Effects of Munchausen Syndrome by Proxy | Literature Review

Effects of Munchausen Syndrome by Proxy | Literature Review What are some of the factors associated with mothers inflicting consistent harm on their children? Munchausen by proxy. A review of the literature. Introduction The literature on Mynchausens syndrome by proxy is considerable and growing at a rapid rate. Many professionals are sure that the condition exists and there appears to be an equally certain number in the non-professional sector who argue vociferously that such professionals are misguided. The purpose of this review is to determine the evidence base for the condition (Sackett, 1996). and to try to present a rational assessment of the very emotive arguments in this area. Literature review The first article that we shall consider is the book by Feldman (et al 1994) which appeared a decade ago, but is useful as it was considered by many to be the â€Å"gold standard† on the topic in its time. The book itself is written as a series of case narratives followed by a discussion on each. This is clearly instructive, but the most important seminal feature of the book is the fact that it was the first to draw a clear distinction between factitious illness and malingering. It describes the authors’ perception that factitious disorders lie along a spectrum from the benign use of illness on one extreme to the syndrome of Mynchausens syndrome by proxy at the other. It is fair to comment that, inevitably, thinking has progressed since this book was published and the basic amalgamation of factitious illness with malingering no longer finds a resonance with mainstream practice today. Malingering is defined here as â€Å"conscious manipulation for external gain such as compensation† while factitious disorder is defined as â€Å"an unconscious motivation to gain attention or control†. More modern opinion believes that many people who seek compensation after trauma are genuine, as can be their symptoms, whether they are purely physical or psychological. The more modern appreciation of the problem would consider that malingering is a conscious manipulation – and therefore not an illness, whereas the factitious disorders generally are essentially unconsciously motivated and therefore more akin to a hysterical conversion disorder and therefore a true illness. The next book to consider is a more recent publication which takes the same presentation – discussion format, as the last. This book (Gregory 2004) is remarkable as it is written by a survivor of the abuse from Mynchausens syndrome by proxy and, in our opinion, should be read by every worker in the field. It presents a remarkably perceptive insight into the mechanisms of the disorder together with a remarkable analysis of the actual resultant coping mechanisms employed by the proxy child who progressively gains both insight and resilience as she gets older and approaches adulthood. It is equally important for the consideration that the author develops for her younger siblings as she becomes aware of them being damaged in the same way. From the healthcare professional’s point of view, there are a number of truly insightful comments including: But the memories that hang heaviest are the easiest to recall. They hold in their creases the ability to change ones life, organically, forever. Even when you shake them out, theyve left permanent wrinkles in the fabric of your soul. Such books as these two are clearly inspirational and edifying, but they do not contribute to the evidence base directly. For that we must turn to the peer reviewed literature. Professors Craft and Hall (2004) have published an excellent review of the pertinent issues which looks, with a degree of concern, at the media presentation of the issues. They suggest that the presentation of Mynchausens syndrome by proxy in the media tends to both glamorise and demonise the condition in a way that is very unhelpful to the healthcare professionals working in the area. They cite tabloid phrases such as â€Å"Meadows discredited theory of Munchausen syndrome by proxy† as being truly hostile to the overriding needs of the victims. The paper itself sets out the evolution of the condition from Caffey’s 1942 paper, where the condition was described but not named, through the papers by Money and Werlwas (1976) to the present day assessment of the condition. The authors specifically consider the issues of Mynchausens syndrome by proxy in relation to severe child abuse and apparent cot death, and provide what should perhaps be considered a most authoritative resume on the issue. In terms of specific psychopathology we can turn to papers such as the one by Eminson D (et al 2000) who suggest that the perpetrators have an increased incidence of personality disorder or, more rarely a psychotic illness. Firstman R (et al 1998) point to the fact that women who suffer from the condition tend to have reported a number of â€Å"fantasies, obsessions and anxieties† regarding their babies which typically focus on their perceived inability to care adequately for them. Golden M (et al. 2003) adds the observation that many of these fantasies include the worry that the mother may actually harm the child together with the observation that there is an associated increase in the incidence of Post natal depression in these cases. References Caffey 1942,  quoted in Royal College of Paediatrics and Child Health.  Fabricated or induced illness by carers.  London: RCPCH, 2002. Craft AW and D M B Hall 2004 Munchausen syndrome by proxy and sudden infant death BMJ, May 2004; 328: 1309 1312 ; Eminson DM, Postlethwaite RJ. 2000  Munchausen syndrome by proxy abuse: a practical approach.  Oxford: Butterworth Heinemann, 2000. Feldman MD, Ford C, Reinhold T 1994  Patient or Pretender: Inside the Strange World of Factitious Disorders  London: Wiley, ISBN 0-471-58080-5 Firstman R, Talan J. 1998  The death of innocents.  New York: Bantam, 1998. Golden MH, Samuels MP, Southall DP. 2003  How to distinguish between neglect and deprivational abuse.  Arch Dis Child 2003;88: 105-7. Gregory J 2004  Sickened: The True Story of a Lost Childhood  London: Century books ISBN 1 844 13442 3 Money and Werlwas (1976)  Quoted in Fisher G, Mitchell I.  Is Munchausen syndrome by proxy really a syndrome?  Arch Dis Child 1995;72: 530-4. Sackett, (1996).  Doing the Right Thing Right: Is Evidence-Based Medicine the Answer?  Ann Intern Med, Jul 1996; 127: 91 94. 7.12.05 PDG Word count 1,083  

Broken Angel :: essays research papers

Broken Angel by Francine Pascal Broken Angel by Francine Pascal is a story about Angel Desmond who is at the racetrack and has gambled away all of his money. His girlfriend Tia Ramirez and her friend Conner McDermott are looking for him. They find him at the racetrack and Tia gets very angry with Angel when she finds out he has lost all of his money. Angel dreads telling his parents, because he lost his whole savings account which was for college. He graduated form El Carro is supposed to go to Stanford in the spring. His parents are really excited about it.Angel stayed up late that night thinking about what happened. The next morning his mom offers to take him to get a small refrigerator for his dorm room at Stanford. He cannot take the pressure anymore so he tells his parents he does not have any money. Then he tells them what happened and they are very disappointed in him. His father fires him from his job at the garage that his father owns. Tia and Conner meet ant the cafà © and try to think of ways to help Angel. Finally when everything seems hopeless Conner thinks of a good idea. Conner’s mom is in all kinds of charities that give out scholarships at the end of school. Conner said he would ask his mom to put in some good words for Angel. Conner goes to ask his mom to help Angel. He is very nervous because she is usually drunk. She is an alcoholic. He finally gets his nerve up and knocks on her bedroom door. He walks in and she is cleaned up and sober. It was a big shock to Conner. His mom calls a few people for Angel and makes a few dinner dates.Tia goes to Angel’s house to tell him the good news. He comes to the door smiling from ear to ear. He said he has got good news for her. She tells him the news about Conner’s mom trying to get him a scholarship. He tells her tell Conner to just forget it. He is not going to college. He tells Tia he is going to stay with her. She tells him he cannot because he has worked so hard to go to Stanf ord. He then tells Tia she does not love him because she is pushing him away.

Management of pressure ulcers in a high risk patient: a case study

1. Introduction Clinically, pressure ulcers are defined as the lesions that are the result of localized tissue damage or cell death (generally necrosis), developed because of pressure over a bony prominence.More commonly, they are also known as pressure sores or bedsores as they are mainly developed by patients that are bed-bound (Wake, 2010). Approximately, 3 million adults are affected by pressure ulcers and are most common in hospitalized patients (Lyder and Ayello, 2008). However, effective management and care plans against pressure ulcers are still lacking. The role of nursing care is a fundamental aspect to pressure ulcer management, including its prevention and treatment (Wake, 2010). In this case study report, I visited a diabetic patient as a district nurse for insulin administration and provide support by assessing the patient’s risk of developing pressure ulcers due to associated pathological and other risk factors.1.1. Purpose of the studyIn all health care settings, pressure ulce rs remain one of the major issues. More so, pressure sores or pressure ulcers are associated with significant cause for morbidity in the medical community. The main purpose of this patient visit was to provide healthcare support for patients who were at risk of developing pressure ulcer. The healthcare support included the risk minimisation by doing risk assessment, therapeutic interventions, suggestions for lifestyle changes including exercise and dietary habit. All these were targeted with the views of providing timely assessment of pressure ulcers in high risk patients, and suggest therapeutic interventions for timely treatment of the condition.1.2.Patient historyThe patient was 75 years old male, diabetic and paralysed due to recent stroke attack. He was completely bed bound and was on wheelchair. Furthermore, the patient was suffering from cancer of the oesophagus. Since the patient could not mobilize, his family members and carers used to transfer him from the bed to his whe elchair and wheelchair to his bed.1.3. Risk assessments of needs, vulnerabilities and strengths of the patientThe patient was chronically ill and had several complications associated with his conditions. Stroke attack had caused him paralysis and was unable to move. This had put him in significant risk of developing pressure ulcers. The patient was also diabetic. Diabetes causes slow healing of wounds that may lead to ulcer (Guo, et.al. 2010). In this patient, the combination of factors including diabetes and immobility had increased his risk of developing pressure ulcers. Other factors such as old age of the patient, cancer and dietary factors would trigger the development of these pressure sores. Cancer is a chronic disease that may cause severe debilitation and prolonged confinement to bed. Therefore, it is expected that patients with cancer are at significant risk of developing pressure ulcers (Walker, 2001). Diet may have a supporting role in the development of pressure ulcers . Although the role of nutrition in preventing the development of pressure ulcers is still debatable, it is obvious that patients who are malnourished are at risk of developing those (Doley, 2010). Thus, nutrition therapy could be central in minimising the risk of developing pressure ulcers. It was seen that the patient was clearly underweight due to his chronic health conditions. Overall, the following risk factors of the patient were considered while making his assessment. Based on these risk factors, care plans and suggestions were made to minimise the risk in the patient. Sensory factor: This factor was assessed in order to identify how well the patient can process sensory input from the skin, as well as how effectively he can communicate level of sensation. Since the assessment of skin is an important way to identify patient’s risk of developing pressure ulcers, it would ensure the degree of risk of pressure ulcer in this patient and hence, take measures to prevent them before complications arise. Moisture: Moisture is another hallmark of pressure ulcers. Excess skin moisture puts patients at greater risk of developing pressure ulcers. It is common that patients who are confined to bed produce more sweat. Thus, it is required to evaluate what degree the skin is exposed to moisture. Activity Lack of activity is one of major risk factors of developing pressure ulcers in bedbound patients. Continuous friction between the skin and bed mattress may result the development of pressure sores. Measuring the activity is another important parameter to predict the patients’ risk of pressure, irrespective of their degree of mobility. Patients who are unable to move need to be physically turned by healthcare staffs or family members at regular intervals Nutrition As mentioned earlier, although nutrition may not have direct effects on the patient’s risk of developing pressure ulcers, it may be possible that lack of required nutrients may increase its complications. It is thus important to evaluate what constitutes the usual pattern and amount of caloric intake in the patients. After evaluating the above risk factors in the patient, it was concluded that the patient was likely to develop pressure ulcers if timely interventions were not introduced. These would have direct effect in patient’s health. These ulcers influence the risk of bacterial and viral infections, which can become life threatening in chronically ill patients. In addition, there is a high rate of mortality associated with pressure ulcers. Mortality rate is high as 60% is reported in older patients with pressure ulcers within 1 year of hospital discharges (Lyder and Ayello, 2008). The patient in this case study could have weakened immune system due to his old age and illnesses such as cancer and diabetes. In immune-compromised patients, the risk of infections spreading into their blood and other organs of the body are considerably high. This may result blood poisoning and septicaemia. Both these conditions are very fatal and categorised as medical emergencies (Redelings, et.al. 2005). However, despite of several associated risk factors, the patient was provided with proper care and support by his carers and family members. He was regularly taken off from his bed with the support of wheelchair. More so, the patient was on medications to control his blood sugar. He was also supplemented with vitamin to strengthen his immunity. To conclude, patient although was receiving appropriate healthcare service, these were mainly therapeutics which included medications against the chronic illnesses which he had. Patient and family members were lacking suggestions and expert advice in regards to minimising the risk of pressure ulcers. It was also observed that the patient was provided with a normal bed and mattress that would further trigger the risk of developing sores. 2. Interventions and referrals After evaluating the patient’s condition, as a district nurse, I provided the evidence based interventions and referrals to the patient and his family members and carers as preventive approaches of pressure ulcers. Firstly, the patient was provided with a hospital bed with pressure relieving mattresses. This would help minimise the friction between patient’s body and the bed and hence, reduce the risk of pressure ulcers. Moreover, this would provide support surfaces and help in pressure redistribution (Stannard, 2012). Several recommendations for skin care including the use of cold water instead of hot water, use of mild cleansing agents to minimise irritation and dryness of the skin and excessive moisture was suggested. The patient was also advised to avoid low humidity as it may promote scaling and dryness (Lyder and Ayello, 2008). Further suggestion such as avoiding mechanical loading was given. This is considered as one of the most effective preventive measures of p ressure ulcers in hospitalized patients (Lyder and Ayello, 2008). Thus, family members were advised to frequently turn and reposit the patient while in bed. It is essential that patient intake adequate levels of both macro and micronutrients to prevent complications of pressure ulcers. This patient was already supplemented with vitamins and minerals, so no action was taken. However, the patient was suggested to eat diet high in proteins, which are essential for wound-healing and overcome malnutrition. Management of pain is another key aspect in patients with pressure ulcers (Cooper, 2013). Pressure ulcers can be very painful and may require interventions with analgesics (Wake, 2010). However, this patient did not require analgesic treatment as the pain due to pressure ulcers was not very severe. Instead, focus was given on the preventative approaches in minimising the complications associated with pressure ulcers. Finally, the focus was given on the patient/carer education in the management of pressure ulcers. Both patient and carers/family members were made aware about the risk factors of pressure ulcers. Also, they were educated and made aware on the most vulnerable sites of the body that are at risk of developing pressure ulcers. General training was also given on how to take care of skins and methods for pressure reduction. They were told about the severity of the condition and requested to seek medical advice if symptoms of pressure ulcers persist. 3.Critical evaluation and evidence-based examination of outcomes of interventions and referrals The interventions and referrals made for the patient in this case study were evidence based. Risk assessment was made considering the standard pressure ulcer prediction tool, Braden Scale, by observing the six vital signs of pressure ulcers as explained earlier. This tool has allowed for the early prediction of pressure ulcers and thus introduction of early interventions before the complications are developed (Sving, 2014). Classification of pressure ulcers is one of the best ways to predict its outcome. Pressure ulcers are classified into various stages (Lyder and Ayello, 2008). Stage I is determined by the presence of redness in the skin. In case if the redness in the skin is observed, nurses are required to make thorough skin inspection and advice patients about the preventive measures. Stage II is characterized by the loss of skin with the presence of blisters. In stage III loss of skin is quite thick; however, not exposed to muscle or bone tissue. In this stage, there is a high risk of infections, so care should be given in personal hygiene (Sving, 2014). Also, patient should be suggested to include vitamins and minerals in the diet to prevent the possible risk of infection. In stage IV there may be an exposure to bone, tendon and muscle. This condition is considered as potentially dangerous, due to associated risk of life threatening bacterial infections. In many cases, this may also require hospi tal admission to reduce further complications (Lyder and Ayello, 2008; Sving, 2014). To conclude, nurses are required to assess various stages of pressure ulcers and provide treatments and suggestions based on these stages. This is because; different stages of pressure ulcers may require different treatment plans. Some could be minor and may be improved through general suggestions such as encouraging patients to move and involve in physical activities and maintaining healthy diet; whereas some may require therapeutic interventions including the use of antibiotics to treat bacterial infections, dressing and cleaning of the wound and hospital admissions if complications are severe. (Wake, 2010). Ample evidence is now available on the understanding of effective pressure ulcer treatments. Treatment strategies such as use of hospital bed, avoiding mechanical loading, and physical activity are now considered as the standard form of treatments in pressure ulcers. These approaches not only reduce the risk of pressure ulcers, but are also beneficial in lowering its complications. Furthermore, the association of pressure ulcers with other chronic diseases such as cancer, diabetes and stroke are well understood. Thus, much attention is to be given while giving care to the patients who have these conditions. Educating patient and family members on the risk factors and management is another approach to pressure ulcer management as suggested by NICE guidelines (Wake, 2010) However, the available knowledge on the evaluation of risk assessment of pressure seems insufficient. The evidence lacks support and requires further epidemiological research to understand risk factors of pressure ulcers in greater depth. Some of the interventions and their effectiveness including re-positioning and nutrition are still questionable. Further studies on the influence of different turning intervals on the development of pressure ulcers need to be carried out. Similarly, what specific diet is suitable for pressure ulcer patients needs further clarification. Appendix1: Care plan of the patient Risk assessmentCare goalsInterventions and evaluations Patient’s needs and vulnerabilities : old age, bed-bound, chronic diseases including cancer and diabetes, paralysed due to strokeTo identify the patient’s risk of developing pressure ulcersThe patient was provided with hospital bed, cushion for his wheelchair and family members were suggested to move the patient time to time Patient’s strength: on proper medications, carers and family members providing the support, supplemented with vitamins and minerals to boost the immune functionTo build on the patient’s strengths and to meet his needsPatient was provided with full support from the family members. High protein diet was suggested as this may improve would-healing. Signs of complications, such as pain, bacterial and viral infections.To avoid complications associated with infections including blood poisoning and septicaemiaImmune booster such as vitamins and disinfectant creams to avoid infections. References Cooper, K.L. 2013, â€Å"Evidence-based prevention of pressure ulcers in the intensive care unit†, Critical Care Nurse, vol. 33, no. 6, pp. 57-66. Doley, J. 2010, â€Å"Nutrition management of pressure ulcers†, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, vol. 25, no. 1, pp. 50-60. Guo, S and DiPietro, L.A, 2010. Journal of dental research. Factors Affecting Wound Healing, vol. 89, no. 3, 219-229. Lyder, C.H and Ayello, E.A, 2008. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Pressure Ulcers: A Patient Safety Issue. Lyder, C.H, 2003. Clinician’s corner. Pressure Ulcer Prevention and Management, vol. 289, no. 2, pp. 223-226. Lyder, C.H. 2006, â€Å"Assessing risk and preventing pressure ulcers in patients with cancer†, Seminars in oncology nursing, vol. 22, no. 3, pp. 178-184. McInnes, E., Jammali-Blasi, A., Bell-Syer, S., Dumville, J. & Cullum, N. 2012, â€Å"Preventing pressure ulcers–Are pressure-redistributing support surfaces effectiveA Cochrane systematic review and meta-analysis†,International journal of nursing studies, vol. 49, no. 3, pp. 345-359. Redelings, M.D., Lee, N.E. & Sorvillo, F. 2005, â€Å"Pressure ulcers: more lethal than we thought?†, Advances in Skin & Wound Care, vol. 18, no. 7, pp. 367-372. Stannard, D. 2012, â€Å"Support surfaces for pressure ulcer prevention†, Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses / American Society of PeriAnesthesia Nurses, vol. 27, no. 5, pp. 341-342. Stechmiller, J.K. 2010, â€Å"Understanding the role of nutrition and wound healing†, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, vol. 25, no. 1, pp. 61-68. Sving, E., Idvall, E., Hogberg, H. & Gunningberg, L. 2014, â€Å"Factors contributing to evidence-based pressure ulcer prevention. A cross-sectional study†, International journal of nursing studies, vol. 51, no. 5, pp. 717-725. Wake, W.T. 2010, â€Å"Pressure ulcers: what clinicians need to know†, The Permanente journal, vol. 14, no. 2, pp. 56-60.

Canadian Government essays

Canadian Government essays The government of Canada is based on the Government of the United Kingdom, though there are some differences. The Government can be broken down in to three groups. The first being The Queen, The Governor-General and the Lieutenant Governors, The second group is the Senate and the last is The House of Commons. Her Majesty, Queen Elizabeth the second is the Head of State in Canada. She is also Head of State for many other countries. All legal authority is vested in The Queen. Every time Parliament passes a law, they are doing so with The Queen's authority. Every time the Armed Forces go somewhere, whether for peace keeping, or war, they are doing so in the Queen's name. Even when you are pulled over by a local police officer, he too, is acting with The Queen's authority. The Queen has many duties to perform both in The United Kingdom, and the rest of her Kingdom's. Thusly, she can not be in each of the countries of which she is Head of State all the time. So Governor-Generals are appointed to represent Her Mother and execute her powers. The Governor-General is usually appointed by Her Mother on advice of the Prime Minister. While in office, the Governor-General maintains and as needed, executes all powers of the Crown on behalf of Her Majesty. Generally speaking, the Governor-General is a lso given the position of Commander-in-Chief of the Canadian Armed Forces. The Federal Government is not equipped with any means to start by itself. No form of governing can take place with out the Governor-General, in the name of Her Majesty calling Parliament to order. Just as the Queen can not be in all of her Kingdoms all the time, the Governor-General can not be in all of Canada all the time. So they appoint a Lieutenant Governor. Lieutenant Governors act with the Governor-General's authority on a provincial level. They have almost the same duties as the Governor-General's but locally as opposed to nationally. ...

american bungalow essays

american bungalow essays The article Manufacturing and Marketing the American Bungalow by Scott Erbes discusses the effects that The Aladdin Company had on the American Bungalow. The Aladdin Company was a main manufacturer of these mail order homes. By intense marketing and propaganda the Aladdin Company, along with several others, was able to promote and sell these precut homes by mail. The Aladdin Company was founded in 1906 in Bay City, Michigan by William and Otto Sovereign. William and Otto started their firm having had no architectural experience at all. They were inspired by a friend who was in the business of selling precut boats by mail so they decided to venture into selling precut homes by mail. In order for William and Otto to get their company started and up to the level that they wanted, it became necessary to use mass-marketing as a ploy to draw people into the idea of homes through the mail. Their way of enticing people to buy these homes was through their catalogue. They portrayed the homes by mail, bungalows, as an escape from lifes worries: A place where one could commune with nature. By taking the promotional aspect to such a high level the bungalow became very prominent in the America in the early 1900s. By 1917, William and Otto were selling more than three thousand homes per year. They had homes spread all over the United States and included in that array of owners were several large- scale companies such as the Dupont Company. Their success continued for the next two decades and William and Otto were able to broaden their product line from not only the houses but also the furnishings in the houses. However, the companies momentum was nearly depleted during the Great Depression. Aladdins output dropped drastically during the Great Depression but in the decades following the Depression, it was able to regain some of their profit but they never reached the lev...

WE 7 AL&Resarch Paper Responses Essay Example | Topics and Well Written Essays - 500 words

WE 7 AL&Resarch Paper Responses - Essay Example Fruits of DNA profiling have actually been incredible even though there have been call from various group to strictly limit utilization of DNA databases. This point has been exhausted in a good way by showing its development and where the issue stands currently as well as the actions taken by various bodies such as the federal government. The case discussed in the paper has strengthened the points and validated the significance of familial DNA. The paper is generally good and informative. Forensic fingerprint analysis has been accurately exhausted right from its initiation, development and the current use. Theories and facts relating to use of the fingerprints has been well detailed to validate the significance of the principles of fingerprint identification. The principles actually stand as the core of forensic fingerprint analysis and show a deeper understanding of the act. The diagrammatic representation of the ridges has also helped in understanding and even informing the logic behind the ridges. It is therefore easy for even a layman to grab what the student writes about because everyone has the ridges. However, the writer could have included some significant information such as who conducts the analysis and give a comprehensive explanation on how and where the analysis is performed. In addition, the writer could have considered a thorough analysis of the fingerprint analysis process by tackling issues such as comparisons, analysis, evaluation and verification process. Generally, the paper is fairly written and touches on the relevant information deemed important in the discussion. Use of bloodstain pattern analysis in crime scene reconstruction has been thoroughly examined by the writer. The writer has given the paper an excellent summarized introduction about the topic and highlighted examples of how to know the source of blood and the position of both the victim and the perpetrator. There is an element of deeper understanding of the

The Better Man Essay Example | Topics and Well Written Essays - 1250 words

The Better Man - Essay Example By examining the single most important feature of both candidates’ policy i.e. economic policy, the author argues that Obama is the better man because he has a comprehensive approach to solving the most pressing issue today: the American economy. As shown by a Times-Rockefeller Foundation poll, the biggest problem that 85% Americans want to see resolved is related to the economy in some way (Saporito, 2008). The current economic situation and its impact on middle class, working Americans is a sharp shift away from the expectations brought by living the American dream. A further classification of the TIME poll found that 96% black Americans and 88% latin Americans were unhappy with the economy. It does make sense that most Americans are extremely unhappy dealing with falling income, real-estate bubble burst, a shaky stock market and rising poverty (Saporito, 2008; FOX Business, 2008; Epstein & Gorzelany, 2008; Villaraigosa, 2007). In Michigan alone, unemployment has risen by 76% from 2001, Income has fallen 11.5% and poverty has increased by 30% from 2000 to 2006 (FOX Business, 2008). It is clear that the most pressing issue for Americans is in fact their own economy. As the author of this paper will continue to show, the Ame rican people, and more specifically the working class Americans deserve an economic policy that reflects their hard work and strength to survive the impending doom in their lives. According to Epstein and Gorzelany (2008), more than 5 million people will fall under the already large poverty line by 2010. The poverty rate would increase an average of 2 points to about 16%. More importantly, â€Å"the US stands second only to Mexico as having the worst rate of relative poverty among the world’s developed nations. Let us examine what this means for a lower-middle or lower income American: These figures are not being quoted