlines and Multiplicity: Journalism Ethnics in a Changing World, edited by Valerie Alia, Brian Brennan, and Barry Hoffmaster. Halifax: Fernwood Social Planning Council of Winnipeg. 1996. Media Watch: A Study of How Visible Ethnic minorities and Aboriginal Peoples are Portrayed in Winnipeg's Two Major Newspapers Winnipeg: Social Planning Council of Winnipeg. March Tator, C. 1995. â€Å"Taking a Stand against Racism in the Media,† Text of a speech at â€Å"Racism in the Media: A Conference Sponsored by the Community Reference Group on Ethno-Racial and Aboriginal Access to Metro Toronto Services,† October Valaskakis, G. 1993. â€Å"Guest Editor's Introduction: Parallel Voices: Indians and Others — Narratives of Cultural Struggle.† Canadian Journal of Communication 18 (3): 224-234 Zolf, D. 1989. â€Å"Comparisons of Multicultural Transmiting in Canada and Four Other Countries.† Canadian Ethnic Studies/Études ethniques au Canada 21 (): 13-26

The Strain Theory - Free Essay Example

Sample details Pages: 2 Words: 674 Downloads: 7 Date added: 2017/09/13 Category Advertising Essay Did you like this example? The Strain Theory There are many theories to crime causations one in particular caught my attention, one that I believe is the most accurate. The strain theory was developed in 1938 by Robert Merton and then updated by Robert Agnew in 1985. Agnew’s general strain theory is based on the general idea that â€Å"when people get treated badly the might get upset and engage in crime†. The general strain theory identifies the ways of measuring strain, the different types of strain, and the link between strain and crime. Agnew came up with two different ways to measure strain in an individual’s life. The first way is the subjective approach, where the researcher directly asks the â€Å"individual whether they dislike how they are being treated†. The second approach is the objective view, where the researcher asks individuals about pre-determined causes of strain. The causes of strain are things that the researcher identifies as treatment that a member of the group being studied would dislike. Don’t waste time! Our writers will create an original "The Strain Theory" essay for you Create order The objective approach is most commonly used way to measure strain and it usually involves relationships with friends, families, and the community. But when doing research one must consider that individuals have different reactions to certain types of strain. To get an effective measure of strain the researcher must first make a list of all the negative circumstances that can result in strain. The second thing to be considered is the magnitude, duration, and clustering of negative events. There are three major types of strain. The first is the failure to achieve positively valued goals, the second is the loss of positive stimuli, and the third is the presentation of negative stimuli. Agnew noted that the three positively valued goals members of society strive for are 1) money, it is a cause for strain when it is not available through legitimate means and delinquents desire to gain large amounts of money. 2) status and respect, an individual strives to prove their masculinity by using criminal behavior. ) Last is autonomy, the power over oneself, this affects mainly adolescents and the lower class because of their position in society. The loss of positive stimuli can cause stress when an individual experiences a family death or a broken relationship with a friend or a romantic partner or it can be a result of the theft of a valued object. This could lead an individual to delinquency by the person trying to prevent the loss, retrieve what was lost, or to seek revenge on those who removed the positive stimuli. The presentation of negative stimuli can be through child abuse, neglect, neighborhood problems, and homelessness. The individuals who usually experience these negative events are adolescents with pain avoidance behaviors and juveniles with the inability to legally avoid noxious stimuli. The link between strain and crime are the criminal’s feelings. Strain can be caused by negative feelings an individual has for example defeat, despair, and fear but the feeling most connected to crime is anger. Individuals become angry when they blame their negative circumstances and relationships on others. Anger incites a person to action, lower inhibitions, and creates a desire for revenge. Anger and frustration enables an individual to justify crime. Also individuals who repetitively experience strain may be more likely to commit crime. The strain theory proposes that an increase in strain would lead to an increase in anger, which may then lead to an increase in crime. Robert Agnew’s general strain theory has come back in some crime causation explanations. Out of all theories that I researched, the strain theory made the most sense to me in explaining the cause of an individual to committing crime. The general idea is that when a person experiences negative stimuli they are most likely to engage in crime. I understand that individuals do get mad and seek revenge on those who brought them negativity or when a person is stressed over money they tend to engage in criminal behaviors. This theory seems to be the realest to me because I know people everywhere, everyday experience these events.