Psychological and Sociological Insights Essay

This essay will address how psychological and sociological insights help nurses to understand health lifestyles by exploring life sciences, focusing on people who engage in smoking and how they seem to override the fact that they are putting their health at risk. In addition to this I will also be highlighting statistics and briefly discussing the health complications that develop from smoking. Consequently, it is important for nurses to understand how people function, more so when they are healthy so we know how to help when a health problem arises. Functioning as a person involves social and psychological aspects, as well as having functioning body systems. Over the decades there have been many different explanations on how people function, this essay will discuss psychological and sociological ideas that will give nurses an understanding of people’s behaviour, thoughts, feelings and lifestyles. For this purpose, this essay will be reflecting on the psychological perspective s of social learning theory, unrealistic optimism and the health model locus of health. Secondly, it shall be discussing the sociological perspectives of socio-class and low-incomes and socialisation to discover why people may start to smoke and why people continue to smoke knowing the risks involved. Ironically, as recent as the 1940’s smoking was considered harmless and the overall attitude of people was that smoking relieved tension but research has since confirmed that smoking causes many diseases detrimental to one’s health such as cancer, cardiovascular and lung diseases. Smoking is a greater cause of death and disability than any single disease, says the World Health Organisation (WHO). According to WHO, smoking is responsible for approximately five million deaths worldwide every year (WHO, 2012). Presently, in the United Kingdom smoking is the leading cause of death with 120,000 people dying annually due to smoking related diseases and costs the National Health Service (NHS) the sum of  £2.7 billion to provide health care for people with smoking related illnesses (Department of Health, 1998). Even so, people still continue to engage in this life threatening behaviour despite knowing the dangers and risks that it involves. Therefore, as nurses we need to consider how addictive smoking is to some individuals (Rana, Upton. 2009) this can influence the health choices people make. Health psychologists attempt to predict how people make choices about their lifestyles. According to Albert Bandura’s theory (1965,1991) on social learning suggested that learning can occur not only by association, reward and habitation but also by observing others behaviour and by imitating it and does not require the individual to be actively involved in the learning process (Barker, 2007) this is referred to as vicarious learning through modelling. The social learning perspective implies that smoking behaviour is learned by modelling and social influences (Rana, Upton, 2009). Statistically, most smokers start smoking as teenagers (Payne, Walker 1996) and children are more likely to smoke if their parents smoke and their parent’s attitude to smoking is an important factor (Action on Smoking and health, 2011).Valente et al (2005) suggests that one of the main reasons for adolescents to start to smoke is the influence of peers and siblings and parents generally become less influential ( Rana, Upton, 2009). Therefore leads us on to social influence, this refers to the way in which people’s behaviour is influenced by the presence and actions of others (Cialdini, 2004). Despite knowing the health risks of smoking, young people still conform to engage in smoking as the number of young people who smoke remains the same (ASH, 2012). Some will manage to quit but a good percentage will endure to smoke for decades, this increases the risk substantially in developing illness and early death (Department of Health, 1998) even though 7 out of 10 adults say that they would like to give up but continue to smoke, the reasons for continuing they say it is a way of coping with stress, a way of relaxing and women seem to be anxious with putting on excess weight. Understanding when and why the individual started to smoke and the reasons for continuing can help the nurse understand more about the individual’s lifestyle. The nurse can then offer support and advice on how the individual can use different strategies enabling them to overcome these hurdles and promote the health benefits of quitting smoking. In an attempt to explain why individuals continue to damage their health by continuing to smoke, Weinstein (1983, 1984) suggests that the reasons people often engage in unhealthy behaviour is due to the individuals perceptions of risk and susceptibility are inaccurate (Rana, Upton. 2009). A study carried out by Weinstein, he asked subjects to examine a list of health problems and to rate their chances of developing the problem, compared to others of the same age and sex. The outcome of this study showed that most of the subjects believed that they were less likely to develop the health problem. Weinstein called this phenomenon ‘unrealistic optimism’, as he argued that not everyone can be less likely to develop an illness (Ogden, 2007). He claims that individuals ignore their own health risks and smokers convince themselves that they are not at risk of developing illnesses, as much as other smokers. Many smokers have the belief that if there is not a problem now there will not be one in the future and their lifestyle continues knowing the risks. This model can be used in nursing to help the nurse to understand the attitudes of most smokers. Understanding the attitudes the nurse can help promote healthy lifestyle choices by providing the individual appropriate information about the impact that smoking has on their health. Reasons for continuing this lifestyle can be explained using the Health Locus of Control (HLC), people’s attribu tions about health and illness. For instance, Wallaston & Wallaston 1982, states that internal control is when individuals tend to regard the control of their health there responsibility by believing that their health and recovery of illness are dependent on their own actions (Payne, Walker. 1996) or they believe it is down to fate or luck this could relate to people that continues to smoke. Whereas external control is when the individuals believes their health is not controllable by them and is controlled by powerful others, for example; doctors and nurses and are less likely to take their own action and believe that it is the responsibility of external factors. The health locus of control has been shown to relate to whether the individual changes their behaviour towards smoking. External individuals who wish to give up smoking will generally be more complying to change their lifestyle and seek advice and help from health care professionals more so than internal individuals (Odgen, 2007). Nurses can apply this model to people with external HLC who are considering giving up smoking by providing the appropriate information enabling the individual to seek help from the available sources and work alongside them to devise a programme in which will benefit them (Rana, Upton. 2009). The sociology perspectives look at the social world and differences in lifestyles that can influence the individual’s health. Studies have shown that inequalities in health is not just down to ones behaviour but displays a connection to the social and economics and environment all of which influence peoples lifestyles (Taylor, Field. 2007). The Black Report 1980 inevitably found that poor health and earlier deaths are the magnitude to socio-economic inequalities (Denney, Earle. 2010). The socio economic classes are still divided as the prevalence of smoking regular among people who work manual jobs are more than likely to smoke more so than people that work in non manual jobs ( Action on Smoking and Health, ASH. 2012), (appendices 1.1). Smoking prevalence is an important element of the differences in the state of health and death rates between social classes and remains high among men and women in the lower socio economic group (Richardson, 2001). As nurses we need to be aware of the social world in which we practice, understanding the differences in how people live will determine the lifestyle choices they make (Marsh, Keating. 2006). Nurses must consider the factors underlying the socio economic differences in smoking such as occupational status, income, education, housing and environment. It may be considered that the decision to smoke is influenced by social factors and social circumstances of the individual. The behaviour of smoking is often linked to poverty and illness, as the poorest family group- single parents have the highest rates of smoking an 80% chance of being smoker if you fall into this social class (Crosier, unknown). Marsh and McKay (1994) reported that people who are living on low income are most likely to smoke; least able to quit smoking; least able to afford smoking; most likely to suffer increased hardship due to the expenditure on tobacco (Richardson, 2001). The debate about women and smoking illustrates this well. Despite over the past decade, the number of people smoking has declined but only has shown a small decrease in women smoking, yet the differentiation between the working and middle class women has increased (Nettleton, 2006). Research into women in low income families with young children, smoke as it is a means of a coping strategy to help deal with the multiple demands that are placed upon them. Graham (1987) found that mothers on low incomes used smoking as a coping strategy that could provide ‘time out’. The mothers where all aware of the health risks associated with smoking so providing more education was unlikely to have an impact (Scambler, 2008). The nurse would, however, have to address that the added pressure for the mothers on low incomes, to give up smoking may cause more stress and could lead to additional health implications, as a result this could have a negative impact on their lives (Bury, Gabe. 2004).It is the nurses role to address this issue by providing appropriate support and information on alternative ways of coping with stress, whilst retaining their autonomy (Naidoo, Wills. 2004). Socialization is more often than not the main reason for people to start smoking, as 82% of adult smokers started smoking in their teenage years (ASH, 2012), as adolescences are more than likely to indulge in risk taking behaviour such as smoking, to create a sense of belonging to a peer group (Clarke, 2010), this soon becomes a regular daily smoking pattern, sustained by nicotine addiction but is reinforced by social norms (Ewles, 2005). It is a nurse’s role to help change of attitudes of the younger society by continuing to provide education on the addiction of nicotine and health risks of smoking and prevention of disease. The Department of Health brought about The White paper: Smoking Kills (1998) as they recognised the health issues of smoking and that one of their main concern was the rises in children /adolescences smoking, Appendices 1.2. They have put in measures to reduce smoking among the younger generation by minimilising tobacco adverts in shops, proof of age cards were introduced and the age to purchase tobacco has risen from 16 to 18 years old. Although in general we are living healthier and longer lives due to the overall improvements that has been made throughout the past decades there is still room for improvement in health inequalities within the top and bottom ends of the social scale (Clarke, 2010). To conclude, nurses need to understand the principles of psychological and sociological insights to health lifestyles. As a result, this helps the nurse understand the reasons why people choose to take up smoking and continue to smoke, leading a lifestyle that is detrimental to their health. From exploring these life sciences the nurse will have a better understanding of the different attitudes, health beliefs, thoughts and feelings that differ within the socio-economic classes, this gives the nurse the ability to deliver the holistic approach relevant to the individuals needs. As nurses by providing care to people, more often than not we do not share the same values and beliefs and may not agree with the life choices people have made but gaining an insight to their lifestyle will in turn enable us to provide the appropriate support, information and treatment. Nurses are obliged to promote good health behaviour but this does not always work towards smoking, many people will take the advice and may try to quit smoking (Appendices 1.3) but due to demands of life some have a tendency to start again but we must realise as nurses, smoking is an addiction and is not easy to give up it, so we have to respect the individuals lifestyle choices without being judgemental.

Principles of Safeguarding

The Gogh Inquiry During investigations at Staffordshire Hospital, findings revealed serious failures of care, cases of unnecessary suffering of patients and higher than average mortality rates. Five other hospitals are also being investigated regarding their unnecessary death rates and poor nursing. Following these findings, Sir Bruce Gogh, England's INS Medical Director, has started an inquiry. Koch's inquiry looks at different cases where there has been unnecessary deaths and a lack of quality nursing.This report kooks at the different recommendations that have been made to improve the INS put in place by Gogh and looks at what has happened since Staffordshire regarding resignations, blame and public opinion. Different Opinions Patient groups are angry as there has been no prosecutions or resignations since the Staffordshire scandal. Katherine Murphy of the Patients Association quoted â€Å"It is deeply disturbing nurses fear the door is open for another tragedy on the scale of Mi d Staffs. It is vital politicians listen and ensure they provide the tools nurses need o provide a safe level of care to patients. The families of the patients who have died or have received poor quality care, are understandably angry and have lost faith in the INS. INS staff (front line nurses) feel like that the is blame aimed at them, as they are given targets to hit, which are impossible to achieve as well as first class care. Also, front line nurses warn that this could happen again due to lack of staff, cuts and the rationing of front line services. The Recommendations Following the Gogh Review, the current set of regulations are to be revised.This will include a call for greater regulation of INS managers and an overhaul of training for nurses and unqualified health care assistants. Also, changes to the supervision and regulation of health care are required to protect patients and to respond to public anger about the scandal, which has drained confidence in the rest of the he alth service. A recommendation for better training for health care assistants, and a call for them to be regulated, meaning they could be struck off if they failed in their duties.The report will also recommend changes to ensure managers are held accountable for their decisions. This could mean they are struck off a central register if they do not follow a revised code of conduct. The Effect on Public Opinion Patients at Stafford Hospital were left lying in their own urine and excrement for days, forced to drink water from vases, given the wrong medication or sent home with faith in the INS and health and social care. Whilst working on the wards staff may find themselves being scrutinized by patients and relatives, finding fault where there is none.

Third Party Conflict Resolution

Third Party Conflict Resolution MGT/445 Organizational Negotiations March 11, 2013 | | | | Third Party Conflict Resolution Conflict is an omnipresent facet of human existence present at every level of society. Differences in culture, norms, beliefs, wants, needs, and personality causes conflict. Throughout history people involved in conflict solicit assistance from a third party with the primary goal to negotiate a resolution. Team A is assigned to review a case involving two managers of a manufacturing company involved in a conflict. The following paragraphs provide an overview of the case and different third party interventions strategies.Team A included below the analysis of the case, a third party intervention strategy to resolve the conflict, the reason the strategy resolves the conflict, and an alternate strategy if the first strategy does not work. Case Overview The case involves a conflict with managers of a major producer of office furniture -Seatcor. Acting as the senior vi ce president of operations and chief operating officer, Team A must provide an appropriate solution to the conflict. Joe Gibbons is the vice president and general manager of Seatcor’s largest desk assembly plant. Joe has been with Seatcor for 38 years and is two years away from retirement.He worked his way up through the ranks to his present position and has managed successfully his division for five years with a marginally competent staff. Joe is a long-standing personal friend. There is a perception Joe has surrounded himself deliberately with minimally competent people possibly because he may have felt threatened by talented assistants. During lunch with Charles Stewart, assistant vice president and Joe’s second in command, it became clear there is a conflict between Charles and Joe. Joe’s potential replacement upon his retirement is Charles, who was hired last year.Joe was reluctant to hire Charles. Charles is 39, a tenacious, bright, and well-trained busine ss school graduate. Charles is doing a good job in his new position. Joe is in the process of completing a five-year plan for his plant. This plan will serve as the basis for a proposal to management for several major plant reinvestment and reorganization decisions. According to Charles, Joe has not included Charles in the planning process. Joe excluding Charles is disturbing him. His distress may be influencing his work and relationship with Joe. Charles may have an ulterior motive for disclosing this information.Joe runs a good ship and has good judgment. Confronting Joe may upset him and appear to undermine his authority. Joe may have a good reason for excluding Charles. Joe felt threatened by a junior manager or he may not be aware of Charles’ distress regarding exclusion from the planning process. Some tension between Joe and Charles may exist even though they are not in a verbal dispute. From a business standpoint, the potential conflict between Joe and Charles is a ver y serious problem. Joe will retire in two years so it will be important to have a trained replacement in place well in advance.Charles probably will have to live with the results of any major decisions about the plant after Joe retires. In addition, it is essential Joe support Charles so he can grow properly into his present position and future job. The goal is to resolve the potential conflict between Joe and Charles as well as benefit the company. It will be important to get Joe and Charles talking. The company will benefit if Joe and Charles have an amicable relationship so Joe can train Charles and collaborate on the five-year reinvestment and reorganization plan. According to the â€Å"The FreeDictionary† (2013), intervention means â€Å"to come, appear, or lie between two things† (Intervene, para. 1). As acting senior vice president of operations and chief operating, Team A must intervene to resolve the conflict. Third Party Intervention Strategies and Selection In the Seatcor case, Team is considering using a third party. â€Å"The terms third party and intermediary are both used to refer to a person or team of people who become involved in a conflict to help the disputing parties manage or resolve it† (University of Colorado, December 2, 2005,  p. ) Third parties can take the role of intermediary, consultant, facilitator, mediator, or arbitrators. â€Å"The various forms of observed third-party intervention are distinguished primarily by the degree of power that the intervener exercises over the process and outcome of the conflict† (Fisher,  April 2001-03-30, p. 1. The role of a consultant is to analyze the conflict and develop a plan to help resolve the conflict. The role of a facilitator is to arrange and manage meetings until a reasonable agreement is reached. More serious conflicts may warrant a mediator.Mediators are more involved and impose more structure to the discussion process between both parties. The goal of the mediator is to get both parties talking so each side understands the conflict from the other party’s point of view. Common understanding between both parties often yields a solution to the conflict. The role of the arbitrator is to listen to both sides, collect evidence, and determine the resolution to conflict. Decisions made by arbitrators are final. Informal interventions are incidental to the negotiation, whereas formal interventions are designed intentionally or in advance (Lewick, Saunders, & Barry, 2006, p. 87). As the senior vice president of operations and chief operating officer, Team A decides the best approach is to use a formal mediation strategy through an impartial third party. Applying the Intervention Strategy There are six steps to the formal mediation process that include introductory remarks, statement of the problem by both parties, gathering information, identification of the problem, bargaining and generating options, and finally reaching an agreeme nt. In general, the information gathering step is done after the parties have stated the problem. In this case it is important to ollect some data about the five-year plan and more on the relationship between Joe and Charles. It will be difficult to gather information without alarming the parties involved and creating rumors within the plant. Before the meeting with both parties, Team A will meet with Joe to allow him to explain his concerns with the development of the short-term plan. The mediation process will begin with arranging a meeting with both parties and the third party mediator. The mediation between Joe and Charles is set to take place at a local conference room close to the assembly plant with the third party mediator and Team A.This gives the mediation neutrality and takes away any implied bias by having the mediation at the plant. Hilary (2000) stated â€Å"Mediator neutrality legitimizes the mediation process because the parties, rather than the mediator, are in con trol of decision-making† (p. 145). The ground rules are simple but ensure Joe and Charles stay amicable with one another. Introductory Remarks The mediation begins with the mediator speaking to both Joe and Charles in the room. The mediator explains why he is there and the intent of the mediation. At the beginning of the eeting, the mediator will outline the reason for the meeting, the expectations of both parties, and protocol of the meeting such as allowing each party to speak without interruption. Also each party is asked to sign a paper agreeing to follow the ground rules, and the mediator can clarify any questions the parties may have about the ground rules The ground rules are simple but ensure Joe and Charles stay amicable with one another. * Both parties agree to take turns talking and will refrain from interrupting the other party. * Both parties will address the other party on a first name basis. The parties agree to pay attention to the other party to understand the other party’s wishes. * Each parties can request breaks when necessary. * Either party can speak up if the mediation falls off track. * Each party is to follow the guidance of the mediator. Statement of the Problem by the Parties Each party is asked to step outside and the other party speaks one-on-one with the mediator. This gives the mediator an overview of the situation and allows the mediator to counsel the parties on the correct language to not provoke the other party.Both parties are allowed in the room for face-to-face dialogue on the issues they believed led to the situation. Joe should be allowed to go first as senior manager. As the conversation progresses, the mediator writes down the problems from the views of both parties. The statements by both Joe and Charles will not necessarily be a true representation of the situation but will allow both parties express their respective view on the conflict. Joe may deny excluding Charles and is likely to place blame in an attempt to make Charles out to be the scapegoat.Charles may try to make Joe look bad to hide his own shortcomings or attempt to make himself look better. Either way, Charles’ distress may be warranted. Information Gathering In the information gathering step, the mediator will ask both parties questions to get to the potential root of the problem and evaluate the emotional undercurrents. Gathering information helps the mediator build rapport with both parties plus helps identify the root of the problem. Problem Identification After a short break, the mediator should summarize and repeat the highlights of the discussion to Joe and Charles.Summarizes the highlights helps both parties understand the primary points of the conflict. â€Å"The mediator tries to find common goals between the parties. The mediator will figure out which issues are going to be able to settle or those that will settle first† Stepp, J. A. , (February 2003). Bargaining and Generating Options Once th e mediator is confident of Joe and Charles’ commitment to achieve a negotiated settlement, the mediator may choose to hold private sessions with both parties to help move the negotiations along. The goal of the mediator is to find some common ground.This can lead to a final agreement, which diffuses the conflict and provides a new basis for future relations. Both parties may entertain alternative solutions without committing to any concessions. Reaching an Agreement During the final step of the mediation, Joe, Charles, and the mediator will work through the problems to find common ground. The ultimate goal would be for Joe to agree to mentor and train Charles for his position. In addition, Joe and Charles should agree to collaborate on completing the five-year reinvestment and reorganization plan.If an agreement is not reached an alternative strategy will be used. Alternative Actions Ultimately the needs of the company come first. If the relationship between Joe and Charles d oes not improve and an agreement is not reached then Team A will implement an alternative strategy. The next step would be to use arbitration. The third party mediator and Team A would advise both Joe and Charles are expected to act professional and put personal differences aside. Joe will be directed to provide training to Charles as well as work together on the five-year plan.If either party cannot agree to the terms of the agreement they may face possible termination. Conclusion Resolving conflicts, especially in a business setting is important. Conflicts can disrupt business operations and impede a company’s profits and growth. Team A selected the best approaches to resolve the conflict between Joe and Charles. The company solicited a third party mediator to protect the best interest of the company. Conflicts among employees are not uncommon and can be a simple a misunderstanding or personality conflict.If employees are not willing to work to resolve conflicts interventio n becomes necessary. From the information provided regarding this case it is unclear if Joe and Charles would have reached an agreement without a third party. Team A believed the information provided was serious enough to require the intervention of a at least a third party mediator or as a last result an arbitrator. References Fisher, R. (April 2001-03-30). Methods of Third-Party Intervention. Berghof Handbook for Conflict Transformation, ISSN 1616-2544(), 1-25. Retrieved  from  http://www. berghof- handbook. net/documents/publications/fisher_hb. df Lewick, R. , Saunders, D. , & Barry, B. (2006). Negotiation (5th ed. ). Retrieved on March 7, 2013 2013 from The University of Phoenix eBook Collection database. Stepp, J. A. (February 2003). How Does The Mediation Process Work? Retrieved from http://www. mediate. com/articles/steppj. cfm The free dictionary. (2013). Retrieved on March 7, 2013 from http://www. thefreedictionary. com/intervention 4 University of Colorado. (Dec 2, 200 5). Third Party Intervention. Retrieved from University of Colorado, International Online Training Program On Intractable Conflict website.

Answer 5 questiona thoroughly and accurately Assignment

Answer 5 questiona thoroughly and accurately - Assignment Example It had a larger brain of 1500cm3. It had a long skull with a bulge known as the occipital bun(Paul 32). It had large jaws with a space called retromolar. Neanderthal man had a physical demanding form of life which was depicted by its thick limbs. Unlike Homo erectus, Neanderthal had quite a complex culture which resembles that of the modern man. It practiced painting, making of jewelry and portable art. The Homo sapiens had long limbs and slender body which was an adaptive feature of the tropical region. Homo sapiens had the largest brain size of nearly 1500cm3. Unlike their ancestral species, Homo sapiens had short for heads which depicted large brain capacity. Their limbs were much less robust and thinner compared to the modern man (Paul 53). Homo sapiens were characterized by a simple and relatively advanced culture compared to Neanderthal and Homo erectus species. They made tools from stones. These tools were more advanced than those made by the Homo erectus and the Neanderthal m an. Homo florensiensis is described as a small hominid species which was dated approximately between 95, 000 and 17000 years ago. The species depict a variety of features similar to Homo sapiens and Homo erectus. Their teeth and skull share similar derived features. Their canines and molars are small in size similar to those of Homo sapiens and Homo erectus. Their brains are small in size with an approximate volume ranging between 380 and 420 centimeters cubic. This aspect makes it similar to apes and Australopithecus. In this case, homo florensiensis can be dated to human ancestral linage as they bare similar characteristics. Their feet are estimated to be 20 centimeters long similar to those of the chimpanzee as well as the astralopiths. The floresiemsis foot longitudinal arch which is a feature present in both Homo erectus and Homo sapiens. Non-metric methods are anomaly traits found in skeletons. They cannot be measured thus are recorded on the

An Examination of Intertextuality Between Alice Munros Simons Luck and Essay

An Examination of Intertextuality Between Alice Munros Simons Luck and Margaret Atwoods Happy Endings - Essay Example Whether or not the average reader is familiar with the particulars of the hypothesis, one cannot avoid several decades of literature and culture influenced by these ideas, as they range from the daydreams of Thurber's The Secret Life of Walter Mitty to the fantastic worlds of C. S. Lewis's Narnia books. The two stories examined in this paper, Alice Munro's "Simon's Luck" and Margaret Atwood's "Happy Endings," couple the form of multiple realities with the human psychology of traditional literature. Reader's need only the latent immersion of the involved concepts that permeate the today's world; their inner empathy and the authors' skill will maintain one's attention. Only through closer examination can the levels of intertextuality begin to be distinguished, compared, and analyzed. Munro's story has already existed in a different reality, i.e. it was originally published in 1978 under the title "Emily," which perhaps was the narrator's name before she blossomed into this incarnation as Rose. The reason for the name change will be addressed momentarily. Rose's first instance of confusing reality happens when she is accosted by the student at the party. While she registers that his name is David and that he is a former student, she recalls nothing else, and instead idly projects a history onto him, "He had probably been brought up in a gentle home, where people talked about answering Nature's call and blessed each other for sneezing." When Simon later fails to come to the house, Rose realizes that "Preparations court disaster," in that she had been preparing for one future that did not happen. To console herself, she then imagines alternate futures in which she takes action, either by calling him or writing him a note, or alternately, where he has taken action, by going traveling or having gotten married. She lives through all of these realities through the course of the weekend. Rose has lived through a number of different realities, between teaching and acting, but her relationships patterns seem to end with her fleeing regardless of what the situation was. AS she flees away from Simon, she imagines a number of possibilities for what he is doing, perhaps pulling up to her house. She imagines how the retionship would have only become more akward with time. To escape this cycle of depression, she has extended her excuse to the university, saying that she has run into a job opportunity a future she has accurately predicted for once. She lands an acting role and moves out to British Columbia. Months later, she meets a mutual acquaintance or hers and Simon's, at which point she learns that Simon has died, apparently from an illness that he had for some time. While the title of the story initially seems to relate to the anecdote Simon tells of escaping during World War II, it actually relates to his ultimate fate. For all of the possible futures that Rose had imagined for him, of all the endings she has ever experienced for relationships, his death was tailor made as the only possibility to truly exit her life. He will always be unique to her for that, if no other reason. And as for the

Depression in the Elderly in a Giatric Hospital Research Paper

Depression in the Elderly in a Giatric Hospital - Research Paper Example A condition for inclusion in the sample was that the patient must have stayed in the hospital for a period of not less 3 months. This was informed by the reason that anxiety/depression is directly proportional to amount of time one spends away from their accustomed residence. Other criteria for inclusion included no psychological diseases, Korean Mini-Mental State Examination (K-MMSE) score of 18, and participants’ informed consent of the study. The choice of sample from four different health facilities is laudable as it improves the randomness of the data used and thus limits un-representativeness of the findings. Administration of questionnaires formed the primary method of data collection. All participants were required to fill in their questionnaires with the best possible answers. Those who had difficulties providing responses were assisted by research assistants, who read out the questions to the patients and basing on the responses, filled in the questionnaires. All but 5 of the 200 administered questions were returned with completed responses. While questionnaires are effective tools for data collection, they may not be as effective among the elderly as compared to the other age groups. This is because a significant number of the elderly in these facilities suffer from abnormal conditions such as dementia which may compromise their responses. As such, the researcher should have focussed on either interview or observation. The research used descriptive research design. Such a design is the best technique for gathering information that would show relationships and define why the world exists as it is. In this research, Jee and Lee were certainly concerned with the cases of depression among the elderly. The choice to send the elderly people in rehabilitation facilities is often dreaded by many people who are aging. The fact on the ground is that such a shift in

Review of Rain Man Research Paper Example | Topics and Well Written Essays - 750 words

Review of Rain Man - Research Paper Example There are a number of critical perspectives on Rain Man that argue the film positively contributed to society’s understanding of autism and individuals with mental disabilities. In this context of understanding one considers Kim Peek, the inspiration for Dustin Hoffman’s character in the film. It’s understood that following the film Peek found a new degree of confidence and heightened sense of mission (Treffert). In these regards, Hoffman’s depiction of autism is interpreted as empowering and beneficial to social understandings. Another understanding is that as the film demonstrates Raymond’s significant emphasis on routine -- among other peculiarities -- it allows individuals greater insight and understanding for people with autism that exhibit similar character traits (Solomon). This is a perspective that was shared by the filmmakers, including writer Barry Morrow who cried during an award acceptance speech and noted how the film positively change d perspectives on autism (Perring). Although many argue that the film’s depiction of autism is unrealistic, converse perspectives contend that the film did not try to specifically depict one form of autism, but is instead a conglomeration of many disparate elements ("debatewise"). Ultimately, it’s clear the film shifted perspectives on autism in many positive ways. ... Critics have noted that in addition to demonstrating new perspectives on autism, the film also demonstrated Raymond’s emotions and challenges socially relating to his brother (Giordano). It follows then that these emotions, which greatly contributed to the narrative, also allowed the audience to significantly identity with the Dustin Hoffman character. Through this identification the film was able to change perspectives and increase autism awareness, giving it significant social utility, and making it important. While there exists a great degree of positive views on the film’s depiction of autism, others argue that the film changed social perspectives in negative ways. One major perspective in this mode of investigation considers that Raymond -- Dustin Hoffman -- is depicted as better off in the mental asylum. It’s been argued that this depiction is harmful to individuals with autism as it glamorizes the asylum environment, subsequently restricting the freedom of people with autism (Solomon). Other criticisms of the film argue that rather that the film glamorized autism and shifted public perception such that a wave of self-diagnosis took hold that is actually harmful for individuals that are truly autistic ("debatewise"). While such arguments constitute perhaps the most scathing criticisms of the film, other have argued along less stringent lines. One such perspective contends that the film, while accurately portraying a savant, stilted public perception of autism (Lacob). In these regards, critics argue that the vast majority of individuals with autism lack such savant-like abilities, yet the film changed social perspectives to a belief that this is an element that is

French History Essay Example | Topics and Well Written Essays - 1000 words

French History - Essay Example In the next section, the writer gave a brief explanation of the contents of the declaration. The article deduces that the many clauses in the Declaration had several setbacks and hence was not a perfect document in terms of equality of every human being. The writer has even mentioned of one clause that discusses the freedom of man and his equal rights. It has also been stated that absence of clauses regarding slavery and women was one principle factor that makes the Declaration less impactful. Here, the writer has attempted to establish the weak points of the Declaration. This section needed more elaboration on the features of the Declaration. I feel his argument was not strong enough to make his statement that the Declaration was a flawed one much convincing. This section should mention about more clauses and with that there should be logical explanations as to how this Declaration cannot be called as a perfect one. However, the writer has mentioned that this Declaration induced peo ple to speculate on why things are the way they are. I feel here there should have been a brief mention of the positive elements of the Declaration to bring out the logic of the final statement of this section. In the next section, the writer has briefly explained how Haitian Revolution was partly sparked by the French Revolution. I feel this section has been quite clear about the circumstances that led to Haitian Revolution. During this period, Haiti demanded freedom when the French National Assembly began advocating freedom of all men. The Revolution was started by Toussaint Louverture when plantation owners refused to give fair treatment to the slaves and on the contrary treated them even worse. The article then explained how Napoleon, at the end of the revolution, reinstated slavery and restored Haiti to its original form. Napoleon’s

The Narcotic Addict Rehabilitation Act of 1966 Research Paper

The Narcotic Addict Rehabilitation Act of 1966 - Research Paper Example However, history shows that these drugs were once deemed to have social value. The Narcotic Addict Rehabilitation Act was established in 1966 in order to rehabilitate the drug addicts in three programs namely pretrial civil commitment, a death sentence to those convicted and voluntary (Musto, 1999). It was enacted when social construction of a drug had begun to shift from favorable to unfavorable; people utilized the pronounced the drug’s problematic physiological and psychological effects in order to control its use. Even though these concerns were beneficial, they are not the only reasons the controlled drugs are categorized within jurisdiction of the criminal justice system. Several factors including health concerns, economic, and political factors are still unknown by the public. Drugs were first utilized in the United States in the 1800. The first drug to be used was opium, which was very popular after the civil war. Cocaine was introduced in the 1880 and was used in health drinks by the Coca-Cola Company. Although, it was not a significant concern at the time with the dependency to cocaine, doctors grew a concern about the psychological effects including hallucination, depression, and psychoses. In 1906, morphine was discovered which was used for medicinal purposes prescribed by health practitioners as a pain reliever, while heroin was used to treat respiratory illness. Over the years, there has been increased awareness that these drugs have high potential for causing addiction. At the end of the 19th century, abuse of drugs such as opium and cocaine reached epidemic proportion, and the government began prohibiting their importation. The physicians were also required to label their medicines because they were no longer seen as harmless remedies for pains. The Federal Bureau of Narcotics was formed in 1930 by the Treasury Department headed by Harry Anslinger until 1962 (McWilliams, 1990). Under his tenure, the

Power In The First Part Of A Clockwork Orange Essay Example for Free

Power In The First Part Of A Clockwork Orange Essay The opening of the novel is the line Whats it going to be then, ey? This is clearly something that is said by someone in an authoritative position and we learn in the next sentence that this is Alex. He is our narrator and this gives him a certain amount of power as he can choose what he wants to tell us as readers. Burgess also shows Alexs power through the various violent attacks he perpetrates on people who we would consider to be in a position of more authority than Alex is in our own society. The first of these instances is the attack upon a schoolteacher, which is a clear and obvious indicator that this society is very wrong. At the tender age of fifteen, it would be considered totally inconceivable that Alex would not only attack, but also humiliate a man who relies upon respect from youths in order to do his job. The physical power the gang have over the teacher is almost a way of compensating for Alex and his gang feeling threatened intellectually and in this sense the teacher is the more powerful. This idea of physical versus intellectual power is explored again when the gang leave the town centre to seek victims in the suburbs. When they find the writer and his wife, they destroy the book and beat the couple into teary subordination. These actions are lead by Alex who is portrayed as an almost psychotic intellectual and so dislikes the idea of not understanding the fair gloopy title of the book. I believe he is also prone to paranoia because he gets angry at the merest suggestion of someone being more intelligent or cultured than himself. As a totally egocentric way of asserting his power, Alex also beats up a drunk who is stumbling around and singing because he found him disgusting. This does not show any correlation to the other attacks as there is obviously no intellectual challenge from this man and so this attack is purely a confidence boost and has no real reason at all. Aside from their physical power, Alex and his gang also command a certain amount of fear amongst the elderly folk at the pub they visit. They are able, through brash bribery and intimidation, to get a room full of adults to comply with their wishes fairly easily even though no violence is used, or even suggested. This shows that the gangs of youths roaming the streets are infamous and that the civilised society they prey upon is doing little, if anything, to stop them. The power presented to us here, or lack of it, is the states diminished power over criminals of a violent and numerous nature. This is further demonstrated when Alex and his gang come across a rival gang in a desolate place where their laws are obeyed e. g. survival of the fittest. The power each gang has over the other is decided in a very fitting way considering what is done with this power because the gang who can cause the most injury and pain wins the power to carry on doing so to other people outside the gang wars. One such unfortunate victim is the old woman who is the last of Alexs victims as a free man. The gang, and Alex, assume they have unrivalled power over the old woman not only because of her age but also because they see themselves as untouchably strong in fights and aggression. However, Alexs power seems to be with his gang because, contrary to his own beliefs, he finds he cannot do the robbery alone and is shocked to find the old woman beating him with a stick. This is a very strange thing to happen to Alex as he sees himself as above the possibility of actually getting hurt. However, it is clear that this invulnerable character is only as such when he is supported by his gang, who are given very little credit throughout the first half of the novel for their various roles within the crimes. The utterly surreal struggle for power and control between the old woman and the young but hardened criminal ends with a swift blow to the head from Alex and so we see his physical power keeping him in control yet again. However, the authorities finally get Alex under their control through (ironically) fairly violent methods. The police are portrayed as fighting fire with fire, so to speak, as they beat Alex and humiliate him just as he had done to so many before. This is cleverly done by Burgess as this lets the reader see how these people, who are fighting against Alex and the culture he represents, are actually no better than him in a moral sense as they get their power in exactly the same way e. g. through violent beatings and intimidation. Another example of role reversal is the relationship between P. R Deltoid and Alex both before and after his arrest. Prior to the arrest, Alex was very dismissive of P. R Deltoids warnings and cared little about what he had to say, as he was untouchable and would never be caught, as he was such an intelligent young man. However once he realises how much trouble he really is in, he becomes very meek and humble before P. R Deltoid and asks him for help. It is then that P. R Deltoid becomes the one who does not care and, in his position of power over Alex, spits in face. This is an act usually saved for use by the very lowest of people and is yet more evidence of the hypocritical use of humiliating actions on Alex by the people who are supposed to be putting an end to these actions. Throughout the first part of the novel, Alex uses barbaric force and pure physical strength to overpower his enemies and victims. He sees this as proof of his own undeniable strength when, in fact, it is down to his gang that he is not harmed by his numerous encounters with violence. His egotistical delusions lead him to believe that he can impose his power upon someone by himself and this over-confidence ultimately concretes his arrest. From this point, the readers of this novel would expect to see the police processing and punishing Alex harshly but effectively and humanely. Instead, we realise that the police are so used to seeing the violence that they no longer try to avoid it and instead resort to it themselves. We are shown that power has changed hands dramatically over the course of the first part of the novel but we can also recognise that the way in which the power is gained and exerted does not change in the slightest as it passes from criminals to civilians to policemen. This is a very interesting comment on the dystopian society presented to us in this book and serves as a powerful warning for our own future.

Role Of Womens Rights In Afghanistan

Role Of Womens Rights In Afghanistan Do you think that Afghan nation from the outset needs only men to serve it? Before Islam, women were treated like slaves or property. Their personal consent concerning anything related to their well-being was considered unimportant, to such a degree that they were never even treated as a party to a marriage contract. Women were used for one purpose, and then discarded. They had no independence, could own no property and were not allowed to inherit. In times of war, women were treated as part of the prize. Their condition was unspeakable. In addition, the birth of a daughter in a family was not an occasion for happiness, but was regarded as embarrassment. The practice of killing female children was uncontrolled. With the arrival of Islam a verse came from the Quran criticizing those who practiced female infanticide: And when the news of (the birth of) a female (child) is brought to any of them, his face becomes dark, and he is filled with inward grief! He hides himself from the people because of the evil of that whereof he has been informed. Shall he keep her with dishonor or bury her in the earth? Certainly, evil is their decision (An-Nahle 16:58-59). Afghanistan is the only country in the world where women are symbolized to all other countries. Afghan womens current situation is not only the result of Taliban, but there exists a history over the centuries of Afghan womens situation. Afghanistan is a country that lost all its economical infrastructures passing three decades of war, has been faced with Economical, Social and cultural problems. One of the major problems that Afghans are suffering is violence against womens rights. Taking in to consideration that many activities have been accomplished since 2001 by international and governmental organizations but statistic show that problems have been remained and vast number of women are still suffering from violence. Many of women are deprived from education. A few women participate in political and social activities. As observed in Kabul, a woman suffers from violence every 30 minutes and 3% of women participate in governmental decision making activities. Only 11 percents of women were candidates in the 2010 parliamentary elections. Some of the challenging facts Afghan women faces in daily life are listed as following: Every 30 minutes, an Afghan woman dies during childbirth, 87 percent of Afghan women are illiterate, 30 percent of girls have access to education in Afghanistan, 1 in every 3 Afghan women experience physical, psychological or sexual violence, 44 years is the average life expectancy rate for women in Afghanistan, and 70 to 80 percent of women face forced marriages in Afghanistan (The Plight of Afghan Woman) Since the fall of the Taliban in late 2001, many people would agree that the political and cultural position of Afghan women have improved substantially. The recently adopted Afghan constitution states that the citizens of Afghanistan whether man or woman- has equal rights and duties before the law. So far, women have been allowed to return back to work, the government no longer forces them to wear the all-covering burqa, and they even have been appointed to top positions in the government. Although many people believe that women have equal rights to men, but Afghan women, especially in the rural areas of Afghanistan are not equally treated and their rights are violated. Women are not allowed to get education, women are forced into early age marriage and they have no right to work equally with men and take part in social activities. In many societies today, especially in Afghanistan, a woman is only valued and considered important if she performs the functions of a man, while displaying her feminine attractions to the public. If women get involved in politics, they would stop marrying, having children, and the human race would greatly be affected. Women are emotional creatures, and incapable of making a sound political decision. Afghan men, Typically among Pashtun families, parents believe that their daughters going to school is an immoral act, such as: being friend with the boys and then claiming to marry with the boy of their own choice. They have the ideas saying that their daughters may adopt non-cultural behaviors at school, such as: changes in their clothing, adapting modern clothing and ways of thinking, which are not accepted in Afghan culture. In most afghan families, relatives and friends advise each others for not letting their daughters attend school. A girl is considered as a financial burden on her parents; therefore, parents give their daughters to men who are in their fathers age to receive marriage cost and lessen their home expenses. In the most provinces of Afghanistan, girls are sold to men without knowing a girls consent, and then these girls are used as labors by her husband and in-laws family for carrying physical loads of the whole family. First, its known that education, especially for girls is among basic requirements for an improved life standard in any society, however 85 percents of women and girls are illiterate in Afghanistan. The United States of America International Aid (USAID) allocated fund to address this challenge that constitute the lowest educational level in the country, and girls are facing many problems in this area. Womens education is a foundation for building womens human capital and a requirement for their meaningful participation, effective leadership, and enjoyment equal of rights. Although, the womens right to education is legally protected by law, the Afghan women have been long deprived of their right to education and still the participation of girls and women in various levels and fields of education is limited and they face numerous constraints. Access to equal education opportunity still is a dream for many women. Despite of educational improvements in recent years, women still face a num ber of obstacles in their way to education such as early marriage; restricted movement; cultural barriers, security, transport constraints, shortage of qualified female teachers especially in rural areas, poor school infrastructure and facilities and the lower value attached to girls and womens education. In Afghanistan, the number of girls going to school is less than half the number of school boys and even in some provinces, like Zabul, this percentage is 3%; though the numbers of male and female populations aging between 6-18 year old dont have a considerable difference. Another problem in terms of education in Afghanistan is the number of female schools including elementary and high schools that has decreased considerably. In Kandahar, for example, there are 255 elementary schools, whilst 20 high schools exist in the city. In central region of the country there are 256 elementary schools and only 27 high schools, which show unwillingness of girls to study (Commission). Nearly 10 00 girls schools have been destroyed. Girls and teachers have been killed in a return of the Taliban reign of terror. Only 18% of Afghan women have skilled medical personnel present when they give birth (Feminism, Womens Rights Articles Issues). In Paktia province last year, a shura of elders decided that a 25-year-old man who sexually abused a 7-year-old relative girl should pay compensation to the childs family. They also decreed the girl should marry her rapist when shes older (The Star). Due to fear of Taliban or local warlords, girls cannot go outside their homes. If they go to schools, they are burnt, acid is thrown on their faces, or Taliban kill their family members. Almost in all provinces of Afghanistan girls are sexually abused and harassed. Girls are kidnapped on their way to school. They are kidnapped for different purposes by the Taliban or local warlords, to make money by selling them or to use for smuggling, or marry them by force. Second, forced marriages constitute the other serious problems of women in Afghanistan which is exercised on different ways and forms as to payment of huge dowry, underage marriage, engaging in the very early days when a child is born. Widows are still considered as a heritage and are not allowed to marry other man willingly. Forced marriage is considered to be one of the main cases of women rights violation in all over the country. For instance, only in Helmand Province 144 cases of forced marriage is registered by the Commission so far this year, mostly exercised as badal (girls exchange in families for marriage) and huge payment of dowry. In many parts of Afghanistan, marriages have taken place with threats by the powerful people, gunmen or in repayment for depts. Another reason considerably increases the number of early age marriages is the poverty in Afghan families. Third, in Islam, the value and importance of women in society and the true measure of their success as human beings, is measured with completely different criteria: their fear of Allah (SWT) and obedience to Him, and fulfillment of the duties he has assigned them, particularly that of bearing, nurturing and teaching children. Islam is a practical religion, and responds to human needs and life situations. Many women need, or wish, to work for various reasons. For example, they may possess a needed skill, such as a teacher or a doctor. While Islam does not prohibit women working outside the home, it specifies that the following restrictions be followed to safeguard the dignity and honor of women and the purity and stability of the Islamic society. Muslim women are not forbidden from going out in the community, working, or visiting relatives and female friends, if there is no objection from their guardian/husband and they are covered and behave and speak according to Islamic guidelines and, if necessary, escorted by their Mahram (male relative). However, a womans home should be the main base that she works from. Allah (SWT) instructed the wifes of the Prophet (SAW): O wives of the Prophet! You are not like any other women. If you keep your duty (to Allah), then be not soft in speech, lest he is whose heart is a disease (of hypocrisy or evil desire for adultery, etc.) should be moved with desire, but speak in an honorable manner. And stay in your houses, and do not display yourselves like that of the times of ignorance, and offer prayers perfectly (Iqamat-as-Salat), and give Zakat and obey Allah and His Messenger. Allah wishes only to remove Ar-Rijs (evil deeds and sins, etc.) from you, O members of the family [of the Prophet (SAW)], and to purify you with a thorough purification (Quran Al-Ahzab 33:32-33). Afghanistans social development can only be ensured through democracy and the reduction of poverty, the success of both being assured through full participation of women, especially in rural Afghanistan. Afghanistan has always had elite and middle-class women who asserted their rights and walked towards modernization. But a lot of most Afghan women in rural areas have been one of oppression through tribal customs and dictates. Womens rights are human rights. They are not simply American, or western customs. They are universal values which we have a responsibility to promote throughout the world, and especially in a place like Afghanistan. It is not only the right thing to do; it is the smart thing to do.

Challenges Faced Rural Healthcare Facilities Health And Social Care Essay

Challenges Faced Rural Healthcare Facilities Health And Social Care Essay Twenty-five percent of the total population in the United States are living in rural areas and compared with urban Americans and healthcare facilities in rural areas generally serve low-income, the elderly, and individuals who are less informed and armed with less knowledge concerning health care prevention measures. Moreover, rural individuals accessing healthcare in rural facilities face barriers to healthcare such as fewer doctors, hospitals and health resources in generation and face difficulty in accessing health services. Statement of the problem   Hospital closures and other market changes have adversely affected rural areas, leaving State and Federal policymakers, and others concerned about access to health care in rural America. Considerable changes in the health care delivery system over the past decade have intensified the need for new approaches to health care in rural areas. Managed care organizations, for example, may not be developed easily in rural areas, partly because of low population density. Research Questions          The primary research question in this study is the question of whether rural health care facilities overcome the ongoing challenges to provide quality medical care to their communities. Rationale of the Research The rationale of this research is based upon the following facts: 1.) Rural Healthcare and Barriers to Accessing Care: Many small rural hospitals have closed, while other health care supply of primary care physicians and other health care provider facilities are in financial straits. Unavailability of resources and transportation problems are barriers to access for rural populations. 2.). The supply of primary care practitioners and other health care providers in rural areas is decreasing. Some are leaving rural areas to join managed care organizations elsewhere. 3.) Barriers to Health Promotion and Disease Prevention. Goals for improving the Nations health over the next decade can be achieved only if rural populations are included in efforts to remove barriers to access and use of clinical preventive services. 4.) Barriers Related to Lack in Health Care Technology. Technologies including telemedicine offer promise of improved access to health care, but their most efficient and effective applications need further evaluation. 5.) Organizational Barriers of Service Provision to Vulnerable Rural Populations: Low population density in rural areas makes it inherently difficult to deliver services that target persons with special health needs. Groups at particular risk include: the elderly; the poor; people with HIV or AIDS; the homeless; mothers, children, and adolescents; racial or ethnic minorities; and persons with disabilities. 6.) Consumer choice and the rural hospital. Factors that drive changes in rural hospitals have a critical effect on consumer choice and access. Significance of the Study This study is significant in that individuals in rural areas are likely to continue to receive less healthcare as well as less effective healthcare if rural healthcare does not gain necessary knowledge, informed by research study as to what should be done to better deliver health care services to those in rural areas. This study is of significance to several groups including patients depending on rural healthcare services, the families of these patients, the rural communities at large and the insurance companies who provide insurance coverage for individuals in rural areas. Methodology The methodology of the proposed research is one of a qualitative nature in which data will be gathered through survey/questionnaires of individuals, physicians and business in the rural community at focus in the research in order to asses whether the needs of the community in terms of healthcare provision are being met. Data analysis will be both qualitative and quantitative in nature. After having administered and compiled data from the survey/questionnaires focus groups will be scheduled to gain further insight into the unmet needs of the community in health care services in needs assessment focus group discussions. Literature Review The California Healthcare Foundation, in its Rural Health Care Delivery: Connecting Communities through Technology report of December 2002 states : Challenges facing rural health care include scarcity of local medical resources and distance between patients, physicians and facilities. (Turisco and Metzger, 2002) Furthermore, it is related in this report that there are insufficient numbers of primary care practitioners in rural areas. (Turisco and Metzger, 2002; paraphrased) In the instance where a patient is forced to travel from home to another area for accessing health care services resulting is a range of difficulties including: (1) time away from work; (2) additional expenses; and (3) the complications of coordinating care in different locales. (Turisco and Metzger, 2002) This increases the chance the patient information will come up missing or incomplete and as well may result in care that is delayed or fragmented. (Turisco and Metzger, 2002) The physicians in rural areas as wel l as other health care providers experience negative impacts due to the low number of health care practitioners in rural areas as well as in the distance factor, which results in limitations on productivity, communication and ongoing education. (Turisco and Metzger, 2002) Research notes that there is more difficulty for the rural providers in communication with other providers of health care. There is much less in the way of opportunities to attend conferences and training due to the requirements of travel, which limits access to medical knowledge and research work. Lower efficiency results due to travel time involved in visiting patients in hospitals and nursing homes as well as in à ¢Ã¢â€š ¬Ã‚ ¦fewer face-to-face visits, and more time on the telephone with other providers and with patients. (Turisco and Metzger, 2002) In a recent report relating to healthcare in rural India stated is that: The number of patients is increasing exponentially each year, putting enormous pressure on healthcare delivery systems worldwide. Hospitals and specialists are concentrated in cities and are inaccessible to the rural poor. (Tata Consultancy Services and Microsoft Corporation, nd) This report relates that several physicians in India along with Tata Consultancy Services (TCS) and the largest IT company in India collaborated in the creation of WebHealthCentre.com which is stated to be: à ¢Ã¢â€š ¬Ã‚ ¦a comprehensive healthcare portal like no other. (Tata Consultancy Services and Microsoft Corporation, nd) Offered are abundant health-related reference material, online medical consultation, online appointment scheduling, and online lab results for physicians. (Tata Consultancy Services and Microsoft Corporation, nd) The WebHealthCentre.com website was stated to have been created with the Microsoft.NET Framework, Micr osoft Windows 2000 Advanced Server, Web services and Microsoft SQL Server 2000. The requirements set out by the physicians in rural areas included: Ease of use by a wide cross section of people; Cutting-edge yet cost-effective technologies; Simple log on by many different users and easy assignment of user rights; Tight security to keep medical records confidential; Structured data capture for future data mining; Scalable to handle millions of users; and Extensible to accommodate audio and video interface. (Tata Consultancy Services and Microsoft Corporation, nd) Benefits resulting from implementation of this healthcare service delivery Network include: Improved access to healthcare; Better use of doctors time; Rapid development, usability; Scalable to millions of patients; and Extensible to new technologies. (Tata Consultancy Services and Microsoft Corporation, nd) Key features of WebHealthCentre.com are stated to include the following: Online, real-time medical consultation with remote healthcare professionals. PC or mobile-phone access to regional directories for hospitals, specialists, blood banks, medical appliance suppliers, and welfare agencies. An online appointment scheduler that enables patients to make appointments with participating physicians. An online lab report tool that helps diagnostic centers automate the process of uploading lab reports to the Web. Access to test results through mobile devices. Online access to electronic health records. Medical image upload services. Online sonogram viewing. A medical student resource center. Healthcare job listings. Online shopping for healthcare supplies. (Tata Consultancy Services and Microsoft Corporation, nd) The Agency for Healthcare Research and Quality (AHRQ) held an expert panel meeting to provide guidance on its new health information technology on July 23-24 2003. The focus of AHRQ is the implementation and evaluation of technologies, which have been shown to be effective in small and rural communities. Secondly, the AHRQ has set its focus upon supporting advancement in the HIT field through implementation and evaluation support for innovation in technologies for use in diverse health care settings. (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003) The Meeting Summary reports that two general themes emerged from the discussion which are those of: (1) Bringing people together; and (2) Providing technical assistance. (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003) Activities recommended for achieving their goals are those as follows: Support demonstration projects that involve HIT implementation and will lead to the creation of learning networks comprised of providers from various types of rural health care organizations. Create learning communities that span geography; collect and analyze the outcomes associated with participation. Once factors that facilitate learning communities and HIT implementation have been identified, engage CMS and other purchasers to define an appropriate reimbursement strategy. Incorporate evidence-based primary care guidelines with rural relevance into technological templates. Clinicians are likely to accept clinical guidelines offered by the Federal Government at no cost. Support local capacity development for HIT, including barrier analysis, education and other activities. Provide sustained technical assistance (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003) Evaluation of the process in rural and small communities includes: (1) scope of the project; (2) goals; (3) critical success factors; and (4) technical assistance. (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003) Community grants have been focused on the provision of personal digital assistant (PDA) systems in assisting with the decision support role. The initiative is stated to include: (1) development of toolkits; (2) leveraging known tools; (3) developing capacity; and (4) disseminating best practices. (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003) Ormond, Wallin, and Goldenson report in the work entitled: Supporting the Rural Health Care Safety Net (2000) state: The policy and market-driven changes in the health care sector taking place across country are not confined to metropolitan areas. Rural communities are experiencing changes impelled by many of the same forces that are affecting urban areas. However, due to the demographical differences and other facts existent only in rural life the health care system can be differentiated from those in urban areas in various ways. According to Ormond, Wallin, and Goldenson, it is that difference that highlights the importance of giving consideration explicitly to the impact of competitive forces and public policy developments on rural health care systems and the patients and communities they serve. (2000) The changes that are occurring in the health care sectors are resulting in many providers being threatened in both rural and urban areas however, health care provider failures in a rural area is likely to a much greater impact as compared to health care provider failure in urban areas. Because alternative sources of care in the community or within reasonable proximity are scarce, each provider likely plays a critical part in maintaining access to health care in the community. For this reason, in most rural communities all providers should be considered part of the health care safety net if not directly through their care for vulnerable populations, then indirectly through their contribution to the stability of the communitys health care infrastructure. (Ormond, Wallin, and Goldenson, 2000) The study reported by Ormond, Wallin and Goldenson is based on case studies in rural communities in the states of Alabama, Minnesota, Mississippi, Texas, and Washington selected in representation of à ¢Ã¢â€š ¬Ã‚ ¦a broad range of pressures facing rural providers. (2000) A debate is stated to exist in terms of limited services models for hospitals who fear that more insure d patients or those who are wealthier will be reluctant to use this facilities. Challenges to full-service facilities in rural areas include recruitment and retention of health care professionals and of ensuring the financial viability of local hospitals. (Ormond, Wallin, and Goldenson, 2000) Also related is the fact that health care providers are very reluctant to locate in communities without a hospitalà ¢Ã¢â€š ¬Ã‚ ¦ while simultaneously when there is not a strong physician practice in an area, hospitals find it difficult to attract patients. (Ormond, Wallin, and Goldenson, 2000) Constraints upon a rural hospital of either a full or limited service hospital include its rural location. The population required to support given service, such as a hospital or particular physician practice is spread over a much greater area. Low volume can mean high average costs, a factor that rural health officials feel is not always taken into account in reimbursement. (Ormond, Wallin, and Goldenso n, 2000) Demographical and socioeconomic differences in rural areas places demands upon health care system providers in terms of the need for treatment for more elderly people which are those more likely to have chronic health care needs. (Ormond, Wallin, and Goldenson, 2000) Furthermore, due to the lack of access to mass and major media in rural areas, the individuals residing in these areas are much less likely than those in urban areas to be aware of the availability of health care and public programs. Insurance coverage in rural areas is also a factor because rural areas have higher self-employment than urban areas, and specifically relating to farming operations making it very likely the employer-sponsored insurance in minimal. Of those who are insured in rural areas, it is likely that many of these are under insured with high premiums and low benefits as compared to those insured in urban areas. The social structure of rural communities may make the stigma attached to particip ation in public programs greater, particularly in the case of Medicaid. (Ormond, Wallin, and Goldenson, 2000) The range of services offered in rural hospitals is limited by the size of the area it serves as compared to the population within that area. Many of the hospitals in the study reported by Ormond, Wallin and Goldenson relied on a local primary care physician for core servicesà ¢Ã¢â€š ¬Ã‚ ¦but augmented his or her capabilities by making arrangements with other, nonlocal providers. The core services each hospital offers depend primarily on the capabilities of their physicians. (2000) In order that a hospital be able to support a visiting specialist program it is a requirement that the hospital have the staff that is appropriate and qualified to assist in the various specialties and physicians be able to monitor recovery, as well as the necessary space and equipment for procedures. (Ormond, Wallin, and Goldenson, 2000) The rural hospital is not in the position to provision all the services needed within the community it serves and this makes a requirement of having a referral system of a reliable nature. Stated to be a mainstay of the safety net in rural areas just as is the case in urban areas is the community health center. (Ormond, Wallin, and Goldenson, 2000) Another important provider of care in rural areas is the local health department. Another problem in rural areas is transportation for patients in that in rural areas there is oftentimes no public transportation. Internal strategies reported to be used by rural health care providers are inclusive of: à ¢Ã¢â€š ¬Ã‚ ¦increasing the stock of physicians and other health professionals, tailoring facilities and services to the needs of the community, and expanding, downsizing, or diversifying as needed. (Ormond, Wallin, and Goldenson, 2000) Other stated strategies are inclusive of cooperation among rural providers and developing links with urban providers through mergers, management contracts, and joint projects. (Ormond, Wallin, and Goldenson, 2000) Initiatives have been developed for recruitment of physician s and other health professionals who are familiar with life and medical practice in rural areas. (Ormond, Wallin, and Goldenson, 2000) Those who are recruited for practice in rural areas are likely to remain after recruitment. All five states in this study report that they provide support: à ¢Ã¢â€š ¬Ã‚ ¦for the development of rural health professionals by requiring, facilitating, or funding training opportunities in rural areas so that students become familiar with the particular demands and satisfactions of rural medical practice, or by funding education either through scholarships for aspiring providers from rural areas or through loan forgiveness for providers agreeing to locate in rural areas. (Ormond, Wallin, and Goldenson, 2000) Only the state of Washing is stated by this report to have a formal residency program. Service expansion is reported to be utilized by rural hospitals and clinics for enabling them in meeting a broader range of health care needs in their communities. (Ormond, Wallin, and Goldenson, 2000) Areas of expansion included: (1) the construction or renovation of a physician plant; (2) the addition of new medical services; and (3) diversification beyond traditional acute services. (Ormond, Wallin, and Goldenson, 2000) In fact, growth and expansion as compared to downsizing appeared to be the more common, and seemingly more successful, route. (Ormond, Wallin, and Goldenson, 2000) Expansion is also noted in outpatient services offered by hospitals and clinics. Cooperative efforts among rural providers as these health care providers collaborate in order to ensure the capability of serving their communities will continue is noted in this report stating that cooperation with other rural providers is also a mainstay of rural hospitals strategy to ward off encroachment by urban health care systems. (Ormond, Wallin, and Goldenson, 2000) The work of Rygh and Hjortdahl entitled: Continuous and Integrated Health Care Services in Rural Areas: A Literature Study makes a review of literature that examines possible methods of improving healthcare services in rural areas. Stated by these authors is the fact that: Healthcare providers in rural areas face challenges in providing coherent and integrated services. (Rygh and Hjortdahl, 2007) This study proposes a need for greatly flexibility in traditional professional roles and responsibilities, such as nurse practitioners of community pharmacists managing common conditions. (Rygh and Hjortdahl, 2007) Further stated is that the substitution of health personnel with lay health workers or paraprofessionals often in combination with interdisciplinary teams, is among measures proposed to alleviate staff shortage and overcome cultural barriers. (Rygh and Hjortdahl, 2007) Other findings of this study include that for those working in rural areas called for is flexibility of roles and responsibilities, delegation of tasks, and cultural adjustments by the healthcare practitioners. (Rygh and Hjortdahl, 2007) This study states that rural case management is greatly dependent upon a locally based case manager and that the highest ranked skills for rural case managers are: the ability to be creative in the coordination of resources, multidimensional nursing skills, excellent communication skills, high-caliber computer skills and excellent driving skills. (Rygh and Hjortdahl, 2007) Stated is that: Case management in a rural environment requires a much broader and generalist knowledge base, it covers all levels of prevention and transverses all age groups. Rural case management is a distinct specialty area of practice, with a distinct knowledge base and skills level, and nurses should be prepared at the advanced practice level. (Rygh and Hjortdahl, 2007) This study further relates that evidence exists of the success of: à ¢Ã¢â€š ¬Ã‚ ¦collaboration at the interface betw een primary and secondary sectors may improve access, continuity of care and the quality of service delivery in rural areas. (Rygh and Hjortdahl, 2007) This study defines telemedicine as Medicine practiced at a distance therefore encompassing diagnosis, treatment and medical education. (Rygh and Hjortdahl, 2007) The state of Maine is stated to have a well-functioning telemedicine services system using telemedicine in a broad array of interactive videoconferencing applications, including mental health and psychiatry, diabetes management, primary care, pediatrics, genetics and dermatology. (Rygh and Hjortdahl, 2007) According to this review telemedicine has the potential to be a tool of a valuable nature in achievement of healthcare access in rural areas although the cost-effectiveness of telemedicine has yet to be documented. (Rygh and Hjortdahl, 2007; paraphrased) The work entitled: Providing Hospice and Palliative Care in Rural Frontier Areas states that the National Rural Health Association (NRHA) à ¢Ã¢â€š ¬Ã‚ ¦believes that all Americans are entitled to an equitable level of health and well-being established through health care services, regardless of where they live. An important but often overlooked aspect of health and well-being is assurance of appropriate care and support when people are experiencing chronic, progressive illness and/or approaching the end of their lives. (Providing Hospice and Palliative Care in Rural Frontier Areas, 2005) In order to study this area of service provision the method for defining and assessing needs is stated to be through a needs assessment to include recruitment of a group of members of the community for participation in identifying the needs and creating a method of assessing results. Data is gained from various sources an may include the following: Demographics of the community; disease statistics (county health department and state vital statistics division); List of health care organizations/agencies that provide related services; A definition of unmet or under-met service needs; Identification of the unique characteristics that differentiate palliative care and/or hospice services from other services in the community; Vital statistics, including cause of death, age at death and location of death; Loss data; Community residents satisfaction with current hospice and/or palliative care services, obtained through interviews; and Community members preferences about hospice and palliative care. (Providing Hospice and Palliative Care in Rural Frontier Areas, 2005) Recruitment of individuals in this type study are stated to include: Community residents; Representatives from other community service providers such as a librarian, store owners, chiropractor or dentist; The president of a fraternal organization, the Rotary Club, another service club or the Chamber of Commerce; Pastors or leaders of local faith communities; Someone involved with the local food pantry or other emergency relief organization; An influential local business person such as the feed store owner; A county extension staff person active in community events and volunteer work; Someone who organizes the towns annual parade, festival or other special events; Someone who works on civic clean-up and beautification; and Representatives from other small organizations and entities in each of the countries the provider serves. (Providing Hospice and Palliative Care in Rural Frontier Areas, 2005) This study speaks of the creation of capacity building in expansion of the service provision and in meeting unmet or undermet needs in rural areas. Capacity building strategies include education and training of staff for skills development needed in broadening the services provided. Community education in establishing a broader understanding of what services and opportunities are available for care is also stated to be a strategy for capacity building as service utilization will be increased as well. Capacity building strategies as well are stated to include outreach strategies for development and sustaining partnerships and collaborations as well as in sustaining and supporting growth of expectations related to hospice and palliative care services. (Providing Hospice and Palliative Care in Rural Frontier Areas, 2005; paraphrased) Stated as practical examples of the training and education of staff and the philosophy used by rural providers in the creation and sustaining of program ca pacity are those as follows: Development and adoption of service performance parameters; Education of the board and/or local leaders in national trends such as palliative care, open access, managed care, chronic care management and the nursing shortage; Establishment of an ethics committee comprised of community members, hospital representatives, palliative care and hospice program staff, and church members to review specific ethical considerations/cases and to address projects such as advance care planning and advance directives; Importing best practices in enhancing service definition and outreach; Offering support for local and offsite continuing staff education an subsidies for staff to pursue relevant credentials; Offering support for local and offsite continuing staff education and subsidies for staff to pursue relevant credentials; Appointing full-time or substantially part-time physicians and advanced practice nurses as soon as feasible and involving these individuals in professional and community outreach; Establishment of bridge programs and/or extended palliative home care; Improved/extended utilization of volunteers in meeting caregiving requirements. For hospices, this may include volunteer participation in providing continuous care as allowed by regulations; and As needed, referrals to other organizations. (Providing Hospice and Palliative Care in Rural Frontier Areas, 2005) The work entitled: Planting the Seeds for Improving Rural Health Care relates the Chronic Care Model which portrays the essential involvement of the community, the design and function of the health care system and effective interaction between patients/families and their team of caregivers, producing optimal clinical outcomes. (2005) The following figure labeled figure 1 shows the Chronic Care Model: Figure 1 Chronic Care Model Source: Planting the Seeds for Improving Rural Health Care (2005) Components of this program include the following: Use of a rapid-cycle method for implementing quality improvements; Use of a standard set of changes for teams to implement; Sharing a vision of the ideal system of care developed by clinical experts; Monthly reporting of process and outcome measurements; Three learning sessions; A final national forum during which teams attend sessions with expert faculty to share progress, best practices, and lessons learned. (Planting the Seeds for Improving Rural Health Care, 2005) The work entitled: Practical Tips and Information Resources for Developing Collaborative Relationships Between Rural Community Health Centers (CHCs) and Rural Hospitals asks the question of Why Collaborate? and answers this question by stating that collaboration strengthens community health infrastructure; improves efficiency levels; and provides joint economic advantage. Collaboration is stated to be a process through which parties who see different aspects of a problem can explore constructively their differences and search for (and implement) solutions that go beyond their limited vision of what is possible. (Taylor-Powell, et al., 1998) There are five levels of relationships in building collaborative interorgnaizational relationships around health issues in a rural community which are: (1) networking; (2) cooperating; (3) coordination; (4) coalitions; and (5) collaboration. These five levels of relationships according to purpose, structure and process are shown in the following C ommunity Linkages- Choices and Decisions matrix. Figure 2 Community Linkages Choices and Decisions Source: Practical Tips and Information Resources for Developing Collaborative Relationships Between Rural Community Health Centers (CHCs) and Rural Hospitals (2005) The following are examples of the ways that CHCs and hospital partnerships are able to collaborate. These initiatives may also be used by any rural hospital, CHC or primary care provider: Joint training, recruitment, human resources, and clinical direction; Shared case managers; Working together on disease collaboratives; Shared medical laboratory; Partnership establishment enables organizations in qualifying for funding through grants for which they would not otherwise have been eligible to receive; and Shared electronic patient medical records systems; (Practical Tips and Information Resources for Developing Collaborative Relationships Between Rural Community Health Centers (CHCs) and Rural Hospitals (2005) This study states findings that a number of activities specific to an individual site have the potential for wider replication. Those activities are stated to be as follows: Local foundations can support rural health-related activities; namely physician recruitment and retention. Collaboration of CHCs, hospitals, nursing homes, and assisted care facilities in the same location can serve a large rural area and make efficient use of scarce resources; namely physicians. Affiliation with a large regional hospital can be a positive experience that is supportive of community-based services. Collaboration may be a vehicle for expanding benefits to CHC patients; namely as a result of the collaborative, a hospital utilizes the CHCs sliding fee scale for laboratory services provided to CHC patients. Case management for discharge planning and care coordination between the CHC, home health care agency, and the hospital can improve patient care. Electronic patient medical records systems that integrated the CHC and the hospital medical records are the key to future collaboration and the development of a comprehensive model of a health care system for the rural community. (Practical Tips and Information Resources for Developing Collaborative Relationships Between Rural Community Health Centers (CHCs) and Rural Hospitals (2005) There are important factors identified for organizing a successful collaboration which include: (1)

Wireless Area Networks Essay -- Technology Technological Essays

Wireless Area Networks Wireless technology has become an increasingly crucial part of today's world. From health care and retail to academia across the world, wireless systems are improving the rate and ease with which data is sent and received. Two specific examples of the wireless technology used today personally and professionally are local area networks (LAN) and personal area networks (PAN). A wireless local area network, or LAN is a flexible data communications system implemented as an augmentation to, or an alternative for a, wired local area network. These networks rely on electromagnetic airwaves to transmit and receive over a defined area, usually a few hundred feet. (Yahoo-wireless) In most cases, a wireless transmitter will be connected directly to a wired land network using Ethernet cables. Once the network feed has been connected to the transmitter, and a constant power supply is established, a steady stream of radio, or infrared waves with be produced (both are electromagnetic waves). The vast majority of wireless LAN systems tend to rely on radio waves as the carries for their signals, because infrared waves tend to have a shorter distance at which they are able to transmit, and are more easily interrupted. Radio waves, or radio carriers as they are referred to, transfer data through modulations of the carrier signal. The addition of d ata to a radio carrier causes the signal to occupy more than a single frequency. Once data is imprinted onto the radio signal it is a simple reversal of the transmitting process that allows the information to be decoded by a receiving station. (Rho Wireless) Radio waves offer another benefit to the wireless system in... ...ta instantaneous and without the hindrance of cables. Whether or not wireless systems are practical or necessary in a given situation is a matter of personal opinion. However, one cannot dispute the success these systems have had in numerous professional and personal areas and it is very likely that usage of LAN and PAN wireless systems will increase dramatically in the near future as technology continues to advance and evolve. Bibliography Rho Wireless. Wireless Local Area Networks. Oct. 20, 2003. Oct. 25, 2003. www.rhowireless.com/lans.htm Bluetooth Corporation. Bluetooth. 2003. Oct. 20, 2003. www.bluetooth.com Yahoo Wireless. Wireless LAN. 2003. Oct. 20, 2003. www.wireless-lan.com Home Networking Internet Sharing. Home help-802.11b. 2001. Oct. 22, 2003. www.homehelp.com/802.11b/index.asp Wireless Area Networks Essay -- Technology Technological Essays Wireless Area Networks Wireless technology has become an increasingly crucial part of today's world. From health care and retail to academia across the world, wireless systems are improving the rate and ease with which data is sent and received. Two specific examples of the wireless technology used today personally and professionally are local area networks (LAN) and personal area networks (PAN). A wireless local area network, or LAN is a flexible data communications system implemented as an augmentation to, or an alternative for a, wired local area network. These networks rely on electromagnetic airwaves to transmit and receive over a defined area, usually a few hundred feet. (Yahoo-wireless) In most cases, a wireless transmitter will be connected directly to a wired land network using Ethernet cables. Once the network feed has been connected to the transmitter, and a constant power supply is established, a steady stream of radio, or infrared waves with be produced (both are electromagnetic waves). The vast majority of wireless LAN systems tend to rely on radio waves as the carries for their signals, because infrared waves tend to have a shorter distance at which they are able to transmit, and are more easily interrupted. Radio waves, or radio carriers as they are referred to, transfer data through modulations of the carrier signal. The addition of d ata to a radio carrier causes the signal to occupy more than a single frequency. Once data is imprinted onto the radio signal it is a simple reversal of the transmitting process that allows the information to be decoded by a receiving station. (Rho Wireless) Radio waves offer another benefit to the wireless system in... ...ta instantaneous and without the hindrance of cables. Whether or not wireless systems are practical or necessary in a given situation is a matter of personal opinion. However, one cannot dispute the success these systems have had in numerous professional and personal areas and it is very likely that usage of LAN and PAN wireless systems will increase dramatically in the near future as technology continues to advance and evolve. Bibliography Rho Wireless. Wireless Local Area Networks. Oct. 20, 2003. Oct. 25, 2003. www.rhowireless.com/lans.htm Bluetooth Corporation. Bluetooth. 2003. Oct. 20, 2003. www.bluetooth.com Yahoo Wireless. Wireless LAN. 2003. Oct. 20, 2003. www.wireless-lan.com Home Networking Internet Sharing. Home help-802.11b. 2001. Oct. 22, 2003. www.homehelp.com/802.11b/index.asp

Youth Smoking and Prevention Essay -- Tobacco Addiction Papers

Youth Smoking and Prevention Introduction: Ascertaining the Issue and Addressing the Problem As we progress into a more sophisticated and knowledgeable future, it is no wonder that our prosperity and health are first on our list of priorities. By simply looking at the longevity people have in today's world, one can see something that was unfathomable less than one hundred years ago. In this proposal, an issue is addressed that deals on many levels. It is an issue that touches everyone, whether one is directly involved or not. It is an issue that lives in every community around the world and affects more people than most realize. So as we advance into an increasingly foreseeable future, where our standard of success rises higher and higher toward perfection, it is ironic how we allow such an issue slip past our view and remain forever in our periphery. It is this, the issue of smoking, which has stood the test of time and has raised all of these concerns. The importance of addressing this blemish on society's face is something that can no longer be ignored. The purpose of this proposal is to effectively state a solution to the problems of youth smoking and illegal sale of tobacco, issues that have been pushed aside in the minds of so many for too long. Background Information: Linking the Past With the Present Prologue Cigarette smoking is ubiquitous. It seems today that everywhere we turn we see media channeling or promoting their attention on smoking. How this effects society in America and others around the world is substantial. Over recent years, prominence of smoking has been seen to be on the upswing and this in effect not only influences adult smokers, but youths as well. However, the issue of youth smok... ...'s April 2002 report on Smoking. Washington, DC: U.S. General Accounting Office, 2003. Insel, Paul M. and Roth, Walton T. Core Concepts in Health. New York: McGraw-Hill Companies, Inc., 2004. Jamrozik, Konrad. â€Å"ABC of Smoking Cessation: Population Strategies to Prevent Smoking†. British Medical Journal, Issue 328 (2004: 759-62). â€Å"Special Reports: State Tobacco Settlement.† Tobacco-Free Kids. 25 March 2004. . Unites States Department of Health and Human Services. Changing Adolescent Smoking Prevalence. Maryland: National Institute of Health, 2001. United States. One Hundred Eighth Congress. Youth Smoking Prevention and State Revenue Enforcement Act. Washington: GPO, 2003. â€Å"When Smoking Was A Choice Addiction.† Why Quit. 29 Mar. 2004. .