Drug and Alcohol Use Among Adolescents and Young Adults

Running head: REGULATION OF DEVIANCE: DRUG AND ALCOHOL USE Regulation of Deviance: Drug and Alcohol Use among Adolescents and Young Adults Nikkee L Payne University of Nebraska at Lincoln Abstract This paper explores the overall affects that peers, family members, and religious affiliations have among adolescents and young adults when it comes to the use of deviant substances such as drugs and alcohol. Here we will examine the specific affects that peers tend to have on individual adolescents and how subgroups can influence the future of the individual.We will look at the errors in the limitations placed throughout the different studies done and speculate on what could have been done to better generalize the results. Drug and alcohol use among adolescents and young adults is common and tends to lead to later abuse of said substances. Here we will find better understanding of the overall outcomes of deviant adolescents and their choices that they make about drugs and alcohol in congru ency to environmental factors.Regulation of Deviance: Drug and Alcohol Use among Adolescents and Young Adults There have been numerous studies done on the use of drugs and alcohol within the different cultures and subcultures seen throughout society. Many of these studies tend to focus more so on the young adults and adolescents use of different substances more often than the use across all different age groups. There has been much speculation among many psychologists and sociologists around the different influences of these adolescents and young adults.Different studies have focused on the influences of peers and parents as well as religion on the use of drugs and alcohol. It is seen that peers tend to have a more direct influence on the use of different substances than that of parents. Research by Bahr, Hoffmann and Yang (2005) shows that the attitudes of the parents tend to affect the overall outcome of adolescent drug use. It is easy to see the correlation between drug use, devi ance, and future accomplishments of the adolescents who choose to partake in these deviant acts.No matter what the choice of substance is there is a direct correlation between the use and committing different deviant acts. Literature Review There are many studies that emphasize the direct connection between adolescent drug use and the influences that family members and peers have on this. According to Walden et al (2004) there is a clear correlation linking parents, peers and substance use among youth. This study attempts to look at the genetic influences versus the environmental influences in question of which is more significant to adolescent sway.In the study they attempt to illustrate two possible genetic influences that could possibly help explain the connection between peers, parents and what is seen as substance use phenotypes. â€Å"First, the associations could be the product of active genotype–environment correlations, wherein individuals gravitate to different env ironments (or perceive similar environments differently) on the basis of their unique, genetically influenced dispositions. To the extent that risk for early adolescent substance use is influenced by heritable factors (e. g. temperament), selection into deviant peer groups by adolescents with a propensity to use substances would represent an active genotype–environment correlation. Second, the associations could owe to evocative genotype–environment correlations, which occur when individuals elicit reactions from their environments on the basis of their own genetically influenced behavior. For example, an adolescent’s early use of substances (again, as influenced by heritable factors) could negatively impact the relationship between the adolescent and his or her parent(s) by resulting in increased parent–child conflict.Given the possibility that these putatively environmentally mediated associations could, in fact, result from genotype–environment correlational processes† [ (Walden, McGue, Iacono, Burt, & Elkins, 2004, p. 441) ]. When looking at the results of the study Walden et al (2004) came to the conclusion that these genetic, heritable factors were far less significant than that of the environmental factors to influence youth early youth substance use. The findings here provided a much needed view on the different relationships between peer influence and substance use and parent haracteristics and substance use. The different parenting styles definitely had a great affect on the choices that the youth made when it came to the different uses of substances. It is speculated that the choice of peers can also influence the parent-child interactions and account for relationship problems amongst youth and their parents. There are many positive correlations that came out of this study; however there were limitations on the study that did not account for specific aspects of young adult use of specific substances.There is an absence of the influence of that of teachers in the environment as well as a lack of an overall representative sample in that it consisted of mostly Caucasians. Also, there was a lack of recognizing the sibling influences possible. For the lack of coverage on the influence of the siblings of the deviant youth Stormshak et al makes up for in her article covering Sibling and Peer Deviance. Here the study looks at the different constructs set in place as predictors of substance use of adolescents; these constructs consist of sibling deviance, warmth, and conflict.It is also speculated that the sibling relationships will outweigh that of peer relationships when it comes to influencing deviant behavior [ (Stormshak, Comeau, & Shepard, 2004, p. 637) ]. The results compare significantly with that of the hypotheses of the study. Sibling deviance was the more significant forecaster for adolescent substance use in comparison to that of peer influence. They bring up a good perspective on th e fact that the antisocial youth, especially those with behavior problems, often are rejected from the main social groups around them; however they usually end up making their own subgroups.Usually these subgroups are focused on the thing that they have in common; the deviant acts they partake in. This study tends to jump back and forth on the stance of peer groups versus sibling influence on the outcome of the adolescents. However Stormshak does state that sibling relationships comparatively to peer relationships are far more stable and therefore could possibly serve as a more high risk context for adolescents [ (Stormshak, Comeau, & Shepard, 2004, p. 645) ]. One thing that we need to keep in mind is the limitation of age in this study.Age here can be applied in numerous cases; that is the age of the adolescent at risk as well as the age difference between the youth and their siblings. One thing that the majority of these articles can all agree on is the fact that early initiation of substance use is associated with more addictive behaviors later on in the youth’s lifespan. Often early substance use is associated with more delinquent behavior, academic problems, impairments in the individual’s ability to function as a contributing member of our society, and health problems.Kumpulainen (2000) gives several examples of different studies done with the conclusion that psychiatric problems reported earlier in the adolescents life is correlated with that of drug use later on in life; also, â€Å"mental disorders generally precede the development of addictive disorders† [ (Kumpulainen, 2000, p. 1848) ]. Here she focuses more on the mental state of the individuals and its correlation with the drug use.One can see that the mental health is significantly lower when it comes to the use of drugs and alcohol earlier in the adolescents life. Again, Kumpulainen (2000) refers to other sources to confirm that addictive behaviors and mental disorders tend to go hand in hand. Additionally, in a separate study by Andrews and Duncan (1997) they address the mental capacity and academic motivation of youth and its inverse relationship with substance use; rather than the mental state of the individual.Andrews and Duncan’s study had three major constructs to it; focusing on the family relationships, the deviance of the adolescent, and the academic motivation. One of the limitations as well as benefits to the study was the fact that all of the information gathered came from the reports of the mother and the target adolescents [ (Andrews & Duncan, 1997, p. 527) ]. Also, the confine of the individuals mostly being Caucasian and living in single-parent households may slightly skew the overall generalization of the study.The study comes to the conclusion that there is no significant relationship between alcohol use and that of academic motivation; also, for the other substances of marijuana and cigarettes it is inconclusive to the fact th at the results cannot determine which act precedes the other. In that substance use precedes academic motivation or the inverse of this as well. However, they can conclude that the increased use in marijuana and cigarettes does lead to more of a lack of motivation when it comes to academics. [ (Andrews & Duncan, 1997, p. 541) ].There are two separate longitudinal studies that focus more so on the transitions made from these earlier adolescent years into the later adolescent years and adulthood. Here we look at the friendships and peers to understand the direction in which the adult will end up going. Dishion and Owen (2002) have findings consistent with numerous other studies in that many of these individuals tend to be put into specific peer groups that more regularly use substances [ (Dishion & Owen, 2002, p. 488) ]. One needs to remember that the connection made between these peers with the use of these substances is substantial and tend to be long lasting.Therefore we can assume that these connections will be significant throughout the individual’s life and not just the adolescent years. Similarly, the study done by Mason, Hitch and Spoth (2009) shows the transition from early to late adolescents in that with the interaction of the proper peer group at age sixteen along with what they see as the negative affect can be a predictor of the amount of substance use in later adolescence. This negative affect that they speak of is alluding to the use of substance to escape or cope with the current reality that each individual may be facing at that time.This is one of the few studies that hint toward this hypothesis; â€Å"other studies have not supported the self-medication hypothesis among teens† [ (Mason, Hitch, & Spoth, 2009, p. 1153) ]. Here you see more of a lack from this study when it comes to the overall assessment of negative affective states. This is where you gain more insight through other articles concerning the actual mental states of individuals and the direct correlation that it has with the use of different substances.The study done by Dishion and Owen (2002) has fewer limitations on it; their unexpected findings helped to further understand the hypothesis of deviant friendships and the relationship to dangerous drug use. They have seen to have fewer discrepancies when it came to the results and findings. â€Å"The Young adult years are a critical transition point for many individuals,† Dishion and Owen (2002) state; this is â€Å"when selection of partners, formation of families, and the foundation for the next generation are established† [ (Dishion & Owen, 2002, p. 89) ]. One cannot forget the influence of religion and its effects on the use of what is seen as deviant substances by our different sub-cultures and societies. Walker et al states that, â€Å"research has shown religiosity to the a protective factor with regard to substance use and other problem behaviors† [ (Walker, Ainette, Wills, & Mendoza, 2007, p. 84) ]. There are clear indications of differentiation of substance use dependent upon the entirety of the relationship that one has with religion.When it comes to religion they tend to encourage certain behaviors that are more socially accepted and fewer deviants. Therefore, one can assume that adolescents involved in their religious organizations will be less likely to commit acts of deviance such as use of specific substances. This study is yet another indication of the inverse relationship between religiosity and substance use. Discussion It is clear that there are many factors that come into play when it comes to deviance in adolescents and young adults.Many of the findings in the articles come to the same conclusions; that is that numerous environmental factors along with that of peer groups, religious groups and family members all come into play. The speculation that the sibling relationship is more significant than that of peer relationships by Sto rmshak et al. is simply just that, speculation. Looking at the results as a whole we can see that peer relationships are just as significant of that of sibling relationships as well as parent relationships. Peer groups are what help adolescents more or less decide who they would like to be and the activities that they would like to partake in.Bahr, Hoffmann and Yang (2005) also concluded that â€Å"peer drug use had stronger affects than any of the other variables; However, the results [also] showed that the family variables had significant impacts on adolescent drug use as well† [ (Bahr, Hoffmann, & Yang, 2005, p. 545) ]. A major limitation of the majority of the studies would be the ability to generalize them across a number of populations. Many studies are done on Caucasians and also have other specific measures that are not easily able to be generalized across many cultures and subcultures.In order to fully understand the compete influence on peer, family and religious gr oups one would need to look at numerous characteristics not just specific sub-groups. Conclusion and Future Study As a whole the amount of research done on peer, family and religious influence is significant enough that we can get a good idea on the overall affects. Substance use among more troubled adolescence is far more common than that of adolescence involved in religious organizations and those who are motivated academically as well.Those youth who have been labeled as antisocial and having more mental health problems are forced into this more deviant peer group and are more likely to become substance users and abusers later in life. There are clear correlations between deviant peers and drug usage among adolescents. In future studies we should make sure to have a more wide population to study. Not focus as much on the Caucasians and troubled youth. When it comes to troubled youth you need a comparison of what is seen as society as the more angelic adolescents who tend to not g et mixed up in substances that are deviant.Here, however, it is clear that there are many factors that come into play when determining the adolescent’s use of drugs and alcohol. References Andrews, J. A. , & Duncan, S. C. (1997). Examining the Reciprocal Relation Bewteen Academic Motivation and Substance Use: Effects of Family Relationships, Self-Esteem, and General Deviance. Journal of Behavioral Medicine, 20(6), 523-549. Retrieved from http://0-web. ebscohost. com. library. unl. edu/ehost/pdfviewer/pdfviewer? sid=21d20bb2-d5ad-4a31-8aef-c9c56a727cbf%40sessionmgr10&vid=1&hid=16 Bahr, S. J. Hoffmann, J. P. , & Yang, X. (2005). Parental and Peer Influences on the Risk of Adolescent Drug Use. The Journal of Primary Prevention, 26(6), 529-551. Retrieved from http://www. inspirationsyouth. com/Teen-Substance-Abuse/Parental-and-Peer-Influences-Adolescent-Drug-Abuse. pdf Brook, J. S. , Lukoff, I. F. , & Whiteman, M. (1977). Peer, Family, and Personality Domains as Related to Adoles cents' Drug Behavior. Psychological Reports(41), 1095-1102. Retrieved from http://0-www. amsciepub. com. library. unl. edu/doi/pdf/10. 2466/pr0. 1977. 41. 3f. 109

The Contribution of NUR 300 Class

NUR 3000 is meant to be a bridge for the adult student, by which he or she may make a smooth transition into an academic setting while assuming new responsibilities as a nursing student. The course is designed to give to the student those skills which are necessary for the successful completion of the student’s education. There are specific skills needed to be successful as a nurse and this course is designed to bring those to the student. The educational goals set by the student can best be achieved if the student is fully versed on all the tools of the trade, and NUR 3000 is designed for that purpose. During the course of this class the student participates in discussions concerning the role of the student nurse vis a vis the university milieu. The student is required to demonstrate the ability to produce an academic work meeting the guidelines of the American Psychological Association style. The student is instructed in ways to identify the tools needed by professional nurses in the course of their duties. This includes guidelines for evidence-based practice and the student is taught to apply those tools to further productivity and learning. The student is taught to identify a system in which responsibilities can be prioritized. In this course there are participatory discussions relative to the most efficient methods of educating clients and colleagues. The use of a word processor is virtually mandatory in any technical work and knowledge of the ways in which it can be used is vitally important to nurses (L. Pray, personal communication, February 20, 2007).   In this course the students becomes familiar with all aspects of the program and are then expected to be skilled in their uses. The old typewriter, which the word processor replaced, served but one purpose, which was to put print onto a sheet of paper. The word processor is multi-dimensional and saves time and effort, which can be better spent on clients and other work. The word processor has become indispensable, and students of this course are now competent on it. There are different formatting styles in academic writing. Nurses are expected to become proficient in the American Psychological style. The course teaches student nurses the nuances of this particular style, coupled with the understanding of what its primary use happens to be.   It is for scientific works primarily and has a unique method for in text citations and referencing. ‘APA is a widely accepted format for writing research papers, particularly for social science manuscripts and theses,’ (APA, n.d.). Coupled with the word processor, it is one more weapon in the nurse’s arsenal, and beneficial in the spreading of information in a uniform manner. There is a distinction between scholarly journals, periodicals and popular magazines, with much of that difference in the quality of the written word. Peer reviewed material is considered the highest authority available to the student. Journalists write popular magazine articles, for the most part. They are frequently full of opinion and conjecture. Periodicals are the most prolific in terms of sales. They are ubiquitous and come in various formats, with ‘Some periodicals [using] the newspaper format,’ (Burkart, 1964, 11-22). The course has taught that peer review material is the most reliable and valuable source of information. No academic writing can contain plagiarized material. It is not only theft of intellectual property, it is a disservice to the creator of the material. The reason that APA style is so useful is that it makes it relatively easy to cite the source of any material or idea used in an academic paper. There is no excuse to overlook the citation of another person’s work. Though Mallon wrote, in Stolen Words, that the Romans often reworded Greek literature and that Virgil is Homeric (1991), that is not a license to steal. Paraphrasing and summarizing are techniques used in academic writing to set apart words and ideas that do not belong the author of the document. They are not the same as a direct quote, but still convey the gist of the idea. Paraphrases take the original author’s words and put them into the words of the student writing the new paper. Summaries have the flavor of the original but lack the detail. Both must be attributed to the creator of the original words or ideas in the text of the new document. In this course students learn to cope with the stress that naturally arises on the job.   Job related stress among nurses can be a source of illness and lead to burnout. According to the Framingham Heart Study data, failure to show or discuss anger leads to coronary problems later in life (Thomas, 2004). This course teaches the student effective methods to deal with what can become a major problem if not addressed. The time management strategies that are taught in this course have been beneficial. The concept of assessing where the time goes and how the student spends it will be an asset to be used in the field when the student becomes the nurse. One advantage to online learning is that the student can, within limits, go at his or he own pace. The student can learn anytime or anywhere, again, within reason. However, they take up time, for they utilize the printed word as opposed to oral lecture. Still, it appears that the advantages outweigh the disadvantages. This course was designed to teach student nurses the basics job skills required in the nursing profession. It covered the topics well and did a superior job of instructing the students in the subject matter with which it dealt. References .APA style. (n.d.) Retrieved 2-22-07 from: http://en.wikipedia.org/wiki/APA_style J. Burkart, (1964)   The Journal of Industrial Economics, Vol. 13, No. 1, pp. 11-22 Retrieved 2-22-07 from:http://links.jstor.org/sici?sici=0022-1821%28196411%2913%3A1%3C11%3ARTIPP%3E2.0.CO%3B2-9&size=SMALL   Mallon, T., (1991) Stolen Words U.S.A.: Penguin Books 4 Thomas, S. 2004 Transforming Nurses’ Stress and Anger New York: Singer Publishing Co. Inc.   50         

Communication in Health and Social Care

Communication in Health and Social Care BY chrtssy7694 Different forms of communication. In these two sections I am going to identify the four different forms of communication and later on I am going to describe them all briefly. Pl) Identify different forms of communication. Verbal Communication Non-verbal communication Written communication Technological aids MI) Describe different forms of communication. Verbal communication: Verbal communication is when one make use of a spoken language to show his or her opinion or simply Just to communicate with others.Verbal ommunication has a wide range of purposes. The most obvious function is that verbal communication is the main procedure when it comes to communicate with others. Also the purpose of verbal communication is to show one needs, desires, and ideas but above all it serves in the course of teaching and learning. Apart from all the purposes mentioned above, verbal communication can be used to form better relationship and building relationships with others.Non-verbal communication: Nonverbal communication refers to the actions that one make to communicate with others apart rom the obvious ones like speaking or writing. This form of communication includes: facial expressions, body language (hand movement, head movement), eye contact, proximity, posture, appearance, signs, symbols and pictures. It can be more efficient and sometimes more than verbal communication. Body language is all the body movements that one makes to express his or her feelings.This include how one stands, the way that someone is walking or simply Just the way one moves can give signs of how we are feeling. Another type of non-verbal communication is gestures. Hand movement, facial expression, head movement and even body postures are all gestures. Signs, symbols and pictures can be used tor example by workers to indicate some sort of work in progress in the streets. Another important type of non-verbal communication is the use of sign lang uage.This type is very useful to those who have hearing problems for example, someone deaf can use lip reading or hand signals to communicate with others. Even more there are those actions which we do them involuntary, we Just do them automatically which show how we are feeling, for xample: when someone is has a slumped posture it shows sadness. Written communication: This form of communication means a lot in todays life. Writing is more effective and formal than speech because writing is something permanent while speech is something that when it is said it can be forgotten.Even more writing can serve as a proof on something or someone or Just it can be records about a patient or some medicines. Written communication can be practiced in any business sector, for example in the health and social care area. When someone is sing written communication as his way of communication he needs to know how to include the right choice of words, write sentences in the correct Technological aids: In this present day technology is advancing a lot and we have many technologic aids that we can use to communicate with others.We have mobile phones to send text messages to someone and we can even call them. Apart from this computers help us to communication even worldwide with others or save some information. Technologic aids can help disabled person to communicate more freely without being reliant on others, or example nowadays in movies one can choose to enable subtitles so that one can understand better the movie.Another good example is the voice box which was invented by Professor Stephen Hawking which can convert small movements into speech. (Sian Lavers, Helen Lancaster, Howarth Elizabeth,Higgins Heather, 2010) From these two sections one can notice how people can interact with each other in different forms of way. One can even know if someone is really interested in what he is saying or not. Even more by examining the other person and keep eye contact one can have a good co nversation. Communication in Health and Social Care BTEC Level 3 National Diploma in Health and Social Care. Unit 1: Communication in Health and Social Care. P1: Create an article for the ‘Nursing Times’ magazine. Effective communication in a Hospital setting. In the health and social care setting, two types of communication take place in one-to-one and group communication. These are formal and informal communication. You may take part in a few one–to–one situations. This may be with staff and staff, staff with patients and staff with the patient family. Also as staff you may find yourself in group situation with the patient and a number of the patient’s family members. Related reading: Evaluate the Effectiveness of Agreed Methods of Communication With An IndividualThe usual form of language in a group conversation if formal but in formal is also used as well depending on the circumstance. There are a number of factors that influence effective communication within both one-to-one interactions and group interactions. These are formal, informal, verbal, and non-verbal skills. One-to-one Communication. In a hospital, communication takes place more frequently than informal interactions. Formal interactions will be between staff and staff, staff with patients and staff with family members.Formal interactions are very effective in one-to-ones because it is polite and medical terms are used to make it sound more professional in a serious matter. Formal communication is effective when used by staff because it is a professional way of communicating important information. Informal communications is used only in curtain circumstances not in all because it is n ot always polite to be informal with everyone all the time but using informal communication can lighten up the mood and make the patient feel better about the situation.Verbal and non-verbal communication is used everyday by every staff member in the hospital setting so it is vital that the staff know how to communicate correctly. Verbal communication is when you are talking to a person. You should be confident so that the person that you are speaking to is reassured that you know what you are talking about. You should also be listening to what the person says carefully because you want to make that person feel better about being in the situation they are in. Non-verbal communication covers body language, proximity, posture, hand gestures and facial expressions.You can use this effectively by using these things well in the right way. E. g. when you are talking to someone in a one-to-one you should be standing/ sitting straight and making eye contact. Jargon and slang are used in the hospital between staff and staff when communicating. Jargon is more medical terminology, so when an incident occurs then the staff can use jargon to make the staff fell more confident so they are not embarrassed. Jargon is an universal language so it can be used by everyone which is an advantage. Slang is a terminology that continues to change.It is an informal way of communicating and is used normally between staff with staff and staff with patients. Slang also covers nicknames or terms for patients they are talking about. It can be used effectively to protect the identity of the patient they are discussing over which can add humour to very stressful situations. Group Communication. Group communication can take place between staff, patients and family members. It can also take place between a group of professionals. Both formal and informal communication is used.Again, formal communication is used more often in a group conversation. Group conversations are effective because it let s more people know important information and more ideas and opinions can be shared. Informal conversation can be used to make patients feel patients feel better about the situation and can be quite humorous but if it is used in the wrong circumstance people can be offended by what is said in a jokey manner. In a group conversation verbal communication is important because it is key to make sure that each person involved knows what is being said and each person can participate.When talking in a group it is effective to speak loud and clear so that the patient and family members know what you are saying. Also, having a good posture when talking is also effective because you will then come across as positive. Non-verbal communication is just as important as verbal communication when talking in a group. Body language is effective because it lets other people know that you are positive and confident about what they do. Jargon is generally used in group communication between staff profess ionals because it is not a professional way to communicate to patients and family members with.It is effective when used between colleagues because it is a universal language so when staff from different countries communicate Jargon can be used to tell the other hospital what has happened. Slang is only used when staff are by their own so if staff are having a group meeting then slang is usually used. Written communication is used to communicate between staff and staff. E. g a board of notes about each patient is used to communicate in a ward without having to spent time to find each other when they could just write it down.Writing, good hand writing and reading skills are need to communicate through written communication. When written communication takes place, it needs to be clear and neat with good grammar. Signs and symbols are used everywhere in hospitals. E. g no smoking, directions etc. They are effective by communicating information to people who need it where they are. It c an communicate to many people without any human communication. Also with people with different cultures and languages can all understand what the signs and symbols mean. Communication in Health and Social Care BTEC Level 3 National Diploma in Health and Social Care. Unit 1: Communication in Health and Social Care. P1: Create an article for the ‘Nursing Times’ magazine. Effective communication in a Hospital setting. In the health and social care setting, two types of communication take place in one-to-one and group communication. These are formal and informal communication. You may take part in a few one–to–one situations. This may be with staff and staff, staff with patients and staff with the patient family. Also as staff you may find yourself in group situation with the patient and a number of the patient’s family members. Related reading: Evaluate the Effectiveness of Agreed Methods of Communication With An IndividualThe usual form of language in a group conversation if formal but in formal is also used as well depending on the circumstance. There are a number of factors that influence effective communication within both one-to-one interactions and group interactions. These are formal, informal, verbal, and non-verbal skills. One-to-one Communication. In a hospital, communication takes place more frequently than informal interactions. Formal interactions will be between staff and staff, staff with patients and staff with family members.Formal interactions are very effective in one-to-ones because it is polite and medical terms are used to make it sound more professional in a serious matter. Formal communication is effective when used by staff because it is a professional way of communicating important information. Informal communications is used only in curtain circumstances not in all because it is n ot always polite to be informal with everyone all the time but using informal communication can lighten up the mood and make the patient feel better about the situation.Verbal and non-verbal communication is used everyday by every staff member in the hospital setting so it is vital that the staff know how to communicate correctly. Verbal communication is when you are talking to a person. You should be confident so that the person that you are speaking to is reassured that you know what you are talking about. You should also be listening to what the person says carefully because you want to make that person feel better about being in the situation they are in. Non-verbal communication covers body language, proximity, posture, hand gestures and facial expressions.You can use this effectively by using these things well in the right way. E. g. when you are talking to someone in a one-to-one you should be standing/ sitting straight and making eye contact. Jargon and slang are used in the hospital between staff and staff when communicating. Jargon is more medical terminology, so when an incident occurs then the staff can use jargon to make the staff fell more confident so they are not embarrassed. Jargon is an universal language so it can be used by everyone which is an advantage. Slang is a terminology that continues to change.It is an informal way of communicating and is used normally between staff with staff and staff with patients. Slang also covers nicknames or terms for patients they are talking about. It can be used effectively to protect the identity of the patient they are discussing over which can add humour to very stressful situations. Group Communication. Group communication can take place between staff, patients and family members. It can also take place between a group of professionals. Both formal and informal communication is used.Again, formal communication is used more often in a group conversation. Group conversations are effective because it let s more people know important information and more ideas and opinions can be shared. Informal conversation can be used to make patients feel patients feel better about the situation and can be quite humorous but if it is used in the wrong circumstance people can be offended by what is said in a jokey manner. In a group conversation verbal communication is important because it is key to make sure that each person involved knows what is being said and each person can participate.When talking in a group it is effective to speak loud and clear so that the patient and family members know what you are saying. Also, having a good posture when talking is also effective because you will then come across as positive. Non-verbal communication is just as important as verbal communication when talking in a group. Body language is effective because it lets other people know that you are positive and confident about what they do. Jargon is generally used in group communication between staff profess ionals because it is not a professional way to communicate to patients and family members with.It is effective when used between colleagues because it is a universal language so when staff from different countries communicate Jargon can be used to tell the other hospital what has happened. Slang is only used when staff are by their own so if staff are having a group meeting then slang is usually used. Written communication is used to communicate between staff and staff. E. g a board of notes about each patient is used to communicate in a ward without having to spent time to find each other when they could just write it down.Writing, good hand writing and reading skills are need to communicate through written communication. When written communication takes place, it needs to be clear and neat with good grammar. Signs and symbols are used everywhere in hospitals. E. g no smoking, directions etc. They are effective by communicating information to people who need it where they are. It c an communicate to many people without any human communication. Also with people with different cultures and languages can all understand what the signs and symbols mean.

Palm Feedback Loops Essay Example | Topics and Well Written Essays - 1000 words

Palm Feedback Loops - Essay Example The managers have been able to identify three probable generative feedbacks that drive the scenario specific environment into a new situation, that is, the movement from the centralized to the decentralized power generation (Ramirez and Van der Heijden, 2008). Various growing companies have basically found new and useful ways that help them develop their institutions and attain their goals. With the help of the new initiated ways these companies have been able to develop successful client feedback programs that mainly go forward through the many challenges that were there right from the start. These companies did not build the elaborated and centralized client research system but instead the firms started their feedback loop just at the leading edge. Employees of these firms mostly got to know how the firms work was doing and how much they (the firms) were appreciated by receiving evaluation of their performance from the various people (basically the customers who got services from these firms and appreciated what the firms were doing) who were much able to rate the firms and render their appraisal and views on the firms. The keen employees would usually take note on what the customer/clients were suggesting or recommending on a one on one conversation. The employees follow up the customer’s suggestions and see how they could implement them into the firms and get the customers a more desired and appreciated services all over. When deciding on how to formulate the suggestions, the employees usually take note on what the customers/clients have stressed much on (what the customer’s value more) and how they can deliver the requests of the customers in a best way (Dullweber, Markey and Reichheld, 2009). The companies (the growing companies) compile all the suggestions into a data form; the complied suggestions are usually arranged correctly looking at the

Navajo Nation Water Crisis - Propose a legislation change Essay

Navajo Nation Water Crisis - Propose a legislation change - Essay Example Speaker, Lawrence T. Morgan of the 21st Navajo Nation Council seeks to focus the attention of the Council on the need to enact a new piece of legislation to remedy a long-time anomaly in the Navajo area, i.e. convenient access to safe and affordable drinking water. The Navajo Nation is a semi-autonomous region of Native Americans and is spread in the northeastern Arizona, southeastern Utah and northwestern New Mexico, covering just 26,000 square miles of territory. Its unique position of being the largest Native American jurisdiction in the USA, gives it a heightened importance both as a semi-autonomous region and a culturally distinct entity. Thus in the eyes of the external world, it’s a very important civilization with a dynamic cultural dimension. Human existence and survival has been facilitated much more by the presence of water and this need is just second only to the air that humans breathe. Through centuries of human settlement expansion, the available amount of pure drinking water has been depleted and right now sources of such natural drinking water have naturally shrunk to a few spread over a large expanse of the territory. The Navajo Nation is not immune to this creeping problem either. Right now many people in the Nation have to travel considerable distances to fetch drinking water (DeZuane, 1996). Apart from the hazards involved there are such negative factors as costs, inconvenience and loss of time to be taken into account. The relative scarcity of drinking water in the region is a well known problem and so far little or no attention has been paid to possible remedial measures that can be adopted to solve the problem. Before it happens to assume crisis proportions, the Navajo Nation Council ought to actively promote a legislative remedy to bring about a solution. However such a legislative process intended to remedy an existing anomaly or shortcoming of this magnitude requires thorough pre-planning and a rational program of action. As the

Personal Statement for M.S in statistics Essay Example | Topics and Well Written Essays - 750 words

Personal Statement for M.S in statistics - Essay Example Since my teenage years, my curiosity found out that ‘a man will always be a man.’ I am the kind of person who does not fit many of the typical expectations of many young women in many societies. Whenever other people give negative attitudes to my new ideas, I always refuse to give up but chose to believe in myself. It is believed that girls do better in humanities than in sciences; however, I can compose popular stories and also construct SAS and R programs. People always argue that statisticians are introverts and as such poorly socialize with other people. However, I have built up a large social network of friends and business associates. I always surprise people with my personality, my hard work and insistence. Nevertheless, nothing could be easy forever. I still remember the moment when I first came to the United States, ready for a new life, full of passions and hope. Facts turn to be cruel; my tuition fee is and has been a burden for my family and I could not easily figure out befriending the Americans. I suffered a heavy blow of depression, felt helpless and was nostalgic. This led to my doubts in the future of my college studies and career aspirations. Such negative attitudes resulted in poor academic performance. Nonetheless, my strong will is never easily beaten by such hindrances. I therefore used my statistics ability to design ways and means to reduce the financial crises I faced and at the same time, gained great academic performances. Thanks to challenges, I could proudly say that I am an independent, resilient and highly empowered woman with strong wills. The above traits have greatly enhanced my performance in all aspects of life, more specifically in financial empowerment. Having participated much in social and academics involving data analysis in my undergraduate studies, I feel better placed to earnestly pursue my lifetime

Impact of the Globalization on a More Even Distribution of Economic Essay

Impact of the Globalization on a More Even Distribution of Economic Activity - Essay Example II. Measuring Globalisation: It is very difficult to measure globalization basing on the movement of production factors. Dispersion of production happens in order to have more access to inputs and so also more access to the external markets. Since there are interdependencies between the factors such as direct investment flows generate exports and movement of knowledge and technology while exports can also generate technology transfers and new inflow of FDI, measuring the extent of globalization becomes a difficult task. However there are some indicators by which one can have a fair idea of extent of globalization. Some of them as cited in the OECD Handbook on Economic Globalisation Indicators are: A. Globalisation through FDI- 1. What is the FDI position (inward and outward) as a share of GDP 2. What is the balance of inflows and outflows of direct investment for a given country 3. What is the propensity to reinvest earnings (earnings/income) from direct investment 4. What is the share of foreign-controlled affiliates in economic output. B. Globalisation through Trade: 1. Share of total exports in GDP. 2. Average of exports in GDP. 3. Share of domestic final demand met by imports. 4. Share of GDP generated by total exports. There are many such indicators mention of which is beyond the purview of this essay. FDI1 is a good measure to know the extent of economic activities across the globe. "To create, acquire or expand a foreign subsidiary, MNEs undertake FDI. The total direct capital owned by non-residents in a given country each year constitutes the stock of FDI" (Navaretti & Venables, 3). As stated earlier that with a propensity of access to market and also access to inputs companies goes for cross border activities or disperses their business... This essay attempts to analyze the development of economic activities in various regions of the world under the influence of the globalization processes. After the year 1980 the world witnessed a new movement for the global economic integration, which was rapid rapid due to technological changes in various sectors. The unprecedented technological change in the transport and communication sector making the swift movement of goods and services, human resources and information on knowledge and technology across the globe at a cheaper cost is the main factor which continues to drive the globalization process. The changing attitude of the people and more liberal government policies contributed to deepen and widen the process of the economic integration by shifting the focus of the planners from national economies to an integrated world economy. With breaking of the trade barriers and changing of the economic policies of the nations across the world make the companies to become transnational by opening up subsidiaries to distribute the business processes throughout the world. Though the process of economic integration occurring at a faster rate in the developed countries but the same is yet to be achieved at rapid rate in developing world. What is needed for redressing global imbalances is a responsible multilateral effort, rather than pressure on parts of the developing world. A well-coordinated international macroeconomic approach would improve the chances of the poorer countries to consolidate their gains in growth performance

Film and Culture Essay Example | Topics and Well Written Essays - 2750 words

Film and Culture - Essay Example Culture is the force behind every variable aspect of a person’s life, including language, race, traditions, art work, and even movies. Culture can vary from within a group of people to, however people with similar traditions and life styles are often put together in similar cultural groups. Culture can also highly influence the beliefs and life styles of a group of people. Different beliefs can be based on the effects of a person’s culture on those beliefs. Cultures can also change or shift, depending on trends and the ideologies of people of that time. Some cultures fade or die away with time, well other main stream cultures, or their ideas directly effected by them, may stay around for many years. While culture may seem like an overwhelming idea and ideology set, in simplifying it we must not forgot to include all aspects of a person’s life that may affect their culture, or to be effected by it. Culture is an important aspect of who we are, and why we are like that. One of the most unique aspects of culture is the art forms that various different people come to deeply connect with their culture. As far back as the Native Americans, different art mediums have become deeply ingrained within a people’s culture, and have also grew to define who a people are. This can no more be true in modern times than in the ways film and culture have become so deeply ingrained with each other. In today’s fast paced world, the connection between films and culture may not be seen at a first glance. However, just as it has been sense the dawning of Hollywood, the myriad of ways that film and culture connect with each other is almost uncountable. Film and culture have become almost inseparable in places, and there is such a deep running connection between the two that it is often times hard to see the difference between them. Film critic John Frame said these words on the deep connection between

The New Acropolis Museum and Ancient Greece's Architecture Research Paper

The New Acropolis Museum and Ancient Greece's Architecture - Research Paper Example The New Museum of the Acropolis is located in Makryianni district. The entrance of the museum is on Dionysios Areopagitou Pedestrian Street, which connects it to the Acropolis and the other historical sites in Athens. Many scholars have discussed the numerous similar characteristics between The New Acropolis museum and ancient Greece’s architecture varies widely. However, this paper will be discussing how the museum is similar to ancient Greece’s architecture, in not only its design, but also how it fits in the mathematical scheme of space, which is the most abstract similarity and the less noticed yet the strongest evidence. The mathematical scheme used in building the sites in Athens is based on the ancient Greeks’ believes, and the museum fits in it, which proves that The New Acropolis Museum was built to meet ancient Greece’s strategies, believes and myths and not randomly as it’s been claimed. There are three main types for concept of space, biological, symbolic, and mathematical. Ancient man has shown very clearly the biological and the symbolic scheme, in almost everything. His activities, religion, and culture played a huge role in the way towns were laid and landscape was designed. The biological and the symbolic concepts are shown clearly to the observer. It is well known that The New Acropolis Museum relates to Ancient Greece’s Architecture in many visually noticeable characteristics as it meets the clarity of Greece architecture. It has a simple exterior just like the structures in ancient Greece. The most obvious similarity is the way light was handled in the museum. Where ancient Greeks surrounded their temples with columns but left it open for direct light. The New Museum of The Acropolis was built to give the same lighting level but with using a high maintenance, heat resistant, many types of glass to light a big part of the museum naturally, and in the same way, the other historical

Shakespeare Essay Example | Topics and Well Written Essays - 250 words - 2

Shakespeare - Essay Example Shakespeare moved to London in around 1590 and by 1592, his plays and ability as a playwright were already being recognized and handsomely rewarded all over London. During this period of 1590s, his plays became famous all over London and this made his wealthy through investments and purchases. The wealthy and lavish life of London made most of his work contain issues of social class and its effects on society in general and hence this marked the theme for almost all his literary works (Bradbrook, 2005). The contents of the literature and art in Europe gave a reflection of different issues in society. This is true for example in the literary works of Karl Marx which discussed political and economic ideologies through his books and other works and gave a reflection of what was happening in Europe at the moment and what could be done about it. Other art works like paintings also gave reflection of the different events in the different eras. This was also true for plays like those by Shakespeare which gave an understanding of the society’s division through social status and even the religious issues happening in the society during those times (Arendt, 2007). Through these various art and literature which gave a reflection of Europe, people are able to understand and deduce what was happening and even the cause of such

The Virtual Memory Manager Assignment Example | Topics and Well Written Essays - 750 words

The Virtual Memory Manager - Assignment Example The virtual memory is created by the operating systems when the computer does not have enough memory when it comes to executing a program. As mentioned earlier, the hard disk and the Random access Memory are in charge of data storage. On the operating system, the applications which are executed the data is kept in the RAM, this is to ensure that the data is accessed quickly for processing. The RAM can be easily be accessed as compared to the hard disk and CD-ROM. The data in the RAM is only accessible when the computer is running (Andrews, 2007). In case of a power shut down or the computer is shut down, all the data in the RAM are lost, and the operating system is gaining loaded into again into the RAM. The physical memory is a non-volatile memory this means it has the capabilities of storing the data even if the computer is not powered. The hard dismiss made of spherical disks known as platters which store magnetic data. The data are written, and it is later read using the read and write heads. The virtual memory comes into place when the system units lack enough the RAM space to execute an application; the virtual memory is used to transfer data from the to the paging file that frees up space in Random Access Memory. A certain portion of the physical memory is used in the storage of files (Carr, 2008). ... This is because there is a resource sharing of the available memory this increases the efficiency of the machine over time. The application, which shares the virtual memory, does trade the protection of the different address spaces for efficiency of communication. This also reduces the consumption of the physical memory. The virtual memory allows the sharing of the files and the memory by the multiplication process, with several benefits the system libraries can also be shared by mapping into the virtual address space of more than one activity (Andrews, 2008). The activities can also share the virtual memory by mapping the same block of memory for more than an activity; the activity page can be shared during the folk time, which eliminates the need to copy all the pages of the initial activity. The virtual memory architecture deals with various advantages over that system that make the physical memory visible to programs. However, one of the main drawback is the increased number of t he increased number of the physical memory which are vital for each virtual address reference. If the two approaches are combined, the additional memory reads are needed. The operating system divides the physical memory into different partitions, the partitions can be of different sizes. Each partition can be given to a process as a virtual address space. The memory management unit of the central processing contains a relocation registers. Whenever the thread tries to access the memory location, the value of the transfer register is added to the virtual memory address which is referred to as dynamic binding. This process translates the memory address into the physical address

The Rise of Christianity in the Roman Republic Essay Example for Free

The Rise of Christianity in the Roman Republic Essay Throughout the Roman republic and most of the empire, the Roman religion was polytheistic. The religion was based on the Greek religion and included multiple gods and goddesses who were anthropomorphic and cruel. However, during the first century of the Common Era, Judaism and â€Å"mystery religions† such as Mithraism, Eleusis, and Christianity were becoming increasing popular. Roman rule tried to control the spread of these religions but eventually Christianity became the chief religion of Rome and its empire. In the early stages of these new religions, Rome was surprisingly tolerant. Many rulers allowed citizens to practice these religions and asked only for simple patriotism and to recognize the holidays of Roman gods. Most Jews and Christians were uncooperative with this notion. In fact, many radical Jews and Christians emerged. A notable radical Jesus, who was an orthodox Jew, led and taught â€Å"the good news† to his followers. This stubborn disobedience enraged rulers such as Nero and Diocletian, who ordered for many Christian persecutions. Diocletian ordered that churches and sacred books be destroyed throughout the Empire. Nero is best known for a devastating fire which was rumored to have been started by Nero himself. He tried to end these rumors by punishing many Christians as a distraction. Persecutions were common and often resulted in death. Women were persecuted the same as men. Christians accepted Jesus as their messiah after he had been put to a gruesome death under the orders of Pilate. At this time, the Roman Empire was in economic turmoil and Christian persecutions were its last attempt at control. A major turning point in the history of Christianity occurred in 312 of the current era. The story is told that Constantine, Roman emperor during this time, had a dream telling him to decorate his shield with the Greek letters for Christ. When he did so and was victorious during battle, Constantine decided that he would convert to Christianity. Constantine also ended all persecutions and allowed all Christians to worship freely. Theodosius the Great took the work of Constantine a step further. He forbade any religion to be practiced except Christianity. This movement gave many more privileges to the church. Churches could now own property and were exempt from certain taxes. Christians were finally free to live and worship. The phenomenon of Christianity was not a battle won easily. There were many cruel and devastating punishments to those who practiced against Roman religion. Men and women were put to death or forced into hiding in the first century. However, as the population of Christians grew rapidly, Roman law found it necessary to revise laws and allow Christianity within the Empire. Christians had won the victory of faith and progressed onward through history.

The Theme Of Alienation Loneliness And Selfhood English Literature Essay

The Theme Of Alienation Loneliness And Selfhood English Literature Essay In Krapps last tape, Krapp systematically distanced himself from companionship and love of other people. When Krapp was twenty nine years old, he lived with a woman named Bianca, whose love he later described as a hopeless business despite the fact that she truly loved him and possessed very warm eyes that always seemed to impress him (Beckett 54). After the death of his mother when Krapp was only thirty nine, he felt that life had lost meaning. This is evident from the words he said to his new love that it was hopeless and there was nothing positive about life. He rejected his lover and completely lived alone from this time onwards, although he was sometimes visited by Fanny, who was a bony old ghost of whore (Beckett 98). At the age of sixty nine, Krapp was only accompanied by his loneliness during his birthday celebration, whereby he spent the day in a pub deeply occupied by heavy thoughts of his past life and his lost chance for love and fulfilled life (Beckett 67). Krapps last tape is a compact statement of a mans predicament as a prisoner of time. He preserved the worst for himself and threw the best away by rejecting love of others. At the age of sixty nine, the only thing he could do was to play a tape he made when he was thirty nine, reminding him of the last love that he rejected when he still had potential for happiness in life (Beckett 89). Krapp was a lonely man, whose isolation was self inflicted. He viewed women as bad influence and valued his career as a writer more than any human companionship or relationship. He confessed that he could not withstand the thought of his future career as a writer being interfered with by women and love (Beckett 89). Krapp chose a tape recorder to be his sole companionship. He seemed to find comfort in recorded voice, which he faithfully listened to, even in old age. However, although Krapp lived like he did not need anyones company, he seems to have been inwardly desperate to have someone to engage in a conversation. He eventually discovered that he had made a terrible mistake by forsaking the rest of humanity (Beckett 130). Loneliness, selfishness and selfhood are clearly illustrated throughout Krapps character and way of life. He never found satisfaction in life even after selfishly living a lonely life that he had chosen to live and he realized that the selfhood that he had discovered had truly misled him. He realized that he needed other people and the rest of the world in order to be fulfilled but it was already too late. In Kate Chopins story of an hour, Mrs. Mallard went through feelings of relief as soon as she received the bad news of her husbands death, which was said to have occurred in a train accident. Although at first she was sorrowful and confused by the news of her husbands death, she was suddenly relieved by the thought of being free from marriage and slavery of love. She knew that no amount of love and security could pay the lack of control over her own existence (Chopins 194). Mrs. Mallard seemed to have been controlled by society, pretending to be happy and fulfilled in her marriage. As molded by the society, she appeared to be a perfect wife, who enjoyed companionship of her husband and loved being a wife. She suppressed her true selfhood and sacrificed her delight to please the society, pretending to be happily married. As expressed in her reaction and sigh of relief when she heard the news of her husbands death, it is quite evident that she had always inwardly struggled with her marriage to Mr. Bently Mallard, that was dominated by male chauvinism. Feminism shown through freedom upon her husbands death explains her happiness and relief to be alone, free from bondage of marriage and love (Chopin 193). Her own feelings of freedom came back possessing her when she first uttered the words free, free! In this story, Mrs. Mallard is described as a woman who had forgotten and abandoned herself throughout the entire period of marriage to her husband. The husband is described as being happy with the marriage, despite the fact that Mrs. Mallard was not happy and inwardly viewed the marriage as slavery. Her emotions had been stiffled and and suppressed to fit into hollow social conventions of the society. She was the submissive woman, who believed that her husband had a right to impose his will on her (Jamil 216). However, she suddenly gained control over herself after discovering that she had been set free from bondage of marriage and slavery of love by the death of her husband. She embraced visions of a bright future and realized that whether she had loved him or not was not important anymore, all what was important to her now was the possession of self assertion that she experienced afte r his death. (Choppin 193, 194). This was the nineteenth century American womans hour of awakening into selfhood, which gives her immesurable joy and beauty of life. (Jamil 215). Her happiness after discovery of her selfhood was so strong that when she realized that her husband was not dead, she immediately collapsed. She could not imagine how she was going to abandon her new found freedom and return to life with her husband, where she would be required to bend her will to his. Mrs. Mallard preferred to live alone, without her husband because that meant freedom to her just like Mr. Krapp chose to live alone and viewed women and love as a hopeless business. To him, they would interfere with his freedom of pursuing his writing career, while to Mrs. Mallard, the presence of her husband was a permanent bondage to slavery that had taken away her freedom and selfhood. The story of a sorrowful woman by Gail Godwin depicts a wife and a mother who gradually withdrew from her family after becoming overwhelmed by her husbands and childs presence and completely shut them out of her life. Their presence was a daily reminder of the fact that she had lost her freedom as well as her self- identity and her life would never be the same again (Godwin 78). She wanted her freedom and her self -identity back. She wanted to stay away from her husband, her child and the rest of the community and live a lonely life because to her that would be more fulfilling, just like Mr. Krapp. She viewed marriage as a source of pain, that had taken away her identity, her selfhood and her freedom. She further wanted to stay away from the society that advocated for marriage and therefore decided to live a lonely life. However, what she considered as freedom and selfhood did not give her the fulfillment that she had longed to have. Her dissatisfaction with her role as a mother and a dutiful wife made her to try many other alternatives in life but she did not find satisfaction in any of the options that she tried out. She did not find any particular role that could suit her and therefore she ended up withdrawing from the rest of the world. This is illustrated by the coldness and isolation of the undecorated white room that she moved into. She even pictured herself as a virgin in a tower, untouchable and profoundly isolated (Goldwin 117). This shows that she had not only isolated herself physically from her family and the rest of the world but also emotionally thus making herself an outsider looking in on the world. She viewed her family as source of bondage, slavery and dissatisfaction in life. However, isolating herself from the rest of the society did not give her any satisfaction like she had expected. She only ended up being a lonely woman, both physically and emotionally. The theme of alienation, selfhood and loneliness cut across the three stories discussed. The three main characters in the stories viewed family as a source of bondage, limitations and dissatisfaction in life. It is portrayed as a form of slavery that would tie women and men to their families and take away their freedom as well as their selfhood. These stories portray traditional marriages whereby women are supposed to be submissive to their husbands and be good home makers as unfulfilling and undermining to women. The women discussed here are seemingly tired of living under bondage and slavery of their husbands and the entire society and are looking for liberation and freedom. They want to rediscover themselves and find more fulfilling roles that define them and give them a voice as useful members of the society. They can no longer stand the idea of being dominated by society as well as by their husbands as clearly observed when Mrs. Mallard collapsed on discovering the truth that he r husband was truly alive and not dead as it had been reported. On the other hand freedom in these stories is categorically accompanied by loneliness and lack of fulfillment as portrayed by Krapp and Godwin. The woman in Godwins story did not find any satisfaction in her loneliness after abandoning her family and the society at large. Her freedom brought more emotional and physical dissatisfaction as she tried to rediscover herself and even to assign her new roles, which only tormented her mental and emotionally, causing even more pain to her life. After spending all his life alone with the tape recorder as his sole companion, Krapp finally came to his senses and realized that he had actually ruined his own life because he was lonely and desperate for companion. He realized that listening to the tape recorder alone could not give him the delight and the fulfillment that he had longed to have in his entire life. However, it was already too late as he was already an old man.

Prochaska and Di Clemente Stages of Change

Prochaska and Di Clemente Stages of Change The transtheoretical model of change is one of several models of health promotion used by health care professionals in an effort to recognise and foresee health behaviours. The model is supported by various authors as a successful tool and framework within health education. (Warner 2003) This assignment will introduce the model and briefly discuss its input to health promotion together with further developments since its beginning. A concise account of its use in present health education will be given and referred to where applicable. The assignment will go on to discuss the relevance of the transtheoretical model of change within nursing practice and provide an understanding of the model by explaining the main theories. In addition the assignment will discuss and provide further information on what areas impact on how the model is used and why. Further discussion will take account of the strength of the approach used by this model and include theories on why it is used giving consideration to the patient as well as the health care professional. It is recommended that successful health education models can be used to asses goals in order to engage in pre-emptive behaviour and consequently it is crucial that the model is explained in order to take full advantage of its use. (Downie et al. 1997, Ogden 2004) The approach will be investigated in order that the reader can form an opinion on its use and why it is needed within health education. It is acknowledged that nursing and health care practice should be established on the most current and reliable research available and nurses must practice in partnership with equally the patient and other health authorities (NMC 2008). The writer hopes to establish the reader with the necessary information that satisfies these requirements and gives further discussion on how the transtheoretical model of change can be applied to clinical practice. This will include criticisms and challenges against the model and look at how the model is included within broader professional health care such as current health promotion campaigns. Finally a conclusion will be provided which will summarise the findings of this assignment and emphasise any significant features that add to the validity of the model and its use within health care. The transtheoretical model of change was developed by Prochaska and Di Clemente (1983) and grew from systematic integration of more than 300 theories of psychotherapy, along with analysis of the leading theories of behaviour change (Prochaska and Velicer, 1997). Consequently following the inception of public- health programmes this model has been implemented and is used within current health promotion. (Wood 2008) Health promotion is defined by the World Health Organisation (WHO 1986) as the process of enabling people to increase control over, and to improve, their health. Health education is considered an approach of health promotion which also includes many theories, beliefs and concepts in regards to effective intervention. (Tones 2001) The transtheoretical model of change focuses on the decision-making abilities of the individual rather than the social and biological influences on behaviour as other approaches tried (Velicer, Prochaska, Fava, Norman, and Redding, 1998; Scholl, 2002). This model was developed to provide a framework for understanding how individuals change their behaviours and for considering how ready they are to change their substance use or other lifestyle behaviour. The stages and processes by which people change seem to be the same with or without treatment these include the individuals perceptions of susceptibility to illness, severity of illness, barriers to changing behaviour, benefits to changing behaviour and finally action and maintenance. Although the model has been adapted and modified to include further components for the purpose of this assignment it is necessary to explain the theory behind the original before discussing modifications. (Ogden 2004, Bennett and Murphy 1997, Naidoo and Wills 2000) In addition it is suggested that by using these concepts in the transtheoretical model of change it will predict the likelihood that behaviour will or will not change depending on the individuals perception. The idea of anticipating behaviour and therefore adjusting intervention is supported by various researchers who suggest that using cognitive models can assist in how individuals perceive health by conscious thought as to the behaviours and the cost of those behaviours. (Yarbrough and Braden 2001, Roden 2004a, Wood 2008) This supports healthcare professionals to allow the patient to change behaviours based on their own awareness as opposed to medical tactics to health promotion that have been used previously. Ewles and Simnett (2003) recommend that using a client centred approach empowers the patient to change behaviour and independently manage behaviour and as a result the health care professional becomes a facilitator instead of an instructor. Using a client centred approach does not discount the benefits of the medical approach as it may require various tactics depending at what stage of the model the individual is identified as being at. However by using an effective health promotion model, it encourages the patient to become an active participant and more responsible for their health related decisions. Ogden (2004) describes the concept of an individuals perception of control on their health as the Health locus of control which will be discussed later within this assignment. Based on the understanding of individual perceptions influencing behaviour it reinforces the use of the components previously discussed and by looking at these separately it is hoped that health care professionals will be able to detect the risks of behaviour and the probability of change. (Naidoo and Wills 2000, Ogden 2004) The previous mentioned components can be identified in the Transtheoretical model of change; these include pre-contemplation, contemplation, action, and maintenance. However the aspect that makes the transtheoretical model of change unique is the theory that change occurs over time, an aspect generally ignored by other models of change (Prochaska and Velicer, 1997; Velicer et al., 1998; Scholl, 2002). This temporal dimension of the theory suggests that an individual may progress through five stages of change when trying to adjust their behaviours (Prochaska and Di Clemente, 1983; Prochaska et al., 1992; Prochaska and Velicer, 1997). In the transtheoretical model of change, behaviour change is treated as dynamic, rather than an all or nothing phenomenon. This distinction is considered one of the theorys strengths (Marshall and Biddle, 2001). The first stage of change within the transtheoretical model of change is the precontemplation stage, where individuals have no intention of taking action within the next six months (Prochaska et al., 1992; Prochaska and Velicer, 1997; Scholl, 2002). Individuals at this stage may or may not be aware of the consequences of their behaviour (Prochaska et al., 1992;Scholl, 2002) or may have tried to modify/change their behaviour and failed several times and as a consequence are dejected and unwilling to have another attempt (Prochaska and Velicer, 1997). Prochaska et al (1992) propose that the main characteristic of someone in the precontemplation stage is that they struggle to accept that they have problem behaviour and as such they cannot move on from this particular stage of the model. In order for the individual to move on they must experience cognitive dissonance which is acknowledging that there are negative aspects to continuing with this behaviour (i.e. smoking and the possibility of contracting lung cancer as a result) (Scholl, 2002). Following on from precontemplation, contemplation is the individual trying to make significant changes within another six month period, this includes evaluating any benefits or disadvantages to the individual changing their behaviour (i.e. cost of smoking, as opposed to loss of social activity) as a consequence many people stay within this stage for longer (Patten et al., 2000; Prochaska et al., 1992; Prochaska Velicer, 1997; Velicer, 1997; Velicer et al., 1998). Therefore the behaviour may seem more attractive than the change needed to be made (Scholl, 2002). This is known as chronic contemplation or behavioural procrastination (Prochaska and Velicer, 1997). Whilst within this phase the individual will still continue with the risky behaviour despite being aware of the consequences that this behaviour could cause (Patten et al., 2000). However it is widely accepted that someone within the contemplation stage is genuinely trying to resolve their problem behaviour (Prochaska et al., 1992) and as a result will only move on to the next stage when the positive aspects of change outweigh the negative aspects of remaining the same (Scholl, 2002). Preparation proceeds contemplation and in this area of change the time scale for the individual to modify their behaviour reduces to within the next month (Patten et al., 2000; Prochaska et al., 1992; Prochaska and Velicer, 1997; Velicer et al., 1998). An individual in this stage has tried to change or adjust their behaviour within the last year and has been unsuccessful however this has not discouraged them from continuing to i.e. binge drinking, smoking, or misuse of drugs. As a result of this the individual is at a loss as to how to proceed with any changes and if they are ultimately able to make these changes given that they have up until now failed (Scholl 2002). In this instance a plan of action can be produced by the healthcare professional in order to identify how to reduce or eliminate the problem behaviour and therefore give the person the opportunity to choose between alternative solutions i.e. smoking 10 cigarettes as opposed to 40 cigarettes a day or to stop smoking with the help of nicotine patches (Prochaska et al., 1992; Prochaska and Velicer, 1997; Velicer et al., 1998). Consequently when an individual feels confident and in control of the situation and has identified a suitable plan of action they will naturally move on to the next stage of the model (Scholl, 2002). The action stage follows on from preparation and as a result efforts have been made to adjust the individuals, behaviours, experiences, or environments over the previous six months in order to conquer their predicament. This stage requires a considerable amount of time and energy and is the stage where the individual receives the most amount of attention from others because of their obvious hard work (Patten et al., 2000; Prochaska et al., 1992). However it should be noted that research has stated not to mistake trying to change with actual change, this only occurs when the criteria is reached for the individual and will reduce the risks associated with their particular problem behaviour (Prochaska et al., 1992; Prochaska and Velicer, 1997; Velicer et al., 1998). Prochaska, DiClemente, and Norcross (1992) suggest that the main ways of identifying a person within the action stage is by the individuals obvious lifestyle changes i.e. healthy eating and documented weight loss to a more acceptable criterion level. Progress into the final stage happens when the individual perceives positive changes to their lifestyle, health and as a result feels better whilst also receiving encouraging feedback from family, friends and health professionals (Scholl, 2002). Lastly the transtheoretical models maintenance stage is where people work to prevent a relapse and only after six months of being free of the problem behaviour can it be recognised as the criteria of an individual being within the maintenance phase. Research also recognises that maintenance is a continuation of change not an absence of it (Patten et al., 2000; Prochaska et al., 1992; Prochaska and Velicer, 1997; Velicer et al., 1998). Consequently individual perception is referred to the threat of illness and modifying factors can be referred to as behavioural response. In addition the likelihood of action is influenced by environmental cues. As a result the behaviour change occurs because of a threat to illness and therefore the behaviour changes or is adapted. Mc Clanahan et al. (2007), Warner (2003) and Clark (2000) all describe the threat as an individuals susceptibility to illness or disease. If an individual believes they are open to the illness or disease they may identify this as a danger to their health. This is only applicable if there is a significant risk factor such as smoking, diet, alcohol or drugs misuse. If an individual does not take into consideration their own vulnerability then it is unlikely that the transtheoretical model of change will be successful in predicting associated behaviour. Ogden (2004) suggests that perceived susceptibility can not be used as an effective predictor of behaviour change. Furthermore consideration must be applied to adolescents who are more likely to expose themselves to risks but be less aware of the consequences to their associated health. Naidoo and Wills (2000) suggest that health promotion can be challenging when dealing with young people in regards to risk behaviour as risk taking is essentially a part of adolescence. On the other hand it is usually accepted that if an individual perceives themselves to be vulnerable to a disease (i.e. lung disease from smoking) they will also consider the severity of that disease. (Daddario 2007, Simsekoglu and Lajunen 2007) The perception of severity or seriousness of a disease is subjective depending on the individuals understanding of the potential threat. Browes (2006) refers to the variance of perceived severity in relation to sexual health. The severity can vary from the belief that most diseases can be treated to the belief that sex can result in contracting potentially fatal diseases such as HIV. Therefore it may be necessary for the health care professional to encourage learning in relation to the severity of conditions in relation to the susceptibility. Finfgeld et al (2003) outline that to facilitate learning effectively it may be necessary for the health care professional to apply a more direct attitude which would involve the nurse addressing the increase of behaviour (susceptibility) as well as identifying potential risks (severity). However with this intervention the approach becomes nurse led as opposed to patient led which may compromise empowerment and likelihood that risk behaviour will return when the intervention is reduced. As a result the delivery of the necessary information to the patient may result in feeling of fear or guilt. Although it is suggested that fear and guilt can be effective in changing behaviours , it is criticised as it does not change behaviour long term and can contribute to feelings of denial and therefore affect the relationship between both patient and healthcare professional. (Naidoo and Wills 2000) Based on perceived susceptibility and severity the transtheoretical model of change believes that behaviour change will take place if the benefits outweigh the barriers to changing behaviours. However it is expected that potential benefits may be small compared to the barriers that prevent changes to behaviour. (Daddario 2007) Then again as previously discussed the transtheoretical model of change has had several modifications made to it in order to maximise its use within healthcare in order to apply it to other more complex health conditions. The psychologists who developed the stages of change theory in 1982 did so in order to compare smokers in therapy and self-changers along a behaviour change continuum. The idea behind this was to allow health care professionals to adapt a plan of action for each individual and as a result their therapy would be tailored to their particular needs. This process was then added to by a fifth component (preparation for action) as well as ten processes that help predict and motivate individual movement across the stages of the continuum. In addition, the stages are no longer considered to be linear; but are components of a cyclical process that varies for each individual (Diclemente and Norcross 1992). Used correctly and by incorporating the various modifications to the model, it is recognised that the transtheoretical model of change can assist health care professionals in health education. However as a psychological theory, the stages of change focuses on the individual without assessing the role those structural and environmental issues may have on an individuals ability to enact behaviour change. In addition, since the stages of change presents a descriptive rather than a causative explanation of behaviour, the relationship between stages is not always clear. Consequently each stage of change may not be appropriate for characterising every population. An example of this would be the study of sex workers in Bolivia which highlighted that very few of the participants were actually in the precontemplative, contemplative stages with regards to using condoms with their clients (Posner, 1995). However mass media campaigns can motivate individuals to change behaviours by highlighting the benefits of safer sex by the use of condoms. The use of positive messages as opposed to negative messages within mass media campaigns increases the likelihood of retaining the relevant information for longer. (Bennett and Murphy 1997) Naidoo and Wills (2000) also suggest individuals may have personal experiences of illness and disease within their family or friend network therefore this will influence how the benefits are perceived.These modifying factors will influence the likelihood of action and therefore determine if behaviour will change. As a result research conducted by Charron-Prochonwnik et al. (2001) found that changes to individual sexual behaviour correlated to the consideration of modifying factors such as social support, culture and positive attitudes resulting in safer behaviour. Additionally there are other features of the Transtheoretical Model of Change that are not easily applied to non-addiction type clinical problems. Howarth (1999) noted that the application of Transtheoretical Model of Change has promise in the field of eating behaviours but the translation is made difficult because the goal of smoking intervention is cessation whereas eating interventions is reducing intake of some foods and increasing the intake of others. Also in smoking interventions the main aim is to stop and is clearly understood by everyone. However in eating interventions the main aims are not so easily understood. Whereas in smoking research the outcome variables are reasonably simple compared to eating research where outcomes are more complex and the results variable. Ultimately smoking interventions target one behaviour whereas eating interventions focus on multiple behaviours. Furthermore there is the degree of difficulty in discontinuing smoking in the initial stages but as time progresses things get easier for the individual whereas eating more healthily can be easy at first but hard to maintain. Moreover when smoking discontinues it produces immediate physiological changes but eating interventions in the early stages only produce distant and subtle changes. As a result behaviour change will not only be on the basis of potential benefits but may also be subject to internal and external cues. As previously mentioned campaigns can promote changes to behaviour and this would be considered an external cue, the individual is motivated by the message that is projected. (Naidoo and Wills 2000) However internal cues may also influence behaviour, this may be a change in physical health or psychological wellbeing which encourages the individual to ask for help from health care professionals. Daddario (2007) suggest that internal cues are most likely to change behaviour in individuals that are over weight. Clarke et al, (2000) further suggest that with the incorporation of self-efficacy, health models can be more effective in predicting behaviours; this concept was developed by Bandura (1977) and can be described as an individuals confidence in their ability to complete a task. Finfgeld et al. (2003) also acknowledge that nurses can promote self-efficacy alongside models of health by reinforcing the importance of the contribution of individual capability in changing behaviours and can be used within educational and client centred approach to health education. In addition to self-efficacy Hughes (2004) considers the concept locus of control in order to maximise the use of various models of health. Locus of control refers to how the individual perceives control over their life and physical health. An individuals beliefs may be based on the idea that their health is subject to internal actions such as diet, lifestyle and as a result able to be changed. However in contrast others may believe that health is subject to external factors such as bad luck or fate. Just as important is the belief that religion and culture can contribute to the belief that health is predetermined and therefore cannot be influenced by behaviour changes. (Niven 1994, Naidoo and Wills 2000) Consequently Syx (2008) suggests effective questioning technique to establish where an individual places the locus of control, which should then determine how likely they are to engage in health education behaviours. In conclusion despite conflicting evidence for the transtheoretical model of change Macnee McCabe (2004) do not have conceptual concerns regarding this, but question the applicability of the model to specific populations. Sutton (2001) also suggests that there are some serious problems with the existing methods used to measure the stages of change. For example, stage criteria are not consistent across studies that use the approach. Some studies do not include questions about past attempts to change, and various time frames are used as reference points which alter distribution of people across stages (Lerner, 1990; Nigg et al., 1999; Stevens Estrada, 1996; Weinstein et al., 1998). Finally, Littell and Girvan (2002) suggest that a continuous model of readiness for change may be more integrated with related concepts from other theories. It is also documented that healthcare professionals be able to distinguish readiness for change from readiness to participate in particular treatments, and that change may come about quickly as a result of life events, or external pressures. Accordingly at this time there is an increase in the number of studies criticising the model over conceptual, methodological analytic concerns. On the other hand there is an equal amount of evidence supporting the model, verifying the constructs, and showing support for application to modifying health behaviour. Therefore the benefit of understanding this model and maximising it to its full potential can support nurses and other health care professionals to practice in accordance to guidelines set out by both clinical and academic bodies. The NMC (2008) outline the responsibilities of nursing professionals to work in a professional manner and ongoing research provides evidence in how the model can be used with modifications to suit different needs. (Roden 2004a, 2004b) REFERENCE LIST Bandura, A. (1977) Self-efficacy; toward a unifying theory of behavioural change. Psychology Review, Vol. 84, no.2, pp. 191-215 Bennett, P., Murphy, S. (1997) Psychology and health promotion, Open University Press: Buckingham. Browes, S. (2006) Health psychology and sexual health assessment. Nursing Standard, Vol. 21, no. 5, pp. 35-39 Charron-Prochownik, D., Sereika, S., M., Becker, D., Jacober, S., Mansfield, J., White, N., Hughes, S., Dean-McElhinny T., Trail, L. (2001) Reproductive health beliefs and behaviours in teens with diabetes: application of the expanded health belief model. Paediatric Diabetes, Vol. 2, no. 1, pp. 30-39 Clark, A. V., Hildegarde, L., Williams, A., Macpherson M. 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Body Image in Children and Adolescents Essay examples -- Self Esteem W

Body Image in Children and Adolescents What is body image? A two-dimensional model of body image incorporates both perceptual and emotional components. It focuses on both how we feel about the size and shape of our bodies and how accurately we perceive our body size as well. A more recent cognitive approach suggests that body image is a complex set of cognitive schema. A schema is a grouped body of knowledge. Groups of schema are readily available for important tasks such as guiding behavior, circumstantial scripts (or dialogue), and evoking the appropriate emotional, somatic, visual, and auditory responses in certain situations. The cognitive schema for body image is an organized domain of knowledge about oneself and others. Different situations evoke different schema. For example, watching a runway show or looking at a women’s magazine filled with page after page of waifs may evoke the "I’m fat" schema, while being complimented for how good your body looks in a certain dress may evoke the "I’m sexy" schema. We begin constructing schema from a young age; thus, by the time we are adults we have been through many experiences and established very elaborate schema. Such elaborate constructs are resistant to change. These schema influence our perception of the world and ourselves, our feelings, and our behaviors. Every culture around the globe stresses specific ideals for body image. In the United States and many other countries, the media plays a big role in how we view ourselves- it shows us what is "good" and what is "bad." In many ways our society infiltrates our concept of ideal body image by setting unrealistic expectations for both genders. At an early age we are instructed to pay special attention to our appearance. A... ...ertal development among male and female adolescents. Adolescence, 34(133), 69-79. Gardner, R.M., Friedman, B.N., & Jackson. (1999) Hispanic and White children’s Judgements of perceived and ideal body size in self and others. The Psychological Record, 49(4), 555-564. Wong, Y., Bennink, M.R., Wang, M., & Yamamato, S. (2000) Overconcern about thinness in 10- to 14-year old schoolgirls in Taiwan. American Dietetic Association, 100(2), 234-237. O’Dea, J. & Maloney, D. (2000) Preventing eating and body image problems in Children and adolescents using the health promoting schools framework. The Journal of School Health, 70(1), 18-21. Coller, T.G. & Neumark-Sztainer, D. (1999) Taste of food, fun, and fitness: A community-based program to teach young girls to feel better about their bodies. Journal of Nutrition and Education, 31(5), 292-293.