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In the nineteenth century treatment lead poisoning order chloroquine without a prescription, the flow of slaves slowed medicine wheel images order chloroquine canada, first as a result of the British Slave Trade Act of 1807 that banned imports of slaves into British colonies medications qt prolongation buy generic chloroquine 250mg line, and later because of the British Slavery Abolition Act of 1837 medicine 3 sixes discount 250 mg chloroquine with mastercard, which abolished any use of slave labor within the British colonies. In response to the abolition of the slave trade, many employers resorted to bonded labor contracts as a way to obtain a continued supply of cheap labor. Caribbean plantations provided the main demand for laborers from French Indochina and the British colonies in Asia. For example, over half a million indentured laborers were moved from the Indian subcontinent to the British Caribbean during the nineteenth century and the beginning of the twentieth century (Williams, 1962, p. China, after its forced opening to the West upon losing the Opium Wars (in 1842 and 1860), provided another important source of indentured labor. Employers 182 Journal of Economic Perspectives of these "coolies" included guano pits, cotton and sugar industries in Peru, sugar cane fields in Cuba (following the abolition of slavery in 1886), and railways in the United States and British Columbia (Campbell, 1923). Although most indentured laborers entered servitude voluntarily, many parallels can be drawn between the harsh conditions of slavery and those faced by the indentured laborers (Northrop, 1995, pp. For example, many would die on the voyage to the Americas, where crowded conditions and malnutrition made the laborers vulnerable to disease (for example, Castro de Mendoza, 1989, p. And like slaves who were denied the rights of ordinary citizens, indentured laborers were often denied the right to naturalize and obtain citizenship after their contracts were over. The nineteenth and twentieth centuries also witnessed a dramatic increase in voluntary migrations from the Old World. Between 1851 and 1924 alone, 45 million people migrated from the Old World to the Americas, with the majority, 34 million, choosing to migrate to the United States. A recent data construction effort by Putterman and Weil (2009) provides comprehensive estimates of the magnitudes of post-1492 population flows from the Old World to the New World. Using this matrix, we are able to calculate, for the 27 New World countries in their sample, the share of their current populations originally from the Old World. In the second and third columns of the table, we further disaggregate the Old World category, reporting explicitly the population shares from Africa and from Europe. Concluding Thoughts the aim of this paper has been to provide a historical overview of the Columbian Exchange, with a particular emphasis on aspects of the exchange that have generally been neglected by economists. The New World provided soils that were very suitable for the cultivation of a variety of Old World products, like sugar and coffee. The increased supply lowered the prices of these products 3 For all of the fine details, including data sources and calculation procedures, see Putterman and Weil (2009), as well as their online appendices, which are available at. The Columbian Exchange: A History of Disease, Food, and Ideas 183 Table 4 Origins of New World Populations Share of population in 2000 that is of: Country Haiti Jamaica Trinidad and Tobago Cuba Canada Dominican Republic Uruguay Guyana Argentina Brazil United States Puerto Rico Costa Rica Venezuela Panama Colombia Chile Belize Nicaragua Paraguay El Salvador Honduras Ecuador Mexico Peru Bolivia Guatemala Old World origin 1. Note: the table shows the proportion of the population of New World Countries in 2000 that were descendents of individuals living in the Old World, Africa, and Europe in 1500. The production of these products also resulted in large inflows of profits back to Europe, which some have argued fueled the Industrial Revolution and the rise of Europe (Inikori, 2002; Acemoglu, Johnson, and Robinson, 2005). Potatoes were embraced by the Irish and the eastern European societies, chili peppers by the cultures of South and Southeast Asia, tomatoes by Italy and other Mediterranean societies, and tobacco by all nations of the world. This depopulation along 184 Journal of Economic Perspectives with the production of valuable Old World crops like sugar cane and coffee then fueled the demand for labor that gave rise to the transatlantic slave trade. The result was the forced movement of over twelve million slaves from Africa to the Americas and devastating political, social, and economic consequences for the African continent. Following the slave trade, the African continent was divided and brought under European colonial rule, an event that some have argued would have been impossible without the discovery of quinine in the New World. Our hope is that this broad overview will spur further research examining the neglected aspects of the exchange. One interesting question that is particularly relevant for the exchange is the effect that diseases had on domestic institutions, social structures, and development generally. The recent book by Mann (2005) argues that the New World was much more politically, economically, and technologically developed than scholars have presumed, and one reason for this mischaracterization is the large negative impacts Old World diseases had on New World societies. The study by Hersh and Voth (2009) provides estimates of English welfare gains from the increased supply of sugar and coffee that arose after the discovery of New World virgin soils. Their study makes one wonder about the welfare gains that arose from the introduction of various New World crops. For example, what were the welfare gains from tomatoes in Italy, maize in Lesotho, chili peppers in Asia, or cassava in West-Central Africa
Nursing has been identified as having the potential for making the biggest impact on a transformation of healthcare delivery to a safer 98941 treatment code generic chloroquine 250mg with visa, higher quality symptoms lyme disease generic chloroquine 250 mg online, and more costeffective system medicine 93 5298 purchase chloroquine 250mg amex. With the increasing awareness of the need for change in the healthcare system treatment for scabies chloroquine 250 mg generic, the clinical microsystems (small, functional units where care is provided within the larger system) have become an important focus for improving healthcare outcomes (Nelson, Batalden, & Godfrey, 2007). In addition to the concern over healthcare outcomes, the United States and the global market are experiencing a nursing shortage that is expected to intensify as the demand for more and different nursing services grows. Despite annual increases in enrollments in entrylevel baccalaureate nursing programs since 2001 (Fang, Htut, & Bednash, 2008), these increases are not sufficient to meet the projected demand for nurses. Addressing the need for an increased number of baccalaureateprepared nurses is critical but not sufficient. The environments in which professional nurses practice have become more diverse and more global in nature. Scientific advances, particularly in the areas of genetics and 5 genomics, have had and will continue to have a growing and significant impact on prevention, diagnosis, and treatment of diseases, illnesses, and conditions. The increased prevalence of chronic illness is a result of an increasingly older adult population, environmental threats, lifestyles that increase risk of disease, and enhanced technological and therapeutic interventions that prolong life. Increases in longevity of life have made the older adult the fastest growing segment of the population. By 2030, this population will increase to 20%, with a large majority older than 80 years of age (He, Sengupta, Velkoff, & DeBarros, 2005). Those older than 65 years of age had almost four times the number of hospitalization days than those younger than 65 years of age (Centers for Disease Control, 2007) Education for the baccalaureate generalist must include content and experiences across the lifespan, including the very young who are especially vulnerable. Prevention is critical in addressing both acute and chronic conditions across the lifespan. The professional nurse practices in a multicultural environment and must possess the skills to provide culturally appropriate care. With projections pointing to even greater levels of diversity in the coming years, professional nurses need to demonstrate a sensitivity to and understanding of a variety of cultures to provide high quality care across settings. Liberal education, including the study of a second language, facilitates the development of an appreciation for diversity. Nursing is uniquely positioned to respond to these major forces, requiring an increased emphasis on designing and implementing patientcentered care, developing partnerships with the patient, and a focus on customer service. The dialogue has focused on the knowledge, skills, and attitudes needed by nurses to practice effectively within this 6 complex and changing environment. Baccalaureate generalist education, as defined in this document, is the foundation upon which all graduate nursing education builds. The preferred vision for nursing education includes generalist, advanced generalist, and advanced specialty nursing education. Generalist nurse education occurs at a minimum in baccalaureatedegree nursing programs. The Discipline of Nursing Roles for the baccalaureate generalist nurse are derived from the discipline of nursing. Nursing generalist practice includes both direct and indirect care for patients, which includes individuals, families, groups, communities, and populations. In addition, nursing practice derives knowledge from a wide array of other fields and professions, adapting and applying this knowledge as appropriate to professional practice. In the senior college and university setting, every academic discipline is grounded in discrete inquirybased applications that are distinctive to that discipline. Scientific advances, (particularly in the area of genetics and genomics), changing demographics of patient populations, new care technologies, and patient access to health care information call for new ways of thinking and doing in the provision of health care. The academic setting provides a forum for contemplating physical, psychological, social, cultural, behavioral, ethical, and spiritual problems within and across disciplines. Faculty have a responsibility to facilitate the translation of knowledge from a liberal education base into the practice of nursing. Patientcentered care also involves the coordination of continuous care, listening to , 7 communicating with, and educating patients and caregivers regarding health, wellness, and disease management and prevention.
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