Han Dynasty and Roman Empire Essay Example for Free

Han Dynasty and Roman Empire Essay Both the Han dynasty and the Roman Empire were bureaucratic. The central rulers all eventually became hereditary and both empires had rulers that oppressed the peasants in order to boost political control. However, the two empires differ in that the emperors had varying justifications for ruling and rose to power in different ways. The Han Dynasty and The Roman Empire both were able to expand and develop their empires with their distinctive governing methods and control. To China, the centerpiece that supervised everything was knows as Confucianism. With all dependability focused on the emperor and society serving as a family unit, Han Chinas political system was known for a centralized, closed unit. It was ruled by an emperor who greatly observed the Mandate of Heaven. The Han developed a supply of soldiers, which kept their borders secured and made them capable to exchange with others from time to time. On the other hand, Rome had a centralized, blended structure. The main focus points of the Roman Society were operated by a Roman Republic, which was more like a monarchy, who controlled their complex structure. The Roman Society had more residents and rights than the Hans, Romans political control lay in the hands of the wealthy, which then they were elected to a political seat. The governors were picked from family networks. The only way Romans could accomplish anything big in a certain time span was to make strong changes in their community. It was an enormous weight on Romes resources and power, when they had to stress over big wins. For example, when there was barely any food to support the developing empire. The Romans and the Hans both had their wealthiest people control over their peasants, which caused a social distribution to each and every one, and could have leaded to outbreaks in little battles, wars between the communities, and what not. This was entirely not beneficial on each empires part and especially their social interaction. The political structures of both Rome and Han China were based on bureaucratic systems with a strong monarchy set of succession. They strengthened their control by reducing the land holdings of old aristocratic families. However, the reversal of this process led to breakdown of authority in the central government. During its reign of power, the central bureaucracy promoted trading with neighboring societies. However, Rome was more aggressive with its role in trading in the Mediterranean verses Han China’s river trade. Rome’s trade led to a much greater technology, culture, and general transfer of knowledge in areas surrounding the Mediterranean which in turn led to a much longer lasting influence on the world. Under the Han Dynasty, the power of the emperor and bureaucracy were emphasized. The organized structure of government allowed such a large territory to be effectively governed, even though it was the largest political system in the world at the time. The Hans political framework stressed male dominated families. Han rulers didnt support local warrior-landlords, believing that they were corrupt. Because bureaucracy was so important, civil service exams were first given, a tradition that would be incorporated into modern politics. Not only did bureaucracy effectively govern, but it had a sort of checks and balance on the upper class. Chinese bureaucracy from the Han Dynasty lasted well into the twentieth century. The imperial government sponsored intellectual life, such as astronomy and mathematics. Han rulers promoted Confucianism, with the idea that they were in charge of their subjects beliefs. The administration also took part in the economy. It organized production, standardized currency and measures, sponsored public works like canal systems and irrigation, and tried to regulate agricultural supplies to control price increases. The Roman republic allowed all citizens to meet in assemblies to elect magistrates. The most important legislative body was the Senate, made up of aristocrats. Public service and participation, political ethics, uncorrupt government, and oratory were extremely important. Roman leaders were very tolerant of local customs and religions and believed that well-made laws could hold the lands together. Aristocratic leaders supported legal codes to protect private property as well as their poor subjects. It was a sort of check on the upper class. They believed that laws should evolve to keep up with the demands of the changing society. Imperial law codes also controlled property rights and trade. The law of the land was fair and equal for everyone, for the most part. The Roman government also supported public works like roads and harbors to facilitate transport and commerce. It also supported an official religion, but tolerated others as long as they didnt interfere with loyalty to the state. Unlike the Chinese, the Romans didnt emphasize as much on hierarchy, obedience, or bureaucracy, but more on participation. However, some of the Romans political writing did resemble Confucianism. Both governments also supported government funded public works.

Learning Plan Essay Example for Free

Learning Plan Essay The learning plan described in this paper is to have students debate a topic related to the Civil War. The debate topic is â€Å"Was the Emancipation Proclamation enacted for moral reasons or political reasons? † The main concept of this learning plan is to have students work collaboratively to research facts, and recall and use facts from the Civil War unit to incorporate into their arguments. (It should be noted that the learning plan described in this paper will take several classes to complete, however the learning plan procedures will only address the class where the debate will occur. ) It is  assumed that debate skills were taught in a previous class. The learning theory certainly incorporates constructivist aspects. They are constructing knowledge rather than absorbing it. This is constructivist approach is illustrated through the collaborative nature of the assignment, as well as through the research that students’ must produce. In terms of the use of technology and media; the students will be instructed to research one source of information, from the internet, related to their argument. They must submit a one-page analysis of the information in which they found along with a references page. This must be submitted to the teacher a week before the scheduled debate. The teacher will assess the content of the paper, but the references page will also be important. Teacher must evaluate the kinds of internet sources that the students have used. The credibility of the internet source, and the strength of student’s research will be analyzed by the teacher. The purpose is to assess student’s traditional literacy and critical analytical skills (assessed when evaluating the content), and information 1 2 LEARNING PLAN: HISTORY DEBATE CLASS literacy/interpretation skills of online material (assessed by reviewing the  reference page). Finally, the teacher will hand back papers to the students, and he/she will instruct each group to use at least two of their group members’ papers into their group’s arguments. Media and technology will also be incorporated with the use of social media. The teacher will tell students that their debates will be recorded and submitted to youtube or a private school website (if issues of privacy are raised). Others will be allowed to view the video to evaluate the strength of each team’s arguments. Based on the comments of public viewers, a winner will be chosen (by popular vote). This popular vote will be incorporated as a small percentage into the assessment. This is being done as to allow students to participate in new media opportunities within an educational context. Learning Plan Context Setting †¢The high needs school will be a High School in the Bay Area, either in San Francisco or Oakland. †¢There will be 25-30 students in an individual classroom. †¢The lesson will take place the week after the Civil War unit is finished. †¢It is anticipated that the unit will last about two weeks, therefore the debate class will occur during the third week. The actual debate class will take up one class period. †¢The content area is US History/Politics. The grade level is Juniors (11th grade). †¢In sum, the curriculum unit is 11th grade, US History/Politics, Civil War unit. 2 3 LEARNING PLAN: HISTORY DEBATE CLASS Standards †¢According to California standards for literacy in History/Social Studies in 6-12th grades. A student must be able to demonstrate analysis of primary and secondary sources, and connect these insights to the understanding of the whole text. This ability will be addressed and assessed when students must incorporate information learned from the textbook with information gained from the internet, and use both  sources of information, into their debate. The student’s ability to undertake this task will be evaluated by the teacher with the submission of student’s sources, and also during the debate. (http://www. cde. ca. gov/be/st/ss/documents/finalelaccssstandards. pdf. ) †¢ Also according to California standards, students must be able to evaluate various explanations for events and actions. This standard is illustrated in the nature of the activity. A debate, in itself, evaluates different explanations for one event, which makes it an ideal means of addressing this standard. (http://www. cde. ca.gov/be/st/ss/documents/finalelaccssstandards. pdf. ) †¢Finally, according to California standards, students must be able to evaluate differing points of view on the same historical issue. Once again, this standard is illustrated within the nature of a debate. It is also illustrated when students submit their own analysis of internet research (http://www. cde. ca. gov/be/st/ss/documents/finalelaccssstandards. pdf. ) Learning Objective 3 4 LEARNING PLAN: HISTORY DEBATE CLASS †¢Students will be able to collaboratively demonstrate their knowledge of Civil War policy, events and information, from the textbook and from  online sources, by formulating arguments to be presented within a debate. Learning Theory Applications †¢Constructivism is certainly at play in this lesson plan: †¢The activity allows knowledge to be organized into schemas, concepts, and worldviews. †¢This activity is emphasizing the use of authentic activities by constructing knowledge through interaction with the environments (internet and peers), and applying it to real-life situations (debate). †¢The collaborative component certainly illustrates constuctivism; learners will help each other create conceptual connections. †¢Finally, students are working autonomously with the help of the  teacher as facilitator, supporter, and model (Ormrod, 2006). Learning Accommodations: †¢Individualized Education Plan for Special Accomodations: In each team, all students will be assigned a role. For example, â€Å"speaker†, â€Å"writer†, â€Å"time-keeper†. A student’s IEP will be taken into consideration when assigning roles. A student with an IEP, will be assigned a role that best fits their IEP. For example, a student with ADD, may be best suited to be a time-keeper since their attention span is not as focused. They may be anxious to change the pace of the group’s discussions, and therefore they may be eager to keep track of the time. 4 5 LEARNING PLAN: HISTORY DEBATE CLASS †¢Language Development needs: When assigning the internet-based research; the teacher will give ELL students a website to navigate to, instead of having the students navigate the internet themselves. Teacher will give explicit instructions as to where to look on the website so students do not feel too overwhelmed with the English language. Teacher will ask the students to try to comprehend some of the information, however if this proves too difficult, then the teacher will ask the students to find 15-20 words from the website that the student did not understand. The student will then find the meanings of these words in their own language. They must write at least a paragraph about the Civil War unit incorporating five of the words that they found on the internet. Also, at least two of these words must be incorporated into the arguments of their team. †¢Gifted and Talented needs: This is a challenging component to consider because a gifted/talented student does not necessarily mean an academic-rigorous student. To really tailor the lesson to address the interests of a gifted/talented student, then the teacher will have to be familiar with the personality of that particular student. However, some situations will be addressed here. First of all, from the research, the lesson itself befits that of a gifted/talented student. Competition, which characterizes a debate, usually suits the nature of gifted/talented students. (http://www. teachersfirst. com/gifted_strategies. cfm) The first situation to consider is a student who is gifted/talented, but not academically 5 6 LEARNING PLAN: HISTORY DEBATE CLASS rigorous. This student will be given a leadership role within his/her team. He/she may be assigned to organize/manage all the ideas of the students. He/she is the one who will be given the rubric for what the  teacher is assessing when observing the team’s discussions and arguments. He/she is the manager, and he/she will be assessed on their ability to keep his/her team on task. In this way, this student isn’t necessarily doing more â€Å"academic† work, but he/she is being challenged in a rather difficult manner. A second situation to consider is to have a gifted/talented student who is academically rigorous. The teacher will give this student a second component to add to his/her research paper. The student must connect textbook material and internet material to the US politics of today. This is increasing the  cognitive process from analyze (which all students must do with their research papers) to evaluate (Anderson and Krathwol, 2001). The student can choose to incorporate this extra component into their team’s arguments. Resource Accommodations: †¢Low tech: There are no computers, projector, or internet access in the classroom. If this is the case, teacher may have to allocate time in different lessons to use school facilities where computers are available. Computers must be used so that the teacher can show students the kinds of websites that are credible, as well as to use sites, like youtube, to show students examples of debates. Computer use is necessary so 6 7 LEARNING PLAN: HISTORY DEBATE CLASS teacher may have to take time before or after school to meet with students (who are willing) to show them the above-mentioned websites. †¢Mid tech: One computer connected to a projector is available in the classroom. The teacher can use this computer to show examples of credible websites, as well as to show examples of debates online. †¢High tech: Class is equipped with several computers. Teams can go online themselves to view videos of debates and start research for their paper. In this way, the collaborative nature of the lesson will  start even earlier (in the pre-planning stage). Content-Based Literacy Skills †¢In terms of text-based literacy; students must incorporate information from their textbook into their arguments †¢Critical thinking, reflective thought, and text-supported thinking will be illustrated when students must draw connections between internet-based information and textbook information while doing their analysis/research paper. This connection will be evaluated when student’s cute their sources within their paper. (This explanation will also illustrate students’ information literacy. ) New Media Literacy Skills  Ã¢â‚¬ ¢Performance: This skill is illustrated when students view sample debates on the internet and use this as models of performance in their own debates. 7 8 LEARNING PLAN: HISTORY DEBATE CLASS †¢Collective Intelligence: This skill is done when students are within their respective teams and they must draw upon their own and others ideas, research, and knowledge to formulate strong arguments. †¢Judgement: This skill is illustrated when students must judge which websites and information are to be included in their research/analysis paper. †¢Networking: Once again, this skill is illustrated when students must  search, connect, and analyze information on the internet for the purpose of their research/analysis paper (Jenkins, 2001). Learning Material: †¢Textbook: Learners will need textbook so that they can recall information. †¢Paper, pen: Leaners will need so that they can write down information. †¢Rubric: Both the learner and teacher needs. Learners need it so that they are aware of what’s expected of them while working in teams and formulating their arguments. Teacher needs it so that he/she can refer to it when assessing the team’s progress. †¢Notes: Learners will need them as a reference when formulating arguments. †¢Stopwatch/watch: This will be given to the student whose job is timekeeper. †¢Video Camera: Used to record the debate Learning Plan Procedures Phase I: Motivation Activity †¢Teacher will show a short clip of a very powerful, interesting debate. Possibly a presidential debate. The clip will only show the most 8 9 LEARNING PLAN: HISTORY DEBATE CLASS poignant part (according to the teacher) of the debate. Hopefully the clip will be no longer than 5 minutes long. (if there’s no computer available, then teacher must bring in her/his own computer. ) †¢In a class of 30 chair/table. There will be 15 chairs/ tables on each side  of the room. They will be facing eachother. †¢Learners will enter the classroom and sit down immediately with their team. †¢The teacher will then show the video as soon as the class is seated and quiet. †¢This activity is being done to motivate, encourage, and remind students of what a good debate looks like so that the output of the students’ debates can match skills such as speaking (clear and concise) and eye-contact of the debaters within the video. Phase II: Input (Teacher Driven) Activity: †¢During this class, the teacher will, serve only as facilitator, therefore not much activity will be driven by the teacher. However, after the video, the teacher will remind students of the rubric that was given to them, and tell students that she/he is only their to assist in the logistics of the debate (time, flow, managing emotions if this becomes a problem). The teacher will also instruct students to take notes on each other’s arguments because this assignment will be important for their homework assignment. She/he will also remind student that they will be recorded. †¢Teacher will tell all students to take out their rubrics. †¢She/He will go over some key point from the rubric as it relates to the debate. 9 10 LEARNING PLAN: HISTORY DEBATE CLASS. †¢The teacher will tell students to make sure that they keep these key points in mind because these points will be assessed during the debate. †¢The teacher will instruct students to have their rubrics out for the entire class so they can monitor their team’s progress by themselves. †¢Teacher will formally go over key questions from the rubric that he/she hopes the teams have incorporated into the nature of the debate (clear speech, eye contact, concise points, respectful behavior) as well as into the content of the debate. In term of the nature of the debate, questions might look like â€Å"Is my team being quiet/respectful as the  other team presents their arguments? †, â€Å"Are my responses to the other’s teams arguments not insulting? † etc. In terms of the content of the debate, questions may look like, â€Å"Did my team incorporate facts from the textbook? †, â€Å"Did my team use at least two credible internet sources within the argument? †, â€Å"Did my team follow special instructions assigned by the teacher (e. g. incorporating ideas from IEP students, ELL student, gifted students)?. † †¢This activity and these questions serve to remind students of the importance of the collaborative nature of the learning objective. They  also serve to remind students that they must be able to demonstrate their understanding of the Civil War unit, as well as their understanding of outside sources within the context of an argument. Phase III: Output (Learner Driven) Activity 10 11 LEARNING PLAN: HISTORY DEBATE CLASS †¢Students will take part in a debate. The topic is â€Å"Was the Emancipation Proclamation enacted for moral reasons or political reasons? † This activity will illustrate the learning objective in several ways. First, the collaborative nature of the previous classes will finally be demonstrated. Second, the students must illustrate their knowledge of  Civil War policies within their arguments. Third, both sides’ arguments must include information from outside sources. †¢The teacher will select one team to present their arguments first. †¢Recording will begin †¢The speaker of that team will stand up and come to the front of the class. They will present their team’s argument. In the argument they must mention the sources in which they got their information. For example, if they got a particular piece of data from the textbook, then they must state â€Å"As is presented in the textbook†¦Ã¢â‚¬ . If they got a particular piece of data from the internet then they must state, â€Å"As is  presented on so-called website, or by so-called author†¦Ã¢â‚¬  They must also explicitly state how they used the â€Å"special instructions† from the teacher. For example, â€Å"(ELL’s student’s name) found that ‘compromise’ was not a possible solution of the Civil War. † In this example, it is assumed that compromise was on a list of words that an ELL student did not understand. He/she presented these list of words to his/her team. The team reviewed the list, and chose to use the word compromise as part of their argument. †¢The student will finish the presentation of his/her argument. 11 12 LEARNING PLAN: HISTORY DEBATE CLASS. †¢The teacher will tell the next team to present its argument. The team will follow the same procedure as above. †¢The teacher will then stop recording of the debate. †¢This debate will naturally lead to questions, comments from both the teacher and the students. Phase IV: Culmination †¢The teacher will ask the groups to clear up any misunderstandings or misinformation the teams may have had within their argument. This is to give other team members a chance to speak about the argument, which reinforces the collaborative effort of the lesson. †¢The teacher will also ask students how their team’s or the other team’s  information and debate skills differed and how these things were similar to the debate presented in the beginning of the class. †¢As a smaller activity, the teacher will instruct all the students to come up with one question, comment, critique of the other team’s argument. This assignment will illustrate each student’s understanding of the Civil War Unit because it challenges students to relate, connect, or counter-argue their own knowledge of the unit. This question will be submitted to the teacher. Phase V: Extension †¢For homework, students will write a one-page analysis of the opposing teams arguments. The student will address the opposing side’s arguments. He/she will evaluate the argument’s weaknesses, strengths; and why he/she disagreed or agreed with the points that were made. 12 13 LEARNING PLAN: HISTORY DEBATE CLASS Learning Plan Analysis Formative assessments will include analyzing the collaborative efforts of the team, the behavior of each team during the presentation of the opposing team’s arguments, how well each team member took on their role within their team, and how well the team incorporated textbook information, outside information, and ‘†special instructions† from the teacher into their  argument. A summative assessment will include the teacher’s evaluation of the internet analysis/research paper, the one-page analysis of opposing team’s argument, teacher’s evaluations of the strength of the arguments, and finally the â€Å"popular vote† (the results of youtube or school-based website). Weaknesses of this lesson plan include time constraints, and the many assessments involved. It may be difficult to accurately assess how well each team members took on their roles. Some students may still be taking on more work than others. Also, incorporating ELL/IEP students proved to be a difficult task.. Strength of the lesson is it fosters team work, analytical skills, and gives students more power in the direction and implementation of a lesson. The teacher will implement these varied assessments in its first year, and then will evaluate the effectiveness of these assessments for future classes. The learning theories applied in the first phase was Vygotzky’s Cognitive Process. Students are witnessing two adults debating and they are expected to try to learn/imitate the behaviors of those adults. In the second 13 14 LEARNING PLAN: HISTORY DEBATE CLASS phase, social cognitive theory is at play. The teacher both models desired behaviors/outcomes, as well as emphasizes self-efficacy and self-regulation. In the third phase, constructivism is illustrated. The debate is student-driven because the students are demonstrating their constructed knowledge within the debate. The assessments have a behaviorist component. Negative reinforcement (decrease a behavior) is illustrated when the teacher warns students that if they are not respectful or a team member does not contribute meaningfully, then they may be marked down (Ormrod, 2008). References Anderson, L. W. , Krathwol, D. R. (2001) . A Taxonomy for Learning, Teaching, and Assessing, 28-31. California Department of Education. (2013) California Common Core State Standards. http://www. cde. ca. gov/be/st/ss/documents/finalelaccssstandards. pdf Jenkins, H. , Clinton, K. , Purushotma, R. , Robison, A. J. , and Weigel, M. (2006). â€Å"Confronting the Challenges of Participatory Culture: Media Education for the 21st Century. † Chicago, IL: MacArthur Foundation. Ormrod, J. E. (2008). Educational Psychology Developing Learners, 8. 25-36. Teachers First. (2014) http://www. teachersfirst. com/gifted_strategies. cfm 14 15 LEARNING PLAN: HISTORY DEBATE CLASS.

Psychosocial Interventions for Psychosis Evaluation

Psychosocial Interventions for Psychosis Evaluation Introduction This report aims to critically appraise psychosocial interventions (PSI) that are utilised when working with complex cases. In order to do this the term complex is explored with reference to people with psychosis. Different types of complexity are discussed with a more detailed examination of a specific complexity; the relationship between substance misuse and psychosis (dual diagnosis). The effects that substance misuse and psychosis have upon the service user and their care givers are outlined. An overview of the use of psychosocial interventions when working with complex cases is given. This discussion is then focused on particular interventions for dual diagnosis that show promise for enhancing service user and carer experience, namely a integrated treatment approach of cognitive-behavioural therapy, motivational interviewing and family therapy. These interventions are critically appraised with reference to evidence base, policy and guidelines. Examples from clinical practice are given to illustrate potential barriers, and outcomes when implementing such interventions with service users with complex needs and their caregivers. Strategies to overcome such barriers are generated and recommendations are made. Aliases are used within the scenarios of this report in order to maintain anonymity of the service users and carers described to illustrate points and examples. Complexity The term complex case is referred to frequently within mental health literature, policies and guidelines but there are very few definitive explanations of what the term actually means. Griffiths Allan (2007) discuss how the term complex case is ill defined within mental health literature summarising how the term is often used to denote circumstances where people appear to have many interrelated needs that require several, coordinated responses from multiple services. The term complex case is often used to denote needs that services do not fully understand or provide for effectively. This report aims to explore the term complexity in relation to individual cases of those with serious mental illness. Complex: ‘Made of many different things or parts that are connected; difficult to understand (Soanes Stevenson 2005) Interpreting the above definition of complex within the Oxford Dictionary of English one could describe a complex case as a service user with more than one problem or need that are connected making the case more difficult to work with. For example having a diagnosis of schizophrenia and being detained within a medium secure unit. A person fitting this example would potentially present the mental health professional with more challenges than a person with moderate depression living with their supportive family. Wilson, Holt and Greenhalgh (2001) discuss the term complexity in relation to human health and illness. They suggest there are a number of factors (outlined in Table 1) that we all posses that makes us all complex. They go on to suggest that human illness and behaviour are not predicable and neither can be thought of as a simple cause and effect system. Again, adding to the complexity of individuals that because one individual responds one way to an event does not mean all will. Although this list of human complexities was written with medical practice in mind it applies to all and provides the baseline of those service users we work with in mental health services. Table 1 (Wilson, Holt, Greenhalgh 2001 p685) Factors that add the human complexity The human body is made up of multiple interacting and self regulating physiological systems including biochemical and neuroendocrine feedback loops. An individuals behaviour is determined partly by an internal set of rules based on past experiences and partly by unique and adaptive reaction to external stimuli. The web of relationships in which individuals exist contained varied and powerful determinants of their beliefs expectations and behaviour. Individuals and their immediate social relationships are embedded within wider social political and cultural systems which can influence outcomes in entirely novel and unpredictable ways. All of these interacting systems are dynamic and fluid. A small change in one part of the web of interacting systems may lead to a much larger changes in another part through amplification of effects. If we bear this in mind, that all humans are complex, then maybe the term complexity needs to be described as a continuum (Figure 1). That the more problems a person has or the more difficulties they face the further they move up a complexity continuum. People with a diagnosis of serious mental illness (as with all people) can face a large number of problems and difficulties through the course of their lives for example, positive symptoms, negative symptoms, anxiety, depression, mania. When adding this to the complexity of an individual this produces more challenges for the health care professional, the individual and their carers/families. However, these experiences also produce problems and difficulties for the service user making their case even more complex. For example the impact of experiencing voices does not end here but effects other areas of a persons life (see Table 2). Table 2. Laura Case study Laura first started to hear voices at the age of 9 and at first these did not bother her. As she got a bit older and discovered that this wasnt ‘normal her voices started to become critical of and derogatory towards her. To cope with this Laura started to experiment with Illicit drugs and alcohol as this blocked out the voices for a short time. However, this also made Laura lose her inhibitions and she would participate in sexual acts with men in her local area. This fuelled the voices and they became much more negative. So to cope Laura would take more drugs. Eventually Laura would run out of money and so would shoplift and resorted to prostitution. Her life became very chaotic and at 16 her mother kicked her out. Laura was now sleeping in neighbours gardens, sheds, anywhere she could. Laura lost touch with all her family and friends, her physical health suffered and she ended up very underweight and her voices became worse. Eventually Laura was found by the police sleeping se mi-clothed in a car park under the influence of drugs and alcohol. It was at this point she was admitted to an acute mental health unit. From the case of Laura it can be seen how not even having a diagnosis of schizophrenia, but experiencing positive symptoms can result in stigma, social exclusion and have a huge impact on a persons life. Lauras case was exacerbated by the use of illicit substances and alcohol demonstrating how substance misuse can add greatly to the complexity of an individual. Within the literature it can be seen that there are many factors that add to the complexity of a person with mental health needs including: medication resistant symptoms (Tarrier et al 1993), receiving care within secure forensic units (DOH 2005), psychological reactance (Moore, Sellwood, Stirling 2000), poor social functioning (Cather 2005, Couture et al 2006), , learning disabilities (DOH 2001a), insight (David 1990 and Buckley et al 2001), physical health (Marder et al 2003) homelessness (Randall et al 2006), and dual diagnosis (DOH 2002). These complexities have been recognised by the government and national drivers have been produced to guide mental health professionals and services to enable delivery and provision of the best services. For example ‘The National Service Framework for Mental Health (1999a) outlines a number of interventions for several complex groups including some of those mentioned above. Rankin Regan (2004) discuss how the term complexity means that there is no generic complex needs case. This therefore suggests each individual has a unique interaction between their own health and social care needs, therefore, requiring personalised responses from mental health services. Adopting an approach that incorporates psychosocial interventions could help to achieve a personalised response and provide individualised, tailored care for the service user and their care givers. Psychosocial Interventions The use of psychosocial interventions (PSI) is advocated in national drivers such as ‘Schizophrenia: Core intervention is the treatment and management of schizophrenia in adults in primary and secondary care (NICE 2009). This guidance recommends that all service users and their families are offered psychosocial interventions as a treatment of schizophrenia. Also, documents such as ‘From values to action: The chief nursing officers review of mental health nursing (DOH 2006) recommends the use of psychological therapies to improve outcomes for service users and ‘The mental health policy implementation guide (DOH 2001b) advocates the use of psychosocial interventions through a variety of service delivery modes. Demonstrating the emphasis that is placed upon such interventions in the treatment of serious mental illness. Mairs and Bradshaw (2005 page 28) suggest PSI is â€Å" a range of evidence-based interventions for people with psychosis and their care givers. The term is generally used to include both models of service delivery such as assertive outreach and specific interventions, for example Family Intervention and Cognitive Behavioural Therapy (CBT). PSIs aim is to reduce stress experienced by an individual with psychosis or help him or her to cope with stress more effectively.† As a result of adopting a PSI approach an individualised service is offered to the service user to help meet their needs utilising a variety of interventions and services with great emphasis being placed upon collaboration. Psychosocial interventions assume a complex link between biological, environmental, and sociological factors which suggests that ambient stress, together with life events may trigger onset or relapse of, mental health in some people (Gamble Curthoys 2004). A model which displays this link is the Stress Vulnerability Model by Zubin and Spring (1977 cited in Norman, Ryrie 2004). This model helps explain the aetiology, course and outcome of mental illness, demonstrating how stress has different effects on individuals. The Stress Vulnerability Model (See figure 2) suggests that some people are more vulnerable to stress than others and that when an individuals stress threshold is passed they can become unwell i.e. experience positive symptoms. In terms of a complex case it could be proposed that an individuals complexities cause stress in themselves and/or increase a persons vulnerability to stress. An example of how ‘The Stress Vulnerability Model can be illustrated to enable it to be shared with a service user with complex needs, using an easy to understand analogy can be seen in Appendix 1. As previously mentioned the aim of PSI is to reduce stress or to help cope with stress better; therefore, it can be seen how the Stress Vulnerability Model plays a central role in providing psychosocial interventions. Substance Misuse and Psychosis Over 50% of people with a severe mental illness also use illicit drugs and/or alcohol at hazardous levels (Cleary et al 2009) and even low levels of substance misuse can have detrimental effects and cause serious complications (Barrowclough et al 2001). The combination of substance misuse and mental health problems (dual diagnosis) is associated with a range of social, behavioural, physical and psychological problems (see table 3) providing challenges for mental health services and adding to the complexity of an individual (Hussein 2002). In addition to this complexity ‘The national service framework of mental health (DOH 1999a) identifies patients whom misuse substances and have a diagnosis of serious mental illness as a population of greater risk of stigmatisation and exclusion from existing service provision. Demonstrating some of the factors that add to an individuals complexity. Table 3 Complications posed by dual diagnosis (Cleary 2009, Drake Mueser 2000, Clark 1996, Dixon, McNarey Lehman 1995, Griffiths Allen 2007 and Gibbins Kipping 2006) Increased risk of Suicide, Self Neglect, Violence, Poor compliance with treatment, More inpatient stays worsening psychiatric symptoms Relapse, Homelessness, HIV and Hepatitis, Contact with criminal justice system Prejudice and Stigma. Negative impacts on Social relationships Financial resources (of individual and/or family/friends) Family Relationships i.e. increased burden, increased expressed emotion Within literature the most commonly reported reason that people with serious mental illness use illicit drugs is to self medicate, for example, to relieve negative symptoms of schizophrenia (Littlejohn 2005). However, as Conley Benishek (2003) report there is the additional complexity of trauma that has lead to the use of substances for various reasons including dissociation, and modelling from parents. They continue recommending that nurses working within the substance misuse field should be trained in picking up such information. If an approach adopting psychosocial interventions was utilised and therapies such a cognitive behavioural therapy were delivered then this historical information may be identified and dealt with appropriately. Therefore, leading to a different delivery of services compared to someone who uses substances to self medicate. However, the mental health professional must also bear in mind that service users also use substances for the same reasons as others (L ittlejohn 2005). Even though the NICE (2007) Guidelines, ‘Drug Misuse: Psychosocial Interventions recommends that CBT be offered to those with anxiety and depression who are stabilised with their drug use, but does not discuss its use with those with psychosis. There is growing literature examining the use of CBT for those with a dual diagnosis (Cleary et al 2009, Barrowclough et al 2001, Baker et al 2006, Weiss et al 2007 and Haddock et al 2003) although, as mentioned earlier the amount of literature in this area is limited. Also the CBT that is delivered to the participants within the studies has been adapted to suit the needs of those with dual diagnosis. This integrated treatment, namely C-BIT (Cognitive-Behavioural Integrated Treatment), has a number of components; Cognitive Behavioural Therapy, Motivational Interviewing and Family Interventions. C-BIT is not only about adapting psychosocial interventions to suit those with dual diagnosis but it is also about service provision and developm ent (Thylstrup Johansen 2009, Graham et al 2006, Graham et al 2003). Such interventions are used as part of an individualised treatment plan that incorporates the key principles of working with dual diagnosis (see table4). Table 4 (Drake et al 1993 cited in Abou-Saleh 2004) Principles of treatment of substance misuse in people with severe mental illness Assertive outreach to facilitate engagement †¢ Close monitoring to provide structure and social reinforcement †¢ Integrated concurrent service †¢ Comprehensive, wide range of interventions †¢ Stable living situation †¢ Flexibility and specialisation (modified approaches) †¢ Stages of treatment: engagement, persuasion, active treatment and relapse prevention †¢ Longitudinal perspective for relapsing and chronic disorder †¢ Optimism instilling hope in patients and carers Motivational Interviewing (MI) The aim of this intervention is to increase a persons ability to recognise and do something about any problems they have (Gamble Curthoys 2004) and that change would be desirable (Kipping 2004 and Miller Rollnick 2002). This approach conveys hope and is non-confrontational in it style (Kemp et al 1996) and is largely used within substance misuse services (DOH 1999b). This intervention is used alongside Prochaska DiClemente (1986 Cited in Kipping 2004) Model of Change (see Figure 3) to provide a framework of which interventions should be used at which stage of change a service user is at. Motivational Interviewing is mainly used as a persuasion tool to move people from precontemplation/ contemplation to decision and active change. Four General principles are followed as outlined by Miller Rollnick (2002); expressing empathy, developing discrepancy, rolling with resistance, and supporting self efficacy in order to facilitate this change. When a service user demonstrates that they have arrived at the decision or action stage of the cycle of change cognitive behavioural interventions are then commenced. Cognitive Behavioural Therapy (CBT) The aim of CBT is to lessen distress caused by negative feelings; it attempts to do this by changing the thoughts (cognitive) and beliefs that underpin them. It can also alter actions (behavioural) and circumstances that are affecting these thoughts and feelings (Nelson 2005). This approach has been written about for many years and has arguably evolved from the work of Aaron Beck, a psychiatrist whose work dates back to the 1950s. There is a vast amount of literature examining the use of CBT with psychosis (Jones et al 2004). Generally the research and literature supporting the use of CBT for Those with serious mental illness often excludes people who misuse illicit drugs and/or alcohol for example Garety et al (2008), and Jackson et al (2008). The topics covered within CBT sessions for those with dual diagnosis differs from that of someone who does not use substances. For example Baker et al (2006) outlines components of CBT sessions used within their trial. They include, presenting the model of problematic substance use and psychotic symptoms (Graham et al 2004), specific techniques for managing substance use, and identification of triggers and beliefs that could lead to substance use and increase psychotic symptoms. Finally a large component of CBT for dual diagnosis is around relapse prevention, identifying unhelpful thinking patterns and managing cravings. Family Interventions (FI) A relative of a person with a diagnosis of schizophrenia may experience negative consequences in many areas including: emotionally, socially, psychologically and economically, as they adjust to their new role as a care giver (Reader 2002). How the care giver attempts to cope with these consequences can have an effect on their relative. Research has shown that expressed emotion within families could lead to relapse in schizophrenia (Brown et al 1962, Kavanagh 1992). Often a person with dual diagnosis is only marginally engaged with services but may have regular contact with their families who provide financial and psychological support (Thylstrup Johansen 2009). Putting them under immense strain; but also in prime position to work with mental health services to promote engagement and treatment adherence. There is a vast evidence base to support FI for promoting recovery from psychosis (Pharoah et al 2006, Pilling et al 2002). The family dynamics of a person with a dual diagnosis is often impacted greatly due to the complexities discussed earlier and there is growing evidence to suggest how family involvement can have positive impacts on outcomes for both the service user and their families (Fischer et al 2008; Dixon, McNarey and Lehman 1995). Within integrated treatment Barrowclough et al (2001) use family interventions as a means of encouraging care givers to adopt motivational interviewing styles to improve motivation, and treatment adherence amongst other interventions. See Table 5 to illustrate how minimal family work in the form of psycho-education enhances the experience of service users and their care givers, even when staff have had no formal training. Unfortunately, family relationships of those with dual diagnosis can often be put under vast amounts of strain that cause the family dynamics to breakdown. Leading to people losing contact with their friends and families. This therefore makes family interventions very difficult as often one or both parties (care giver(s) and service user) do not wish to accept family work. In addition to this there are service users who do not wish their care givers be informed of their illicit drug use as they are worried of the consequences this may bring, for example: negative appraisal due to the stigma surrounding substance misuse. From experience this can be overcome in some cases through normalisation and psycho-education. Providing a good rationale of why care givers should be informed and how doing this can help the situation. Although, this often takes a lot of guidance and motivational interviewing techniques. Table 5 Psycho-education with Laura and her Father. Once Laura was admitted to the rehabilitation unit where she is currently residing her father got in touch. Laura was keen to build on the relationship between her and her father and started to visit him once a week. Staff at the unit (whom are not trained in family interventions) thought it would be a good idea to spend some time with Laura and her father to help them both gain an understanding of each others situation, thoughts, feelings and behaviours. After explaining the benefits of this to Laura she consented and her dad was offered to come and have a few informal sessions with Laura and her named nurse. Lauras dad explained how he had never been given any information about schizophrenia or substance misuse and how he knew very little of how these effected his daughter. This information was shared with both Laura and her dad. The stress vulnerability model was explained to Lauras dad with a view to building on his understanding of why his daughter experiences psychotic symptoms and providing a reason why she uses drugs. Leading on to state how this only causes more problems (all of this was discussed with Laura at an earlier date). Lauras Dad was given the opportunity to voice any concerns he had about regaining contact with Laura i.e. financial drain, crime, and ‘picking up the peices. These problems were discussed and brainstormed with both Laura and her dad to identify ways to prevent these happening, and produce a contingency plan if either person felt they needed support. Lauras Dad reported that these sessions made it easier for him to build on lost relationships with his daughter and reduced his fears that he would have to ‘deal with it all if things went wrong. Laura also felt much more positive as now she was starting to rebuild relationships providing more motiviation to change and sustain change. Her mood improved slightly and she had more hope for the future. Arguably the benefits Laura experienced may have inevitably occurred with out staff intervention. Literature Review A small number of studies examining interventions for use with people with dual diagnosis will now be appraised.Two of the Studies are Randomised Controlled Trials (RCTs) and are considered the gold standard method for evaluating treatment efficiency (Greenhalgh 2006). They are said to produce the least biased results as random samples are used to minimise the possibility of error in design and conduct (Roberts, 1999). Barrowclough et al (2001) and Haddock et al (2003) Barrowclough et al (2001) produced one of the first robust RCTs to examine the impact an integrated intervention programme consisting of CBT,MI and FI had upon service users. The design of the trail was robust in that it was a RCT, ensured as far as possible good treatment fidelity (making certain that the treatment being delivered is the one intended (Leeuw 2009)) and the assessors in the trial were blind to group allocation (reducing the risk of bias). However there were some limitations of this study such as small numbers of participants, short follow up period, and treatment was delivered by cognitive behavioural therapists. In reality it is not possible for all service users with dual diagnosis to receive interventions from a cognitive behavioural therapist. All of these limitations question the generalisibility of the results. Although care givers were in receipt of interventions their outcomes were not reported in this study. It would have been interesting to see these results; even those whom were in the control group received more interventions than the majority of families of substance misusers get (based on experience). One could hypothesise that the results of the two groups were not too dissimilar due to the fact that both sets of care givers were being supported. The Haddock et al (2003) study is a follow on from the Barrowclough et al (2001) study reporting further service user outcomes, cost effectiveness and carer outcomes over an 18month period. The robustness of the study was discussed above. This study found quite significant positive outcomes of those whom received the integrated intervention programme. Results demonstrated improved outcomes for the service users general and social functioning, and reduced number of negative symptoms to a significant degree. When examining this result with experience from practice it could be hypothesised that when a service users level of functioning increases they rely less upon their care givers. Thereupon improved functioning has a positive indirect effect upon carers. There was also a small difference in the percentage of days of abstinence between the two groups with the treatment group proving more favourable. However, the clinical significance of this is questionable. Although carer outcomes we re reported within the Haddock et al (2001) paper they are only briefly examined with more of an emphasis based on cost effectiveness. However, the results do show promise for care givers within the treatment programme, showing some trends towards better personal outcomes. At the 12 month follow up the treatment group demonstrated a reduction in needs and objective and subjective burden. However, these results were not statistically clinically significant. Haddock et al (2003) suggest more intensive work should be done with families due to the high rates of expressed emotion. Baker et al (2006) Baker et al (2006) also produced a RCT to examine the impact a series of sessions of CBT and MI has upon service users with a dual diagnosis. This study was not as robust as the Barrowclough et al (2001) study in relation to randomisation and assessor blindness. Within this study participants were paid for their expenses and time attending assessments. Although the authors suggest this was not enough to influence responses, this procedure was not carried out in similar studies such as the one by Barrowclough and colleagues (Barrowclough et al 2001 and Haddock et al 2003) which should be considered when comparing results. Another negative to this study as with that of Barrowclough et al(2001) was that the interventions were carried out by highly trained psychologists; Echoing the argument of generalisability. On a positive note this study did have a larger number of participants almost double that of Barrowclough et al (2001). Baker et al (2006) suggest both this trial and the one car ried out by Barrowclough and colleagues suggest improvements in substance misuse. However from the results these improvements appear minimal. Baker et al (2006) also report that there was no significant difference in improvement of functioning or positive symptoms; providing opposite and contrast results of the Barrowclough et al (2001) study. Baker et al (2006) conclude that this study demonstrates that this challenging case group (service users with dual diagnosis) is able to engage in CBT and demonstrate positive results. Although this ‘excellent therapy-attendance could be questioned due to the use of payment for time and travel. Graham et al 2006 This study carried out by Graham et al (2006) differs from those discussed above in that it is not a RCT, it is a preliminary evaluation of the impact of C-BIT training on 3 assertive outreach teams and service user outcomes and is not an RCT. Care co-ordinators from 5 assertive outreach teams were allocated to two groups. One of which received immediate C-BIT training and the other groups training was delayed. Results of the training demonstrated increased confidence of care co-ordinators in working with substance misuse and mental illness. Graham et al (2006) suggest these findings illustrate the effectiveness of such training and highlights the extent to which implementation actually occurs. They suggest their findings add evidence to the recommendations made for implementation of interventions for this client group presented in Mental Health Implementation Guide: Dual Diagnosis Good Practice (DOH 2002). Graham et al (2006) also discuss the impact of such training upon service user outcomes. The results highlighted an improvement in engagement, reduction in alcohol use and a reduction in positive alcohol related beliefs. Demonstrating that this team approach to C-BIT shows promise. This report does not measure impact on care giver outcomes. All of the reports mentioned here suggest further research is needed to establish a firm evidence base for integrated treatment programmes that use interventions such as CBT, MI and FI. Nonetheless, they do provide a good grounding for recommending that such interventions show promise for enhancing service user and carer experience. In order to do this there may need to be a change in service provision. For example for a change within treatment philosophy of a team may mean that all staff must be trained preferably at the same time (Graham 2004). This causes barriers on numerous levels such as cost implications of all staff receiving training, back fill of their hours, cost of trainer and venue etc.. Potential barriers may occur when implementing these newly acquired skills and knowledge due to feelings of diminished confidence as part of the learning process (Atherton 2008). Discussion Substance misuse services separated for mental health services some time ago (Conley Benishek 2003) and as a result mental health professionals have limited training and experience in working with people who misuse substances. In addition, many drug and alcohol workers have only had minimal education in mental health issues (Frankel 1996). This could result in mental health professionals and substance misuse workers feeling unequipped in working with people with a dual diagnosis; resulting in them receiving inadequate care. A way to overcome this is for more health professionals to acknowledge their deficits in knowledge and attend training. Perhaps as a result of having minimal education in the field of substance misuse, negative attitudes towards those who misuse substances is still present (Howard Chung 2000 and Richmond Foster 2003). This can take the form of moralistic and stereotypical attitudes leading to mistrust, suspicion and avoidance on both sides. Evidence indicates that when such attitudes are held problems of substance misuse are often overlooked and not dealt with or referred on (Howard Chung 2000). Table 6: Luke Case Study Luke was brought up in a deprived area of a large city and often experimented with illicit substances with his friends. He had a very poor relationship with his mother and siblings (although he did reside with them) and never saw his father. Luke started to hear voices at the age of 18 and was soon admitted to an acute unit where he commenced anti-psychotic medication. Luke was discharged from hospital back to his home. Lukes motivation was draining and he was experiencing little enjoyment in life. it wasnt long before he stopped taking his anti-psychotic medication because it was making him put on weight and causing side effects. L

The Importance of Organ Donation Essay -- Organ Donor Health Medical P

The Importance of Organ Donation   Ã‚  Ã‚  Ã‚  Ã‚  Each day approximately 6,300 people die and what makes this haunting is that presently there are 83,513 people waiting for organs to be donated, yet each day 17 people die because they do not receive a transplant (http://www.donatelife.net/facts_stats.html). These statistics show that people who are waiting for organ transplants have a good chance at being saved and get what they need. The sad truth is though, because of the lack of people willing to donate organs, many people will continue to wait for organs to save their lives. ?Waiting lists of patients for organ transplants become longer as the need for transplantable organs increases? (Sheehy 1). Think back to how someone might feel when a close family member or friend dies. With out argument, the feeling one experiences when going through a time like that is one of the most painful experiences. The feeling when one gets when they know that they will never again see the person you loved so much, never hold th em, touch them, experience their presence. It is a horrible feeling. What many do not realize is simply by donating organs, you can help someone else not have to deal with that pain.   Ã‚  Ã‚  Ã‚  Ã‚  Organ donation is when someone who has died, has previously given permission for their organs to be taken from their body and transplanted into someone else?s who because of some sort of medical condition, can not survive off of their own. At the time of death one?s heart, intestine, kidneys, liver, lung, pancreas, pancreas islet cell, heart valves, bone, skin, corneas, veins, cartilage, and tendons can all be used for transplantation. Choosing to donate organs is beneficial to many people, morally the right thing to do when you pass on and, is also one of the most important ways for survival of many people.   Ã‚  Ã‚  Ã‚  Ã‚  Organ donation is often perceived with doubt because many people do not know the truth. There are many myths out about the donating of organs that cause many people to opt not to. What many do not realize is the truth about organ donation. The body of the donor after the surgery is not mangled up and is presentable for the funeral. Organ donation is ethical and should not be looked down upon. Organ donating is there to save lives, not to hurt anyone. Many people think that they should be paid or given something in return for donating their organs, which is... ...en through the example of Nickolas Green, when you donate organs you not only save one life, but often numerous. Your body has so many vital organs and tissues that can be donated and given to many different people. For many of these people, what you donate to them, can be a matter of life or death. If they don?t receive a donation soon enough, their time will run out and they will pass away. By donating organs you are giving of your body, something that will never again by seen after death. You are making the morally correct decision to help others. It seems we are all brought up to help others and give of yourself, and what better way to do so then by donating of your organs.   Ã‚  Ã‚  Ã‚  Ã‚  When you go to get your drivers licence, be sure to mark that you will donate. Put yourself in the shoes of someone waiting for a donation. They hear of people dying and yet nothing will happen for their benefit if these people don?t choose to donate. Picture you husband or wife, on their death bed unless someone will donate their organs. Make the right decision to bring happiness out of death. Do not put your organs to waste, help those in need, and choose to donate.   Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  

Incorporating Nonverbal Communication into Dietetics and Nutrition Essa

1.1 Introduction This research paper makes recommendations for incorporating nonverbal communication into Dietetics and Nutrition. 1.2 Limitations This report is limited to paralinguistics, gestures, clothing and adornment within nonverbal communication in the field of Dietetics and Nutrition. 1.3 Scope This report aims to highlight the importance of paralinguistics, gestures, clothing and adornment in the setting of Dietetics and Nutrition. Peer reviewed articles and theoretical evidence provided to address how we change individual’s perceptions of professionals by using nonverbal behaviours therefore effecting client health outcomes. Advice and strategies for improving client /professional relationships are included. 1.4 Methodology To complete this report, data was collected over a 5 week period using resources from the Internet and Library of the University. Theoretical evidence was also taken from the Communication Theory textbook. The data was collected and analysed from numerous authors of peer reviewed articles that discussed in varying degrees the many aspects of nonverbal communication. 2.0 Outline of nonverbal communication and link to Dietetics and Nutrition Non-verbal communication plays an integrative role for successful client/professional relationships in the field of Dietetics and Nutrition. Non-verbal communication effects the way we a person perceives our level of empathy, trust, competence, therefore can effect the success of client outcomes. Clothing and adornment, paralinguistics and gestures are aspects of non-verbal communication that are used in conversing consciously or subconsciously, conveying a message to another about themselves and their purpose. Problems can occur... ... p. 504). Koster, FRT. (2005). The power of communication. Modifying behaviour: effectively influencing nutrition patters of patients. European Journal of Clinical Nutrition, 17-22, . Koster, FRT.,Verheijden, MW., & Baartmans, JA. (2005). The power of communication. Modifying behaviour: effectively influencing nutrition patterns of patients. European Journal of Clinical Nutrition, 17-22. Mishra, B. (2009). Role of Paralanguage in Effective English Communication. The Icfai University Journal of Soft Skills, 29-36, NSControl. Nair, B.R., Attia, J., Mears, S. & Hitchcock, K. (2002) Evidence-based physicians’ dressing: a crossover trial. M.J.A. 177, 681–682. (as cited in Cant, 2009, p. 504). Rane, D.B.. (2010). Effective Body Language for Organizational Success. The IUP Journal of Soft Skills, 17-26, . Incorporating Nonverbal Communication into Dietetics and Nutrition Essa 1.1 Introduction This research paper makes recommendations for incorporating nonverbal communication into Dietetics and Nutrition. 1.2 Limitations This report is limited to paralinguistics, gestures, clothing and adornment within nonverbal communication in the field of Dietetics and Nutrition. 1.3 Scope This report aims to highlight the importance of paralinguistics, gestures, clothing and adornment in the setting of Dietetics and Nutrition. Peer reviewed articles and theoretical evidence provided to address how we change individual’s perceptions of professionals by using nonverbal behaviours therefore effecting client health outcomes. Advice and strategies for improving client /professional relationships are included. 1.4 Methodology To complete this report, data was collected over a 5 week period using resources from the Internet and Library of the University. Theoretical evidence was also taken from the Communication Theory textbook. The data was collected and analysed from numerous authors of peer reviewed articles that discussed in varying degrees the many aspects of nonverbal communication. 2.0 Outline of nonverbal communication and link to Dietetics and Nutrition Non-verbal communication plays an integrative role for successful client/professional relationships in the field of Dietetics and Nutrition. Non-verbal communication effects the way we a person perceives our level of empathy, trust, competence, therefore can effect the success of client outcomes. Clothing and adornment, paralinguistics and gestures are aspects of non-verbal communication that are used in conversing consciously or subconsciously, conveying a message to another about themselves and their purpose. Problems can occur... ... p. 504). Koster, FRT. (2005). The power of communication. Modifying behaviour: effectively influencing nutrition patters of patients. European Journal of Clinical Nutrition, 17-22, . Koster, FRT.,Verheijden, MW., & Baartmans, JA. (2005). The power of communication. Modifying behaviour: effectively influencing nutrition patterns of patients. European Journal of Clinical Nutrition, 17-22. Mishra, B. (2009). Role of Paralanguage in Effective English Communication. The Icfai University Journal of Soft Skills, 29-36, NSControl. Nair, B.R., Attia, J., Mears, S. & Hitchcock, K. (2002) Evidence-based physicians’ dressing: a crossover trial. M.J.A. 177, 681–682. (as cited in Cant, 2009, p. 504). Rane, D.B.. (2010). Effective Body Language for Organizational Success. The IUP Journal of Soft Skills, 17-26, .

Lord Of The Flies Essay :: essays research papers

The book, Lord of the Flys, can be interpreted in many different ways. Depending on the point of view of the reader, William Golding has opinions on man and society. Golding is inaccurate for making the assumption that all people are born with evil within them and are not affected by their surroundings. In the book, the author uses a being called â€Å"the beast† to simulate the fear and evil people have inside. The boys on the island apparently see a beast in the forest, which scares them and gives them nightmares. Phil says at a meeting, â€Å"Last night I had a dream, a horrid dream, fighting with things. I was outside the shelter by myself, fighting with things, those twisty things in the trees.† Phil had heard things about he beast from other boys, which caused him to have the nightmare. He is a young boy, on an island with no supervision and is afraid of what’s is happening to him and where he is. Without thoughts of the beast, provoked from the other boys, Phil would never have experienced this nightmare. Not only the thoughts that the boys think affect them, but the things they see cause them to have evil intentions.   Ã‚  Ã‚  Ã‚  Ã‚  Golding used a pig’s head on a stick called â€Å" the lord of the flys â€Å" as another animation to substitute the thoughts of evil and fear within the boys. Seeing the head causes Simon to have hallucinations of this head talking to him. The Lord of the Flys says â€Å"   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   .† After hearing this, Simon returns to the other boys, who are rallying around a fire, indulged in a victorious chant, and is soon trampled to death by the preoccupied boys. Being away from civilization has driven the boys to near delirium and as any person does, they easily got wrapped up in their success. These kids are too young and inexperienced to be alone in the world without any kind of

Notes on How to Write a Good Essay

Robert Cormier’s book ‘Heroes’ opens by introducing us to the main character Francis Cassavant, a ex-military soldier, wounded by a grenade from when he fought in World War Two. There are three main characters in this book; Francis, Larry and Nicole. Throughout this book Cormier gives an insight into how all these characters interlock, with Francis’ mission, to kill Larry LaSalle. In the first chapter of this book Cormier introduces us to the main character of Francis Cassavant, and how he is presented as a hero; this chapter is based entirely on his appearance after a grenade attack from when he fought in the war. Francis’ appearance has obviously changed dramatically as he refers to his face as a ‘gargoyle’ and that he has ‘no face’. Francis also refers to himself as the ‘hunchback of Notre Dame’ and that he is ugly with ‘no ears to speak of’ and ‘the absence of my nose’. This suggests that that he has been in a terrible accident and instantly makes you empathise, and feel sorry for him, but as you further progress through the book you see that maybe that Francis isn’t the hero and as innocent as he seems at first glance. To add further detail Cormier describes his nostrils as ‘two small caves’. This portrays his face as almost like a monster or a mutant. We can infer from the text that Francis has low self esteem and has little or no confidence in himself and when his doctor says ‘don’t expect anyone to pick you for a dance’ doesn’t really help with the fact when he knows he’s ‘not normal’. Francis hides his face with scarves, a hat and a bandage fastened with safety pins, hiding his face tell us that he does not want to be recognised or perhaps to be seen by anyone he knows in Frenchtown. People glance at me in surprise’ and ‘I don’t blame them’ shows that Francis is obviously repulsed and disgusted by the way he looks but isn’t afraid to say so, and also if he looks terrifying and repulsive, he isn’t going to be thought of as a hero. After in depth of describing the physical description of Francis, Cormier then moves on to the main plot, Francis’ mission to kill Larry LaSalle, dropping in little hints and sending up an ‘our father’ and ‘ ail Mary’ and ‘glory be’ for Larry LaSalle, and sending up prayers for Nicole Renard, instantly bringing all the three main characters together but still keeping them separate and not knowing why they are interlocked and how everything is more complicated then it seems behind the eyes of Francis, Larry and Nicole, and how Francis and possibly Larry could either be heroes or cowards. Making Francis seem like an innocent war hero is an interesting and unusual move to make because it makes you feel sorry for Francis at the beginning but as the story unfolds you see that there is more than meets the eye about Francis and how his ‘heroic status’ isn’t as heroic as it seems. One of the ways Cormier presents the concept of heroes is in chapter nine, the chapter when Larry LaSalle reveals he is going off to the ‘fight the japs’ in the Second World War. So when the news first broke that Japan had bombed Pearl Harbour in an attack, a wave of frenzy and fear washed over America. People had ‘patriotic fever’ meaning that they weren’t just feeling patriotic about their country; it was as though a fever had taken over and had plagued through everyone. That day Larry LaSalle stood before everyone in the wreck centre, his ‘movie-star smile gone replace with grim faced determination’ he was ready to go and ‘fight the japs’ he announced that he was going to war, he had ‘anger that we had never seen before flashing in his eyes’. From the quote we realise that Larry is passionate about fighting for his country, but from the way he displays and announces that he is leaving and going to war and when he says ‘none of that kids’ (referring to when the kids clap when he announces he’s going to war) ‘I’m just doing what millions of others are doing’ he almost says it in a way that he wants to be recognised even more as a hero, and he also tries to make it seem as though it’s not important about what he’s doing, but by the way he flaunts it he makes it seem like he’s doing some great and powerful favour for America and the people of Frenchtown. This shows the concept of heroes because as soon as the opportunity comes along to be a hero, Larry will grab it in an instant and makes sure that everyone knows about it and about how it’s making him a hero. This chapter explains the events from Larry returning home, to the episode that happens at the end of the chapter and that is when we come to realise Francis’ hatred for Larry LaSalle. When the crowd are waiting for Larry’s arrival, we see that he is described as ‘Lt. Lawrence LaSalle, US Marines Corps, holder of the silver star’ from this quote we can immediately see that he is being shown as a hero. He is also the star of ‘newsreels’ and ‘radiobroadcasts’ making his seem very important; like a vip – almost a god as far as the town are concerned. They describe him as ‘a bright pied piper’ saying that he can get the towns children to follow him. It shows that he is quite a powerful and a big role model in the children of Frenchtown and maybe not only with children, the adults also seem to love, worship and adore him. In Larry’s actual arrival those there to greet him add the heroic atmosphere. The town goes to greet him at the station, adults, old people and children from the wreck centre are all there to meet this so called hero. When he arrives you instantly remember his ‘movie star smile’ revealing his popularity and confidence. ‘We cheered’ this shows that he is loved and respected by his fellow people and people look up to him as a ‘hero’. You could still see ‘a touch of Fred Astaire in his walk’ implying that he still is the same old Larry, but now ‘lethal’. Him being described as lethal implies that he has changed from coming back from the war; he’s thinner, sleeker. My war hero’ people shout from the crowd. People are proud of him for fighting for their country, they really respect him. ‘Ribbons and medals on his chest’ are a visible representation of him being a hero. Physically the descriptions of Larry show how much he has changed from being a cool dancer to a ‘slen der, knife like killing machine’ he has now changed into a ‘knife-like’ and ‘lethal’ with sharper details, the hero that we saw before has now become a ‘superhero’ in the town’s eyes. ‘You are our celebration’ the mayor proclaims to Larry, emphasising Larry’s heroic status. He is now the town’s hero when he is given ‘the silver key to the city’ people would immediately think that he is of high heroic status is the mayor gives him something so important to the city. When he gives his big speech he says ‘we need to keep the world safe for these young people’ saying this he is almost trying to cover up for what he does later. At the celebration, towards the end Larry tries to get Francis to leave the wreck centre, so he can have ‘one last dance’ with Nicole, he says that ‘this is important’ and he manipulates Francis. Just me and her alone’ makes it feel like something terrible is going to happen. So Francis leaves, ‘I’ve got to go, you and Larry stay. One last dance’ his words sounding false as though Larry placed them in his mouth. She wants him to ‘stay and watch’ but he leaves, to his and Nicole’s misfortune. When the attack happens, it shows just how unheroic and cowardly both Larry and Francis are. ‘In the shadows of the hallway’ Francis lurks waiting for Nicole to leave the Wreck centre, but then Larry does the most inexplicable, disgusting thing, he sexually assaulted her. A sound that could have been a moan and a rustle of clothing’ even though Francis knew something was going on in there, he still couldn’t pluck the courage to go see if his girlfriend was alright. When she ‘stumbles out of the hallway’ she sees Francis, and he saw ‘the betrayal of her in her eyes’ as she runs away, Francis hears Larry, this now shows how wrong people were about Larry and about how he is not a hero but something of the complete opposite ‘whistling the tune-‘dancing in the dark’ as though he had done nothing wrong, that this was no rmal. It’s amazing that the heart makes no noise when it cracks’ Francis is truly heartbroken, and it shows just how cowardly Francis and Larry can both be. In chapter 14, we see how much of a hero Francis could be when we finally get to the part where he goes to kill Larry LaSalle, Larry is no longer a hero. When he sees Larry you can see that Larry’s physical appearance has changed drastically as he’s ‘yellowed with age’, a bit ‘feeble now’, and ‘fragile now’, with ‘white hands’. Larry is not innocent’ and no longer a hero. Francis explains his unannounced visit, with a gun in his hands. Larry ‘rises slowly’ from his chair as Francis begins to question him. ‘You were our hero’ Larry was their hero, he did everything for the people of Frenchtown and now his heroic status had just fallen through the roof, ‘ no more sweet young things’ Larry says, saying as though its normal to sexually assault someone who’s young. Even there heat is sweet’ he says giving Francis even more of a reason to kill him, but he falters when Larry says ‘does that on sin wipe away all the good things. ’ He falters because he’s probably thinking about what he did for him, with the Table tennis and if it wasn’t for Larry renewing the Wreck Centre, Francis would never had been with Nicole, with all these mixed emotions and feelings Francis walks away. But when Francis walks away ‘the sound of a pistol shot cracks in the air’ Larry LaSalle had shot himself. Cormier presents the idea of heroes in his novel, one by setting it in the time of World War Two, which has lots of potential for heroes because theirs the concept of being a soldier. He also presents the idea of heroes by making two characters seem like heroes at first glance but then stripping them of their heroic status by things that come to haunt them from the past that had never been dealt with. Also with Nicole Renard and how she is the innocent victim in this and how one incident made both Francis and Larry cowards and very un-heroic.