1.2: Source Water Quality
Learning Objectives
After reading this chapter you should be able to identify and explain the following:
- The Earth’s Hydrologic Cycle
- Sources of groundwater
- Sources of Surface Water
- Water math: Area and Unit Conversions
A very finite amount of water on our planet (0.34%) is available to treat for human consumption. Knowing where the water comes from assists certified operators in treating raw source water to make it potable. Newer technology has been developed to treat salinized or salty water found in the ocean. These treatment methods are still extremely expensive and not widely accessible. Supplying water to the public is an extremely important function in society as water is the basic building block of life. Because water quality is of the utmost importance new regulations and water quality standards are continually changing and evolving to make sure the public has safe sources of drinking water. The first drinking water standards were written in the Safe Drinking Water Act (SDWA), which was signed into law by President Ford in 1974. Throughout the text, new concepts will be introduced and an acronym will be given and used subsequently. You are going to learn to love acronyms if you become a certified operator. We use them quite frequently!
The Hydrologic Cycle
The Hydrologic cycle is the continual movement of water on the surface of the planet. The water moves above, below, and across the Earth’s surface as a liquid, gas, or solid. The 12 elements of the hydrologic cycle are defined as follows:
- Evaporation—Water moves in the gas state from the Earth’s surface to the atmosphere
- Transpiration—Water moves in the gas state from plants to the atmosphere.
- Advection—Water in the gas state moves through air currents in the atmosphere
- Condensation—Water vapor converts from gas to liquid state in the form of water droplets.
- Precipitation—Water as a liquid and/or solid falls from the atmosphere. We commonly refer to this as rain, snow, sleet, and hail.
- Interception—Water in the liquid state that is captured by plants
- Infiltration—Water in the liquid state that soaks into the surface of the ground. This will be what is known as groundwater which will be detailed later in this chapter.
- Subsurface Flow—Water in the liquid state flows below the Earth’s surface. The movement is generated by gravity and obstructions below the surface of the Earth.
- Runoff—Water in the liquid form travels to bodies of water. This would include the ocean, lakes, rivers, and streams. This is also known as surface water which will be detailed more later in this chapter.
- Channel flow—Water in the liquid form that flows from small channels into rivers and streams
- Storage—Water is naturally stored in liquid form in lakes, ponds, wetlands, and groundwater aquifers. In solid form, water is naturally stored in ice, snow, and glaciers. This natural storage provides much of the water treated for human consumption.
- Snowmelt—Water in the solid form converts to water in the liquid form and is returned to the hydrologic cycle. Note: In California, snowpack is a critical water supply indicator as it is the melting snowpack that recharges rivers and the general supply of water
There are other important terms to note in regard to the hydrologic cycle. The surface to atmosphere movement of water is known as evapotranspiration. This is the combination of evaporation and transpiration from plant life to the atmosphere. The most widely known movement of water is precipitation which is when water in various physical states falls from the atmosphere to the surface of the Earth. The movement of water from the surface to subsurface is known as percolation. Percolation might also be referred to as infiltration or recharge. These terms are commonly associated with underground aquifers. Finally, surface to surface flow is called runoff.
Groundwater
Groundwater is one of the two main sources of storage used by municipalities to produce potable water. It is formed by the percolation (infiltration and/or recharge) of water from the surface of the earth to the subsurface. Water moves through holes and cracks in the subsurface and collects in an underground aquifer. An aquifer is a geologic formation that accumulates water due to its porousness. Important characteristics of groundwater include consistent water quality and the ability to remain safe from surface contamination. With greater technology and testing methods chemicals and constituents known to be harmful to humans have been found in numerous well sites throughout the United States. Wells close to industrial areas have been contaminated with harmful chemicals and substances. New regulations are continually being updated to ensure source groundwater is safe to drink. In normal circumstances, very little treatment is required to yield groundwater.
The Groundwater Treatment Rule (GWTR) was enacted in 2006 to prevent microbial contamination from underground water supplies. The purpose of the new rule was to classify water systems that were at a greater risk for fecal contamination. These systems must employ a multiple-barrier protection similar to the surface water treatment rule which will be covered in more detail in the next section.
There are two kinds of aquifers, confined and unconfined. In an unconfined or water table aquifer the water table is free to rise and fall. The water table in unconfined aquifers rise and fall depending on the amount of precipitation that recharges the aquifer. Confined aquifers, also known as artesian wells, contain water that is confined due to layers of low permeability. These layers, which restrict movement, are comprised of rock or hard clay and are referred to as confining beds, aquitards, or aquicludes. Artesian wells are generally under pressure when drilled. Once drilled the water level at which the column of water will rise is known as the piezometric surface. Sometimes, the water will rise to the surface or past the surface but in the instance, the water remains below it is known as a non-flowing artesian well.
Wells
The construction of wells is critical in the extraction of water from underground water supplies. The placement of wells is very important because proper location will produce the greatest yield. Important terms related to underground wells:
- Static Water Level—The level in the well when no water is being removed from the aquifer. This level can be measured in feet or elevation.
- Pumping water level—The level when water is being removed from the aquifer. This level can vary depending on the rate of flow from the well.
- Drawdown—The difference between the pumping water level and the static water level
- Cone of depression—The shape or “cone” created by the movement of water in all directions during pumping.
- Zone of influence—The area of water affected by the drawdown of water during pumping. It is important to note that wells cannot be placed too closely together because their zones of influence may affect each other.
- Well yield—The amount of water drawn from an aquifer over a specific period of time
- Specific capacity—The amount of water produced per drawdown expressed in gpm/ft
- Safe Yield/Perennial yield—The amount of water that can be pulled from an aquifer per year without a drop in the water table
- Overdraft—Too much water removed. Greater than the safe yield of a well
- Subsidence—The permanent drop in the water table due to overdraft
Specific Capacity Calculation
\[\text{Specific capacity} = \text{Flow (GPM)} ÷ \text{Drawdown (ft)} \label{Specific Capacity}\]
Example \(\PageIndex{1}\)
A well has a yield of 600gpm and the drawdown is 50 ft. What is the specific capacity of the well?
Solution
This is a direct application of Equation \ref{Specific Capacity}
\[\text{Specific Capacity = 600\, \text{GPM} ÷ 50\, \text{ft} = 12\]
Surface Water
Throughout the United States, surface water is the most widely used source of water for large cities and other municipalities. Groundwater is not as widely available so is not a sufficient water supply for major cities. Surface water includes lakes, ponds, rivers, and streams. California is unique as the southern half of the state has 2/3 of the population but only 1/3 of the available water and the northern half of the state has 1/3 of the population but 2/3 of the water. Snowpack in northern California is critical to the state’s water supply. Most of Southern California is very arid and densely populated so water travels from Northern California through the State Water Project to Southern California.
Surface runoff supplies water for all surface water sources. Influences of surface runoff include intensity of rainfall, duration of rainfall, composition of soil, amount of moisture in soil, slope of the ground, vegetation coverage, and human influences. One would think that a lot of rain would be ideal. However, if the rainfall density is too great, more water can be lost because the ground will no longer absorb the water. The same applies to the duration of rainfall. A prolonged rain even makes the soil too moist and unable to capture water. Vegetation coverage and the slope of the ground are very important to stopping runoff. If the slope of the ground is steep, the speed of runoff is increased. Vegetation slows the speed of runoff and allows more water to absorb or infiltrate into the ground. Human influences have a great impact on water runoff. Impervious surfaces like concrete entirely prevent infiltration.
Natural Watercourses
Key Terms
Natural water courses include rivers, creeks, streams, washes, and arroyos. They flow in one of three ways:
-
Perennial streams—Watercourses which flow continuously throughout the year
- EX: Colorado River
-
Ephemeral streams—Watercourses that flow sporadically, generally after rainfall
- EX: Santa Clara River which runs through Santa Clarita and Ventura County
- Intermittent—Watercourses which flow somewhere between ephemeral and perennial streams. Rainfall and high groundwater levels will affect how often these streams flow.
Rivers and Streams are a good water supply source but are not necessarily the best source for public water supplies.
Lakes
Lakes are the most widely used public water supply source. However, very few “natural” lakes exist. Most lakes used for public water supply are man-made and use a dam to create the lake and contain the water. This is known as an impoundment. Water from these lakes is piped to treatment facilities. Due to variances in temperature lakes develop “layers” also known as stratification. Denser, colder water will drop to the bottom (Benthic zone) of a lake during the summer. There are three layers:
- Epilimnion—The strata closest to the surface
- Hypolimnion—The strata near the bottom
- Thermocline—Middle strata with the greatest variance in temperature
Lake turnover will occur during seasonal temperature changes. When the temperature of a lake is uniform it is known as isothermal. Algae growth is a serious problem that causes taste and odor issues in treated water. Copper sulfate can be added to a lake to help remedy algae blooms. In severe cases, the water undergoes eutrophication which is the loss of oxygen. Complete or extreme oxygen depletion can kill all living creatures in the water including animals and fish.
Introduction to Water Math
Mathematics is a key component of water treatment. Operators use conversion tables and basic algebra to complete many daily tasks. Charts are available on the State Water Resources Control Board website that assist operators with most calculations you would find on the state exams or while on the job. Below is a list of basic units and their respective conversion factors:
|
Measurement |
Equivalent |
|---|---|
|
1 cubic foot of water |
62.3832lbs |
|
1 gallon of water |
8.34lbs |
|
1 liter of water |
1,000 grams |
|
1 mg/L |
1 part per million (ppm) |
|
1 ug/L |
1 part per billion (ppb) |
|
1 mile |
5,280 feet |
|
1 yard |
3 feet |
|
1 yard3 |
27ft3 |
|
1 acre |
43,560 square feet or ft2 |
|
1 cubic foot or ft3 |
7.48 gallons |
|
1 gallon |
3.785 Liters or L |
|
1 L |
1,000 milliliters (ml) |
|
1 pound |
454 grams |
Working with Fractions
NumeratorDenominator
44=11 or =1 42=21 or =1
Rounding
Rounding the number 324.179
The above number (324.179) rounded to the nearest tenth would be 324.2. Since the number in the hundredth place is at or above 5, the number in the tenth place is rounded up. If you were rounding this number to the nearest whole number it would be 323 since the number in the tenth place is below 5.
| Placement of Digits |
|---|
|
3 = Hundreds |
|
4 = Tens |
|
9 = Units |
|
1 = Tenth |
|
7 = Hundredth |
|
9 = Thousandth |
Unit Dimensional Analysis
This is the most important function in most water math problems. Make sure to always place your factors in the proper place or the equation will be impossible to solve correctly. The example below will use unit measurements. Water operators will commonly convert between different units of measurement.
Example 1
Convert 48 inches into feet. (There are 12 inches in a foot.)
48 inches11 foot12 inches=4 ft1
Drop the one from the denominator and the answer is 4 ft.
The same process will be to convert between gallons and cubic feet.
Example 2
Convert 22.44 gallons into cubic ft. or ft3 (There are 7.48 gallons in one cubic foot.)
22.44 gallons11 ft³7.48 gallons=3 ft³1
Drop the 1 from the denominator and your answer is 3 ft³
Example 3
How many gallons are there in a tank which holds 300ft³ of water?
300ft317.48 gal1ft3=2,244 gallons
Area
Area will be important for many applications in water math. It may be necessary to calculate the area of a tank that requires painting or an area of ground cover near equipment.
|
Rectangles
|
Area = L × W |
|
Circle
|
Area = 0.785 × D 2 |
|
Trapezoid
|
Area = × H |
Example 1
A wall that is 10ft wide and 40ft in length needs to be painted. What is the total square feet of the wall?
|
|
Area = Length x Width Area = 10ft x 40ft Area = 400ft 2 |
Example 2
What is the area of the top of a circular storage tank that is 100 feet in diameter? (Note: Use the formula .785 x d2. In most cases in water math, we will always be dealing with the diameter and not the radius. These short cuts will help as the problems become more difficult. In this problem I will demonstrate why we will use this formula and not the standard mathematical equation for solving area problems.)
Equation #1 Area= π (3.14) x r 2 (100ft ÷ 2 = 50 to find radius)
Area = 3.14 x 50 x 50
Area = 7,850 ft 2
Equation #2 Area= .785 x d 2
Area = .785 x 100 x 100
Area = 7,850 ft 2
In this example, the first equation was easy to solve because we were working with a pretty friendly number. As the equations become more difficult we do not want to take the extra step to divide the diameter by two to solve for the radius. If the diameter of the tank was 357ft, this problem would have been slightly more difficult using the first equation.
Example 3
The top of a circular storage tank needs to be painted. It is 100 ft. in diameter. Each gallon of paint covers approximately 200 square feet. How many gallons of paint will you need to buy?
|
|
Area= .785 x d 2 Area= .785 x 100ft x 100ft Area= 7,850 ft 2 7850 ft²1x1 gal200 ft²=39.25 gal |
Chapter Review
-
What is the middle layer of a stratified lake called?
- Thermocline
- Benthic Zone
- Epilimnion
- Hypolimnion
-
What is the conversion of liquid water to gaseous water known as?
- Advection
- Condensation
- Precipitation
- Evaporation
-
Water weighs ___________.
- 7.48 lbs/gal
- 8.34 lbs/gal
- 62.4 lbs/ft 3
- Both 2 and 3
-
What is the static level of an unconfined aquifer also known as?
- Drawdown
- Water Table
- Pumping Water Level
- Aquitard
-
What is the cause of taste and odor problems in raw surface water?
- Copper sulfate
- Blue-green algae
- Oxygen
- Lake turnover
-
What chemical reduces blue-green algae growth?
- Chlorine
- Caustic Soda
- Copper Sulfate
- Alum
-
A water-bearing geologic formation that accumulates water due to its porousness.
- Aquifer
- Lake
- Aquiclude
- Well
-
What kind of stream flows continuously throughout the year?
- Ephemeral
- Perennial
- Intermittent
- Stratified
-
The surface to atmosphere movement of water is known as ___________.
- Precipitation
- Percolation
- Stratification
- Evapotranspiration
-
An aquifer that is underneath a layer of low permeability is known as ___________.
- Confined aquifer
- Water Table aquifer
- Unconfined aquifer
- Unreachable groundwater
-
What is the middle layer of a stratified lake known as?
- Hypolimnion
- Benthic Zone
- Thermocline
- Epilimnion
-
The amount of water that can be pulled from an aquifer without depleting.
- Drawdown
- Safe yield
- Overdraft
- Subsidence
Math Questions
Please show all work. On the State exams, you will not get credit if work is not shown.
-
What is the area of the top of a storage tank that is 75 feet in diameter?
- 4,000 ft 2
- 4416 ft 2
- 1104 ft²
- 17,663 ft²
-
What is the area of a wall 175 ft. in length and 20 ft. wide?
- 3,000 ft²
- 2,500 ft²
- 3,500 ft²
- 4,000 ft²
-
You are tasked with filling an area with rock near some of your equipment. One (1) bag of rock covers 250 square feet. The area that needs rock cover is 400 feet in length and 30 feet wide. How many bags do you need to purchase?
- 40 Bags
- 42 Bags
- 45 Bags
- 48 Bags


3.3: Chemistry of Life
To understand life, a basic knowledge of chemistry is needed. This includes atoms (and its components like protons, neutrons and electrons), atomic weight, isotopes, elements, the periodic table, chemical bonds (ionic, covalent, and hydrogen), valence, molecules, and molecular weight:
- Atoms
-
The smallest unit of matter undividable by chemical means. An atom is made up of two main parts: a nucleus vibrating in the centre, and a virtual cloud of electrons spinning around in zones at different distances from the nucleus (not to be confused with the cell nuclei). When atoms interact, its less like the bumping of balls and more a matter of attraction and repulsion; at atomic levels, mass is much less an important consideration than charges, which are electrical: positive, negative, or neutral (balanced).
- Protons
-
Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion.
- Neutrons
-
Like protons but neutral charge and also located in the nucleus.
- Radioactive
-
decay occurs in unstable atomic nuclei—that is, ones that do not have enough binding energy to hold the nucleus together due to an excess of either protons or neutrons.
- Electrons
-
determine how atoms will interact. Located on the outside of the nucleus known as the outer shell and has a negative charge that determines what type of change it has.
- Atomic weight
-
is the average of the masses of naturally-occurring isotopes.
- Isotopes
-
each of two or more forms of the same element that contain equal numbers of protons but different numbers of neutrons.
- Periodic table of elements
-
The periodic table we use today is based on the one devised and published by Dmitri Mendeleev in 1869. The periodic table of the chemical elements displays the organization of matter.
- Chemical bonds
-
are attractive forces between the atoms.
- Valence
-
A typical number of chemical bonds in this element. For example, nitrogen (N) has valence 3 and therefore usually makes three bonds.
- Molecules
-
Molecules form when two or more atoms form chemical bonds with each other.
- Molecular weight
-
calculated as a sum of atomic weights.
- Covalent bonds
-
When two atoms bind in one molecule, there are two variants possible. Non-polar bond is when electrons are equally shared between atoms. Polar bond is when one of atoms attract electrons more than another, and therefore becomes partly negative while the second—partly positive.
- Ionic bonds
-
Ionic bonding is the complete transfer of some electron(s) between atoms and is a type of chemical bond that generates two oppositely charged ions.
It is essential to know that protons have a charge of \(+1\) , neutrons have no charge, and electrons have a charge of \(-1\) . The atomic weight is equal to the weight of protons and neutrons. Isotopes have the same number of protons but different number of neutrons; some isotopes are unstable (radioactive).
One of the most outstanding molecules is water. Theoretically, water should boil at much lower temperature, but it boils at 100 \(^\circ\) C just because of the hydrogen bonds sealing water molecules. These bonds arise because a water molecule is polar : hydrogens are slightly positively charged, and oxygen is slightly negatively charged.
Another important concept related to water is acidity . If in a solution of water, the molecule takes out proton (H \(^+\) ), it is an acid . One example of this would be hydrochloric acid (HCl) which dissociates into H \(^+\) and Cl \(^-\) . If the molecule takes out OH \(^-\) (hydroxide ion), this is a base . An example of this would be sodium hydroxide (NaOH) which dissociates into Na \(^+\) and hydroxide ion.
To plan chemical reactions properly, we need to know about molar mass and molar concentration . Molar mass is a gram equivalent of molecular mass. This means that (for example) the molecular mass of salt (NaCl) is \(23 + 35\) , which equals 58. Consequently, one mole of salt is 58 grams. One mole of any matter (of molecular structure) always contains \(6.02214078 \times 10^{23}\) molecules ( Avogadro’s number ).
The density of a dissolved substance is the concentration . If in 1 liter of distilled water, 58 grams of salt are diluted, we have 1M (one molar) concentration of salt. Concentration will not change if we take any amount of this liquid (spoon, drop, or half liter).
Depending on the concentration of protons in a substance, a solution can be very acidic. The acidity of a solution can be determined via pH. For example, if the concentration of protons is 0.1 M ( \(1 \times 10^{-1}\) , which 0.1 grams of protons in 1 liter of water), this is an extremely acidic solution. The pH of it is just 1 (the negative logarithm, or negative degree of ten of protons concentration). Another example is distilled water. The concentration of protons there equals \(1 \times 10^{-7}\) M, and therefore pH of distilled water is 7. Distilled water is much less acidic because water molecules dissociate rarely.
When two or more carbon atoms are connected, they form a carbon skeleton . All organic molecules are made of some organic skeleton. Apart from C, elements participate in organic molecules (biogenic elements) are H, O, N, P, and S. These six elements make four types of biomolecules: (1) lipids—hydrophobic organic molecules which do not easily dissolve in water; (2) carbohydrates or sugars, such as glucose (raisins contain lots of glucose) and fructose (honey); by definition, carbohydrates have multiple \(-\) OH group, there are also polymeric carbohydrates (polysaccharides) like cellulose and starch; (3) amino acids (components of proteins) which always contain N, C, O and H; and (4) nucleotides combined from carbon cycle with nitrogen (heterocycle), sugar, and phosphoric acid; polymeric nucleotides are nucleic acids such as DNA and RNA.
On the next page is the most important thing for everyone who need to learn chemistry (and yes, you need to): periodic table. It was invented by Dmitry Mendeleev in 1869 and updated since, mostly by adding newly discovered and/or synthesized elements. Note that Roman numerals were added to standard table to show numbers of main groups .


3.4: Language and Speaking to a Global Audience
Learning Objectives
- Distinguish between verbal and non-verbal aspects of language.
- Explain the role of culture in the creation and meaning of language.
- Identify the functions of language.
- Use language effectively in public speaking to a global audience.
“I was born in the Dominican Republic and Raised in the United States–you can imagine the integrative process that was for me. (…)  It was quite the holy grail for the all-American bullies. You’d think color would not be a factor, but it is. Assumptions are rapidly made from one’s appearance, and I can almost guarantee that my peers thought I spoke English as soon as they laid their eyes on me. Those children who possessed a native tongue looked down on me shamelessly. I was very much an outcast for the first few months of my attendance to this institution–more so fraternizing with Spanish-speaking teachers and staff. My peers made the assumption I lacked intelligence, hardly ever assisting me, if any struggle was evident, they would simply continue the discussion at hand; and I’d often be left in the dark.”
— Yuneiris Martinez, BMCC Student
As you can see from the testimony of Martinez, we communicate with others by using language. Language, as a tool of communication, can be used to do many things. For example, language can be used to define phenomena or to label people or things, to evaluate, to inspire, to inform, to persuade, to criticize, to demean, to uplift, to confuse, to deceive, to lie, and so on. To be an effective public speaker, it is important to always be aware of the diverse or heterogeneous nature of your audience, and use language that will be understood by the audience in the way that the speaker intends. This chapter will explore language in its verbal and non-verbal forms and show how each of these forms can be used effectively or ineffectively in speech, especially to a global audience.
Defining Language
Language is made up of symbols that are created by a community or group of people. The community creates the symbol and assigns the meaning of the symbol. These symbols can be verbal or non-verbal. An example of verbal expression is the word “table” which refers to an object that the English-speaking community has decided to call by that name. A Spanish speaking community, on the other hand, uses the verbal expression “mesa” to refer to the same object. If you do not belong to the symbol creating community, you will not know the meaning of the symbol unless you learn the symbols of other language communities.
The symbols created by a community may also be non-verbal. This means that a community or group may have other ways for exchanging messages without using words. Non-verbal symbols or codes include facial expressions, eye contact, time, body language, touching behavior, silence, space and distance, smell, artifacts, or objects people wear or put on themselves, and so on. Although some non-verbal codes in one community may be the same or similar in other communities, the meaning each community assigns to the non-verbal codes may not be the same. This means that even when there is similarity in the code, there is still a possibility of misunderstanding the meaning of the non-verbal expression across linguistic communities.
Meaning of Language
As far as the meaning of words is concerned, we will explore two ways to understand the meaning of language. The first is the denotation, this is the literal meaning of a word, the ‘dictionary definition.’ If someone says something to us using a word that we do not understand, we can find the meaning of that word by looking it up in the dictionary. The other way we can understand language is through connotation. The connotation of a word is the emotional response or feelings that words cause. The connotation of a word also depends on cultural context and personal associations. For example, the word “father” according to the dictionary is “a male parent”, that is the denotation of the word “father.” The connotation of the word “father” may have different associations to different people. If for example, someone had a negative or painful experience with a male parent, the word “father” may connote anger, resentment, and hate.
In other words, the meaning of language, besides being denotative, could also be connotative. Because of the connotative meaning of words, it is important for public speakers to be careful in their choice and use of words to reduce the possibility of misunderstanding. It is not always easy to know what your words may connote to someone or a group of people, but the more aware of and sensitive you are to the people you communicate with, the greater the possibility of reducing misinterpretation of your message.
We have just explained the verbal and nonverbal codes of language. However, it is important to note that when a person says something in words and the words are contradicted by the person’s nonverbal codes, the receiver usually believes the nonverbal messages over the verbal one. For example, if someone who just walked into my office wanting to have a word with me and I said “Sure, no problem,” but my body movements, posture, and even facial expressions give an impression to the person that I am not available to him/her, the person would believe my non-verbal behavior over what I said verbally.
Phonetics
Now that we have looked at the meaning of words or how language is understood (semantics), let us turn to what is called phonetics. The phonetic dimension of language refers to how the verbal codes of language are expressed in sound – pronunciation. Every linguistic community has a way they vocalize or put sound to the words. To be an effective speaker, it is important to pronounce words in the way they are supposed to be pronounced. Pronunciation can be a problem in effectively communicating to diverse groups if people do not understand what you are saying because of how you are pronouncing the words. It is important for public speakers, especially those who are not native speakers of a language, to make every effort to articulate properly and not speak fast. Articulation is a form of pronunciation that pays particular attention to making sure that all the letters of a word, especially the end consonants, come out clearly. For example, “I ought to prepare for the exam” instead of “I outta prepare for the exam.” Pragmatics
Another dimension of language that an effective speaker should take note of is called the pragmatics of language. Pragmatics in language use means the way language is used and understood on a day-to-day basis by a linguistic community. For example, a group of people may use language without paying attention to whether what they say follows the acceptable grammatical rules or not (syntax). Their way of expressing themselves may not pose a problem to them because the group members understand one another. However, in a diverse context, a pragmatic use of language may not be effective. For example, one linguistic community may say “It isn’t right for men and women to do the same job and earn unequal wages” while another linguistic group may say the same thing differently such as, “It ain’t right for men and women to do the same job and earn unequal wages.” Therefore, to avoid confusion in language use, it is always important to use the standard language that is commonly understood by many of the people in your audience.
Responsible Use of Language to a Global Audience
As a matter of ethical and responsible use of language, an effective public speaker should always be mindful of the diverse nature of the audience, and use language that is respectful of the audience. By a global or diverse audience, I mean that the people being addressed differ in many ways. The differences in an audience may be based on age, ability (disability), gender, sex, sexual orientation, ethnicity, race, nationality, religious affiliation, political affiliation, philosophical attachments, etc. Because of these demographic characteristics of an audience, an ethical or responsible public speaker should avoid using the following kinds of language:
- Obscure and unfamiliar words. For example, the word “niggardly” which means miserly or not generous or stingy is very obscure and mostly unknown to many people. So, why use it when you could simply say “miserly”?
 For example, the statement,:“These people think that they deserve free housing, food stamps, medical care, free abortions, and marital rights even though they are contributing little to zero to the economy and culture of this country.” Although the statement does not name the people being addressed, the audience is expected to know to whom “these people” refers in context.
- Language that has two or more meanings. For example, the word “hot” could refer to the temperature or temperament or spicy or even attractive. To avoid misunderstanding, it is always a good thing to use words that can easily be understood.
- Language that avoids making a commitment or a declaration, such as “weasel” words (maybe, allegedly, probably, etc.). This is more so in persuasive speeches.
- Language that is technical and belongs to a certain profession or field. For example, “The bane of postmodernism is the dethronement of God and the enthronement of subjectivity.” What does this sentence mean to an ordinary person?
Responsible and ethical speakers should use language that is familiar to their audience. Familiar language is down to earth and reflects the everyday experience of people. Descriptive or figurative language is encouraged because it not only embellishes the language, but it also makes it easy for the audience to visualize. Figurative language is also called rhetorical tropes. Examples of rhetorical tropes are:
- Metaphor: implicit comparison. He has a heart of gold.
- Simile: explicit comparison. After a good night’s sleep, I felt like a million dollars (this is also hyperbole).
- Personification: assigns human qualities or characteristics to non-human things. Life is a journey; travel it well.
- Hyperbole: exaggeration.
- Negation: saying something in the negative. Do not ask what your country can do for you, ask what you can do for your country (From Inaugural speech by President J. F. Kennedy). https://www.youtube.com/watch?v=u5DODFhQ-H4
- Repetition: saying the same thing several times for impact. I have a dream… I have a dream… I have a dream (From I have a dream speech by Dr. Martin Luther King Jr.). https://www.youtube.com/watch?v=smEqnnklfYs
- Assonance: a play on the sound of the vowels. The Negro cannot find lodging in the motels of the highways and hotels of the cities (From I have a dream speech by Dr. Martin Luther King Jr.).
Responsible and ethical public speakers should make sure that they know and use non-verbal codes appropriately. An example can be found in the Catholic Church. In Africa, many Catholic priests think that the longer they preach the better it is for them and their community. However, in many white parishes in America, the priest is often expected to preach for a maximum of ten minutes. So, an African priest who finds himself in a white parish in America should be mindful of the cultural differences regarding the use of time and limit the preaching to the time frame that is acceptable to the audience.
Another dimension of non-verbal communication that effective public speakers should be mindful of is eye contact. In many Western societies, it is expected that a speaker maintains a generous, direct, and sustained eye contact with the audience. This means that a speaker who is not a native Westerner should make every effort to connect emotionally with the audience by using eye contact.
Conclusion
In this chapter we learned that language is a structured system of symbols used to communicate meaning. Language is very important because it is the primary means of communication among humans. Language is much more than a collection of words. We use language to not only define phenomena or to label people or things, but to evaluate, inspire, inform, persuade, criticize, demean, and uplift. We use language both verbally and non-verbally. Our body language, eye contact, use of gestures, posture, facial expressions send messages to our audience just as much as our spoken language does. We define language through denotation, the dictionary meaning, and connotation, the emotional feelings that words evoke. We use language figuratively and descriptively to help our audience visualize our messages. As a matter of ethical and responsible use of language, an effective public speaker should always be mindful of the diverse nature of their audience, and use language that is respectful of the audience. Effective public speakers should aim to present their messages in a clear, concise, and purposeful manner while always keeping their audience in mind.
Review Questions
- In what ways do the verbal and non-verbal aspects of language differ?
- Explain the role of culture in the creation and meaning of language.
- List any five (5) functions of language.
Class Activities
- In small groups discuss and write down at least four ways in which non-verbal communication can be a source of misunderstanding between (among) people of different cultural backgrounds.
- Describe instance (s) when people have looked down on you because of how you speak. How did the experience make you feel or how did it affect your communication with others?
Works Cited
Lucas, Stephen. E. The Art of Public Speaking . 12th edition. New York, NY: McGraw Hill. 2014. Print.
Martin, Judith. N. & Nakayama, Thomas. K. Intercultural Communication in Contexts . 6th edition. New York, NY: McGraw Hill. 2013. Print.
Martinez, Yuneiris. “Language and Intercultural Communication”. Blackboard. March 8-12. Citation in Text: (Martinez). Web. March 10, 2021.
McCrowskey, James C. An Introduction to Rhetorical Communication. 8th edition. Boston, MA: Prentice-Hall. 2001. Print.
Rothwell, Dan, J. Practically Speaking. .2nd edition. New York, NY: Oxford University Press. 2017. Print.


2.9: Biology
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- Susan Rahman, Prateek Sunder, and Dahmitra Jackson
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Biology is the study of life. There is much to be learned from this discipline, and so many advances we have made as a nation are traced back to work done in the Biology laboratories on college campuses. Despite this, the roots of biology are deeply intertwined with structural racism. From experimentation on enslaved Africans to experimentation on Black bodies post slavery, Biology has a past steeped in racist ideologies that led to gross misconduct and exploitation of African Americans (Nurridan, Mooney, & White, 2020; Savitt, 1982). In response to this history, there is severe distrust of scientist’s motives by Black Americans present day,which may explain why some African Americans have decided not to receive the COVID-19 vaccination. The troubled history is not lost on many Black Americans who, when surveyed, as a group are the least inclined to express an interest in getting the vaccine and this hesitancy is born out of a history of being betrayed by science (Jones, 2021). Examples of abuse and exploitation range from well known Tuskegee and lesser known Guatemala syphilis studies by now defamed physician John Charles Cutler,to the harvesting of body parts for scientific exploration without informed consent (Centers for Disease Control, n.d.; Park, 2017; Rever by,2012; Rodriguez et al., 2013). In 1951, a full four years after the Nuremberg code, Henrietta Lacks, a Black woman from Baltimore MD with cervical cancer, had cells taken from a tumor that could be grown easily in the lab and proved to be transformative to the field of cell biology.Numerous institutions profited financially through use of her cells. The cells were taken without consent and Ms. Lacks and her family were not informed or compensated in any way (Beskow,2016; Nature, 2020).  Indigenous peoples on this continent were also used as science experiments and treated less humanely than animals for slaughter. Lifesaving medicine was used as a bargaining chip for more compliant tribes during the smallpox pandemic.
Similarly in terms of access to present day life-saving COVID-19 vaccines, it is clear whose lives matter most and what populations had to wait to get access to lifesaving testing and vaccines (Hampton, 2020). The mere fact that the United States Government and Big Pharma were debating whether or not to remove the patents that could get more vaccines out quicker worldwide highlights the inhumanity we face when medicine for profit over people is the national model. Use of public funds for research that then turns private companies into multi-billion dollar enterprises while pricing out those most vulnerable of life saving medication is something we should be taking a hard look at.
No more devalued in this culture presently are the millions of incarcerated people held hidden from view. In Acres of skin: human experiments at Holmesburg Prison. A true story of abuse and exploitation in the name of medical science,Tom Wilkie writes of the medical experimentation on 75 Black prisoners in Holmesburg prison (Wilkie, 2000). From 1951-1974, also well after the Nuremberg ethical code had been established, these studies tested the effects of a known contaminant, dioxin, without the informed consent of the 75 men (Wilkie, 2000).
Biology has also been used as a tool to justify racial hierarchies. Scientific racism has been employed as a tool for white supremacy. From the 4 races of man in the mid-1700’s to the Eugenics movement of the early 1900s, both put forth the claim that there were distinct differences in humans based on race (Timeline of Scientific Racism, n.d.). The Eugenics movement laid bare the dangers of using a false scientific rationale to justify the superiority of a race (Miller, 2014). This use of science to justify unequal treatment has been employed by leaders of nations in order to fight the abolition of slavery, to commit genocide, to forceibly steralize the mentally ill and incarcerated men and women to this day, and to defend unequal cultural practices (Manian, 2020; Stern, 2020).
Despite the understanding that Eugenics is a pseudoscience, we still find remnants of it in the scientific data; highlighting the fact that science is not without its failings and that sometimes data is inaccurate and used to support an agenda that is not scientifically valid(Bhopal, 2007; Eigen, 2005; Kevles, 2011; Michael, 2017). The justification of differential treatment based on biological traits has contributed to unequal access to resources including medical care. One example is the differential of prescribed pain medication for Black patients by doctors of all races under the assumption that they “feel less pain” than their white counterparts (See also the section on Human Sexuality for a discussion of presumed racial pain differential) (Hoffman, Trawalter, Axt, et al., 2016). Structural racism plays a role in federal,state and local funding for housing, healthy food, and protection of clean water, all items needed for our biological well-being (Bank, 1996; Branson, 2017; Miller, 1994; Williams & Eberhardt, 2008). Implicit bias on the part of practitioners (also discussed in the section on Health Education) and governmental leaders coupled with years of structural racism has led us to a place where the lived experience of (specifically) Black Americans, but also other people of color in the United States is vastly different from Whites (Mende-Siedlecki et al., 2019; Metzl,2009; Oliver et al., (2014).
Similarly, the Indian Vaccination Act of 1832 has an eerily familiar theme to the Tuskegee and Guatemala studies (Reverby, 2012). While nowhere in the literature does it state that the vaccine trials caused Native deaths, many Native Americans recount the history about how the government forced the trials on them with this act, and kept a list of all the Natives who were vaccinated. The belief is that the shots they were given did not vaccinate from Smallpox as it was claimed to do, but instead gave Native Americans the disease and was akin to murder. It is not hard to imagine this taking place based on the attempted smallpox transmission via blankets handed out to Native Americans during forced relocation as a form of genocide(Brands, 2005). According to tribal elders, the list of names of those who received the smallpox vaccine was lost some time ago so tracing these claims has proven impossible. It is interesting that many academic papers discuss the smallpox genocide was caused by not being given the vaccine, when another argument is that it was caused by the vaccine itself (Pearson, 2003).Because of a well-documented track record of unethical practices on the part of white scientists and practitioners, a severe mistrust of white medicine further exacerbates equitable access to care for many Black, Indigenous and other People of Color in the United States.
The irony behind the amount of ways in which Biology has been used to maintain structural racism and exploit people of color is it is also the key to identifying the truth about race (Kevles, 2011). As a social construction, race and its consequences are quite real but there is no biological basis in racial differences (The Biology of Skin Color, 2015; Public Broadcasting Service, n.d.). Just as in other academic disciplines, the diversification of scholars in the field likely will lead to a more robust anti-biased field. The current numbers still are on par with other STEM fields in terms of diversity of students and faculty but are gaining ground in terms of representation. Although biology boasts a higher number of non-white doctorates awarded,it is still not representative of the population at large so there is much work to be done(National Center for Science and Engineering Statistics, 2017).


6.6: Employee Recognition
Story Highlights
- Top performers need to know their efforts are recognized and valued
- Employee recognition isn't one-size-fits-all
- Money isn't the only, or even the top, form of recognition
In today's war for talent, organizations and leaders are looking for strategies to attract and retain their top performers while increasing organic growth and employee productivity. From offering new perks to designing flexible workplaces, company efforts to optimize the workplace are as strong as ever.
But in their search for new ideas and approaches, organizations could be overlooking one of the most easily executed strategies: employee recognition.
According to Gallup's analysis, only one in three workers in the U.S. strongly agree that they received recognition or praise for doing good work in the past seven days. At any given company, it's not uncommon for employees to feel that their best efforts are routinely ignored. Further, employees who do not feel adequately recognized are twice as likely to say they'll quit in the next year.
This element of engagement and performance might be one of the greatest missed opportunities for leaders and managers.
Workplace recognition motivates, provides a sense of accomplishment and makes employees feel valued for their work. Recognition not only boosts individual employee engagement, but it also has been found to increase productivity and loyalty to the company, leading to higher retention.
Beyond communicating appreciation and providing motivation to the recognized employee, the act of recognition also sends messages to other employees about what success looks like. In this way, recognition is both a tool for personal reward and an opportunity to reinforce the desired culture of the organization to other employees.
Acknowledging the Individual
Gallup's data reveal that the most effective recognition is honest, authentic and individualized to how each employee wants to be recognized. Acknowledging employees' best work can be a low-cost endeavor -- it can be as small as a personal note or a thank-you card. But the key is to know what makes it meaningful and memorable for the employee, and who is doing the recognizing. Keep these employee recognition ideas in mind the next time you praise a colleague.
In a recent Gallup workplace survey, employees were asked to recall who gave them their most meaningful and memorable recognition. The data revealed the most memorable recognition comes most often from an employee's manager (28%), followed by a high-level leader or CEO (24%), the manager's manager (12%), a customer (10%) and peers (9%). Worth mentioning, 17% cited "other" as the source of their most memorable recognition.
What's most surprising about these findings? Nearly one-quarter said the most memorable recognition comes from a high-level leader or CEO. Employees will remember personal feedback from the CEO -- even a small amount of time a high-ranking leader takes to show appreciation can yield a positive impression on an employee. In fact, acknowledgment from a CEO could become a career highlight.
When asked what types of recognition were the most memorable, respondents emphasized six methods in particular -- and money isn't the only (or the top) form of recognition:
- public recognition or acknowledgment via an award, certificate or commendation
- private recognition from a boss, peer or customer
- receiving or obtaining a high level of achievement through evaluations or reviews
- promotion or increase in scope of work or responsibility to show trust
- monetary award such as a trip, prize or pay increase
- personal satisfaction or pride in work
It is essential for leaders and managers to keep these employee recognition examples in mind when acknowledging their team members’ successes or accomplishments.
Recognition From All Sides
The best managers promote a recognition-rich environment, with praise coming from every direction and everyone aware of how others like to receive appreciation. This type of employee feedback should be frequent -- Gallup recommends every seven days -- and 2/6timely to ensure that the employee knows the significance of the recent achievement and to reinforce company values.
The criteria for recognition should align with the purpose, brand and culture of the company and should reflect its aspirational identity to inspire others. Rewarding employees who are not top performers could adversely affect high performers' motivation. As such, companies need to state specific standards for awards to avoid any backlash. Great managers know that they can never give too much recognition as long as it's honest and deserved. Acknowledging an employee's best work goes a long way toward making him or her feel valued and can lead to other desirable workplace outcomes.
Source: Gallup, "The Importance of Employee Recognition: Low Cost, High Impact" , January 12, 2024


5.2: Basic Concepts
A nasogastric (NG) tube is a flexible plastic tube inserted through a nostril, down the posterior oropharynx, and into the stomach or the upper portion of the small intestine. It is typically used for decompression of the stomach for clients with an intestinal obstruction or ileus or for administration of nutrition or medication to clients who are at risk for aspiration or unable to tolerate oral intake. Depending on the intended purpose of the tube, there are different types of NG tubes designed specifically for its use. [1]
Orogastric (OG) tubes have similar indications, monitoring, and care as NG tubes, but they are inserted through the mouth instead of the nose. OG tubes are often preferred for clients receiving mechanical ventilation.Anatomy and Physiology
The nurse should be familiar with the anatomy and physiology of the nose, pharynx, esophagus, and stomach when caring for clients with NG tubes. See Figure 5.1 [2] for an illustration of the nasal cavity and pharynx.
The nares are the exterior openings to the nasal cavity. Usually, one nare is larger and more patent than the other. A septum, composed of bone and cartilage, divides the right and left nasal cavities. The nasal floor is parallel to the roof of the mouth. The end of the nasal cavity is narrow and ends at the juncture of several bones, including a portion of the cribriform plate, which is a very thin bone that, if fractured, could provide a direct portal into the brain. For this reason, NG tube placement in clients with suspected head trauma may be contraindicated.
The pharynx is a mucous membrane lined tube that begins at the nasal cavity and is divided into three major regions: the nasopharynx, the oropharynx, and the laryngopharynx.
- The nasopharynx serves only as an airway. It is a muscular passageway at the beginning of the pharynx, located behind the nasal cavity. It curves to extend behind the oral cavity to become the oropharynx.
- The oropharynx is a passageway for both air and food. The oropharynx is bordered superiorly by the nasopharynx and anteriorly by the oral cavity.
- The laryngopharynx is inferior to the oropharynx and posterior to the larynx. It continues the route for ingested material and air to the inferior end where the digestive and respiratory systems diverge. Anteriorly, the laryngopharynx opens into the larynx, and posteriorly it enters the esophagus that leads to the stomach. The larynx connects to the trachea and the lungs, so for this reason, great care must be taken when inserting an NG tube to ensure it enters the posterior laryngopharynx and goes into the esophagus, not anteriorly into the trachea and the lungs.
The epiglottis is a cartilaginous flap of connective tissue located at the entrance to the larynx. During swallowing, the larynx moves upward, and the epiglottis closes over the glottis to prevent aspiration of food and fluid into the trachea. Many clinicians use this natural movement during NG tube insertion by asking clients to swallow ice chips or water once the NG tube passes beyond the oropharynx (i.e., the back of the oral cavity). As the client swallows, the rising and falling of the larynx and the opening and closing of the epiglottis can assist passage of the NG tube beyond the laryngopharynx toward the esophagus. The nurse can request the client to tuck their chin to ease this passage.
The esophagus starts at the upper esophageal sphincter and runs down through the diaphragm past the lower esophageal sphincter to the stomach. See Figure 5.2 [3] for an illustration of the pharynx, trachea, esophagus, and stomach.
Indications for NG Tubes
These are the indications for NG tubes [4] :
- To decompress the stomach and gastrointestinal (GI) tract (i.e., to relieve distention due to bowel obstruction, ileus, or atony)
- To administer nutrition and/or medication
- To empty the stomach to prevent aspiration (for example, NG tubes may be inserted in intubated clients to prevent aspiration)
- To remove blood from clients with GI bleeding [5]
- To obtain a sample of gastric contents to assess bleeding, volume, or acid content
- To remove ingested toxins
- To give antidotes such as activated charcoal
- To give oral radiopaque contrast agents
- To provide bowel rest
Bowel Obstruction and Ileus
The most common indication for placement of a nasogastric tube is to decompress the stomach of a client with a distal bowel obstruction or ileus. Bowel obstruction is a mechanical blockage of intestinal contents by a mass, adhesion, hernia, impacted stool, or other physical blockage such as volvulus (i.e., twisting of the stomach or intestine) or intussusception (i.e., one segment of intestine telescopes inside another). Bowel obstructions block the normal passage of bodily fluids such as salivary, gastric, hepatobiliary, and enteric secretions, causing the fluids to build up, resulting in abdominal distension, pain, and nausea. Eventually, the fluids will build up to a point that nausea will progress to emesis, putting the client at risk for aspiration. [6]
Ileus occurs when there is a nonmechanical decrease or stoppage of the flow of intestinal contents. Ileus is often an unavoidable consequence of abdominal or retroperitoneal surgery but can also be found in severely ill clients with septic shock or mechanical ventilation. An ileus usually manifests itself from the third to the fifth day after surgery and usually lasts 2 to 3 days with the small bowel being the quickest to return to function (0 to 24 hours), followed by the stomach (24 to 48 hours), and lastly the colon (48 to 72 hours). Other causes of ileus may include the following [7] :
- Prolonged abdominal/pelvic surgery
- Lower gastrointestinal (GI) surgery
- Opioid use
- Intra-abdominal inflammation (sepsis/peritonitis)
- Peritoneal carcinoma
- Perioperative complications (pneumonia or abscess)
- Bleeding (intraoperative or postoperative)
- Hypokalemia
- Delayed enteral nutrition or nasogastric (NG) tube placement
NG tube placement is a temporary intervention for bowel obstruction and ileus when normal peristalsis is temporarily altered. It serves to decompress the stomach and keep it empty until normal peristalsis returns. If decompression is needed for more than six weeks, then something more permanent like a jejunostomy tube may be inserted.
Nutrition and Medication Administration
Nasogastric tubes may be placed to administer nutrition or medications for a client who has a functional GI tract but is unable to ingest, chew, or swallow food safely or in adequate amounts. This indication is common for clients who have suffered a cerebrovascular accident (i.e., stroke) that has left them unable to swallow effectively. Nasogastric tubes may be placed for nutritional support while waiting to see how much function the client will recover. If the client does not adequately recover their swallowing ability or will otherwise require long-term nutritional support, then a more permanent feeding tube is placed such as a gastrostomy or jejunostomy feeding tube. [8]
Other examples of conditions where clients have a functioning GI tract but cannot tolerate oral intake are as follows:
- Decreased level of consciousness, such as a coma or a sedated client on a ventilator
- Following upper gastrointestinal surgery where an anastomosis (i.e., a surgical connection between parts of the intestine) must be protected in the initial postoperative period
- During preoperative period to prepare malnourished clients for major abdominal surgery
For many of these indications for NG tubes, an orogastric tube (OG tube) can also be placed. Many of the principles used to manage an NG tube are the same for managing an OG tube, such as checking placement and monitoring for potential complications.
Contraindications for NG Tubes
There are two types of contraindications for any procedure or intervention and are referred to as absolute and relative. An absolute contraindication means the procedure or intervention may produce a life-threatening situation and should be avoided if possible. A relative contraindication means caution should be used because the possibility of an adverse event is possible; therefore, benefits must outweigh the risks.
Absolute contraindications to the placement of an NG tube include significant facial trauma; basilar skull fractures; or recent nasal, throat, or esophageal surgery where attempted placement of a tube via the nares may exacerbate the existing tissue trauma. In some cases of esophageal surgery, such as an esophagectomy, the surgeon will place the NG tube in the operating room and then remove it when indicated; the nurse should not manipulate the NG tube in this case. Esophageal obstruction, such as a neoplasm or foreign object, is also an absolute contraindication to nasogastric tube placement. [9]
Relative contraindications include esophageal trauma, especially if caustic substances were ingested. Coagulation abnormalities or anticoagulation therapy may cause bleeding from the tissue trauma from tube placement. For clients with previous gastric bypass surgery, hiatal hernia repair, or abnormal GI anatomy (such as esophageal varices or strictures), NG tubes should be placed by a provider under endoscopy. [10]
Types of NG Tubes
There are two basic types of NG tubes, those used for decompression and those used for feeding.
For decompression, a double-lumen, rigid tube is used with one large lumen used for suction and a smaller lumen to act as a sump. (A sump allows air to enter to prevent suctioning of the gastric mucosa into the eyelets at the distal tip of the tube or obstruction when the stomach is fully collapsed.) These tubes are often referred to as “Salem Sump.” Their bore size ranges from 6 to 18 French, with those most commonly inserted being 14 to 16 French. A blue pigtail on this type of tube is the air vent, so it should never be clamped, connected to suction, or used for irrigation. See Figure 5.3 [11] for an image of a Salem Sump.
NG tubes used for administration of medications or feeding are single lumen and are softer than those used for decompression. They have a smaller bore with a size ranging from 8 to 12 French. NG tubes placed for feeding or medication administration may be a Levin tube or a Dobhoff tube.  A Dobhoff tube is a special type of NG tube that is small-bore and flexible, so it is more comfortable for the client than a standard NG tube. The tube is inserted with the use of a guide wire, called a stylet, that is removed after correct tube placement is confirmed. A Dobhoff tube also has weight on the end to allow gravity and peristalsis to help advance the end of the tube past the pylorus, providing an additional barrier to reduce aspiration risk of nutrition or medications administered. See Figure 5.4 [12] for an image of a Levin tube and Figure 5.5 [13] for an image of a Dobhoff tube.
NG Tube Insertion
Insertion of an NGT is typically a clean (not sterile), “blind” procedure, meaning the person performing the procedure can’t visualize where the tube is going in the client’s body as they are inserting it. Insertion involves passing the tube through the nose, along the nasal floor, through the pharynx and down the esophagus until the proximal tip of the tube rests in the client’s stomach. See “Checklist: Insert a Nasogastric Tube” for detailed procedural instructions.
NG tubes are inserted and removed by nurses and other health care providers. Due to the invasive nature of the placement process, privately ask the client if they desire visitors to leave the room during placement or removal of the NG tube. Nurses provide the daily care of NG tubes, as well as the administration of nutritional formulas, medications, and other substances through the tube. Nursing management of NG tubes are further described in the “Applying the Nursing Process” section of this chapter. The nurse is also responsible for verifying the NG tube has been accurately placed prior to initial use and before each use thereafter. [14]
Estimating the Depth of NG Tube Placement
Five to seven centimeters posterior to the nares, the nasal sinus connects to the nasopharynx. The length of the pharynx from the base of the skull to the start of the esophagus is 12 to 14 centimeters. The esophagus, from the upper esophageal sphincter to the stomach, is approximately 25 centimeters. The stomach is a highly distensible structure and can vary in length, but the empty stomach is typically about 25 centimeters long. Thus, approximately 55 centimeters of the NG tube is typically inserted in an adult. [15]
There are several methods used to estimate the depth that an NG tube should be placed. A common preprocedural maneuver used to estimate the length of the tube that should be inserted is to measure the tube from the tip of the client’s nose to the earlobe and then against the throat down to the xiphoid process, about 1/2 inch to 1 inch below the sternal notch. [16]
Special Circumstances
Insertion of weighted NG tubes used for feeding, as well as NG tubes for post-GI surgery clients, is performed by specially trained advanced practice nurses, physician assistants, or physicians.
The NG tube inserted for a post-GI surgery client should never be repositioned due to the risk of rupturing a suture line. If the NG tube becomes dislodged, the surgeon should be notified.
If a client is unconscious, gag reflex should be assessed before initiating the procedure. Flex their head forward with your nondominant hand during the procedure as the tube is passed through the larynx. Extra precautions must be taken for clients with head injury to avoid misplacement of the NG tube.
Request assistance prior to starting the procedure based on the client condition. For example, clients who are confused, anxious, at risk for pulling out the tube as it is being inserted, and children often require assistance. Additionally, for pediatric clients it is often helpful to have their parents or caregivers at the bedside. For infants, sucrose may be administered to alleviate discomfort, based on agency policy.
Verifying NG Tube Placement
Insertion of NG tubes is considered a simple procedure, but incorrect placement can lead to client harm and possibly death. The risk of harm and death increases when misplaced tubes are not identified prior to their use. For this reason, placement must be verified immediately after insertion by an X-ray to ensure it has not been inadvertently placed into the trachea and into the bronchi. The nurse should monitor for signs and symptoms of incorrect placement during the procedure, such as coughing, decreased pulse oximetry readings, and cyanosis. If these signs occur, the tube should immediately be withdrawn until normal breathing resumes. See Figure 5.6 [17] for an image of an X-ray demonstrating correct placement of an enteral tube in the stomach as indicated by the lower red arrow. (This X-ray also demonstrates an endotracheal tube correctly placed in the trachea as indicated by the top arrow.) After X-ray verification, the tube should be marked with adhesive tape and/or a permanent marker to indicate the measurement on the tube where the feeding tube enters the nares or penetrates the abdominal wall. This number on the tube at the entry point should be documented in the medical record and communicated during handoff reports. At the start of every shift, the nurse should evaluate if the incremental marking or external tube length has changed. If a change is observed, bedside tests such as visualization or pH testing of tube aspirate can help determine if the tube has become dislodged. If in doubt, the provider should be notified and an X-ray repeated to confirm tube location. [18]
After the tube placement is initially verified by X-ray, it is possible for the tube to migrate out of position due to the client coughing, vomiting, and moving. For this reason, the nurse must routinely check tube placement before every use. The American Association of Critical‐Care Nursing recommends that the position of a feeding tube should be checked and documented every four hours and prior to the administration of enteral feedings and medications by measuring the visible tube length and comparing it to the length documented during X-ray verification. [19] , [20] , [21]
Older methods of verifying tube placement included observing aspirated GI contents or administering air into the tube with a syringe while auscultating (commonly referred to as the “whoosh test”). However, research has determined these methods are unreliable and should no longer be used to verify placement. [22] , [23]
Assessing the pH of aspirated gastric contents is a method used to verify placement in some agencies. Gastric aspirate should have a pH of less than or equal to 5.5 using pH indicator paper that is marked for use with human aspirate. However, caution should be used with this method because enteral formula and some medications alter the gastric pH. [24]
Follow agency policy for assessing and documenting tube placement. Additionally, if the client develops respiratory symptoms that indicate potential aspiration, immediately notify the provider and withhold enteral feedings and medications until the placement is verified.
Potential Complications
The most common complications related to the placement of nasogastric tubes are discomfort, sinusitis, or epistaxis, all of which typically resolve spontaneously with the removal of the nasogastric tube. [25] Other complications associated with use of an NG tube range from minor to more severe and may include the following conditions:
- Trauma to the nares, larynx, esophagus, and/or stomach during insertion.
- Trauma to or erosion of gastric mucosa, especially if gastric suctioning is prolonged.
- Mucosal pressure injury of the nares.
- Placement-related issues: Inadvertent placement in the trachea that can lead to pleural injury, pneumothorax, tracheobronchial aspiration, pneumonia, and death. Respiratory distress is a medical emergency, and emergency assistance must be obtained immediately.
- Esophageal perforation, evidenced by neck or chest pain, dysphagia, dyspnea, subcutaneous emphysema, or hematemesis.
- Inadvertent intracranial placement through a fractured cribriform plate.
- Knotting of the NG tube around an endotracheal tube or retrograde positioning (i.e., the proximal tip of the tube curves upward through the esophagus).
- This work is a derivative of StatPearls by Sigmon and An and is licensed under CC BY 4.0 ↵
- “ Blausen_0872_UpperRespiratorySystem.png ” by Blausen.com staff (2014). “ Medical gallery of Blausen Medical 2014 ” for WikiJournal of Medicine 1 (2). DOI : 10.15347/wjm/2014.010 . ISSN 2002-4436 is licensed under CC BY 3.0 ↵
- “D_M3_24.jpg” by unknown Cenveo is licensed under CC BY 3.0 . Access for free at https://pressbooks.ccconline.org/bio106/chapter/digestive-structures-and-functions/ ↵
- This work is a derivative of StatPearls by Sigmon and An and is licensed under CC BY 4.0 ↵
- This work is a derivative of StatPearls by Sigmon and An and is licensed under CC BY 4.0 ↵
- This work is a derivative of StatPearls by Sigmon and An and is licensed under CC BY 4.0 ↵
- This work is a derivative of StatPearls by Beach and De Jesus and is licensed under CC BY 4.0 ↵
- This work is a derivative of StatPearls by Sigmon and An and is licensed under CC BY 4.0 ↵
- This work is a derivative of StatPearls by Sigmon and An and is licensed under CC BY 4.0 ↵
- This work is a derivative of StatPearls by Sigmon and An and is licensed under CC BY 4.0 ↵
- “11720205623covidien-salem-sump-nasogastric-suction-tube-P” by unknown author used on the basis of Fair Use. Access original image at www.healthproductsforyou.com/p-covidien-salem-sump-nasogastric-suction-tube.html?utm_source=google&utm_medium=surfaces&utm_campaign=shopping%20feed&utm_content=free%20google%20shopping%20clicks&gclid=Cj0KCQiAsdKbBhDHARIsANJ6-jcX4iGGwtT30nfQXurA9kiTlvlvBJQNj6BXyuGL4mGAnc40lL0tdCQaArZzEALw_wcB ↵
- “2-Levin-Tube.jpg” by unknown author is used under Fair Use. Access original image at https://www.smd-medical.com/product-detail/levin-tube-stomach-tube/ ↵
- “ COV711006CN_PRI03.JPG ” by unknown author is used under Fair Use. Access original image at https://punchout.medline.com/product/Kangaroo-Dobbhoff-Tip-Nasogastric-Feeding-Tube/Nasogastric-Tubes/Z05-PF10706 ↵
- Patient Safety Movement. (2020). Actionable patient safety solutions (APSS) #15: Nasogastric tube (NGT) placement and verification. patientsafetymovement.org/wp-content/uploads/2017/10/APSS-15-4.pdf ↵
- This work is a derivative of StatPearls by Sigmon and An and is licensed under CC BY 4.0 ↵
- Nasogastric or orogastric tube insertion. (2021). Lippincott procedures. http://procedures.lww.com ↵
- “ ETTubeandNGtubeMarked.png ” by James Heilman, MD is licensed under CC BY-SA 4.0 ↵
- Boullata, J. I., Carrera, A. L., Harvey, L., Escuro, A. A., Hudson, L., Mays, A., McGinnis, C., Wessel, J. J., Bajpai, S., Beebe, M. L., Kinn, T. J., Klang, M. G., Lord, L., Martin, K., Pompeii‐Wolfe, C., Sullivan, J., Wood, A., Malone, A., & Guenter, P. (2017). ASPEN safe practices for enteral nutrition therapy. Journal of Parenteral and Enteral Nutrition, 41 (1), 15-103. doi.org/10.1177/0148607116673053 ↵
- Boullata, J. I., Carrera, A. L., Harvey, L., Escuro, A. A., Hudson, L., Mays, A., McGinnis, C., Wessel, J. J., Bajpai, S., Beebe, M. L., Kinn, T. J., Klang, M. G., Lord, L., Martin, K., Pompeii‐Wolfe, C., Sullivan, J., Wood, A., Malone, A., & Guenter, P. (2017). ASPEN safe practices for enteral nutrition therapy. Journal of Parenteral and Enteral Nutrition, 41 (1), 15-103. doi.org/10.1177/0148607116673053 ↵
- Lemyze, M. (2010). The placement of nasogastric tubes. CMAJ: Canadian Medical Association Journal, 182 (8), 802. https://doi.org/10.1503/cmaj.091099 ↵
- Simons, S. R., & Abdallah, L. M. (2012). Bedside assessment of enteral tube placement: Aligning practice with evidence. American Journal of Nursing, 112 (2), 40-46. https://doi.org/10.1097/01.naj.0000411178.07179.68 ↵
- Boullata, J. I., Carrera, A. L., Harvey, L., Escuro, A. A., Hudson, L., Mays, A., McGinnis, C., Wessel, J. J., Bajpai, S., Beebe, M. L., Kinn, T. J., Klang, M. G., Lord, L., Martin, K., Pompeii‐Wolfe, C., Sullivan, J., Wood, A., Malone, A., & Guenter, P. (2017). ASPEN safe practices for enteral nutrition therapy. Journal of Parenteral and Enteral Nutrition, 41 (1), 15-103. doi.org/10.1177/0148607116673053 ↵
- Simons, S. R., & Abdallah, L. M. (2012). Bedside assessment of enteral tube placement: Aligning practice with evidence. American Journal of Nursing, 112 (2), 40-46. https://doi.org/10.1097/01.naj.0000411178.07179.68 ↵
- Best, C. (2019). Selection and management of commonly used enteral feeding tubes. Nursing Times, 115 (3), 43-47. https://www.nursingtimes.net/clinical-archive/nutrition/selection-and-management-of-commonly-used-enteral-feeding-tubes-18-02-2019/ ↵
- This work is a derivative of StatPearls by Sigmon and An and is licensed under CC BY 4.0 ↵


2.2: History of Sexuality Research and Some Early Sex Researchers
As important as any other aspect of physical and mental health, our sexuality, how it operates biologically, and how we as social emotional creatures, approach sex, has been a topic of interest to various thinkers throughout time and location. As the scientific method became the way of knowing across academic fields, sexuality, which fell under multiple disciplines, was no exception. Let’s turn our attention to some (certainly not all) notable contributors to the field.
Sigmund Freud (1856-1939)
Sigmund Freud was born in Freiberg, Moravia on May 6, 1856. At a young age, Sigmund was considered to be very brilliant, and was given the best education his parents could afford. He eventually graduated from the University of Vienna in 1881. With a degree in medicine, he would find his interest in the realm of the mind, and would be greatly influenced by Charles Darwin and his work on the theory of evolution. He worked for a local psychiatric clinic, and from there he started up his research on human behavior. He then received a scholarship to study in France in order to solve the mystery behind the condition of hysteria in women (conversion disorder). He hypothesized that many of the women he treated were merely sexually frustrated, and later, postulated that most mental illnesses were caused by an underlying sexual problem (Haeberle, 1983). Today such notions have been proved wrong and Freud’s legacy is a complicated one. There are many other causes of mental instability. Despite his narrow focus on sexuality as the root of all mental illness, his work in the field does begin the conversation of human sexuality in the academic world. Because of this, Freud is considered a pioneer in the study of human sexuality. Society is more open to the study of sexuality and sexuality itself due in part to Freud’s work (Garcia, 1995).
Freud was the first to theorize that sexuality existed throughout a person’s life beginning at infancy. In 1905, Freud published his work, Three Essays on the Theory of Sexuality. Freud’s psychosexual development theory was the greatest major advancement in the study of sexuality of his time, and present day psychologists still consider Freud’s theory when studying human sexuality. According to Freud, humans have libido, which is the notion of organically generated instinctual energy (Haeberle, 1983).  The oral stage begins during infancy, and each stage is experienced until the child reaches adolescence, ending with the genital stage.
Not all Freud‘s theories were widely accepted during his life. Freud found that his theories on the sexuality of children caused some controversy and he became an outcast among other scientists. Freud wrote 4 major books: The Interpretation of Dreams (1900), Three Essays on the Theory of Sexuality (1905), Totem and Taboo (1913), and Beyond the Pleasure Principle (1919). These books based on the theories of Freud have earned him the title “the founder of psychoanalysis”(Haeberle, 1983).
Margaret Sanger (1879-1966)
An American Social activist who fought for the right of women to learn about and practice contraception. During her time, women were mostly relegated to a cycle of pregnancy and childbirth, and yet, the use of contraception was highly stigmatized. Women of color, poor women and otherwise marginalized women were most at risk of suffering under a system that made it hard to access legal and safe contraception. While not a sex researcher, she introduced U.S. women to the diaphragm and went on to advocate for and promote research that aided in the development of the oral contraceptive known as “the pill”. Sanger was jailed for her activism and even taught her fellow incarcerated women about contraception. The organization she founded in pursuit of women’s rights later became Planned Parenthood.
While Margaret Sanger was a successful American birth control activist, sex educator, writer, and nurse, the difficult truth is that the activist had alliances with Eugenicists (a debunked, discriminatory, evolutionary theory that seeks to eradicate “genetic defects” to improve the genetic makeup of a person through human breeding). Sanger’s beliefs caused irreparable damage to Black, Indigenous, People of color, (BIPOC), people with disabilities, immigrants, and many others through her beliefs that were rooted in white supremacy. While Sanger is the founder of Planned Parenthood, the organization publicly acknowledges the legacy of anti-Blackness and racism as it relates to reproductive health as well as gynecology. Planned Parenthood is a well-known medical organization that specializes in reproductive health while also emphasizing the importance of people controlling their bodies, lives, self-determination and dignity. Planned Parenthood acknowledges Sanger’s problematic beliefs and sees it as an opportunity to address the systemic issues within the organization and redefine its mission to uphold its values that strive to provide a variety of medical services to the communities that they exist in. For more on this, please watch Alexis McGill Johnson Remarks on Margaret Sanger | Planned Parenthood Video
Alfred Kinsey (1894-1956)
Alfred Kinsey was an American researcher, who was most known for his research on sexual behavior. In particular, Kinsey’s study and later book entitled, Sexual Behavior in the Human Male examined the sexual proclivities of males which led to his creation of the Kinsey Scale (Kinsey, 1948 p 636-649). This scale introduced the idea that sexuality is a spectrum rather than a binary set of categories, either or. Kinsey states that there are “patterns of sexual behavior and that the two types (homosexual and heterosexual) are represented in the sexual world, and that there is only a small number of "bisexuals" who occupy an intermediate position between the other groups”(More on this in Chapter 4). Kinsey made the assertion that most individuals were “exclusively either homosexual or heterosexual both in experience and in psychic reactions” by looking back to documented history (Kinsey, 1948 p 636-649). He also found that there were a very small group of individuals who experienced both types of behaviors, which led Kinsey to state that, “Males do not represent two discrete populations, heterosexual and homosexual” (Kinsey, 1948 p 636-649). Kinsey’s work indicates that while an individual can be either homosexual or heterosexual, there are more than just two types of sexuality represented by the population.
Nettie Maria Stevens (1861-1912)
Often overlooked in the literature, Nettie Stevens was one of the first female scientists to make a name for herself in the biological sciences. She was born in Cavendish, Vermont. Her family settled in Westford, Massachusetts. Stevens' father was a carpenter and handyman. He did well enough to own quite a bit of Westford property, and could afford to send his children to school.
Stevens was a brilliant student, consistently scoring the highest in her classes. In 1896, Stevens went to California to attend Leland Stanford University . She graduated with a Masters in Biology. Her thesis involved a lot of microscopic work and precise, careful detailing of new species of marine life. This training was a factor in her success with later investigations of chromosomal behavior.
After Stanford, Stevens went to Bryn Mawr College for more graduate work. Thomas Hunt Morgan was still teaching at Bryn Mawr, and was one of her professors. Stevens again did so well that she was awarded a fellowship to study abroad. She traveled to Europe and spent time in Theodor Boveri's lab at the Zoological Institute at Würzburg, Germany. Boveri was working on the problem of the role of chromosomes in heredity. Stevens likely developed an interest in the subject from her stay.
In 1903, Stevens got her Ph.D. from Bryn Mawr, and started looking for a research position. She was eventually given an assistantship by the Carnegie Institute after glowing recommendations from Thomas Hunt Morgan, Edmund Wilson and M. Carey Thomas, the president of Bryn Mawr. Her work on sex determination was published as a Carnegie Institute report in 1905. In this first study she looked at sex determination in meal worms. Later, she studied sex determination in many different species of insects.
Stevens' assistantship at Bryn Mawr still meant that she had to teach. She wanted a pure research position, and wrote to Charles Davenport to see if it was possible for her to work at his Station for Experimental Biology. Unfortunately, Stevens died of breast cancer in 1912 before she could occupy the research professorship created for her at Bryn Mawr, or work with Davenport at Cold Spring Harbor (Nettie Mae Stevens, 2011).
Margaret Mead (1901-1978)
Mead, an American Anthropologist, sought to study sexuality outside of the Western lens. She traveled extensively abroad in pursuit of this. Her work in Samoa led her to observe uninhibited sex that youth in Samoa engaged in. Sex among the youth was both condoned and encouraged by adult members of the community. Her work challenged the restrictive sexual ethics of her time. Beyond sexual practices differing relative to culture, she also wrote about gender roles differing from what were normative practices in the U.S. She spoke to the concept of sexuality as a social construction in terms of how culture was the shaping force in sexual attitudes and behaviors (Mead, 1928 p 61-76).
Richard von Krafft-Ebing (1840-1902)
Richard von Krafft-Ebing was a German sexologist who wrote the book Psychopathia Sexualis. According to the book, various forms of sexual behavior and arousal were considered disgusting. He believed that there existed numerous sexual behaviors and sexual practices which he called 'natural variations' and that all of them aroused the same cultural phenomenon of stigma. These sexual deviations were classified into four different groups: sadism, masochism, fetishism, and homosexuality. Krafft-Ebing emphasizes that the hand is one the most common fetishes and often joined by masochistic and sadistic behaviors (Bauer, 2003). He wrote that homosexuality was a natural occurrence and that it is not a chosen vice. Krafft-Ebing essentially brought to light the fact that homosexuality exists as part of the spectrum of human sexuality rather than pathologizing it (Bauer, 2003).
William Masters (1915-2001) and Virginia Johnson (1925-2013)
William Howell Masters and Virginia Eshelman Johnson pioneered research on human sexual behavior in the 1950s and 1960s. They worked together to disprove many of the long standing misconceptions about sexual behavior. In 1966 They released their most important, groundbreaking study, a four-stage model of human sexual response based on approximately 10,000 recordings of changes in participants' physiology during climax. From these data, they identified four successive stages: (1) excitement, (2) plateau, (3) orgasm, and (4) resolution. These findings would change how people viewed sexual responses and will be discussed further in Chapter 4. (Fuhrmann, & Buhi, 2009).
In 1995 a study was done on 1200 students at a Northern California University. Students were surveyed about their at home sex education. The hypothesis was that male students got vastly different messages about sexuality than female students did (note: the study demographics look only at gender asking only either male or female. If this study were to be replicated today, the gender question would be modified to include other gender options). The data gathered and resultant Master’s Thesis obtained by this textbook’s author gave support to the hypothesis that sex education falls down gendered lines. The sexual double standard is something we know exists, men are praised for being sexually experienced and women are taught to remain pure. This double standard in the United States dates back centuries and is rooted in Christianity, primarily White Anglo Saxon Protestant (WASP) religion and puritanical culture. The data suggested that this double standard was alive in well the sex education these students received at home. Overall parents were not teaching their children about sex much at all and when they were it was very different depending on the gender of the child.
 To formally introduce me to manhood, my dad gave me a brief description of sexual intercourse which was followed by taking me to a hooker 2 months later. I reluctantly had sex with the hooker to save my pride F8401M
On the contrary, assigned females were taught to keep their bodies safe and not to have casual sex.
I am now very sad. Maybe I can ask my mom about sex. No! No way! They will kick me out of the family if they know I am not a virgin. I won’t even tell them anything. I don’t want my family to treat me like a monster. F9307F
The overall findings were that parents view their child’s sexual rights very differently depending on whether they are assigned male or assigned female (Rahman, 1995). So what this results in is two very different sexual scripts. How does this double standard play out in terms of coupling? If a significant number of people in society end up coupling with another person whose gender is not the same as theirs, how do we navigate sexuality, communication and consent when we have been given radically different messages?


7.1: Introduction to the Central Limit Theorem
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Why are we so concerned with means? Two reasons are: they give us a middle ground for comparison, and they are easy to calculate. In this chapter, you will study means and the Central Limit Theorem .
The Central Limit Theorem is one of the most powerful and useful ideas in all of statistics. The Central Limit Theorem is a theorem which means that it is NOT a theory or just somebody's idea of the way things work. As a theorem it ranks with the Pythagorean Theorem, or the theorem that tells us that the sum of the angles of a triangle must add to 180. These are facts of the ways of the world rigorously demonstrated with mathematical precision and logic. As we will see this powerful theorem will determine just what we can, and cannot say, in inferential statistics. The Central Limit Theorem is concerned with drawing finite samples of size \(n\) from a population with a known mean, \(\mu\), and a known standard deviation, \(\sigma\). The conclusion is that if we collect samples of size \(n\) with a "large enough \(n\)," calculate each sample's mean, and create a histogram (distribution) of those means, then the resulting distribution will tend to have an approximate normal distribution.
The astounding result is that it does not matter what the distribution of the original population is, or whether you even need to know it. The important fact is that the distribution of sample means tend to follow the normal distribution.
The size of the sample, \(n\), that is required in order to be "large enough" depends on the original population from which the samples are drawn (the sample size should be at least 30 or the data should come from a normal distribution). If the original population is far from normal, then more observations are needed for the sample means. Sampling is done randomly and with replacement in the theoretical model.


5.1.3E: Social Class
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Learning Objectives
- Summarize the concept of social hierarchy as related to the development of social class
A social hierarchy refers to the arrangement of people in society, with some people having more power and others having less. Social hierarchies, also referred to as social stratification, largely refers to socioeconomics, or the amount of material and social capital that an individual possesses. However, the socioeconomic classification is a stand-in for the amount of power possessed by an individual. Thus, one can layer and categorize individuals and classify them by group according to how much social power they possess.
Social class is the layer or social stratum denoting socioeconomic power into which an individual falls. In other words, social class describes how people are differentiated based upon their wealth or power. In the late eighteenth century, class came to replace such categories as estates, rank, and orders as the primary means of organizing society into hierarchical divisions. This corresponded to a general decrease in the significance ascribed to hereditary characteristics and an increase in the significance of wealth and income as indicators of position in the social hierarchy. While hereditary characteristics, such as being born into a wealthy family, continue to influence the ease with which one establishes adult social standing, the model that emphasizes class and achieved status maintains the status quo in capitalistic societies, particularly the United States.
The study of social class and hierarchies fundamentally asks questions about inequality. Sociology has a long history of studying stratification and teaching about various kinds of inequality, including economic inequality, racial and ethnic inequality, and gender inequality. Inequality means that people have unequal access to scarce and valued resources in society, such as health care, education, jobs, property, housing, and political influence. Sociologists study the causes and effects of inequality.
As such, sociologists pay particular attention to socioeconomic status, as it signifies an equation of power and wealth that denotes a particular form of inequality. Late-nineteenth and early-twentieth century German social theorist Max Weber proposed that socioeconomic status was configured by a combination of power, property, and prestige. For Weber, power refers to an individual’s ability to impose his will on others, regardless of their wishes. Property refers to the sum total of one’s possessions in addition to their income. Property therefore goes beyond income as a measure of social class because it measures accumulated wealth in addition to one’s earning potential. Prestige refers to the reputation or esteem associated with one’s position in society. Prestige used to be associated with family name, but now more frequently is yoked to occupation. Occupations like physicians or lawyers tend to hold more prestige than bartenders or janitors.
Power, prestige, and property tend to go hand in hand. An individual who is born into a wealthy family is likely to be born with more property and have access to better educational resources to achieve prestige, culminating in more power. Yet this is not always the case. For example, a professor may have little property, but has high prestige. Conversely, a “trust-fund baby” or someone left family money, might have much property, but little prestige in a society that values personal achievement.
Social class is commonly organized into a three-class model, by which individuals are separated into upper, middle, and lower classes. The upper class consists of the wealthy and powerful individuals who own and control the means of production. In the United States, the upper class is comprised of the richest 1-2% of the country, but other countries, particularly in Europe, still emphasize aristocracy and the family into which one was born. The middle class is the broadest swath of society, consisting of professional workers, small business owners, and low-level managers. These people are also referred to as “white collar workers. ” The lower class consists of people who work wage jobs rather than salaried positions. Referred to as “blue collar workers,” the lower class has little economic security and includes both individuals working lower-paying positions and unemployed and/or homeless people.
Social class in the United States looks a little bit different than one might suppose given the three-class model. Consider the following facts: Four hundred Americans have the same wealth as the bottom 50% of Americans combined. Twenty-five Americans have a combined income almost as great as the combined incomes of two billion of the world’s poor. In 2007, CEOs in the top American companies received an average salary of $10.5 million per year, 344 times the pay of the average worker. Half of American children will reside in a household that uses food stamps at some point in their childhoods. As you can see, the upper class in the United States contains very few Americans; the population is concentrated in the middle and lower classes. Yet, the few people in the upper class control a disproportionate amount of American wealth.
Key Points
- A social hierarchy refers to the arrangement of people in society, with some people having more power and others having less.
- Max Weber evaluated an individual’s social class by a measure of power, property, and prestige.
- Social class is typically thought of in a three-class model, dividing a population into upper, middle, and lower classes.
- In the United States, very few people are in the upper class, but the upper class possesses a disproportionate amount of the nation’s wealth.
Key Terms
- socioeconomics : The branch of economics that deals with social aspects.
- White Collar Workers : The term white-collar worker refers to a person who performs professional, managerial, or administrative work, in contrast with a blue-collar worker, whose job requires manual labor. Typically white collar work is performed in an office or cubicle.
- Three-Class Model : It includes the “rich,” the “middle class,” and the “poor. “
- social facts : the values, cultural norms, and social structures which transcend the individual and are capable of exercising a social constraint


10.18: Discussion- Late Adulthood Interview Assignment
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STEP 1
: Find a person above the age of 65 to interview. They
may
be related to you. Keep their information confidential by using pseudonyms.
Include a short introduction detailing their gender, approximate age, occupational status, and cultural background.
Add three of your own original questions. If your interviewee is willing to be recorded for the interview (and they understand their videos will be shared and no longer anonymous), you
may
include the video or audio recording, although this step is not required.
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Please tell me about your childhood, family and school life.
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Do you consider yourself old? At what age did you notice that you were getting older?
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What is the most important historical event or period of time that you have lived through? How did it influence you personally?
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What is the biggest change you have seen in how people conduct their everyday lives?
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What have been the best years of your life so far? What are your plans for the future?
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How are young people today different from when you were their age?
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Have you ever experienced any negative attitudes or discrimination because of your age?
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<add original question>
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<add original question>
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<add original question>
STEP 2
: Post the interview and responses to the discussion forum.
STEP 3
: Write a post between 250 and 500 words discussing what you’ve learned from your interview. Were there any answers that surprised you? How do the responses in the interview tie in with or confirm the things you learned about in this module? How do this person’s experiences and attitudes tie in with Erikson’s psychosocial stages? Has this changed your opinion on aging? What are your own personal perceptions on aging?
STEP 4
: Return to the discussion to comment on at least ONE other post (in at least FIVE sentences). Expand on a classmate’s post in a value-adding, topic-related way. Promote a collaborative, supportive community, and advance the dialogue through follow-up questions. Reply posts cannot be one-liners, off-topic posts, vague statements, unsupported opinions, inadequate explanations or simply say, “I agree” or “good job.”
Sample Grading Rubric
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Criteria
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Proficient
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Developing
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Not Evident
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Points
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Presents a coherent post between 250-500 words
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Writes in clear, descriptive sentences with no or few grammatical errors. The post is well organized and complete, and addresses observations and trends from the interview.
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Does not provide enough detail in the post about connections and observations from the interview, or post contains several grammatical errors.
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Incomplete post or difficult to understand.
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__/10
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Shares complete interview of the senior adult
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Copies and pastes the entire interview in the discussion board, and it includes two original questions.
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Shares a partial interview or does not share enough detail in the interview responses.
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Does not include interview or interview includes only yes or no answers.
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__/6
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Posts at least one reply to the discussion
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Posts a value-adding and related comment that contributes to discussion about late adulthood.
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Includes a weak or off-topic comment on another post.
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Does not post a value-adding and related comment that contributes to discussion about late adulthood.
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__/4
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Total:
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__/20
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Contributors and Attributions
CC licensed content, Original
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Assignment: Late Adulthood Interview Discussion.
Provided by
: Lumen Learning.
License
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CC BY: Attribution