Monday, September 30, 2019

Care Delivery & Management Essay

The purpose of this assignment is to reflect upon my personal and professional development. It will consider the quality of the care I provided, the skills I developed in my specialist placement, plus my learning since the commencement of my nurse training. Personal learning and self-reflection will be identified. I shall be using Gibbs (1988) Reflective Cycle to consider my practice. Gibbs (1988) Reflective Cycle looks at six aspects which include the following; what happened, what were my thoughts and feelings, what was good or bad about the experience, what sense can I make out of the situation, what else could I have done and if it arose again what would I do? Findings will be supported or contrasted by relevant literature. A conclusion will be offered to evaluate findings. I shall also include an action plan, which will address future professional and personal development needs and any factors that may help or hinder this. I will also consider why I have selected these issues fo r my action plan, what my goals are and how I aim to achieve them. At the beginning of my nurse training we were asked to write on a piece of piece what our definition of nursing was. I wrote ‘It’s about being human’. At the time these words were based on my gut feeling and personal belief. Now, two and a half years later, I would write the same thing, but this time my definition would be based on the skills, knowledge and experiences I feel privileged and grateful to have had during my training and not just on gut feeling and personal belief. How does this knowledge impact on me in terms of practice? I can now put my definition of nursing into a framework and relate the theory of it to practice, for example I can identify when I am actively undertaking anxiety management with a patient. This is quite an achievement for me. What else have I learnt? I have gained knowledge of illnesses and understand how bio-psycho-social aspects of mental illness impact on the individual, their family and their life. I have also developed a good basic knowledge of practical skills such as: counselling, anxiety management, assessment, nursing and communication models, problem-solving and psychotherapy. This knowledge and development of practical skills has enabled my self confidence and self esteem to grow. What things have had the most influence on my personal and professional learning? These things are what ‘It’s about being human’ means to me as a nurse. They include a humanistic care philosophy. Evidence suggests that patients have found the humanistic care philosophy to be positive and helpful to their well-being (Beech, Norman 1995.) Humanistic care believes in; developing trust, the nurse-patient relationship, using the self as a therapeutic tool, spending time to ‘be with’ and ‘do with’ the patient (Hanson 2000,) patient empowerment, the patient as an equal partners in their care (Department Of Health 1999,) respect for the patient’s uniqueness, recognition of the patient as an expert on themselves (Nelson-Jones 1982, Playle 1995, Horsfall 1997). Equally important to me is person-centred care, Roger’s (1961) unconditional positive regard, warmth, genuineness and empathy, recognition of counter-transference, self-reflect ion and self-awareness. I was on placement with Liaison Psychiatry also known as Deliberate Self Harm. The team consisted of my mentor and myself. In this placement we would assess patients who had deliberately self harmed. Patients would be referred via A&E only. We would see patients whilst they were still in A&E or after they had been transferred to hospital wards for medical treatment for their injuries etc. We would only see patients once they were medically fit to have a psychiatric assessment. The purpose of the assessment was to find out what was happening for the individual and see if we could offer any help via mental health services to the individual, this is done via implementing ‘APIE’ the nursing process (Hargreaves 1975). The main focus was to consider what degree of risk we felt the patient was in. Therefore we needed to establish what the individuals intent was at the time of the deliberate self harm, and if suicidal, whether they still had suicidal intent after the incident. We also held a weekly counselling clinic. I considered Gibbs (1988) Reflective Cycle. How did I feel about this placement? At first I was apprehensive as to how I would feel dealing with patients who do not necessarily want to live. I belong to a profession that saves lives, so I felt an inner conflict. This is an anxiety that is recognised in most nurses (Whitworth 1984). In my first few weeks I felt distressed by the traumatic events that these patients were experiencing. I felt guilty that I have a family who love me, a fulfilling career, a lovely home and no debts, then each day I talk to people who may have no home, no money, no one to love them and no employment. It was hard for me to make sense of these things when life circumstances, such as class, status, wealth, education and employment create unfairness. I felt a desire to help try and improve the quality of these patients’ situations. Midence (1996) has identified that these feelings are a normal response when dealing with others less fortunate that oursel ves. Patients’ who attempt suicide have lost hope (Beck 1986). I felt more settled and positive once I was able to make sense of the situation (Gibbs 1988). I realised that could help by listening to these patient’s and help to restore hope, develop problem solving ideas to tackle some of their problems or referring them to gain the emotional help and support they needed from appropriate mental health services. Patients find help with problem solving extremely valuable and can help them feel able to cope (McLaughlin 1999). Generally, after most assessments, I learnt that listening, giving emotional support and problem solving helped restore enough hope in the previously suicidal patient enable them to feel safe from future self harm. In only a handful of cases did my mentor and I need to admit patients to any inpatient facility under the Mental Health Act (1983). This was because they still felt at risk of future self-harm. Through using Gibbs (1988) Reflective Cycle to consider my special placement area I feel I have been able to change my nursing practice in a positive way, initially from feeling anxious, guilty and helpless when dealing with suicidal patients to feeling useful, constructive and positive. I’ve learnt that by confronting my own feelings of guilt and discomfort I was able to help in a very positive, practical, constructive and empowering way. My mentor identified that one of my strengths is that I can generally combine common sense, logic and practicality in terms of risk assessment and problem solving and still build up a sensitive and caring, therapeutic relationship when dealing with patients whose circumstances are in crisis and complicated and they themselves are emotionally and mentally vulnerable. Nurses not only need good communication skills (Faulkner 1998) but they also need to have an environment conductive to open communication (Wilkinson 1992). Social barriers such as environment, structure or cultural aspects of healthcare can inhibit the application of communication skills (Chambers 2002) Utilising Gibbs (19988) Reflective Model, in retrospect; I feel our interview with some patients could have been done differently. On occasions when my mentor and I were in the A & E department the two rooms that we had available for our use were occasionally both in use. This meant that we would conduct our assessment interviews in the Plaster Room, if it was empty. This room was where medical patients would have plaster-casts applied. This was a very clinical room. However, due to limited room availability this was sometimes the only option we had at the time, it was not a welcoming or appropriate setting and would not have helped patients feel relaxed or valued. In reflection, I believe it was actually demeaning as we were asking patients who had attempted suicide to sit on a hard chair in a clinical workroom and share their despair with us. I am sad that this happened and I feel as though we were giving the patients the impression that a cold clinical work room is all they were worth. If this arose again (Gibbs 1988) I would suggest to my mentor that we wait for one of our allocated rooms to become available, where the rooms were relaxing, with soft armchairs and a feeling of comfort. Using Gibbs (1988) Reflective Model I shall describe a situation with a patient to highlight my learning. What happened (Gibbs 1988)? Neil had been bought to A&E by his son after he made an attempt to take his own life. His son explained that Neil’s wife had terminal cancer and had died the day before. Neil was unable to engage in conversation other that to repeat over and over again â€Å"I don’t want to live without my wife.† However the more disturbed and difficult to communicate a patient is the less interaction they receive therapeutic or otherwise from nursing staff (Cormack 1976, Poole, Sanson-Fisher, Thompson 1981, Robinson 1996a, 1996b). I found this too be true in Neil’s situation as some A & E nurses did not wish to approach him because of his disturbed state and unresponsiveness to verbal cues. What were my thoughts and feeling (Gibbs 1988)? After spending twenty minutes in the assessment interview Neil had remained unresponsive to our approaches and had remained distressed, distant and uncommunicative for the entire time. I had past experience of recent bereavement within my immediate family and I realised that counter-transference was at play and was a reason for my strong emotional reaction to Neil’s distress resulting in me having an overwhelming desire to ease his suffering. Even though another part of me understood the need for him to experience this extreme pain as a normal part of grieving. What was good or bad about the experience (Gibbs 1988)? This was not a good experience for me because as a compassionate person, I found it extremely hard to suppress my own feelings of wanting to protect him from such devastating distress, although I recognised that I was over-identifying with him due to my own grief. I considered that he might have been embarrassed by the emotional state he was in and his inability to control his grief; he could not speak, maintain eye contact or even physically stand. What sense could I make of the situation (Gibbs 1988)? We adjourned for a few minutes so that my mentor and I could assess the situation. I thought it might be appropriate to utilise Heron’s Six Category Intervention Analysis (1975) cathartic intervention as a therapeutic strategy to enable the patient to release emotional tension such as grief, anger, despair and anxiety by helping to (Chambers 1990). I hoped it would facilitate the opportunity for Neil to open up and express his full feelings in a safe and supportive environment. I initially planned to sit quietly with him and briefly put a reassuring hand on either his hand, arm or shoulder. My mentor supported this action. I was aware that I ran a risk of misinterpretation by choosing therapeutic touch. Therapeutic touch may be criticised because it is open to misinterpretation by the patient and abuse of power by staff. The patient may view holding another’s hand as a sexual advance, violation or abuse, so nurses should always consider patient consent, appropriateness, context and boundaries. Clause 2.4 of the Nursing and Midwifery Council (2002) Code Of Professional Conduct says that at all times healthcare professionals must maintain appropriate boundaries with patients and all aspects of care must be relevant to their needs. Therapeutic touch appeared acceptable given his situation and seemed appropriate to the context it would be performed in, given that my mentor would supervise me. As per Gibbs (1988) Reflective Cycle I considered what else I could have done especially if the situation arose again and mentor not been there. I would may have chosen to utilise Hanson’s (2000) approach of ‘being with’ whereby I use therapeutic use of self through the sharing of one’s own presence, and not involved any form of touch, avoiding any misinterpretation or breach of boundaries. I was anxious because I felt concerned that my nursing skills would be inadequate to address his needs due to his acutely distressed state. In reflection my mentor helped me acknowledge that this was about my own anxiety rather than being accurately reflective of my nursing ability. I approached Neil and explained that if it was acceptable with him I would like to sit quietly with him so that he was not alone in his distress. â€Å"It is likely that the nursing process is therapeutic when nurse and patient can come to know and to respect each other, as persons who are alike and yet different, as persons who share in the solution of problems† (Peplau 1988). I gently placed my hand onto his. Neil reacted by given the impression that he physically disintegrated, he become extremely distressed and crying loudly, squeezing my hand tightly. This continued for several minutes. Neil became calmer and started to talk about his situation. This was a good outcome. I was able to utilise Herons (1975) cathartic strategy with positive effect via empathising with Neil’s situation and using myself as a therapeutic tool through the use of touch, thus enabling Neil to express his emotions and activate a nurse-patient relationship. Studies have shown that nurses can express compassion and empathy through touch, using themselves as a therapeutic tool (Routasalo 1999, Scholes 1996) and this has a cathartic value, enabling the patient to express their feelings more easily (Leslie Baillie 1996). The therapeutic value of non-verbal communication and its harmfulness is overlooked (Salvage 1990). Attitudes are evident in the way we interact with others and can create atmospheres that make patient care uncomfortable (Hinchcliff, Norman, Schoeber 1998) On one occasion, one nurse privately referred to Neil as a â€Å"wimp† because he was having difficulty coping with the death of his wife. I wondered whether her body language had transmitted her bad attitude towards Neil, contributing to his distress and difficulties in communicating with staff. Again using Gibbs (1988) Reflective Cycle, I shall provide another example to highlight my learning in practice. What happened (Gibbs 1988)? Cycle On one occasion my mentor and I received a phone call from A & E asking us to review an 18-year-old girl called Emma who had taken an overdose. They said she was medically fit to be assessed. When we arrived they claimed that she was pretending to still feel unwell and described her as â€Å"milking it†. We found her to be vomiting and discovered she had been left in a bed in the corridor of A & E for 8 hours. McAllister (2001) found that patients who had self-harmed were ignored, had exceptionally long waits and suffered judgemental comments. What were my thoughts and feelings (Gibbs 1988)? I felt very angry towards A & E staff as I felt that she was being unfairly treated because she had caused harm to herself, she had been labelled as a troublemaker by staff and I do not believe she had received good quality care. Emma explained that in the last month her father had died, she had miscarried her baby, discovered that her partner was having an affair, and she had been made redundant leaving her with debts that she couldn’t pay. As I looked at her, I saw a vulnerable young woman at the end of her tether. I felt saddened and disappointed by the judgemental attitudes of the A & E staff who had not even taken the time to talk to Emma or ask her why she had taken an overdose, instead they describe her as an â€Å"immature and attention seeking kid†. As per Gibbs (1988) Reflective Cycle, I felt this was a very bad experience of poor care, bad attitudes and unacceptable moral judgement being made by A & E staff. Cohen (1996) and Nettleton (1995) identify that social status; age, gender, race and class contribute to stereotyping and judgemental attitudes. I noticed that people who self-harmed were judged differently dependent upon their age and the younger they were the worse the attitude of A and E staff. Interestingly ageism towards youth is an area that I could find no research on. I believe ageism towards younger people is overlooked and is really only identified in the elderly. During the assessment I was aware of how my physical presence can impact on the care given. However, I have learnt about the importance of considering how one can communicate to the patient via body language. By attending to patients in a non-verbal or physical way it is another method of saying, â€Å"I’m interested, I’m listening and I care.† To do this during Emma’s assessment I utilised Egan’s (1982) acronym S.O.L.A.R. This meant that I sat facing Emma Squarely, with an Open posture, Leaning towards her, whilst making Eye contact and Relaxing myself, to give her the feeling of my willingness to help. This client centred care recognises her equality in the nurse-patient relationship. What sense did I make of the situation (Gibbs 1988)? I was very unhappy about the attitude of A & E staff but recognised that they had a lack of understanding and knowledge. In one study looking at self-harm admissions it was discovered that patients who deliberately self-harm are often deemed as unpopular patients, being labelled and judged as time wasters by A & E staff. Apparently 55% of general nurses perceived these patients as attention seekers and disliked working with them, 64% found it frustrating, 20% found it depressing and almost a third found it uncomfortable (Sidley, Renton 1996). What else could I have done (Gibbs 1988) After reflecting upon the experience with my mentor, I was able to realise that part of my role is to act as a representative for mental health. If this happened again what would I do (Gibbs 1988)? If staff were to make judgemental comments again it is part of my role to educate and inform them so they can have a positive understanding of the needs of the mental health patient and learn to address any judgemental comments made. This is a view supported by Johnstone (1997), who says that if we are made aware of our actions when we are judging and labelling people it is our responsibility to correct this. Medical staff need to be aware of mental health promotion, and need further training and education in respects of helping to care for and understand of this vulnerable patient group (Hawton 2000). This is a view supported by the Department of Health (DOH 1999a) who have recommended closer liaison between mental health and A & E services in an effort to address the poor understanding and negative attitudes of A & E staff. I have also learnt that I must look at both sides of each situation and should show more understanding towards the A & E staff’s feelings, as they are often confronted with shocking and distressing acts of self infliction which can make them feel despair, helpless and unskilled to deal with these sort of patient. I believe nurses negative attitudes develop because we all intuitively apply own our values and views to everyday situations, people, experiences and interactions. It may be the staff member’s own coping mechanism to keep their distance from the patient or to label them as attention seeking in order to make sense of the situation for themselves. This is a view supported by Johnstone (1997). In reflection, following the assessment and planning of care for Emma my mentor and I reflected upon the care I provided for her. I recognised that I felt nervous because it was my first experience of conducting an assessment. Having my mentor there to observe me made me feel secure because I trusted my mentor and could rely on her expertise to ensure that I provided safe practice for Emma. However, I still felt anxious as I was faced with an unknown situation. This made me realise how difficult and intimidating the assessment process may have felt to Emma. I had the security of feeling safe in the relationship with my mentor. Emma didn’t know either of us. This highlighted the huge value of the nurse-patient relationship and how the importance of utilising Rogers (1961) theory of client-centred care involving unconditional positive regard, warmth, genuineness and empathy towards patients. My mentor said that I provided evidence based care and I appeared to have a good humanistic approach, sensitively providing client centred care. She joked that I was so keen to ‘get it right’ that I was practically sat on Emma’s knee in my efforts to non-verbally show to Emma that I was attentive and listening to her. I think that whilst this was a joke, I will endeavour to continue to be keen but will relax a bit more, hopefully as I gain more experience myself. I will also use the insight and understanding from these experiences to benefit my future practise and the care I provide for patients. Boyd & Fales (1983) suggest, â€Å"Reflective learning is the process of internally examining an issue of concern, triggered by an experience, which creates and clarifies meaning in terms of self, and which results in a changed conceptual perspective.† Self-reflection helps the practitioner find practice-based answers to problems that require more than the application of theory (Schon 1983). I have discovered this to be true, especially in mental health nursing where problem solving may be in the realm of religious, spiritual or cultural beliefs, emotional or intuitive feelings, ethics and moral ideals, which sometimes cannot be theorised. With one patient I couldn’t understand his unwillingness to engage in therapy even though he turned up for a weekly appointment. Once I reflected on this with my mentor I realised that I was not considering his strict religious and cultural background, which complicated his care. I realised that I had been completely ignorant of his needs and had in-fact lacked self-awareness otherwise I would have recognised these issues sooner. According to Kemmis (1995) a benefit of self-reflection is that it helps practitioners become ‘aware of their unawareness’. I have learnt that there are barriers to reflection. On occasions after seeing a patient my mentor may interpret events in a slightly different way to myself. Newell (1992) and Jones (1995) criticize the idea of reflection arguing that it is a flawed process due to inaccurate recall memory and hindsight bias. Another criticism of refection is that it aims to theorise actions in hindsight therefore devaluing the skill of responding intuitively to a patient (Richardson 1995). I considered that my thought to hold Neil’s hand may have been intuitive but because we must use evidence based practice and appropriate frameworks of care, I theorised my care and utilised Heron’s (1975) framework. I believe self-reflection helps me to become self-aware. Self-awareness is achieved when the student acknowledges there own personal characteristics, including values, attitudes, prejudices, beliefs, assumptions, feelings, counter-transferences, personal motives and needs, competencies, skills and limitations. When they become aware of these things and the impact they have on the therapeutic communication and relationship with the patient then they become self-aware (Cook 1999). I have learnt through these experiences that reflection can be a painful experience as I have recognised my own imperfections and bias. I have felt angry with general nursing staffs attitudes towards mental health patients and have now been able to realise that this emotion is unhelpful and instead I should be more tolerant and understanding and help them to understand the patients needs. It is also difficult especially if one is experiencing strong emotions such as anger, frustration and grief (Rich 1995). At times I have over-identified with my patients and personalised their situation to similar situations of my own. This is known as counter-transference and has blinded my ability to address their care needs. Counter-transference is the healthcare professionals emotional reaction to the patient, it is constantly present in every interaction and it strongly influences the therapeutic relationship, but is often not reflected upon (Slipp 2000). Counter-transference can be defined as negative as it can create disruptive feelings in the clinician, causing misguided values and bias (Pearson 2001). I have learnt that it is crucial for me to consider how my reactions to a patient’s problem can impact on the care I provide. Whilst I endeavour to always give 100% best and unbiased care to each patient, I have realised I respond more favourably to patients that I like or identify with. For example I was extremely compassionate and biased towards both Emma and Neil and I feel that my personal life experiences influenced me because I could really empathise with them both. However, I realised that I am only human and that as long as I recognise the impact of counter-transference then I can use it positively as my self awareness of the fact that the process is occurring will enable me to address and challenge my own thoughts, feelings and responses. To conclude, I have been able to highlight my learning over the last two and a half years, both personally and professionally. This has enabled me to look at the areas that I am good at and the areas that I can improve on. I have been able to look at the quality of the care I have given patients and considered what I have achieved, how I felt, how I could have done things better, what was successful and unsuccessful, what issues influenced me and what understanding I had of the experience. I have also been able to recognise my role as a representative for mental health nursing and how I can promote it to other healthcare professionals. I have also identified the value of the role of my mentor in helping me to develop as a nurse. I will use the insight and understanding from these experiences to benefit my future practice and the care I provide for patients. ACTION PLAN Word Count 1086 What are my goals? My mentor and I discussed the areas that I want to improve on. We identified that my stronger points are common sense, logical approach and practical ability in terms of things like risk assessing and problem solving. I am also competent in the building of a therapeutic relationship, utilising a humanistic care philosophy, person centre approach, empathy, genuineness, unconditional positive regard and honest. I also have a good knowledge in respect of mental health promotion, anxiety management, basic counselling skills, understanding of the fundamentals associated with nursing, assessment and communication models and the basic principles of psychotherapy. I feel I have come a long way in two and a half years and have accomplished a lot. However, there are areas that I recognise that I can improve on and I am happy that I can address these as I hope this will improve my learning, skills and competency as a nurse in the future, providing better patient care. The areas I need to gain more knowledge and experience of include: understanding the religious, cultural and spiritual needs of the patient and how this impacts on their care and quality of life, recognising and working with counter transference and my tendency to feel the need to over protect patients as this does not help the patient to utilise choice, be responsible for themselves or empower themselves. I want to continue developing my own self awareness through self reflection. Finally I wish to develop my academic abilities and to train further so that I have more knowledge. Why have I chosen these issues? I have chosen to improve my knowledge and understanding of patients religious, cultural and spiritual needs and how this impacts on their care and quality of life, because by doing this I hope to be able to address their needs holistically. To successfully undertake a thorough assessment the healthcare practitioner needs to identify the holistic needs of the patient, failure to do so would neglect the patients physical, psycho-social and spiritual needs (Stuart and Sundeen 1997.) At present I feel I am unable to fully comprehend or provide best care as I feel I lack the skills and knowledge to do so. I also wish to further consider the impact of counter transference and my tendency to feel the need to over protect patients. I feel that if I gain more understanding and recognition of how counter-transference can change my reaction to a patient then I will be able to address it and have more control and choice over my nursing and my responses. In practice, I have experienced strong emotional reactions to some patient’s, perhaps because I could identify with some of their issues. However, this can result in my wanting to over protect them, which may disempower them, and this is unhelpful. Different characteristic in patients can influence the emotional reaction of the nurse (Holmquist 1998). I need to be able to recognise these characteristics in the patient and be self aware of the way I am responding. I want to continue developing my own self-awareness through self-reflection, as I will need to be able to exercise autonomous and expert judgement as a qualified nurse. The ability to use self-reflection as a learning tool to becoming self-aware will help me achieve this. This is a view supported by (Wong 1995). Boud, Keogh & Walker (1995) believe self reflection is an important human activity, essential for personal development as well as for the professional development of the nurse. By being able to mull over my experiences will help me challenge my beliefs and behaviour as an individual and a nurse. Finally I wish to develop my academic abilities and to train further so that I have more nursing knowledge. Experience alone is not the key to learning (Boud et al 1985). I wish to gain further qualifications so that I may further my career and knowledge, as this will provide a sense of achievement and fulfilment for me. How am I going to achieve my goals? I intend to develop my portfolio and keep an open reflective diary (Richardson 1995) to show evidence of my learning and prepare for my PREPP. Portfolios are seen as a collection of information and evidence used to summarize what has been learnt from prior experience and opportunities (Knapp 1975), and acknowledges professional and personal development, knowledge and competence, providing nurses with evidence of their eligibility for re-registration every three years (NMC 2002). I believe maintaining my portfolio helps with one’s self-assessment and will help me to develop my strengths, plus identify and critically evaluate my weaker areas, this is a view supported by Garside (1990). However in contrast Miller & Daloz (1989) suggest there is no evidence to suggest that self assessment contributes to enhance self awareness. A barrier to one’s ability to self-reflect may be time constraints and socio-economic factors such as high staff and management turnover, low staff morale and staff illness (Bailey 1995) I hope to overcome this by being a supportive team member to my colleagues and maintaining a positive mental attitude. I am happy to work on my portfolio and diary in my own time as I think it is a valuable learning tool. I will use my preceptorship, learning in practice, observation in practice and clinical supervision to help achieve my goals. Reflection on action is considered to be an essential part of clinical supervision (Scanlon & Weir 1997). I will continue to use Gibbs (1988) Reflective Model to help me develop my learning through reflection. I will need to feel confident that by sharing my portfolio, diary, reflection or seeking advice via preceptorship and supervision that this will not reflect negatively on me and effect my ability to feel able to trust my mentor. Students and staff sometimes feel unable to fully express themselves or belittled by the power relationship if supervision is not in a trusting relationship feeling it could be open to bias, personality clashes, counter-transference or could disadvantage them in terms of career development (Richardson 1995 Jones 2001). However, good clinical supervision enables nurses to feel better supported, contributing to safer and more effective nursing (Teasdale 2001, Jones A 2001). I hope to continue with life long learning and would like to be able to study for a degree in nursing. I shall do this by apply for funding once I am employed and hope that whoever my employers are they will support me in my goal to become better qualified. 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Newell R (1992) Anxiety, Accuracy And Reflection; The Limits Of Professional Development, Journal Of Advanced Nursing, Vol 17, 1326-1333 Nursing and Midwifery Council (2002) Code Of Professional Conduct, London, NMC Pearson L (2001) The Clinician-Patient Experience: Understanding Transference And Counter-transference, The Nurse Practitioner, The American Journal Of Primary Health Care, Vol 26 (6) 2001 Peplau H (1988) Interpersonal Relations In Nursing, London, MacMillan Press Poole AD, Sanson-Fisher RW, Thompson V (1981) Observations On The Behaviour Of Patients In A State Mental Hospital And A General Hospital Psychiatric Unit: A Comparative Study, Behaviour Research And Therapy, 19, 125-134 Playle J (1995) Humanism And Positivism In Nursing; Contradictions And Conflicts, Journal Of Advance Nursing, 22, 979-984 Rich A (1995) Reflection And Critical Incident Analysis, Journal Of Advanced Nursing, Vol 22 (6) 1050-1057 Richardson R (1995) Humpty Dumpty- Reflection And Reflective Nursing Practice, Journal Of Advanced Nursing, Vol 21, 1044-1050 Robinson D (1996a) Measuring Psychiatric Nursing Interventions: How Much Care Is Individualised, Nursing Times Research, 1, 1, 13-21 Robinson D (1996b) Observing And Describing Nursing Interactions, Nursing Standard, 13, 8, 34-38 Rogers C (1961) On Becoming A Person, London, Constable Routasalo P (1999) Physical Touch In Nursing Studies: A Literature Review, Journal Of Advanced Nursing, 30, 4, 843-850 Savage J (1990) The Theory And Practice Of The New Nursing, Nursing Times Occasional Paper, 86, (4) 42-45 Scholes J (1996) Therapeutic Use Of Self: How The Critical care Nurse Uses Self To The Patients Therapeutic Benefit, Nursing In Critical Care, 1, 60-66 Schon D (1983) The Reflective Practitioner, London, Temple-Smith Scanlon C & Weir W S (1997) Learning From Practice? 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Sunday, September 29, 2019

Civil War Weapons

Lori Robinson HIS 226-IN1 Module 4 Weapons of the Civil War I have to load a weapon? Oh no! Let’s see, first I have to get my cartridge out of the box. I really hate the taste of gunpowder in my mouth when I rip open the cartridge with my teeth. Then I have to pour that powder into the barrel of the gun. What next? Remove the rammer, ram the barrel to set the ammo, and then return the rammer. Then to prime the gun, I have to set my cap, and now I can finally fire a single shot. Am I really expected to remember to do all these steps, for every shot, while at the same time people are shooting at me?What about all the smoke and noise? The noise of the guns and people next to me screaming in pain, or breathing their last breath. It is all so confusing. Is there not any other weapon in can use? The musket I am using now is most likely the Enfield rifle. It is what is called a cap lock rifle. It’s probably the most popular shoulder arm of both armies. The South did have more in the beginning of the war, as they put in a large order from England, and it took a lot of time to produce the second order for the North. There are two types of muskets used during this war.The smoothbore, which is not very accurate, nor does it have a very long range. The rifled-musket is not only more accurate, but because of the rifling, or grooves in the barrel, that cause the ball to spiral, it has a much longer range. Another category of shoulder arms is the carbine. The carbine, used most often by the cavalry, was shorter and lighter in weight than a musket. Carbines are breech-loaded, which means it is loaded between the barrel and the stock. This makes it easier to reload while still on horseback. There are about twenty different types of carbines, and mostly used by Northern troops.Many were actually produced in the North. One exception to this is the Maynard carbine. It is one of the favorites of the Confederate cavalry. Even though it is manufactured in Massachusetts, it continued to be shipped to Confederate States for several months after the war began. People claimed they were using the guns as Southern sportsmen. What if I want a sidearm? (Otherwise known as a pistol. ) There are hundreds of manufacturers and model being used, but there are about 5 or 6 favorites, including the Remington, the Keer, and the Derringer.The Colt was the most commonly used, but the LeMat is one of the most powerful killing models. It is the one carried by Generals J. E. B Stuart and P. T. G. Beauregard. This revolver holds nine rounds plus the capacity of also holding a load of buckshot in a lower barrel. One problem with the LeMat, though is that it doses not hole standard ammunition. Most weapons use either . 44 or . 36 caliber projectiles, while the LeMat fires . 35, . 40, or . 42 caliber ammunition. I wonder what it would be like to be part of an artillery gun crew. It takes five men to load a cannon.Let’s see if I can get all the procedures right. I h ave not gotten to do this yet, but have watched some of my buddies during drills. The first thing they do is to cover the vent hole. Then another man will ream his â€Å"worm† down the barrel to remove anything left for the last shot. Then a third man rams a sponge down the barrel to put out any hot embers. Good thing they do this, as I would not want any of my friends to reload power on top of a fire already in the barrel. Next the powder monkey comes to present the rounds to the loader, who then puts it in the barrel and it is rammed down the barrel again.Now another man sets the primer cord, and after everyone is cleared of the cannon, it is fired. There are two types of artillery cannons being used in this war — field guns and howitzers. The both use anywhere from six to thirty-two pound projectiles for ammunition. Just as with muskets there are smoothbores, rifled barrels and breech-loaded cannons. The rifled barrel cannons were used less often because as the barr els were made of bronze, a softer metal than the iron of the musket, the rifling was often worn smooth with continuous use.The field gun has a longer barrel and is usually fired straight ahead, or maybe a slight 5 degree upward angle. The howitzer has a shorter barrel, used larger ordnance but a small charge. By the way, ordnance is just a military term for cannonball. The field gun had a longer range, but the howitzer was more accurate, with a higher arc. The longer range of the field gun is not even fully used most of the time, as the gunner must be able to see his target in order to adjust his shots. Are these all the weapons used in this war?Or course not! There are the â€Å"edged† weapons. In most cases all edged weapons, are nearly negligible in as far as how many causalities these weapons accounted for. These include sabers, swords, bayonets and military cutlery. Military cutlery is just another fancy term for hand-to-hand weapons, such as the Bowie knife. I heard a f unny story that was passed down from a Georgia boy about another type of edged weapon, the pike. It seems the Georgia governor, Joe Brown, at a time when there was a shortage of firearms, ordered 10,000 pikes.He imagined that he could create effective soldiers to defend themselves on a battlefield with this mid-evil type of weapon that was actually nothing more than a two-foot knife attached to a six-foot pole. The soldiers were trained using these weapons, but I wouldn’t want to go to a gunfight with nothing more than a knife, no matter how long the knife was. In fact, the 34th Georgia regiment was close to mutiny at the thought of going into battle armed with only the pike. Governor Brown wants his men to charge the enemy with â€Å"terrible impetuosity†.He told him men; about the pike â€Å"at least it will never misfire or waste a single charge of powder. † The pikes were only meant as a last-ditch effort to arm the men with whatever could be found until mor e firearms could be furnished. Other weapons like gunships and submarines are being used in the war, but I will save those stories for later. I need to finish this story now so I can get some rest and prepare for battle in the morning. www. civilwarweapons. net

Friday, September 27, 2019

RED BULL Assignment Example | Topics and Well Written Essays - 1250 words

RED BULL - Assignment Example Red Bull is the first of its kind in the global market, and carved out for itself a new category that did not exist before. This distinction and the elements that built it are the sources of brand equity. Brand equity is defined as the added value that is endowed on economic goods as a result of branding (Bick, 2009; Farhana, 2012; M’zungu, et al., 2010; Znaidi & Fidha, 2012). it is – â€Å"[The] differentiation effect of brand knowledge on customer response leading to long-term outlook, customer knowledge, brand name, brand power, product innovation, brand quality, brand extensions, brand credentials, brand advertising, brand publicity and above all, effective brand management.† (Arora, et al., 2009, p. 75) 2. Case issues 2.1. Identification of Red Bull’s sources of brand equity The most important issue is the identification of Red Bull’s sources of brand equity, because they drive the product’s value creation. If the firm is to move product ion forward into the next higher level and avoid obsolescence, it must innovate along the line of its brand equity to ensure that what has been achieved has not been diminished. 2.2. Determination of new products under the Red Bull brand The innovation necessary to preserve brand equity and create value must emanate from the source of brand equity; having identified this in the first issue, the secondary issue is to put this knowledge into practice by choosing among alternative products that add further value. 3. Analysis of the Case The case treats on the entry of the Red Bull brand into new product categories, and the impact of this move on brand equity. These aspects are the gist of the three questions the answers to which follow: 3.1 Description of Red Bull’s sources of brand equity – Aaker’s sources of brand equity consist of 10 items spread over five dimensions, namely brand loyalty, perceived quality/leadership, associations/differentiations, awareness, a nd market behaviour (Gill & Dawra, 2010). These are all present in Red Bull. One element of brand loyalty is premium pricing; Red Bull is well received because its high price was seen to be justified by its added benefits above other drinks. Perceived quality and leadership are partnered with differentiation; Red Bull was marketed as the first energy drink, and thereafter leader of its class. The fourth dimension, brand awareness, was evident in German and Hungarian markets where, solely through word of mouth, mystique about the brand spread (including reference to â€Å"bulls’ testicles† as ingredient) such that the product was well anticipated and demand created long before its introduction. The fifth dimension, market behaviour, was positive in countries such as Austria where the product was first introduced, and the positive response worked to create brand equity in new markets Red Bull subsequently entered. 3.2 How Red Bull’s marketing program contributes t o brand equity The elements of the marketing mix employed by Red Bull all contributed to a different experience in the mind of the consumer, which was important in creating product recall and influencing future choice (Korkofingas & Ang, 2011). The marketing mix includes the 4 P’s, namely product, pricing, placement, and positioning. 3.2.1 Product – The first of a new class of beverage, the energy drink, which competitors first dismissed as a fad and then later on imitated. In Austria, the company needed to lobby for the creation of a new category, â€Å"functional food,† because the product did not fit into any of the established categories. The taste, which was adjusted to approximate the traditional cola, nevertheless retained a hint of â€Å"medicinal† flavour that still distinguished it as a functional beverage. 3.2.2 Packaging –

Criminal Justice Essay Example | Topics and Well Written Essays - 750 words - 2

Criminal Justice - Essay Example (Bassiouni 34) It is not possible for a justice system to have all people accused of committing a crime get a free trial or vice versa. It is not easy to have absolute justice or free trial and getting the opposite maybe a little easier. But we can use the parameter of the percentage of free trials conducted against the unfair trials to determine if it is possible for a crime suspect to get a fair hearing. In my opinion, it is possible for a person accused of crime to get a free trial in the United States and I think a majority actually do. Whether a crime suspect gets a free trial depends on the following requirements. A free trial requires: All parties involved in a criminal trial have the right to examine all the witnesses. Everyone is entitled to examine or have examined the witnesses under the same conditions. The crime suspect should have unlimited right to obtain the compulsory attendance of witnesses and under similar conditions of the prosecution side. In free trial the most examined specific guarantee is the right of the criminal to be provided with legal counsel. (Planck 3)The person accused of crime should also be able to communicate with his or her legal counsel. It is also important that a fair balance is struck between the amount and availability of legal counsel to parties to the case. The suspect should get the same amount of legal counsel as the prosecution side. In the American justice system, if a suspect cannot afford an attorney, one is provided for by the state. So as to avoid arbitrariness and bias that can potentially arise from a criminal trial, the proceedings should be conducted by a competent and neutral judge. The institutions in charge of the proceedings should also have the same principles and characteristics. (Bassiouni 34) In my opinion the American justice system fulfils the above requirements needed for a fair trial to a person suspected of a crime. This position is however not absolute since

Thursday, September 26, 2019

Comparing Short Stories Essay Example | Topics and Well Written Essays - 500 words

Comparing Short Stories - Essay Example Through the use of plot, tone, and irony, the authors were able to convey that during the realism era of France people were separated by the concepts of wealth and destitution, eventually succumbing to the fact that money never equated to happiness. Though the plots of both stories do differ from each other in the events that lead to their conclusions, they still share the same general idea: each male protagonist starts off with a comfortable life, perhaps not entirely rich, but with money enough to make them pleased with their lives. Due to circumstances, they each find themselves in a position that compromises this wealth and comfort. This is where the similarity ends. Monsieur Lantin sells off his late wife’s jewelry, making him incredibly rich. He dwells in this feeling, though eventually marries another woman who is angry and appalling. Rich he may be, but Lantin had lost his comfort of life. The banker, convinced that the young man would not see out his part of the bet, lives happily, spending money and losing it frivolously. When it becomes apparent that the banker will have to pay the young man, he realizes that he no longer has the money, and the only solution he can come upon is to kill the young man before the time is up. When he goes to perform this horrific deed, he comes upon a note from the young man stating that he despises what money does to people and says that he will not follow though with his part of the debt. The banker is relieved, though upset that he would even consider committing such a crime for money. These plot ideas show that, despite what these men were able to do with their money, they still ended up being morose. The tone of â€Å"The Jewels of M. Lantin†, at the beginning of the story, was cheerful and exuberant, as Monsieur Lantin proposed and lived happily married to one of the prettier girls of the the town. As the story went on, the tone changed to exasperation, then despair as his wife

Wednesday, September 25, 2019

Disaster, Climate, Development Assignment Example | Topics and Well Written Essays - 250 words

Disaster, Climate, Development - Assignment Example Climate change’s effects will continue to be felt despite the prohibition of all greenhouse emissions related to human activity. Development policies should be put in place, to stop activities that cause harm to the environment. Numerous social pressures cause climate disasters such as drought and floods. Poor governance, manipulation of resources and corruption are all drivers. Small Island developing states are at higher risk of climate related disasters. To achieve sustainable Development, activities that result to natural disasters must be stopped. The risk of natural hazards must be put into account in order to achieve sustainable development. Natural disasters result from climate change whose effects are long-term. As a result, infectious diseases emerge and their transmission is rapid due to the many displaced people after the occurrence of natural disasters. In conclusion, trends and events that lead to environmental risks should be stooped. Conservation measures should be incorporated to avoid further destruction of the

Tuesday, September 24, 2019

Critical Thinking about the Viet Nam Conflict Research Paper - 2

Critical Thinking about the Viet Nam Conflict - Research Paper Example The media was allowed more unfiltered access to this war than any previous and was extremely instrumental in shaping opinion back home. The reporting during the first part of the conflict essentially mimicked the government’s â€Å"domino theory† justification, that the U.S. was preventing the spread of communism. However, events during the later part of the war such as My Lai and the Tet Offensive turned the media and therefore public opinion against American involvement. The close-knit relationship between the media and military turned adversarial which affected public opinion and ultimately brought an end to the war. The debate continues whether or not the reporting was unbiased and accurate, if the folks back home knew the real story and if history has recorded the war according to fact or an agenda driven fiction. Media accounts of war consisted mainly of photographs during the First World War. The public saw only what passed the Press Bureau’s censorship guidelines however, a move to ensure public opinion stayed positive. Moving pictures in the form of newsreels shown prior to movies depicted America’s involvement in the best possible light. The people back home saw their soldiers bravely gaining ground against the fascist and Japanese menaces that threatened to take over the world and end the American way of life. In these days before television, these accounts helped theater goers to feel a sense of pride and security. Support for the war was practically unanimous. Everyone wanted to pitch-in for the war effort. The stories coming out of Vietnam were similar at least at first. The general public bought into the idea of America’s fighting men fighting and dying to preserve freedom and democracy in another foreign land. â€Å"This attitude stemmed from the journalistic style that had been used in the preceding American wars of the twentieth century and also from sheer patriotic support for the United States†

Monday, September 23, 2019

Journalism should not be just a trade , it should be a crusade Essay

Journalism should not be just a trade , it should be a crusade . should journalists have a moral responsibility to stand up fo - Essay Example As we all know,  information is power, and if this power is concentrated into the hands of only a few, may lead to inappropriate handling or abuse of the power. It is for this reason, shared power is a safer option for the benefit of the entire society, and it is here that the journalists play the important role of redistributing this power of information. Since journalists have the task of redistributing information, in the process, they may partake in some of the power which is associated with information, and it is here that the role of ethics and responsibilities comes into play. Ethics is a form of commitment where one pledges not to abuse power, and to use the accorded freedom with responsibility, which is never an easy task. There is always an underlying tension between the ethics of freedom and responsibility. Here the dynamics between these two contending ethical factors in respect to an individual or a society can be divided into two main perspectives. The libertarian per spective (of the Enlightenment era), gives more emphasis on the freedom of an individual or the rational being. This perspective has been always prevalent in the US form of journalism, where the press has been accorded complete freedom, at least theoretically. The other view is the communitarian perspective, which emphasises on establishing social or  community connections, with certain responsibilities on both sides, which was clearly outlined in the Hutchins Commission on Freedom of the Press  published in 1947. The report brought in the theory of ‘social responsibility,’ where the press was said to be under moral obligations to work for the general well being of the society; and the modern concept of ‘civic journalism movement’ was formed, based on these guidelines as given in the Commission (Nerone, 1995, 77-100). In this article, I will examine the various theories of journalism, and will analyse, to come to a conclusion as to whether the journalis ts should have a moral responsibility to stand up for the weak against the powerful within a society? Discussion Ethics and journalism: Ethics is the process of analysing and evaluating certain facts and situations, and identifying the correct conduct in the light of the various principles and the prevalent social and religious norms of a particular time. Here the basic question does not simply end at asking as to how one can live well, but also puts in the question as to how one should live by the rules of one’s ethics, while foregoing some of the personal advantages, and even face persecution, as he carries on with his ethical duties. Ethical reasoning is often based on personal interpretations, as one examines and changes his principles, in view of the available new types of information and technology, and new social conditions (Ward, 2007). Ethics thus encompasses both the aspects of theoretical and one’s personal practical reasoning. As regards theoretical reasoni ng, ethics is the study of the various existing forms of ethics, and the types of prevalent ethical reasoning, and of the neutrality of the moral/ ethical principles. In case of practical reasoning, ethics is â€Å"applied ethics,† or the application of the ethical principles to check their suitability in the various dimensions of life domains like while dealing with scientific research, professional work, and also in corporate governance (Dimock & Tucker, 2004). Journalism is a type of ‘applied ethics,’ which involves the analysis and the application of

Sunday, September 22, 2019

Meaning of life Essay Example for Free

Meaning of life Essay Aristotle’s account of motion can be found in the Physics. By motion, Aristotle (384-322 BCE) understands any kind of change. He defines motion as the actuality of a potentiality. Initially, Aristotle’s definition seems to involve a contradiction. However, commentators on the works of Aristotle, such as St. Thomas Aquinas, maintain that this is the only way to define motion. In order to adequately understand Aristotle’s definition of motion it is necessary to understand what he means by actuality and potentiality. Aristotle uses the words energeia and entelechiainterchangeably to describe a kind of action. A linguistic analysis shows that, by actuality, Aristotle means both energeia, which means being-at-work, and entelechia, which means being-at-an-end. These two words, although they have different meanings, function as synonyms in Aristotle’s scheme. For Aristotle, to be a thing in the world is to be at work, to belong to a particular species, to act for an end and to form material into enduring organized wholes. Actuality, for Aristotle, is therefore close in meaning to what it is to be alive, except it does not carry the implication of mortality. From the Middle Ages to modern times, commentators disagreed on the interpretation of Aristotle’s account of motion. An accurate rendering of Aristotle’s definition must include apparently inconsistent propositions: (a) that motion is rest, and (b) that a potentiality, which must be, if anything, a privation of actuality, is at the same time that actuality of which it is the lack. St. Thomas Aquinas was prepared to take these propositions seriously. St. Thomas observes that to say that something is in motion is just to say that it is both what it is already and something else that it is not yet. Accordingly, motion is the mode in which the future belongs to the present, it is the present absence of just those particular absent things which are about to be. St. Thomas thus resolves the apparent contradiction between potentiality and actuality in Aristotle’s definition of motion by arguing that in every motion actuality and potentiality are mixed or blended. St.Thomas’ interpretation of Aristotle’s definition of motion, however, is not free of difficulties. His interpretation seems to trivialize the meaning of entelechia. One implication of this interpretation is that whatever happens to be the case right now is an entelechia, as though something which is intrinsically unstable as the instantaneous position of an arrow in flight deserved to be described by the word which Aristotle everywhere else reserves for complex organized states which persist, which hold out in being against internal and external causes tending to destroy them. In the Metaphysics, however, Aristotle draws a distinction between two kinds of potentiality. On the one hand, there are latent or inactive potentialities. On the other hand, there are active or at-work potentialities. Accordingly, every motion is a complex whole, an enduring unity which organizes distinct parts. Things have being to the extent that they are or are part of determinate wholes, so that to be means to be something, and change has being because it always is or is part of some determinate potentiality, at work and manifest in the world as change.

Saturday, September 21, 2019

Cherish the Childrens Thinking Essay Example for Free

Cherish the Childrens Thinking Essay Do you think teachers should cherish the children’ s thinking? Most people think the teachers should treasure the children’s thinking and give the children a space to think freely. It is important for children to cherish their chance to think freely, because they may lose the imagination when they grow up. If all people in the world do not have imagination, this world would not have some new technology products and this society won’t progress. This world needs to keep the pace of progress because no progress is backwards, for example the gasoline is less and less in the world, if scientists can’t create a new energy, then gasoline will disappear. So, this world need to progress by imagination and creativity. The teachers should train and treasure the children’s imagination in order to develop this world and keep progressing. Nowadays, most people have lost the ability of imagining because they had seen too many real things, for example they can’t believe there are some aliens in this world. However, the children believe that the aliens are real in the world because the children are naà ¯ve and willing to trust anything. Thus, teachers should cherish the children’s freedom to think and make their thinking positive in order to develop their own better, earn more academic knowledge and change their lives in the future. Firstly, in order to get a better development of children, the teacher should make children’s thinking more positive. Ho (2007) argues that the American education is not advanced, but it is better in other ways than other countries from the article called â€Å"We Should Cherish Our Children’s Freedom to Think†. (page112) He compares the education of him and his son and discovers they are very different. He had to memorize something about academic knowledge, for example the main cities in the world, lines for Hamlet and a number of math formulas. In contrast, his son studied everything by some experiences, for example he drew a map from his home to school and label every street and building he passed when he was six years old. (Ho, 2007, page112) He agrees this learning method because this kind of education can help the children develop their ideas and creativity. The children are the hope of world, so the teacher must use current and suitable methods to educate the children in order that children develop better. Secondly, if the teachers make students study in the process of playing games and answer the questions actively, the children will earn more academic knowledge. If the children’s ideas are accepted by their teachers and their teacher praise them, the children will keep their thinking and want to get more praise. In this case, the teachers should praise the positive ideas of the children and veto the negative thinking. Ho’s teachers answered the question and gave them a correct answer only when they asked, and he didn’t have a chance to make a decision in many cases. However, his son got a good laugh and an A grade from his teacher when he asked his teacher question and told his teacher his ideas. (Ho) And Ho’s son learned the knowledge of history through play the role. (Ho) Those are good ways to educate, b ecause this way can make the student more confidence, more interested in study and study more industriously. Thus, they will get more academic knowledge. Finally, the people will be able to change their life through some original ideas if they keep their imagination and creativity. Nowadays, this world needs more new products that can attract your eyeballs. If you have the abilities of imagination and creativity, you can change the world. For example Steve Jobs, who is a legend in the world, changed the whole world. Because of his ideas, he created many technology products called iPhone, iPod, iMac and so on. Those products all changed the habits of people, for example many people always put the iPhone in the hand and watch it. Thereforeï ¼Å'the people of the whole world are fond of his product designed by him. Then he had become a rich and excellent man. Thus, we should treasure the thinking of childrenï ¼Å'either kill the imagination in order that they can get a better life in t he future and change this world. In conclusion, American education can make children think freely. For example Ho’s son drew a map when he was six years ago. Special method that is to praise children and play the role can make children earn more knowledge. Keeping the children’s thinking may make them get better life and become a person who can change the world such as Jobs. I think most countries can change their system of education and the teacher should use other ways to educate children. They should respect the children’s ideas and do not kill their imagination and creativity in order that children develop better, earn more knowledge and change their lives and world.

Friday, September 20, 2019

Biological Basis of Learning, Memory and Motivation

Biological Basis of Learning, Memory and Motivation Human beings are animal. In this world there are lots of animals but human have some special qualities that are why we are the most complex social structure on earth. We live in society there are included family, tribes, clans, nations. We have an incredibly sophisticated method of interacting speech. We can communicate over time and distance through printing and broadcasting. We have longest memories. We have an interaction which is most intricate; we have perception which is show the world simultaneously the broadest and most detailed. The combination of our biology and society is making as what we are and what we do. Any kind of responses are stimuli by our biology guides, which is based on thousands of generations of ancestors surviving because of their responses. On the other hand, our social structures dictate restriction on and alterations in how we carry out our biological responses. As a human being not only I and also all of us have some basic biological work done such as- learning, memory, motivation, emotion, perception, etc. Those biological works helps us to live perfectly in our society. That’s why it’s very much important to know how biological organs are control our major skills, movement and behavior. In this assignment I discuss the major parts of biological basis of our learning, memory and motivation which is contributes our behaviors. Biological Basis of Learning:- We know that learning is a process of relatively permanent changes in behavior brought about by experience. Its means that any type of behavior can changes by using learning. Learning is a long term process. All learning process are not show instantly, sometimes it shows long time later. But learning process can run from birth to death. All biological activities are run by the command of brain which is the basic part of our body. In the brain there are some specific parts of specific organs those are drive our basis activities. Learning process is the same activate which is control by brain. Brain has three major organization those are – fore brain, mid brain, hind brain. In fore brain there is an important part is cerebrum which is valuable organ in our body. Cerebrum has some fixed function such as:- Sensory area: it’s control somato sensory area, visual area, auditory area those are very important for learning process. Because learning are related this three parts. If one part are not support properly then learning process are back. Visual area is located back side of this area. Auditory area is located lower side of cerebrum. Most valuable part of this area is visual and auditory because learning is more depend these two parts. Association area: association is a very important works for cerebrum that is association other complex work. This area are control our learning, thoughts, memory, etc. Learning related area: this area contact the stimulus-stimulus association and stimulus-reactions associations for the brain cover. Others creative work has done this area such as inventive learning, thoughts, work, abstract imagine etc have done this part. Thalamus: the part of the brain located in the middle of the central core that acts primarily to relay information about the senses. Especially the eye, ear and skin collected information and carry to brain who distribute those different parts of the body. That’s why learning process are damage if thalamus has damages. Mid Brain: it has tactum who involved our auditory and sensory process. In those processes are important for our learning system. Cerebellum: it is found just above the medulla and behind the Pons. It is control our bodily balances. So that if this system are flailed then our speech, writing process are hampered. All thought our learning process are also hampered. Limbic system: This system is also included our learning. Neurotransmitters: this is most important part of learning because it conveys messages across the synapse to the dendrite (sometimes the cell body) of a receiver neuron. So that if it works will fail then the process of learning will also fail. Biological Basis of Memory:- We know that memory is the process by which we encode, store and retrieve information. This process can explain imagine the keyboard of a computer is a encoding (initial recording of information), then the cpu of computer is a storage (information saved for future use) and the monitor of computer is the retrieval (recovery of stored information). Usually memory can explain this short way memory = learning – forgetting. So we say that memory is also run by our biological basis help. Brain is the main tool which provides information. In brain there is a fixed part of memory. Now I describe those:- Hippocampus: This part helps to storage any information in brain. That’s why it is closely involved to memory. If this part may be destroy then the memory is also destroy. Amygdale: It’s a part of limbic system, also plays a role in memory. The amygdale especially involved with memories involving emotion. Frontal lobe: This area is included motor area and Boca’s area which is involved to storage memory. Temporal lobe: This area is involved primary auditory area, wernicke’s area, auditory association area which is strongly related to memory. Occipital lobe: This area is involved are visual area and visual association area. We know that anything cans easily memories when we see it. So this part is an important to memory. Sensory area: This area is overall related the memory process. Association area: One of the major regions of the cerebral cortex. This side is produce higher mental process such as thought, language, memory and speech. Biological Basis of Motivation:- Motivation the factors that and energize the behavior of humans and other organizations. Motivation is also internal state or condition to our thoughts, feelings and actions. Basically motivation can crate many regions such as food, money, living good, social standers and etc. But when a human suffer a motive that time his/her body create some biological activities that’s why they needs motivation. So the reasons for biological basis of motivation are- Hypothalamus: This is a small part of brain which is strongly involved to motivation. Amygdale: This is also change the level of motivation. If it can be surgery then the behavior can changes. Frontal lobe: This is also involved motivation of human behavior. Limbic system: Memory is also control by limbic system. It is situated under the cerebral cortex . Temporal lobe: Temporal lobe is also involved to control motivation. All the dictation of those three basic part of human behavior on the basis of biologically it clearly come that any kind of behaviors are fully depends of our internal process which is called biological process. So it is very important to know the main function of our biological organs. The learning, motivation and memory are our basic demand so it is necessary to know which organs is participation on those processes. If we have a rich knowledge about those processes then we can develop our self. References: Feldman Understanding Psychology 8th edition; McGraw-Hill. Psychology – Abu Bokar Siddeky 9th edition; Sahitokos, Dhaka. Psychology An Introduction – Lahey 9th edition Submitted by: Mir Sara Mehzabeen Ahmed; SL- 16; DECP-4 . Biological Basis of Learning, Memory and Motivation Biological Basis of Learning, Memory and Motivation Azharul Islam Introduction Psychologists have to gather specialized knowledge in considering the ways in which the biological structure and functions of the body affect behaviour. The biological processes are the essential part of human psychology. Our understanding of human behaviour cannot be complete without knowledge of the brain and others part of the nervous system. Biological factors are centrals to every sensory experience, states of consciousness, motivation and emotion, development through out the life span and physical and psychological health and wellbeing. Executive summary Biological bases influence the learning, memory, and motivation. The biological factors is very important because it is controlling our behaviour .We might not be able to understand behaviour without an understanding of our biological makeup. Objectives of the study: Basically this study aims to 1. Collect information on the situation of biological factors of our behaviour. 2. Explore ways how to improve the behavior. 3. The function of the neuron is fundamental biological aspects of the body. Findings Biological basis of learning Learning can be defined as a relatively permanent change in behaviour based on experience. Learning is the aspect of new things by using past experience. Many psychologists believe learning is based on the strengthening of the neural connections between stimuli and specific patterns of muscle movements, while others said that learning involvoves changes in cognition. The existence of biological constraints is consistent with assess mental discussion of behavior. Freshly there are making suitable by alternative benefits that promote survival for organism that rapidly learn or neglecte that certain behaviors. Such as, our ability to learning avoid touching hot surfaces increase our change in survival (barkow, and tooby 1992; terry, 2003). Neuclei areas are group of neurons forming structures with specific function. For example each of the different colour on our brain model represent and individual areas each with it own internal structure and function (Jeanette, J Norden Venderbilt university school and medicine). Telencephalon; consists of two cerebral hemispheres the outer covering of the hemespheres is called the cortex. The cortex is responsible for voluntary action or thought and for subjective experience. Mesencephalon; contain many small nuclei that are important to relexs, such as reflexs turning of the eyes toward the source of an objects or sound. Metencephalon: A structure that connect the cerebellum with the rest of the body and cerebellum that involved in learned skilled motor movement. The role of biological factors of learning has an example that discussed john and his associates. On one fateful evening, they ate eight hot dog. Two hour leter, they become more than just a little nauseated. As a result, it was many year until they ate another hot dog. This experience of learning to dislike hot dogs is an example of a learned taste aversion. (Garcia, Hankins and Rusiniak, 1974) Biological basis of memory Memory consists in remembering what has previously been learned .It would be better, however, to say that memory consists in learning, retaining and remembering what has previously been learned (psychology; Methuen and co. Ltd; London; 1964. Memory processes are distributed across the brain, relating to different information processing systems involve during the intitle exprosure to a stimulus. (Friedman and Donoghue 2000). A theory stated by Canadian researchar Donald Hebb (1949) is still considerd to provide a general model of the biological process responsible for memory (Jeffrey and Reid, 1997; Tsien, 2007). According to Hebb, each experience activates a unique pattern of neurons in the brain. This activities cause structural changes to occur in those neurons near the synaptic gaps that link them. To Hebb, these changes in the functioning of synapses in the brain, which he termed †synaptic facilition†, is the biological basis of memory. Many different brain areas play a role in memory. The cerebellum plays critical role in the timing execution of learned, skilled motor movement. Nuclei deep in the hemisphere called the basal ganglia are involves in motor programs. Many different areas of the brain contributes to attention, these include cortical areas of the reticular formation, all areas which contributes to alertness attention awareness. The hippocampus is a part of the brain limbic systems that plays a centrals role in the consolidation of memories.The hippocampus is an older cortical areas involve in multiple aspects of memory. The left hippocampus is more involve in the memory facts, epesodes and words. It is also responsibility for constructing. The right hippocampus is more involve in spatial memory.The hippocampus aims in the initial encoding of information that like akind of neurological e- mail system.(smith, 2000, wheeler, Petersen, and buckner 2000, Wilson; 2000). The results of research on the brains role in memory reveal two ways in which STM (short term memory) and LTM (long term memory). Firstly there is extensive evidence that physical changes in neural synapses are involved in LTM and but not in STM. And secondly there is evidence that different brain structures are involves in different ways in the three stage of memory. Biological basis of motivation Motivation:-motivation refers to the reasons why any behaviour occurs or specifically, to the forces or processes that initiate the behaviour, direct it , and contribute to its strength.(psychology , wadsworth publishing company; 1984; Eating behaviour is subject to homeostasis, as most people’s weight stays within a relatively stable range. The hypothalamus in the brain is central to the regulation of food intake. Acting as a kind of internal weight thermostat, the hypothalamus calls for either greater or less food intake (Capaldi, 1996; woods et al, 2000; Berthoud, 2000). Thirst is the biological process as like as drinking circuits .Drinking circuits is the association of tissue, body, and neuron with in nerve and cellus.It is associate with the hypothalamus deeply as like the other drinking circuits. (Thompson et. Al; 1980). Sex is the powerful biological motivation. The sex motivations easily understand the influence of sex hormone. It is related with the increase of age. Sex hornmone influence the body to create akind of presser for sex activies. This presser to be continued that time the sex activites is not complete. (Morgan, king. Weisz and schopler, 1993). Most of the motivation are based on the body’s need to maintain a certain level of essential elements; adequate sugar in the blood in the nourish cell , enough water in the body. This levels are regulated to homeostatic mechanism. These mechanism imbalance in the body and stimulate action that restore the proper balance. References Psychology; Methuen and co. Ltd; London; 1964 Friedman and Donoghue 2000). Smith, 2000, wheeler, Petersen, and buckner 2000, Wilson; 2000). Psychology , wadsworth publishing company; 1984; Capaldi, 1996; woods et al, 2000; Berthoud, 2000). Thompson et. Al;1980). Morgan, king. Weisz and schopler, 1993. Barkow, and Tooby 1992; terry, 2003. Garcia, Hankins and Rusiniak, 1974).

Thursday, September 19, 2019

Coop :: essays research papers

My advice to someone starting his or her coop would be to start as soon as possible. 150 or 250 hours is a long time, especially if you already have another job. This coop led to two and a half months of a very busy and hectic schedule. It is a very important part of the learning process and I don’t recommend rushing it. In my case I found it a difficult task remembering where I was supposed to be on a certain day, so I bought myself a day planner. I also advise future students starting their coops from trying to do things that you may not feel comfortable with. With me, I was not very comfortable with some of the DOS commands needed to build a new computer. All you have to do is ask someone, no matter how dumb you think the question is because this is supposed to be a learning experience and it will also help you learn to communicate. You will get more out of the coop by asking questions, which why we do the coop. BBS Computing is located in Greece New York It is a Computer Sales, Service center that also does some Networking systems. Paul Saussa, Ron Bess and John Bonacci are both owners and employees of the business. It is a relatively small business that mainly does computer sales and repair with some occasional networking jobs. The actual business consists of a show room and a workshop. The showroom has different models of computers that customers can have built to buy. There are 4 different types depending on a customer’s budget for a computer. The low-end models consisting of a Pentium III processor and 256 Mb of RAM and the basic keyboard, mouse, monitor, printer, and speakers, and the high-end models consisting of a Pentium 4 processor or equivalent with 256 or more Mb of DDR RAM and premium speakers, keyboard, mouse, printer and monitor. Thus, meaning you get what you pay for. The display models allow you to show a customer some of the features of the different types of compute r systems that are offered. Such things as operating systems such as Windows 98, Windows Me, Windows 2000, and Windows XP, and also programs like Nero for CD burners, All-in-Wonder TV tuner cards and applications such as Microsoft Office. This was my first opportunity to work with Windows XP.

Wednesday, September 18, 2019

Act 2 Scenes 8-10 Essay -- Aboriginals Moore River Australia Essays

Act 2 Scenes 8-10 The scene starts at superintendent’s office at Moore river Native settlement, the date set 10 April 1933. It represents an institution of white power-a place of forced confinement and conformity. The importance of the construction of this place is to give a medium for the Aboriginals to resist such conformity, as demonstrated by Joe and Mary escaping from white control. It reinforces the theme of the play –‘the refusal of aboriginal people to submit to the ways of European invaders’ The 1930’s represented two major political turning points of Western Australia. Firstly, the loss of the James Mitchell’s seat as the premier of Northam to the labor government epitomises changing white attitudes by electing a fairer government system. In previous scenes, Mitchell’s desperate attempt to win the election by sending the Aboriginals to Moore River as an act of racial segregation reflects his inequality and exploitation of his political hegemony. The second political concern at this historical point was the success of the secession referendum vote. This secession of the 1930’s was led by the organisation Dominion League of Western Australia and in success of secession, Western Australia would break away from federation and the rule of the Commonwealth of Australia, therefore having dominion status similar to that of New Zealand. Despite the favoured votes for the secession referendum, by 1935 the proposition to Parliament was denied and WA still remained pa...

Tuesday, September 17, 2019

The Christian Century

This article is written by Jimmy Carter, the thirty-ninth President of United States (1977-1981).   The article was published in   The Christian Century on September 20, 2005 in page No.32-35. This article was retrieved only for the purpose of academic pursuit and to gain more understanding from the article about Christian living.   In this task, the article written by Hon.Jimmy Carter, is being analyzed with all the due respect and honor to Sir.Jimmy Carter with a request to grant permit for the article analysis. Former President Hon.Jimmy Carter is presently associated with Maranatha Baptist Church in Plains, Georgia. The discussion is focused particularly about Christian diversions and what are the negative effects that Christian ministries are faced with in the present day church society. It is a great challenge to church leaders as well to the ministerial work that is carried in Christianity.   In letter to Galatians, St.Paul indicated that the three churches established in Lystra, Iconium and Derbe to where St.Paul began the first missionary journey,   where there was huge congregation in the beginning, began to become divided radically from the faith due to the rise of other requirements from leaders for acceptance and retention of fellowship which lead to chaos and disagreements among churches. This is a great threat and does not hold good for missionary work as well for Christian believers about churches unity.   Ã‚  Ã‚  Basic fundamental mistake was being committed by church leaders in Galatia who were departing from the gospel of Christ and were interested in adopting facets of Jewish law and circumcision.   The denominations are man-made viz., Methodist, Baptist, Presbyterians, Mennonites, Quakers and Catholics. There are also other issues in the article about fundamentalism, women preachers and about leadership of church.   St.Paul â€Å"Now I appeal to you, brothers and sisters, by the name of our Lord Jesus Christ, that all of you be in agreement and that there be no divisions among you, but that you be united in the same mind and the same purpose†(1 Cor 1:10). Author’s (Jimmy Carter) favorite Bible verse â€Å"Be kind one to another, tenderhearted, forgiving one another, as God in Christ has forgiven you† (Ephes 4:32)†. Article is reflecting on present day leadership in various denominations of church, women leadership in the church and whether such situation existed in the days of St.Paul.   The thesis of the Author is, follow and practice what St.Paul did in taking the gospel of Jesus Christ to various places and building congregations and not Christian radical associations or depicting superiority of men over women. Jesus Christ gave equal importance to women at par with men and never degraded women at any point of time throughout Jesus missionary work.   It was also stated here that women who would like to preach the gospel of Christ must   â€Å"Any woman who prays or prophesies with her head unveiled disgraces her head – it is one and the same thing as having her head shaved. For if a woman will not veil herself, then she should cut off her hair† Further the author states that as St.Paul stated â€Å"When I came to you, brothers and sisters, I did not come proclaiming the mystery of God to you in lofty words or wisdom. For I decided to know nothing among you except Jesus Christ, and him crucified† (I Cor 2:1-2)   The essence of the gospel should be that we are saved by the grace of God through faith in Jesus Christ and this is sufficient to carry on faith and religion and there is nothing much more important than this either to God or to Christians and believers of Jesus Christ. The article is in close association with New Testament especially with St.Paul missionary work that was much highly spirited in Galatia and in Corinth.   Paul through various missionary letters motivated friends, church leaders and even congregation in those times. Christian religion is one of the world’s most popular religion and there are many Christian churches around the world in various denominations. It is important to carry the unity and integrity of Christian religion whereas politics in Christian denominations, racism, gender differences and other social issues should not be included in gospel work or in church leaderships. Churches are basically human institutions wherein Christ believers grow in faith, carry gospel work and develop social and communal harmony which is the sole motive of any religion.     St.Paul confronted several problems in missionary work and in carrying the gospel of Christ and St.Paul did not give up and instead motivated associates towards evangelism and stated its importance. This article is an excellent piece of writing, that must really be an inspiration to those who are endeavoring in gospel work and those who are actively participant in building up of new churches in various places. Reference Jimmy Carter (2005) ,Back to Fundamentals Accessed May 9, 2008 http://www.religion-online.org/showarticle.asp?title=3249   

Monday, September 16, 2019

Filipinos Then, Filipinos Now Essay

Reaction Paper on the film â€Å"Ganito Kami Noon, Paano Kayo Ngayon?† by Eddie Romero Ganito Kami Noon, Paano Kayo Ngayon is a 1976 film directed by Eddie Romero starring Christopher de Leon and former Miss Universe Gloria Diaz. It’s easy to say â€Å"I am a Filipino†. But when can a person be considered as a true Filipino? In the movie, the word â€Å"Filipino† had different definitions. The word originally referred to a person of pure Spanish decency that was born in the country. However, a travelling Chinese merchant (Lim) born in the country was also considered as a Filipino. Based on these facts, being born in the country is one of the major criteria in order for one to be called a â€Å"Filipino†. Nicholas Ocampo, also called Kulas, was the main protagonist in the film. He was innocently set to find a friar’s son at the peak of the Philippine revolution against the Spanish colonization. He was able to encounter people who influenced hi s way of thinking and his way of living during his journey. He was able to meet different kinds of people; Filipino revolutionaries, Spanish friars, guardia civils, circus folks (where he met Diding, a girl whom he fell in love with), and Filipino elites who identified themselves as the real Filipinos. He was confused on what a Filipino truly is, on who has the right to call himself/herself as a true Filipino. He had no idea of what a Filipino is, or why he was called as one. He asked Don Tibor, a Visayan lawyer, if he has the right to call himself a Filipino, to which the lawyer answered that in order to be a Filipino one must be a worthy and valuable person. Kulas went through a lot of ups and downs during his stay in Manila. He experienced being wealthy, being respected, being bullied, being heartbroken, and being betrayed by the people around him. Kulas, in the end, realized that it is not enough to be born in the country in ordered to be called a Filipino, that being a Filipino doesn’t only mean the physical ties a person has with the land, or with tradition, or even with his or her family. It means recognizing ourselves as the protector of this land, and protector of our fellow men. It is being able to fight a grander cause and being able to fight for what is good for our country. The term Filipino was made because in the past, the people of the Philippines called themselves according to what region or island they came from, for example, the people from Visayas  are called Visayans, people from Manila call themselves Tagalogs, Ilokanos for the people from Ilocos and many more. Since the Philippine archipelago consists of thousands of islands, it created a rift between its people because of their different identities. Because of this, the term Filipino was used to call the people of the Philippines as a whole in order to avoid conflicts among the natives and also to unify the people. According to a study conducted by J. A. Yacat of the University of the Philippines Diliman, there are three factors that are considered in order to have a Filipino identity: a sense of sh ared origins (pinagmulan), growing up in a similar cultural environment (kinalakhan), and a shared consciousness (kamalayan). T he first one, pinagmulan, has something to do with being born in the country, having parents who are Filipinos, residing in the Philippines, or is a Filipino citizen. It basically implies that a person is a Filipino if he or she satisfies the definition of Filipino citizenship as stated in the 1987 constitution. The second factor, kinalakhan (cultural roots) revolves around participation and being immersed in a cultural background acknowledged as Filipino. This includes the speaking of a Philippine language, and other things that differentiates us from foreigners, like the way we see things, the way we look at things, and the way we face every situation that we encounter. The last factor, â€Å"kamalayan† (consciousness), is associated with awareness of the self as a Filipino, acceptance of membership in the category â€Å"Filipino†, and also pride in this membership. The American colonization was helpful in the making of the Filipino identity because of the way they tr eated us in the past, our ancestors thought of a way to distinguish ourselves and put the Filipinos on a classification different than the wicked colonizers. The revolution also helped in shaping the Filipino identity. The revolution unified the people. Without the revolution, we would still be under the hands of the colonizers without having an identity of our own. Though the colonization and Filipino revolution helped in the creation of the Filipino identity, each also brought negative impacts that hindered the Filipinos to create an identity of their own. Because of the booming economy of the United States, there is a noticeably big difference on the physical appearance of the Americans from the Filipinos. This is where the colonial mentality of the Filipinos heightened. Those who had money or were in the upper class of the society  tried hard to dress and act like Americans in order to blend with the colonizers and also to flaunt their newly bought things and their fluency in speaking the American language. Because of this, they believed that they belonged with the Americans, that they are Americans and not Filipinos. In the title, Ganito kami noon , paano kayo ngayon:?, there is a question that needs to be answered. Paano kayo ngayon? What is the state of the Filipinos now? To answer that question, many of the Filipino’s ideas and interests have changed. Technology rises and new trends have been made. Sometimes, the Filipinos now tend to forget what is important and what is significant. Filipinos then were able to think rationally. Filipinos nowadays are simply going with the flow. They go to where they will surely benefit, or to where they can gain much, much more. The sense of Filipino nationalism is in the end forgotten. People patronize more the products that came from other countries rather than the products that were made here in the country. Though Filipinos in the past did the same things, the intensity in this modern era is a lot greater than in the past. Our country is getting more and more liberated. Because of the many colonizers after the Americans, several foreign influences have been adapted as our own. The Filipino culture have been mixed with different cultures from neigh bouring countries like China, Japan, Korea, and others because of intermarriages. The way the government runs the country is becoming worse. The Philippines is now buried in debt. Filipinos nowadays are becoming harder to understand. One runs for election not because he or she wants to serve the country but because he or she wants to make more money. Also, the increasing percentage of crimes involving youth offenders is very alarming. We always ask for reasons why these crimes happened. Maybe because Filipino youth then have good moral attitude than Filipino youth now. The use of â€Å"po† and â€Å"opo† have always been a part of our Filipino culture. We were taught to use these words as a sign of respect to the elders. But now, we rarely hear those words especially from the younger ones. Filipino youth today had become verbally aggressive and delinquent. Another example is, Filipino youth now tend to imitate some characters from different foreign films thinking that it is â€Å"cool† to be violent and aggressive. Unlike Filipino youth then were respectful and God-fearing. Thus, Filipino youth then have good moral attitude than Filipino youth now. We are forgetting our objective, the aim which our  ancestors have passed unto us, which was to protect and fight for what is good for our country. We cannot achieve this goal if we keep on doing these things. It seems that in the present times, the definition of being a Filipino is reduced to just being a citizen of the country. If you are a citizen of the Philippines, then you can already be considered as a true Filipino. I am a Filipino. I became a Filipino because both my parents are Filipinos. I am a Filipino because I speak several Philippine languages. I am a Filipino because I am a citizen of this country. I am a Filipino because I love my country. I am a Filipino and I am proud to be one.