Ancient Mars Rocks Show Evidence of Water

Essay on Gender Inequality in Medical School - 1718 Words

Stereotypes have been around forever: the preconceived belief about a type of person or group. Stereotypes can remark on different races or cultures like Polish people or African American people. For example, stereotypes may say Americans are lazy obese, or unintelligent. There are also many stereotypes about genders. For example, women are weaker than men or women like to cook more than men or they are better caretakers. This discussion addresses major controversial stereotypes within medical schools and health institutions across America. For centuries women have faced the challenge of gender inequality within their medical education and profession. Different medical fields in schools, practices and institutions have different types of†¦show more content†¦Awareness is also growing within med schools and even in the working field. For example, people are seeing issues with inequality in the forms of treatment, promotions and pay levels. The gender gap in pay has been well documented, but what was not understood was whether academic accomplishments could overcome the pay gap. Our study found that, across the board, men are being paid substantially more than equally qualified and accomplished women at academic medical centers† (DesRoches, â€Å"Gender Inequality In Academic Researchers’ Compensation†). These types of studies help awareness to grow which is one way to begin resolving the issues of inequality. These advances are truly evident, but the inequalities are still also evident. Today one major gender inequality that is constantly seen in books, lawsuits and news articles is from the fact that more women want to be doctors. In the last 30-40 years the number of women in the physicians and surgeon medical fields has more than tripled. â€Å"Gender comparisons in professional orientations should suggest ways that the recent increase in the proportion of women in medical school might affect the practice and profession of medicine† (Leserman 142). There are many situations in American hospitals everywhere that do not want women as doctors, simply because they prefer men to play that traditional role. The stereotypes that people believe are that women should stay home and raise a family, orShow MoreRelatedThe Effects Of Gender Inequality On India1604 Words   |  7 PagesEffects of Gender Inequality in India Gender inequality in India has taken a toll on various aspects of everyday life. Unequal treatment of the sexes in India has determined one’s standing on the social hierarchy. It has also caused a sole gender to dominate the majority of power in government. It also has caused a single gender’s opinions to be unheard and completely disregarded. Unfortunately, India’s unequal treatment among genders has caused women to be more susceptible to diseases. Gender inequalityRead MoreAnalysis Of The Article The American Ideal 964 Words   |  4 Pagesequality. Economic inequality has surged into a greater issue over the past several years. Gender inequality is something that has began to reduce in the US ever since the 1900s. Even though big changes have been made, gender inequality stills exists in the workplace due to many reasons. Furthermore, ever since colonial times, racism has been a prodigious problem in the United States . Examples of racial inequality include s poverty and education, as a result, racial inequality has become an obstacleRead MoreIn January 2013 a prominent national US newspaper quoted former Secretary of State, Condolezza800 Words   |  4 Pagesyou are going.† However, In â€Å"The Land of Opportunity,† James Loewen discusses how significant inequality is in America. The social class that you are born into will influence your outlook on social class and will also be the social class you stay in (Loewen, 1995. 322). Your social class will determine the opportunities available for you including health, fitness, nutrition, education, SAT scores, medical resources and more (Loewen, 1995. 321-322). Loewen also proposes that the education system inRead MoreGender Inequality1675 Words   |  7 PagesGender Inequality The issue of gender inequality is one which has been publicly reverberating through society for decades. The problem of inequality in employment being one of the most pressing issues today. In order to examine this situation one must try to get to the root of the problem and must understand the sociological factors that cause women to have a much more difficult time getting the same benefits, wages, and job opportunities as their male counterparts. The society in which we liveRead MoreRacial Gap And Social Mobility1139 Words   |  5 Pagesline with its effects in today’s attainment of life chances and opportunities by individuals for social mobility, we are prompted to conceptualize on matters appertaining to civil rights of individuals in various fields ranging from job allocations, medical attention, education, and distribution of resources. Social mobility refers to a tier in an open system of social strata that involves movement of various categories of people in a societal set up and majorly highlights issues to do with these people’sRead MoreNo Daughter By Sandra Cisneros894 Words   |  4 Pagesand racism ideologies, not only based on gender differences, but in skin color, body shape, and culture as well. Furthermore, the short story â€Å"Only Daughter† by Sandra Cisneros can be effectively analyse through the feminist lens in the belief of oppression, constructions of patriarc hy, and multiple traditions ; to illustrate women struggle in the limitations and restrictions in the search for social acceptance and to bring consciousness that gender inequality is a crucial issue that must be resolvedRead MoreCorrelation Between Income And Infant Mortality1722 Words   |  7 Pagesenvironment, social or political change, etc. Therefore it would be beneficial to study shocks to a smaller system, just as Goldin Margo (1989) did in their analysis on impoverished areas in mid-nineteenth century Philadelphia. They examined the medical records from the almshouse hospitals in the region from 1848 to 1873, and showed that the nutritional status of the infants were surprisingly good(with the exception of the Civil War period). The average weight of the infants born were somewhere betweenRead MoreGender Inequality Within The United States1701 Words   |  7 PagesGender has had a repeating effect on the choice of careers for people all throughout the United States. In history, it is taught that males dominated women in many careers, while women dominated males in only a few other minor positions. Males had an upper hand over women in engineering and in the military. One of the reasons males dominated was the idea of dominance over women has been passed down for centuries. It was never common for a women to be an engineer of a home or anything that wasn’tRead MoreThe Correlation between Poverty and Gender Inequality1211 Words   |  5 Pages Topic: Poverty and Inequality Key Question: To what extent do poverty and gender inequality affect each other? INTRODUCTION: Gender equality, women’s empowerment and good standard of living (financial stability) are important in their own rights. Today gender inequality is not only a cause of women’s poverty but also a barrier to tackling general poverty.Gender inequality impacts on whether women can benefit from development. Unequal distributionRead MoreGender Inequality Within The Workplace1379 Words   |  6 Pages  Gender inequality refers to unequal treatment or perceptions of individuals based on their gender. It arises from differences in socially constructed gender roles as well as biologically through chromosomes, brain structure, and hormonal differences. There is a natural difference also in the relative physical strengths of the sexes. In the workplace Income disparities linked to job stratification Wage discrimination exists when workers are equally qualified and perform the same work but

Theodore Roosevelt and Woodrow Wilson free essay sample

Despite the criticism of their reform efforts, Presidents Theodore Roosevelt and Woodrow Willows commitment to and success In achieving national reform made them successful progressive presidents. There hasnt yet been a presidency that didnt receive criticism, with or without Justification. Roosevelt in particular, received a lot of praise and criticism for his successes and failures. Overall, however, both Roosevelt and Wilson acknowledged and were committed to bringing about changes during their presidencies.They were both good presidents for the Progressive Era. President Roosevelt was deeply criticized during his presidency. Robert La Foliate, the Republican leader of Progressivism before Roosevelt, was one of Roosevelt biggest critics. In his Autobiography: A personal narrative of political experiences, he talks about Roosevelt reform policies, particularly his position on the Ann-Trust Law and his trust strategy In general, and how he didnt solve the problems, but only increased the growth of monopolies and the power of business (Doc E). We will write a custom essay sample on Theodore Roosevelt and Woodrow Wilson or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page There were also many political cartoons published which criticized Roosevelt policies. One In particular pictures Roosevelt singing loudly his Progressive fallacies, with La Foliate sulking in the background (Doc G). There was justification to criticize Roosevelt. Although he was infamous for his square deal, taking on trusts, he busted only about half as many trusts in twice as much time as President Taft later did. The cases he did take on were high profile, and he was noisy about them. Also, he may have only fought trusts because he thought it would be riskier to ignore them.Woodrow Wilson also had policies that were controversial, and the extent of his regressive can be questioned. Willows progressive attitude didnt extent to many areas. For example, he didnt reform the way government corruption occurred. He would even encourage this by giving his friends rewards and punishing his enemies. He operated on a animal spoils system. He was also quite racist. His reform polices didnt extend to African-Americans. He appointed many southern racists to his cabinet and was strongly opposed to black suffrage. He considered enfranchisement an evil.Wilson also didnt want to reform social injustices. Offering no support for the ratification a suffrage movement, Wilson preferred state action for womens suffrage. Child labor was another issue he considered a state matter. Reform was something Wilson only considered on certain issues. Despite questions of motive and success, Roosevelt can be considered a successful progressive president and reformer. In his first Inaugural address, he addressed the problems that needed reforming and that he was aware of the issues and prepared to fight them (Doc B).In High Regard for Theodore Roosevelt by Afro-Americans, room the Cleveland Journal In 1 903, Its discussed that African Americans favored Roosevelt policies. The article also quotes Roosevelt telling the country that he wont square deal sought to create a moral approach to many social problems. In his speech, The New Nationalism, he distinguished between what he considered good and bad trusts and he would not respect labor organizations simply because they represented workers, but based on merits (Doc H). He tried to enforce existing anti- trust laws rather than creating new ones.The square deal called for tighter control of gig business, particularly less power for the railroads. In Roosevelt Annual Message to Congress in 1908, he discussed the corruption in business and how he will reform corporations and reduce their power (Doc F). Roosevelt had many successful endeavors as president. Woodrow Wilson was also a successful progressive president. In his first inaugural address, he discussed all the reforms he planned to overtake. Among these were reforming tariffs, reorganize banking, and more (Doc A).His second inaugural address looked back on his first four years and discussed their success (Doc D). There were many successes to discuss. Wilson took great initiative to reduce tariffs. To discuss the issue, he called Congress into session, something a president hadnt done since John Adams. He proposed a bill to reduce tariffs, which passed through the House immediately. The Senate also passed what would later become the Underworld-Simmons Tariff, after Wilson made a public statement appealing to the Senate regarding the passage of the bill. Wilson also created the Federal Trade Commission, which regulated big business, and still operates successfully to this day. These programs were important victories for the Progressive Era. President Roosevelt and President Wilson were both important progressive presidents. Many of the changes they brought about still affect our society today. Despite criticism, they did good things with their presidencies. Each had a different approach to progressivism, but thats what progressivism was. Progressivism was change and reform. Both presidents were successful in bringing this about, and both presidents impacted society for the better.

The Life of Believers Essay Example For Students

The Life of Believers Essay GCSE RS CourseworkAO2Referring to the types of baptism you have outlined, explain its meaning and importance in the life of believersBaptism is important to all Christians as it is how they enter the church and the church community, whether they are baptised as an infant or as an adult. Many Christians see Baptism as a sacrament. A sacrament is more than a symbol that reminds people of something. It is an action which Christians believe is a channel for Gods presence, which through the outward action an invisible happening takes place. Christians see either infant baptism or adult baptism as what they prefer, but both are very important. Christians find infant baptism because they believe that baptism states the start of eternal life and that at baptism the child is born as a child of God, as a new beginning. Because baptism welcomes people into the family of God, many Christians would like their child to be in the family of God from an early age. In the infant baptismal service, par ents and godparents promise to provide a Christian upbringing for their child and to persuade the child to make a personal dedication to God at a confirmation ceremony when they are about eleven or twelve. We will write a custom essay on The Life of Believers specifically for you for only $16.38 $13.9/page Order now Many Christians believe that when a human being I born they already have a sin called original sin, as it is arduous to envisage an infant, so young, to be capable of sin. At such a young age, children do not know the distinction between right and wrong, but many Christians believe that when a human is born they are capable of sin, and to go against the wishes of God. The water in the font, when blessed, is seen as the Holy Spirit entering the life of the new-born child, giving him or her strength to fight these primitive instincts of future years. In the case that a child is born weak and is struggling to survive, Christian parents may request the child is baptised at the hospital, but on the condition that if he or she were to live, they would be welcomed into the family of God at a later date. In the days of the Early Church, adults who came to believe in Jesus as Saviour and Lord were baptised. Those who follow the practise of Believers baptism say that Jesus was baptised as an adult and therefore they should too. The word baptise comes from the Greek word baptizo meaning to dip. Christians who follow the practise of Believers baptism believe that total immersion follows the way in which Early Church Christians were baptised. In Baptist churches, the adult(s) are baptised in a small pool, or baptistery, which is placed at the front of the church, to symbolise the importance of baptism. Christians wish to identify themselves with the death, burial and resurrection of Jesus. In the service, they enter the pool by a set of steps, which shows that they wish to leave their old sinful life behind. When they are immersed, it shows their old life has died, and that the Christian is buried in the same way as Jesus was buried in the tomb. As they leave the pool, it symbolises them entering their new life as a Christian, like Jesus rose from the dead.

Computer programm essay Essay Essays

Computer programm essay Essay Essays Computer programm essay Essay Essay Computer programm essay Essay Essay Computers have brought about a revolution across all industries. They have changed the face of society. They are no longer specialised tools to be used by specially trained people. They are omnipresent and used in about every domain of life. Computers are the best agencies for storage and direction of informations. they can function as immense cognition bases and can be harnessed for all kinds of fiscal minutess owing to their processing power and storage capacities. As computing machines are a day-to-day public-service corporation. they have gained huge importance in daily life. Their increasing public-service corporation has made computing machine instruction the demand of the twenty-four hours. By computing machine instruction. we mean. deriving the know-how of the basic constructs related to a computing machine and deriving the basic cognition of computing machine operation. Knowing about the basic constituents of a computing machine. the basic constructs behind the usage of computing machines and the know-how of some of the simple computing machine applications constitutes computing machine instruction. Learning about the computing machine rudimentss followed by a practical experience of utilizing a computing machine is the key to computing machine instruction. As computing machines are widely used today. geting computing machine instruction is the demand of the twenty-four hours. Computers are non merely storage devices and treating units. but besides are first-class communicating media. They are the agencies to entree the Internet and acquire connected to the universe. They are besides an effectual audio-visual media. Computers can be used to entree a huge cognition base and hunt for information archives over the Internet. Merely computing machine instruction can ease the usage of computing machines for intents of communicating and amusement. Computer cognition coupled with certain other occupation accomplishments increases one’s opportunities of acquiring a occupation. Those with cognition of computing machines are considered trainable for many sorts of occupations. As most of the occupations involve the usage of computing machines. computing machine instruction is an eligibility standard for about all the contemporary occupations. Higher instruction affecting web disposal. hardware care or package accomplishments unfastened doors for brighter occupation chances. Computer instruction helps one manage one’s ain concern assets and personal fundss. Computers serve as efficient means for direction of information. Personal fiscal assets. medical records and of import paperss can be stored in an electronic format in a computing machine system. Today. banking minutess and payments of measures can be done over the Internet. Similarly. on-line shopping is going widely popular. To be in the race. it is really of import to take computing machine instruction. The word processing applications of a computing machine service as an effectual agencies of certification. The database direction package that are a portion of computing machine systems serve as the agencies of pull offing big sums of informations. The networking capablenesss of a computing machine facilitate connecting to the Internet to make out to the universe. Bet oning applications and media participants are some of the popular computing machine package. which are popularly used across the universe. Computers. which have such a broad assortment of applications. are so governing society. To maintain up the gait in this fast life of today. computing machine instruction is highly of import. Computers are an built-in portion of life and so is computing machine instruction! Read more at Buzzle: hypertext transfer protocol: //www. buzzle. com/articles/importance-of-computer-education. hypertext markup language

Roman Army - Recruitment, Legions, Siege Warfare More

Roman Army - Recruitment, Legions, Siege Warfare More The Roman army (exercitus) did not start out as the superlative fighting machine that came to dominate Europe to the Rhine, parts of Asia, and Africa. It began like the part-time Greek army, with farmers returning to their fields after a quick summer campaign. Then it changed into a professional organization with long terms of service far from home. The Roman general and 7-time consul Marius is considered responsible for the change of the Roman army into its professional form. He gave the poorest classes in Rome the opportunity to be career military, gave land to veterans, and changed the composition of the legion. Recruitment of Soldiers for the Roman Army The Roman army changed over time. The consuls had the power to recruit troops, but in the last years of the Republic, provincial governors were replacing troops without the approval of the consuls. This led to legionaries loyal to their generals rather than Rome. Before Marius, recruitment was limited to citizens enrolled in the top 5 Roman classes.  By the end of the Social War (87 B.C.) most of the free men in Italy were entitled to enlist and by the reign of Caracalla or Marcus Aurelius, it was extended to the entire Roman world. From Marius on there were between 5000 and 6200 in the legions. Legion Under Augustus The Roman army under Augustus consisted of 25 legions (according to Tacitus). Each legion consisted of about 6000 men and a large number of auxiliaries. Augustus increased the time of service from 6 to 20 years for legionaries. Auxiliaries (non-citizen natives) enlisted for 25 years. A legatus, supported by 6 military tribunes, led a legion, composed of 10 cohorts. 6 centuries made a cohort. By the time of Augustus, a century had 80 men. The leader of the century was the centurion. The senior centurion was called the primus pilus. There were also about 300 cavalry attached to a legion. Contubernium of Soldiers in the Roman Army There was one leather sleeping tent to cover a group of 8 legionaries. This smallest military group was referred to as a contubernium and the 8 men were contubernales. Each contubernium had a mule to carry the tent and two support troops. 10 such groups made up a century. Every soldier carried 2 stakes and digging tools so they could set up camp each night. There would also be slaves associated with each cohort. Military historian Jonathan Roth estimated there were 2 calones or slaves associated with each contubernium. The Size and Organization of the Roman Imperial Legion, by Jonathan Roth; Historia: Zeitschrift fà ¼r Alte Geschichte, Vol. 43, No. 3 (3rd Qtr., 1994), pp. 346-362 Legion Names Legions were numbered. Additional names indicated the place where the troops were recruited, and the name gemella or gemina meant the troops came from the merger of two other legions. Roman Army Punishments One way to ensure discipline was the system of punishments. These could be corporal (flogging, barley rations instead of wheat), pecuniary, demotion, execution, decimation, and disbandment. Decimation meant one in 10 soldiers in a cohort was killed by the rest of the men in the cohort by clubbing or stoning (bastinado or fustuarium). Disbandment was probably used for mutiny by a legion. Siege Warfare The first great siege war was waged by Camillus against the Veii. It lasted so long he instituted pay for the soldiers for the first time. Julius Caesar writes about his armys sieges of towns in Gaul. Roman soldiers built a wall surrounding the people to prevent supplies from getting in or people from getting out. Sometimes Romans were able to cut off the water supply. Romans could use a ramming device to break a hole in the city walls. They also used catapults to hurl missiles inside. The Roman Soldier De Re Militari, written in the 4th century by Flavius Vegetius Renatus, includes a description of the qualifications of the Roman soldier: Let, therefore, the youth who is to be chosen for martial tasks have observant eyes, hold his head up, have a broad chest, muscular shoulders, strong arms, long fingers, not too extended a wait measure, lean hams, and calves and feet not distended with superfluous flesh but hard and knotted with muscles. Whenever you find these marks in the recruit, do not be troubled about his height [Marius had set up 510 in Roman measurement as the minimum height]. It is more useful for soldiers to be strong and brave than big. Roman soldiers had to march at an ordinary pace of 20 Roman miles in 5 summer hours and at a fast military pace of 24 Roman miles in 5 summer hours carrying a 70-pound backpack. The soldier swore an oath of loyalty and implicit obedience to his commander. In war, a soldier who violated or failed to carry out the generals order could be punished by death, even if the action had been advantageous to the army. Sources Polybius (c. 203-120 B.C.) on the Roman MilitaryTraining Soldiers for the Roman Legion, by S. E. Stout. The Classical Journal, Vol. 16, No. 7. (Apr., 1921), pp. 423-431.Josephus on the Roman ArmyThe Antiqua Legio of Vegetius, by H. M. D. Parker. The Classical Quarterly, Vol. 26, No. 3/4. (Jul. - Oct., 1932), pp. 137-149.Roman Legionary Fortresses and the Cities of Modern Europe, by Thomas H. Watkins. Military Affairs, Vol. 47, No. 1. (Feb., 1983), pp. 15-25.Roman Strategy and Tactics from 509 to 202 B. C., by K. W. Meiklejohn. Greece Rome, Vol. 7, No. 21. (May, 1938), pp. 170-178.

Lebanon's Confessional System Essay Example | Topics and Well Written Essays - 500 words

Lebanon's Confessional System - Essay Example To bring together Lebanon's diverse religious and political groups into an organized political system that could equally distribute power as well as harmonize with the system of the neighboring Arab countries is definitely a pain. The forces pulling Lebanon apart seemed to be stronger than those of holding it together. Initially, the objective of the French commander, General Henri Gouraud in proclaiming the creation of Greater Lebanon is to safeguard the Maronite community. These are Christians that has the largest religious community in the state. The self-proclaimed protector of the Christian communities in Lebanon wanted to make sure these Maronites won't be absorbed into a Syrian Muslim state. And to ensure they will be dependent of France, several predominantly Muslim areas were added to this new state. Hence, the Maronites do not compose the majority of the population. Political power was based on sectarian affiliations. The Maronites, dependent on French backing to keep their political dominance, assumed political and economic supremacy in their homeland and accepted the Franco-Mediterranean cultural orientation in consequence turned their back to the Arab world. On the contrary, the Sunni Muslims wanted unity with Syria and looked upon the Arabs for their source of cultural identity. The conflict appeared to be endless. Lebanon, dependent of France, does not have good relationship with the Arabs.

The Role of the Colonies in the British Mercantilist System Essay

The Role of the Colonies in the British Mercantilist System - Essay Example This research will begin with the statement that in the early 17th century, England was a second rate producer, merchant and naval force. By the end of the century, it pushed out its first class competitors, such as the Dutch and the French, through its military prowess and economic ingenuity. King James II, a firm believer in the divine right of a ruler, solidified the colonial rule.   Though his successors, who would loosen the grip on the power over colonies, the British Empire was based on commerce and thus its protection through military prowess. British Empire expanded using its colonies as a source of economic progress and status symbol among other countries.   With King James II, British colonies turned into a source of profit and power for the British Empire. King James II attempted to create a centrally managed Atlantic Empire. Though the Glorious Revolution weakened royal grip on power, King James II put forth the foundations of mercantilism, such as the need to expand economically in order to be a glorious empire. British colonies thus served to improve British economic status among other monarchies and independent states and towns in Europe. Mercantilism was a policy promoting self-sufficiency among countries of the day. According to Nettels, â€Å"[t]he policy aimed to gain for the nation a high degree of security or self-sufficiency, especially as regards food supply, raw materials needed for essential industries, and the sinews of war†. With this goal in mind, the British aristocracy pursued colonies which could produce sugar, tobacco and other food products. In exchange, they were required to buy English manufactured goods, or use the English merchants as intermediaries (Henretta & Brody 69). This practice was prescribed by the Staple Act of 1663, according to which colonial planters bought most of the needed manufactured goods from England (Nettels 109). England prohibited trade with other European countries, as it could not impose favorable terms of trade (Nettels 105). English government designed laws that would keep colonies dependent upon English economy: â€Å"Slaves must be bought from English slave traders. The area must depend upon English sources for capital and credit, and the planters could not avail themselves of legal devices in order to ease their burdens of debt† (Nettels 109). Industrial development overwhelmingly took place in England. English policies were to encourage industrial development by any means possible, such as â€Å"tariffs, bounties and other forms of state aid† (Nettels 113). Unlike the English manufacturers, colonial manufacturers received no such subsidies (Nettels 113). English government ensured the policy was followed by forbidding colonial governments to assist colonies with any help whatsoever in the field of manufacturing (Nettels 113). The British aristocracy encouraged conquest of new colonies, and imposed itself as a naval power (Nettels 106). Mercantilists viewed it a government’s duty to guard favorable terms of trade and to store an adequate amount of gold and silver (Nettels 106). Therefore, according to the Navigation Act of 1661, the mercantilist government prohibited its citizens all trade with foreign merchants and vessels (Nettels 109). Its military ensured the law was obeyed and they even imposed it on the Dutch and the French. However, the mercantilist government did not create activities in the colonies. According to Nettels, economic activities sprang up from colonists, who decided which economic activity was necessary for their survival in new lands (108). As a result, the government only controlled a certain economic activity once it had proven itself to be profitable. The British government retarded the economic growth of plantations. The mercantilist system in England did not aim to promote economic development in its colonies. Mercantilism aimed to extract wealth from

HIS 135 Entire Course Essay Example for Free

HIS 135 Entire Course Essay In this archive file of HIS 135 Entire Course you will find the next documents:HIS-135-Assignment-Cold-War-Ideology-and-Policies. docHIS-135-Assignment-The-Vietnam-War. docHIS-135-Capstone-CheckPoint-End-of-the-Cold-War. docHIS-135-CheckPoint-Comparing-KennedyG History General History ASHFORD HIS 204 American History Since 1865 If dragging yourself out of bed at 6:00 am is impossible, dont torture yourself with 7:00 am classes. Most schools offer classes in a wide range of time slots. Take advantage of the classes later in the day and in the evening if you arent a morning person. You will be more likely to go and will get more out of the course. In this archive file of HIS 135 Entire Course you will find the next documents:HIS-135-Assignment-Cold-War-Ideology-and-Policies. docHIS-135-Assignment-The-Vietnam-War. docHIS-135-Capstone-CheckPoint-End-of-the-Cold-War. docHIS-135-CheckPoint-Comparing-KennedyG History General History ASHFORD HIS 204 American History Since 1865 If dragging yourself out of bed at 6:00 am is impossible, dont torture yourself with 7:00 am classes. Most schools offer classes in a wide range of time slots. Take advantage of the classes later in the day and in the evening if you arent a morning person. You will be more likely to go and will get more out of the course. In this archive file of HIS 135 Entire Course you will find the next documents:HIS-135-Assignment-Cold-War-Ideology-and-Policies. docHIS-135-Assignment-The-Vietnam-War. docHIS-135-Capstone-CheckPoint-End-of-the-Cold-War. docHIS-135-CheckPoint-Comparing-KennedyG History General History ASHFORD HIS 204 American History Since 1865 If dragging yourself out of bed at 6:00 am is impossible, dont torture yourself with 7:00 am classes. Most schools offer classes in a wide range of time slots. Take advantage of the classes later in the day a Follow the link Now for full guide https://bitly. com/1wySlYb If dragging yourself out of bed at 6:00 am is impossible, dont torture yourself with 7:00 am classes. Most schools offer classes in a wide range of time slots. Take advantage of the classes later in the day and in the evening if you arent a morning person. You will be more likely to go and will get more out of the course. History General History ASHFORD HIS 204 American History Since 1865.

Sleep and Dream :: essays research papers

Sleep and Dreams Sleep is a behavioral state characterized by little physical activity and almost no awareness of the outside world. Sleep is actually made up of two separate and distinctly different states called REM sleep (rapid eye movement) and NREM sleep (non-rapid eye movement). With NREM sleep it is further divided into stage 1-4 based on the size and the speed of the brain waves. Step one is the stage when you drift off to sleep or doze off. For example people doze off in class because you are bored and have nothing to do but listen to the teacher talk. Some parents may call it a cat nape when their kids go to sleep for about ten minutes or so. The second stage is called an intermediate stage of sleep. That is when the sleeper will gradually descend deeper into sleep, becoming more and more detached from the outside world and progressively more difficult to awaken. Stage three is the beginning of deep sleep, occurring about thirty to forty five minutes after you first fall asleep. The deepest sleep occurs in Stage four. Stage three and four has the biggest and slowest brain wave. REM sleep, a mentally active period during which dreaming occurs, provided a biological explanation for this phenomenon. Scientists found that brain activity during REM sleep begins in the pons, a structure in the brainstem, and neighboring midbrain regions. The pons sends signals to the thalamus and to the cerebral cortex, which is responsible for most thought processes. There are several myths about sleep. For one, how much sleep a person should get? According to our text book people should sleep for at least eight hours to maintain sound mental and physical health. But every one doesn’t get the chance to slee p for that amount of time. There is no normal amount of time you should sleep. Everyone is not the same. For one I might sleep for five hours and feel refreshed enough to work another shift. Other hand my cousin might need more then eight hours of sleep to feel refreshed. Another myth is that you can learn complicated things, like a new language, while you are sleep. Personally no, because the only way you can learn something is to be awake. When a person fall to sleep while listening to a cd player or tape player while they are sleeping they are not going to hear what is said when they are in a deep sleep. Sleep and Dream :: essays research papers Sleep and Dreams Sleep is a behavioral state characterized by little physical activity and almost no awareness of the outside world. Sleep is actually made up of two separate and distinctly different states called REM sleep (rapid eye movement) and NREM sleep (non-rapid eye movement). With NREM sleep it is further divided into stage 1-4 based on the size and the speed of the brain waves. Step one is the stage when you drift off to sleep or doze off. For example people doze off in class because you are bored and have nothing to do but listen to the teacher talk. Some parents may call it a cat nape when their kids go to sleep for about ten minutes or so. The second stage is called an intermediate stage of sleep. That is when the sleeper will gradually descend deeper into sleep, becoming more and more detached from the outside world and progressively more difficult to awaken. Stage three is the beginning of deep sleep, occurring about thirty to forty five minutes after you first fall asleep. The deepest sleep occurs in Stage four. Stage three and four has the biggest and slowest brain wave. REM sleep, a mentally active period during which dreaming occurs, provided a biological explanation for this phenomenon. Scientists found that brain activity during REM sleep begins in the pons, a structure in the brainstem, and neighboring midbrain regions. The pons sends signals to the thalamus and to the cerebral cortex, which is responsible for most thought processes. There are several myths about sleep. For one, how much sleep a person should get? According to our text book people should sleep for at least eight hours to maintain sound mental and physical health. But every one doesn’t get the chance to slee p for that amount of time. There is no normal amount of time you should sleep. Everyone is not the same. For one I might sleep for five hours and feel refreshed enough to work another shift. Other hand my cousin might need more then eight hours of sleep to feel refreshed. Another myth is that you can learn complicated things, like a new language, while you are sleep. Personally no, because the only way you can learn something is to be awake. When a person fall to sleep while listening to a cd player or tape player while they are sleeping they are not going to hear what is said when they are in a deep sleep.

Foreign Intervention Essay

Developing nations are usually countries that lack stability, whether politically or financially. Intervention in such nations may prove to be helpful in such cases, as it may ensure an increased stability within the country. This is much needed in developing nations, as stability is key to economic prosperity. However, intervention in the internal affairs of another nation may undermine the country’s sovereignty, rendering foreign intervention undesirable, as it does more harm than good from the standpoint of the developing nation. Foreign intervention in the form of humanitarian aid does more good than harm, as it hastens the restoration of infrastructure and provides the citizens with the necessities to tide over difficult times. Natural disasters cause substantial damage to a country, with homes destroyed and lives lost. The people involved are often rendered helpless. Developing nations in particular, may not be able to help much due to the lack of financial reserves. Humanitarian aid given in such times is desired and will be of great help to the people, due to the relief provided in times of distress. An example would be Haiti, which was badly hit by an earthquake. International organizations such as the United Nations and Red Cross Foundation provided food and medical care, alleviating the situation in Haiti. Hence, humanitarian aid brings about many benefits, doing more good than harm. Developing nations embattled in internal turmoil may require foreign intervention to restore political stability in the nation. Repressive regimes such as that in Libya have resulted in brutality and oppression. The people are unable to stand up for themselves to lead a change. The people desire intervention, as they wish to be freed from tyrant rulers. Foreign intervention will aid the citizens in effecting a change that will improve their lives drastically. Furthermore, the political stability that results may restore economic prosperity in the nation, which was not achievable previously due to uncertainty and fear for the future by businesses. Political stability will reduce those fears and create a better environment for the economy to flourish. These benefits are far-reaching and long-term, and are essential to the development of the nation. Hence, foreign  intervention in a developing nation does more good than harm. The intervention in another nation’s internal affairs may undermine national sovereignty, which is an important attribute of modern states today. Sovereignty is of great significance, and no country will willingly allow foreign nations to infringe on their sovereignty. Foreign intervention may result in negative repercussions, such as the strain on international relations. This is seen by Greece’s anger over perceived intervention in their internal affairs by Germany during the Eurozone crisis. Strained relations between countries undesirable for both countries as it may lead to restricted trade, and in turn the loss of economic opportunities. Foreign intervention may lead to long lasting harmful impacts if relations do not improve, hence it does a significant amount of harm. Foreign intervention may serve as a tool in correcting the infringement of human rights, which will do good and justice to the people subjected to unfair treatment. The 1994 Rwanda genocide was an instance where human rights were compromised. The Hutus persecuted the Tutsis, and a coalition of states was prepared to put a stop to that. The intervention will help the Tutsi population escape such brutality and violence. The Tutsis will be able to live a life free of brutality, which will improve their physical well being and be able to lead a more peaceful life. Human rights should never be infringed as it is the basic rights that every human being should possess. Therefore, in cases where human rights are compromised, foreign intervention is warranted and it will bring about more good than harm. In principle, it may seem that the harm outweighs the good if sovereignty, a crucial aspect of every nation, is infringed. However, it depends on the circumstances. The dire need for humanitarian aid, fulfillment of basic human rights and freedom from repressive regimes may surpass the need for sovereignty. It will not be harmful to have foreign intervention. Rather, the people in developing nations will experience many positive impacts, and the country may be able to develop further and prosper, hence foreign intervention does not do more harm than good.

Analysis on All the pretty Horses Essay

The title of Cormac McCarthy’s novel – All the Pretty Horses, reflects the significance and variance of roles that horses play in this coming-of-age story, as they relate to John Grady Cole who is the focus of the novel. The horse, which was the social foundation of Western American culture then, is described as an economical and practical asset to the boys – John Grady and Lacey Rawlins. However, the author also describes horses’ abstract qualities using idyllic and impassioned diction, depicting them as animals of a highly advanced spiritual nature, similar to humans in some ways. John Grady has an intimate relationship with all horses and understands the world of horses extraordinarily well. On his journey from Texas to Mexico, he learns that the world of men is very different from that of horses and is forced to rethink about the relationship between humans and horses. John discovers that his preconceived notions about men and human society are false. He finds that they do not live in a romantic world, as he had believed. Therefore, the title that McCarthy has chosen is ironic and symbolizes the change that John experiences. The author uses the title to represent John’s initial perspective on the world, which turns out to be the opposite later on. John’s life, like all of Western American society during the timeframe of the story, revolved around horses. In fact, I think that he is able to understand the horses more than he does about men. The horses in the novel represent strength, untamed passion, and most importantly, freedom of spirit. The veneration that the vaqueros have for horses is apparent in the tales Luis tells the boys. â€Å"†¦ the old man only said that it was pointless to speak of there being no horses in the world for God would not permit such a thing† (111). I feel that this quote demonstrates to the readers very well on the strong feelings of passion of the vaqueros, cattle-ranchers, that they value horses so highly that they are able to regard themselves as nearly divine. It also reinforces John’s romantic notion that horses are highly spiritual beings. Like the vaqueros, the boys respect the horses, and these animals play large roles in their lives. The boys use horses in many ways throughout the novel, such as companions and as means of transportation or escape. John even has dreams about horses, as â€Å"his thoughts were of horses†¦still wild on the mesa who’d never seen a man afoot and who knew nothing of him or his life yet in whose souls he would come to reside forever† (118). This style of expression used in referring to horses here â€Å"wild† and â€Å"souls† is idealistic and almost poetic. Furthermore, the fact that John dreams about horses in this way and that he wants to â€Å"reside forever† in their souls shows that he, like the vaqueros, thinks of them very highly. Throughout the novel, the author does not fail to use romantic and emotional language to describe horses and their connections to humans. By using venerating diction in describing the horses, the author portrays these animals as noble being with wild spirits. Besides that, with vivid imagery, the author is able to paint us a poignant picture of horses. â€Å"The painted ponies and the riders of that lost nation came down out of the north with their faces chalked and their long hair plaited and each armed for war which was their life†¦When the wind was in the north you could hear them, the horses and the breath of the horses and the horses’ hooves that were shod in rawhide† (5). This introduction of horses in the beginning of the novel demonstrates the passion and dedication that the author attributes to horses. The mood created by words such as â€Å"painted ponies† and â€Å"the breath of the horses† is passionate and emotionally charged. The author also continues to describe the raw energy and life that flows through the horses. â€Å"John Grady†¦was holding the horse†¦with the long bony head pressed against his chest and the hot sweet breath of it flooding up from the dark wells of its nostrils over his face and neck like news from another world† (103). These metaphors such as â€Å"the dark wells of its nostrils† and â€Å"news from another world† create a forceful likeness of mysterious animals with a nature that is foreign to humans. The horse’s â€Å"hot sweet breath†¦flooding up† displays the life and energy that fill the horses. This mysterious energy is also apparent later, when the author writes, â€Å"He rode the last five horses†¦the horses dancing, turning in the light, their red eyes flashing†¦they moved with an air of great elegance and seemliness† (107). This imagery of â€Å"red eyes flashing† and â€Å"horses dancing† is very mysterious yet still striking. The descriptive detail is very cinematic, and any of these scenes could easily be made into a movie. These extremely in depth  descriptions are so exaggerated that they are almost unrealistic, but they are able to create the desired effect in making horses seem mystical and bizarre. These are the romantic creatures that John sees, the â€Å"pretty horses† that can be taken off the title. John Grady’s connection with horses is as mystical as the horses themselves. He is one way or another, able to communicate with all horses on a deeper level than any other character in the story. This is evident on the Hacienda in the scene in which John and Rawlins are breaking some new horses. John â€Å"cupped his hand over the horse’s eyes and stroked them and he did not stop talking to the horse at all, speaking in a low steady voice and telling it all that he intended to do and cupping the animal’s eyes and stroking the terror out† (103). John’s ability to â€Å"stroke the terror out† of the horses is just like in a case of a parent calming a frightened child. Obviously, he must have some natural tie with these animals if he is able to do this. Indeed, the author has already unambiguously stated that such a bond does exist between John Grady and the horses earlier on when he writes, â€Å"The boy who rode on slightly before him sat a horse not only as if he had been born to it which he was but as if were he begot by malice or mischance into some queer land where horses never were he would have found them anyway† (23). This passage shows that John’s relationship with horses extends into the metaphysical range, a view that is reinforced throughout the novel as more is revealed about John Grady and the horses. As Luis says, â€Å"the horse shares a common soul†¦if a person understood the soul of the horse then he would understand all horses that ever were† (111). It seems like as if the author is trying to tell us that John Grady has this ability to be familiar with the soul of the horse, and that is why his relationship with horses is so unique. John’s reliance on his knowledge of horses as a guide in the world of men eventually reveals to him that the two species are actually very different. When John starts out on his journey, he has very little knowledge about the inner workings of the human society, but he has superficially assumed men and horses to be similar. As the author writes in the opening of the novel, â€Å"What he loved in horses he loved in men, the blood and the heat of the blood that ran them. All his reverence and all his fondness and all the leanings of his life were for the ardenthearted and they would always be so and never be otherwise† (6). John knows that horses are â€Å"ardenthearted† and believes that men must be the same too. He thinks that his journey will be a romantic and passionate one, like the horses he loves, and will strengthen his view of the world. However, he soon learns that his assumption is not what the reality is. Before anything unfortunate happens to him, John hears from Luis that â€Å"among men there was no such communion as among horses and the notion that men can be understood at all is probably an illusion† (111). The first doubts then began to creep into John’s mind, and eventually, he finds out about this personally. Instead of â€Å"pretty horses,† John’s journey is filled with murder and stealing, prison and broken hearts. His ill-fated journey proves clearly about Luis’ point, and totally destroys John’s belief that the world of men is at all an understandable thing. Finally, when it is all over, he returns home disappointed, only to find that both his father and his Abuela have died. John’s fanciful concept of the world of men now has been completely replaced by a â€Å"world that†¦seemed to care nothing for the old or the young or rich or poor or dark or pale or he or she. Nothing for their struggles, nothing for their names. Nothing for the living or the dead† (301). The world of â€Å"all the pretty horses† is nothing to him now but a distant memory. This reveals the title’s irony, a story titled All the Pretty Horses would apparently never involve the death and violence that is included in John’s travels. Indeed, John has come â€Å"full circle† and realized that his original assumptions about men were false. The title of McCarthy’s novel All the Pretty Horses is not meant to be taken literally. Before he runs away, John Grady believes in the world of â€Å"all the pretty horses,† because he has never known anything else. However, his time in Mexico disheartens him and forces him to believe otherwise, that the real world is not so simple, carefree, or innocent. John learns that the romanticism that he ascribes to horses cannot be applied to men. John respects horses and experiences the praise of these animals in the folklore of the day. His relationship with horses exists on many levels, by being his  transportation, his friends, and his spiritual companions. Furthermore, the author illustrates the horses with emotional diction creating almost a motif of passion whenever horses are described. John’s unusual understanding of the fervent spirit of horses leads him to believe that men are the same. However, on his bleak and disappointing journey, he learns that men do not have the same passion of spirit as horses. Instead, they are unpredictable, violent creatures, and their world is certainly not always pretty. I think that it is utterly important for us as readers to understand what the author is trying to tell us by looking at the title and try to understand deeper with the details that the author provides us. Initially I thought that this novel is just going to give details of various horses that man uses in many different ways. However, I was completely wrong on making the judgment by its cover – title. This novel teaches us about the reality in human world that no one will be able to predict what is going happen. He illustrates the morals and ethics that have survived throughout the ages, while ending up with nothing else is left, leaving only memories to be reminders of the mysterious and naturally beautiful time period. I am sure after reading this novel, one would never be able to forget the pain, suffering, romance, and above all loyalty inscribed on its pages or in the memories of those who lived through it.

exam answer Essay

exam answer Essay exam answer Essay Semester 2, 2007 Exam Question 1: (a) Financial report disclosure and AGM (5 marks) Pierce Pty Ltd was formed recently. During Pierce Pty Ltd’s first year of operations it hired 75 employees and was expected to be extremely profitable this year. Its three shareholders and respective shareholdings are Burns owns 4% of Pierce Pty Ltd’s shares; Donovan Ltd owns 76% of Pierce Pty Ltd’s shares; and McIntyre Pty Ltd owns 20% of Pierce Pty Ltd’s shares. Burns was concerned when Pierce Pty Ltd’s directors told him that it would not send him a financial report. In addition, Burns was also worried that Pierce Pty Ltd would not have an annual general meeting (AGM) even though Burns asked for one to be called. Burns particularly wanted to use the AGM to force Pierce Pty Ltd to use less polluting practices in its production processes. Explain whether Pierce Pty Ltd must give Burns its current annual financial report and hold the AGM to vote on the pollution reduction issue Burns was concerned with. Burns desires to view the Pierce’s financial report and hold an AGM, thus the issue in this case deals with the requirements in the Corporations Act on annual financial report and general meetings for private companies. Annual Financial Report: Large proprietary companies are required to disclose financial reports under s.292(1). However, small proprietary companies are not required to prepare audited financial reports unless directed to do so by shareholders holding 5% or more of the voting shares (s.293). Pierce have 75 employees which satisfies one of the criteria under s.45A(2) to establish a small proprietary company. Assuming that ‘extremely profitable’ does not mean that the company earn more than $25 million revenue and that their assets are less than $12.5 million in value then the company can be assumed to be a small proprietary company, otherwise, if it satisfy one more criteria, it is a large company. Thus, as a small proprietary company, he is unable to direct the company to prepare audited financial reports as he only has 4% of the voting shares, unless he can convince another shareholder. However, as a large company, they are required to prepare financial reports. Annual general meeting: Under s.250N, only public companies are required to hold annual general meetings, whereas proprietary companies are not required unless their constitution requires it. Subsequently, as Burns does not have more than 5% of the voting shares, he is unable to call and arrange a general meeting under s.249F. Among other things, without having more than 5% of the voting shares, Burns can’t give a company notice of a resolution that they propose to move at a general meeting. Under s.249Q, a general meeting must be held for a proper purpose which the proposed meeting by Burns was not as it seeks to interfere with the directors’ exclusive power to manage the company’s business (NRMA v Parker). Conclusion: Burns will not be able to force Pierce to provide annual financial reports and to hold a general meeting due to his lack of voting shares and also that the meeting was for an improper purpose. (b) Altering constitution and Share expropriation (5 marks) Donovan Ltd operated a successful toy importing business. Its directors recently discovered that 10% of its shares were owned by Sleazy who was a convicted child molester. Fearing that Donovan Ltd’s wholesome reputation would suffer if Sleazy’s shareholding became common knowledge, the directors considered the following proposals (i) call a shareholders’ meeting to insert a new clause in Donovan Ltd’s constitution forcing any shareholder with a criminal conviction to sell their shares to the other shareholders. (ii) call a shareholders’ meeting to pass a resolution reducing the company’s capital by cancelling Sleazy’s shares and paying him the issue price. Explain how case law or the Corporations Act operates in relation to both of the proposals The issue

How to Remain Calm and Avoid Power Struggles

How to Remain Calm and Avoid Power Struggles You know the circumstance all too well, a child disrupts you or the class or doesnt want to adhere to rules, routines or your instructions. You reprimand the child who then becomes defiant and refuses your request outright. Before you know it, youre engaged in a power struggle. In no time you send the student to the office or have somebody from the office come to collect the student. What have you gained? The term for this is Short term relief but long term grief. There are no winners in a power struggle. Do what the great teachers do - avoid power struggles. Unfortunately, the classroom is the place where power struggles can occur on a frequent basis because teachers are always wanting our students to comply with things they would prefer not to do. However, think of your strategy as getting commitment rather than compliance. Here are some of the tricks that will help you to avoid power struggles: Remain Calm, Do Not Become Defiant Dont over-react. You are always modeling appropriate behaviors in all that you do. Do not show your anger or frustration, believe me, I know this can be difficult but it is a must. A power struggle requires 2 people, so you cannot engage. You do not want to escalate the students behavior. Remain calm and composed. Save Face Dont center the student out in front of their peers, this is very important to the child. It is never good to humiliate the child in front of their peers and you wont build positive relationships if you do. When you respond with an Ive had enough of you speaking out, off to the office with you or If you dont stop that, Ill.......... youll gain nothing. These kinds of statements often escalate a situation in a negative way. You need to think of the end result and statements like this in front of the childs peers will make him more confrontational and a power struggle is more likely to occur. Instead, get the rest of the class working to enable you to have a one to one conversation with the disruptive student just outside the classroom door or quietly at the childs desk. Do not engage with anger, frustration, power or anything that may intimidate the student, it is more likely to escalate the disruptive behavior. Try to validate the students need, I can see why you are angry about....b ut if you work with me, well talk about his later...... After all, your goal is to calm the student, so model the calmness. Dis-engage Do not engage the student. When you model confrontation you will naturally end up in a power struggle. Regardless of how stressed you are - dont let it show. Dont engage, after all, the disruptive student is usually seeking attention and if you give the attention, youve given the student a reward for acting negatively. Ignore minor behaviors, if the student is acting in such a way that a response is required, simply use a matter of fact comment (Jade, your comment isnt appropriate, lets talk about it later and carry on. If its more severe: Jade those comments you made surprise me, youre a capable student and can do better. Do you need me to call the office? At least this way, they make the choice. Deflect the Student's Attention Sometimes you can re-focus the student by ignoring what was said and ask if the specific assignment is done or if the student has something that needs finishing. A little later you might have a one to one with the student suggesting that you didnt appreciate the interruption earlier that disrupted the rest of the class but that youre happy to see him/her working productively again. Always re-focus on what matters. Ask the student how the problem can be resolved, make the student part of the solution. Chillax Time Sometimes it is important to allow the child a chilling out time. Quietly ask the child if a quiet time elsewhere is needed. A buddy classroom or study carrel might just be enough. You may wish to tell him to take some chillaxing time and remind him/her that youll talk when theyre feeling up to it. Wait Time Allow some time for the child to calm down before determining what the consequence will be. This helps to de-escalate the anger the child may be feeling. If you can use humor in the de-escalation process, all the better and it will help you out of a power struggle. Remember the golden rule: Up, down and up again. For instance Jade, youve had such a terrific day, Ive been so proud of you. I dont understand why you are choosing not to follow instructions now. Perhaps Ill give you 5 minutes to think about it and youll be that terrific person I know you to be. Up, down, up. Use common sense and know when to be flexible enough to compromise.

Lab Report Example | Topics and Well Written Essays - 500 words - 4

Lab Report Example The angle made by the triangle is represents the moon’s angular diameter (in arc seconds). Astronomical experiments predict apparent distances and sizes of the objects in the sky because most of the estimations are based on trigonometric and geometric measurements. This justifies the fact that every experiment would give a varied observation from previous experiments reported in literature that followed a similar protocol. However, the most important determining fact is the location of the experiment relative to the moon as well as the accuracy and the experience of the individual astronomer engaged in the experimentation. Given that the value obtained from this experiment reported an error of about 99 percent compared with the actual distance of the moon previously reported in literature as 384,000 km (Reis, 1), it showed that the distance obtained largely depended on the astronomer’s approximation. When the person carrying out the experiment is closer to the moon, a larger size is likely to be obtained as opposed to when the experiment is done from quite a distan ce. Therefore, the discrepancy noted in this observation could be attributed to the distance of the moon and the inaccuracy in measurements that are common in

Sherman Computer Repair New Direction Essay Example | Topics and Well Written Essays - 1500 words

Sherman Computer Repair New Direction - Essay Example This research will begin with the statement that business growth and development is characterized by changes in activities and operations of the business, consequently impacting on the performance of the business. Initiating and adopting relevant actions that enhance change realization is a process with risks. These risks are spread across business stakeholders and their impact varies according to the stakeholder being assessed in that regard. Change is inevitable if a business is to remain competitive over time, alongside the need to grow and expand. The degree of change adoption determines what direction the business takes and its competitiveness in the market. High reaction in the market is directly proportional to participation in change by firms. Planning for a new direction in business is essential for any given organization. Sherman Computer Repair cannot refute the fundamental role of planning for new business directions. This is a procedural activity that requires both time and resources to put in place. There are expected outcomes to look forward to prior to the operations and performance of the company. Steps and guidelines should be put in place in order to evaluate and assess the achievements of such a plan over time. It is important to note that organizational change is characterized by barriers that emerge from within and outside the business environment. With that in mind, the internal and external environments of the company should be assessed against the strengths and weaknesses of the company.

The War On Drug Dealing Assignment Example | Topics and Well Written Essays - 500 words

The War On Drug Dealing - Assignment Example I. Community policingEffective community policing involves some steps. the first thing to do towards achieving an effective community policing structure is to first educate the people on the manifest dangers of continued drug use and abuse. It is generally known that before there are drug use and abuse, there is drug dealing. it would be appropriate to conduct civic education to get people to know how drug abuse can be destructive to a country’s economy. The economy is derailed when there many people who are engaged in constructive activities that generate income. It generates more dependency and the dependency syndrome puts pressure on an economy, weighing it down. Drug use also leads to rising in vices like robbery with violence, rape etc. once people are made aware of all that, they take up the community policing on drug dealing and abuse as a matter of socio-economic importance and thus will report the crime as and when they are perpetrated. The benefits of the community p olicing approach include the following:A. Engages the people and makes them know the problems they have when the drug problem continuesB. Making people know that if their neighbor’s child reforms from the drug problem, then their own child is safe because nobody is likely to influence and lure them into drug abuseC. Discussing the drug abuse and addiction problem with the people makes it easy for them to relate the vice to slow pace of economic growth and the moral and social decay the societies grapple with today

Historical Origins of Social Work Essay Example for Free

Historical Origins of Social Work Essay Essay: In what ways do the historical origins of social work influence the current profession in Ireland? In order to provide an in-depth discussion on how the historical origins of social work have influenced the current nature of the profession in Ireland, it is important for me to provide a specific understanding of what the term denotes. Defined by Smale, Tuson and Statham (2000; 5), ‘social work is about the interventions made to change social situations so that people who need support or are at risk can have their needs met more appropriately than if no intervention were made’. Morales and Sheafor (1977) state that ‘professional social workers are dedicated to service for the welfare and self-realisation of human beings; to the disciplined use of scientific knowledge regarding human and societal behaviour, to the development of resources to meet individual, group, national and international needs and aspirations; and to the achievement of social justice’. Many individuals, other than field social workers and including all those who work in residential, day care and domiciliary care, otherwise known as social care or care workers are all involved in different types of social work. The Emergence of Social Work According to Sheldon and Macdonald (2009, p.19), ‘the term ‘social work’ was first used in Britain at the end of the nineteenth century’. During this era, people practiced social work in an attempt to establish more realistic ways of overcoming social distress as opposed to relying on traditional forms of charity work and philanthropy. Skehill (1999) and Darling (1972) state that Irish social work shares many traditional aspirations of social work elsewhere, such as in Britain and Finland and has been influenced by such countries. However, it is also shaped by the particular nature of Ireland’s society and by key political processes within the country over the past centuries. Albeit Ireland ‘industrialising’ at a different rate in comparison to England and elsewhere, key features of modern society such as: the growth in expert knowledge in relation to individuals and the family, the emanation of new expert professionals and the emergence of a liberal form of government do appear to have had an impact on shaping Irish social work (Skehill, 1999). Earlier forms of social work in Ireland evolved from religious motives which included the giving of alms and the giving of service. Skehill (1999) highlights that the relationship between the  religious bodies and their concern with the provision of charitable relief is of great importance, with the rivalry between Catholic and Protestant charities being the most significant aspect of the religious base of charities in the 19th century. Down through the years, Ireland has been a place where individuals have been ‘inspired by a sense of vocation and largely guided by intuition’ (Darling, 1972; 24). Such individuals have endeavoured to alleviate the pain and suffering of the casualties within our society. An example of such heroic bodies in Ireland includes ‘Mary Aikenhead, daughter of a Cork doctor and founder of the Order of Irish Sisters of Charity, who began prison visiting in Dublin 1821’ (Darling, 1972; 24). The 19th century is ‘characterised by a whole plethora of charitable activities relating to education, health and welfare’ (Skehill, 1990). In England, social work began with the identification, categorisation and organisation of various charities, which is most evident in the work of the Charitable Organisation Society. The COS evolved in 1869 and was primarily known as the Society for Organising Charitable Relief and Repressing Mendicity. This charitable body had a specific aim of attempting to address the disconnectedness between philanthropic organisations and bring these bodies together under some coherent umbrella (Skehill, 199). Over the same period of time (19th century), no such major body for social work existed in Ireland, however at the beginning of the 20th century the Irish state saw an attempt to standardise charity within the country. Notably, the nature of social work in Ireland is highlighted by the ‘link between philanthropy and its broader cultural and political discursive field, the relations between religion and charity, the gendered nature of practices, and the individualistic approach to soc ial problems’ (Skehill, 1990). Although, social work progressed to a greater extent in the 20th century, one could argue that some of the most defining characteristics of its current shape in society could be accredited to its earlier presence in the 19th century (Skehill, 1990). For example, social work in Ireland continues to be a practice that is primarily interested in assisting the less well off in society, with families and children being a key target for social work intervention and practice remaining individualistic. Also, the profession has continued to function traditionally based on caring for and overlooking the clients of its service (Skehill, 1990). Because of this, it  is important to look at certain aspects of philanthropy in 19th century Ireland in order to explore the charitable works’ contribution to the present day social work strategy (Skehill, 1990). Although social work began to emerge in the 19th century, it was not until the beginning of the 20th century that a coherent strategy o f social work developed (Skehill, 1990). What is significant about social work in the early 20th century is that it continued to be characterised by continuities in voluntary charity work and developed towards a more ‘strategic and structured practice of professional social work’ (Skehill, 1990; 61). However, throughout this era, social work also expanded due to a dual process of development between interacting strands of cultural, political, intellectual and institutional progression. This dual process of development includes ‘the emergence of training and education for social workers and the continued expansion of untrained social work’ within charitable bodies (Skehill, 1990; 97). The pattern of social work training that established in the 20th century persisted in the following decades, with the continuation of an individual focus, home visiting, in-depth inquiries and concentration on the poor, women and children remaining to be at the core of its’ practice. In Ireland, the health and welfare service continued to develop in the mid-20th century and as a result, had a crucial influence on the evolution of social work within this period. There was a decrease in the influence of the Catholic Church, professional training and employment for social workers increased and the State developed a greater role in the provision of social services which led to increasing opportunities for the development of social work. According to Darling (1971), formal social work training in Ireland began in 1899, when Reverend R.M. Gwynn established an association in Trinity College Dublin, with a primary aim of promoting the study of poverty. ‘The establishment of the Civic Institute of Ireland in 1914 marks a significant step in the evolution of social work in Ireland’ (Skehill, 1999; 91). The main aim of this society was the ‘study and investigation of all questions and problems affecting the lives of the Irish public in their capacity as citizens or as inhabitants of a city, urban or rural area of Ireland’ (Civic Institute of Ireland, 1914 in Skehill, 1999; 91). Bibliography * Considine, M. and Dukelow, F. (2009) Irish Social Policy: A critical introduction, Dublin: Gill Macmillan Ltd. * Sheldon, B. and MacDonald, G. (2009) Textbook of Social Work, London: Routledge. * Skehill, C. (1999a): The Nature of Social Work in Ireland, a Historical Perspective, Lewiston, USA: Edwin Mellen Press. * Morales, A. and Sheafor, B.W. 1977. Social Work: A Profession of Many Faces. Boston: Allyn and Bacon Inc. * Darling, V. (1971) ‘Social Work in the Republic of Ireland’. Social studies, Irish Journal of Sociology, 1(1)24-37. *

Life in a Small Village in Greece :: essays papers

Life in a Small Village in Greece This paper is based upon the biography of a couple that is living in Playiari, which is a village 25 km from Thessaloniki, Greece. The couple is three years married, after being four years engaged, and now they are living at a house of their own. They do not have any children, so far, but they have a dog whose name is Lambros. Their names are Tasos and Efi. He is the owner of a cafà © and she is working at a branch of an insurance company. I met them almost six years ago when I got hired by Tasos as a waiter in his cafà ©, and I chose them for my paper because first of all I feel really comfortable with them and second because they are young so the research that is going to be done to be more vivid and up to date. What is going to be presented in this paper are the various information that I have obtained from them, for several aspects of their lives. Furthermore, what is to be accomplished is the comparison of their lives with those of their grandparents and alongside with this the comparison and contrast of these information with the ones in the articles that were covered in class. Firstly what is to be conferred are information about Tasos family. Tasos family originated from Kallipoli which was a suburb of Constantinople (Instanbul). They were living there before the destruction of Asia Minor and the exchange of population between Greece and Turkey taking place. When the exchange of the populations took place his grandfather moved straight to Playiari, which basically is a village composed of immigrants who came from there and at that point in time was nothing but a complex of 4-5 houses. Their residents were locals, who had conflicts with the incoming people, because they did not want others to claim land in that territory. Finally most of the immigrants got to claim and own a piece of land. Tasos was born 32 years ago in Edessa, a city close to Thessaloniki. When he was two years old his family moved in a village, which was located in the district(nomos) Pelas and it is called St.George. They remained there for about nine years, until Tasos became 1 1 years old, and after that they moved to Lakoma, a village in Halkidiki. Life in a Small Village in Greece :: essays papers Life in a Small Village in Greece This paper is based upon the biography of a couple that is living in Playiari, which is a village 25 km from Thessaloniki, Greece. The couple is three years married, after being four years engaged, and now they are living at a house of their own. They do not have any children, so far, but they have a dog whose name is Lambros. Their names are Tasos and Efi. He is the owner of a cafà © and she is working at a branch of an insurance company. I met them almost six years ago when I got hired by Tasos as a waiter in his cafà ©, and I chose them for my paper because first of all I feel really comfortable with them and second because they are young so the research that is going to be done to be more vivid and up to date. What is going to be presented in this paper are the various information that I have obtained from them, for several aspects of their lives. Furthermore, what is to be accomplished is the comparison of their lives with those of their grandparents and alongside with this the comparison and contrast of these information with the ones in the articles that were covered in class. Firstly what is to be conferred are information about Tasos family. Tasos family originated from Kallipoli which was a suburb of Constantinople (Instanbul). They were living there before the destruction of Asia Minor and the exchange of population between Greece and Turkey taking place. When the exchange of the populations took place his grandfather moved straight to Playiari, which basically is a village composed of immigrants who came from there and at that point in time was nothing but a complex of 4-5 houses. Their residents were locals, who had conflicts with the incoming people, because they did not want others to claim land in that territory. Finally most of the immigrants got to claim and own a piece of land. Tasos was born 32 years ago in Edessa, a city close to Thessaloniki. When he was two years old his family moved in a village, which was located in the district(nomos) Pelas and it is called St.George. They remained there for about nine years, until Tasos became 1 1 years old, and after that they moved to Lakoma, a village in Halkidiki.

Pratik

Why Was Fathepur Sikri built ? In Akbar's time the site was occupied by a small village of stonecutters and was the home of Shaikh Salim Chishti, a Muslim astrologer and Sufi Saint. In 1568 Akbar visited the Shaikh to ask for the birth of an heir. The Shaikh replied that an heir would be born soon. Sure enough, Akbar's wife gave birth to a boy on August 30, 1569. In gratitude, Akbar named the boy Salim after the astrologer, and, two years later decided to move the capital to Sikri.Buland Daraza ————————————————- Buland Darwazameaning ‘high' or ‘great' gate in  Persian. It is located in  Fatehpur Sikri  which is located 43  km away from  Agra,  India. It is also known as the â€Å"Gate of Magnificence. † Buland Darwaza or the loft gateway was built by the great Mughal emperor, Akbar in 1601 A. D. at Fatehpur Sikri. Akbar built the Buland Darwaz a to commemorate his victory over Gujarat. 1] Architecture The Buland Darwaza is made of red and buff sandstone, decorated by carving and inlaying of white and black marble and towers above the courtyard of the mosque. The Buland Darwaza is semi octagonal in plan and is topped by pillars and  chhatris  with Buland Darwaiosks on the roof, stylized battlement and small turrets and inlay work of white and black marble. On the outside a long flight of steps sweeps down the hill giving the gateway additional height.A Persian inscription on eastern archway of the Buland Darwaza records Akbar's conquest over Gujarat in 1601. It is 40 metres high and 50 metres from the ground. The total height of the Structure is about 54 metres from the ground level. It is a 15-storied high gateway that guards the southern entrance of the city of Fatehpur Sikri. An inscription on the central face of the Buland Darwaza throws light on Akbar's religious broad mindedness.

Improving Communication for People with Learning Disabilitie

learning zone CONTINUING PROFESSIONAL DEVELOPMENT Page 58 Improving communication for people with learning disabilities Page 66 Learning disabilities multiple choice questionnaire Page 67 Read Annette Martyn’s practice profile on type 2 diabetes Page 68 Guidelines on how to write a practice profile Improving communication for people with learning disabilities NS336 Godsell M, Scarborough K (2006) Improving communication for people with learning disabilities. Nursing Standard. 20, 30, 58-65. Date of acceptance: February 6 2006. Summary Patients with learning disabilities have higher healthcare risks than the general population. Similar essay: Collate Information About an Individual's Communication and the Support ProvidedHealth professionals need to develop skills that enable them to communicate effectively with this patient group. Identifying barriers to communication is the first step to reducing or removing them. Suggested strategies to improve healthcare access for patients with learning disabilities include: developing individualised health action plans, simplifying communication styles and providing accessible facilities and tailored resources. learning activities you should be able to: Understand the impact of communication on interaction between healthcare providers and patients with learning disabilities.Describe the relationship between communication and the health inequalities experienced by people with learning disabilities. Identify strategies to improve communication between health providers and patients with learning disabilities. Authors Matthew Godsell and Kim Scarborough are senior lecture rs, Faculty of Health and Social Care, University of the West of England, Bristol. Email: Matthew. [email  protected] ac. uk Introduction Learning disability is not a diagnosis but a term used to describe people with a wide range of strengths and needs.Eighty per cent of children and 60 per cent of adults with learning disabilities live with their families (Gravestock and Bouras 1997), and many people with learning disabilities exceed the expectations of families and professionals in their capacity to learn new skills and develop their talents (NHS Executive 1999). The term ‘learning disability’ says little about an individual’s strengths and needs but it does incorporate three elements that appear in most definitions (Box 1). Emerson et al (2001) state that the number of people with learning disabilities in the UK has not been determined.They estimate that in the UK there could be as many as 350,000 people with severe learning disabilities (intelligence quotie nt (IQ) 50). This means that 2 per cent of patients are likely to have a learning disability (NHS Executive 1999). The ways in which people with learning disabilities are described have changed. Terminology and related facts are listed in Box 2. NURSING STANDARD Keywords Communication; Learning disabilities nursing: attitudes These keywords are based on the subject headings from the British Nursing Index. This article has been subject to double-blind review.For related articles and author guidelines visit our online archive at www. nursing-standard. co. uk and search using the keywords. Aims and intended learning outcomes The aim of this article is to explore the impact of communication on health care for people with learning disabilities. The article discusses how cognition and communication influence interactions between healthcare providers and patients. It also examines how poor communication can contribute to health inequalities that separate people with learning disabilities f rom the rest of the population.The article explores communication strategies that can overcome or reduce barriers to effective health care. After reading this article and completing the 58 april 5 :: vol 20 no 30 :: 2006 Time out 1 Based on a figure of 2 per cent of patients having learning disabilities, it is likely that 40 per 2,000 patients registered with GP services are likely to have learning disabilities. How many patients with learning disabilities are you aware of in your practice area? List some of the reasons that might prevent people with learning disabilities from accessing local health services. Health inequalitiesAlthough people with learning disabilities are living longer, the gap that separates the health status of people with learning disabilities and the general population has increased. Cohen (2001) asserted that gross inequalities in health are politically, socially and economically unacceptable. An investigation into health inequalities by the Disability Rights Commission (Nocon 2004) found that people with learning disabilities have: An increased risk of early death compared with the rest of the population; mortality rates are particularly high for those with more severe impairments.A greater variety of healthcare needs. Many needs that are not met. High rates of unrecognised or poorly managed medical conditions including: hypertension, obesity, heart disease, abdominal pain, respiratory disease, cancer, gastrointestinal disorders, diabetes, chronic urinary tract infections, oral disease, musculoskeletal conditions, osteoporosis, thyroid disease, and visual and hearing impairments.A briefing paper produced by the NHS Service Delivery and Organisation (SDO) Research and Development Programme (NHS SDO 2004) identified barriers to appropriate and timely BOX 1 Definition of a learning disability A person with learning disabilities has: Significant reduction in the ability to understand new or complex information. Reduced ability to cope inde pendently. Impairment starting in childhood that will have a lasting effect on development. (DH 2001) access to health care within and outside services.Many people with learning disabilities find that identifying their healthcare needs is a major challenge. Proactive strategies are required to encourage people to access the full range of services that are available. Some people with learning disabilities have said that negative and unhelpful attitudes from healthcare workers have prevented them from seeking medical help (Bristol and District People First 2003). Support and encouragement are required by carers, allies and friends before people with these concerns are ready to engage with services again.People are more likely to trust service providers when they are convinced that services and practitioners have responded to their needs by improving communication skills and producing information in an accessible format. People with learning disabilities have the same right to access m ainstream services as the rest of the population (Department of Health (DH) 2001). However, mainstream services have been slow to develop the capacity and skills to meet their needs.In the document Valuing People (DH 2001) it was acknowledged that the wider NHS had failed to consider the needs of people with learning disabilities and that overcoming this source of inequality was the most important issue for the NHS to address for this patient BOX 2 Terminology and facts related to learning disabilities ‘Mental handicap’ was a term used to describe people with learning disabilities. It is no longer used in the UK. ‘Mental retardation’ is a term used internationally, however, it is not an accepted term in the UK and some may find this term offensive. Learning difficulty’ is the term used in education to define individuals who have specific learning needs, for example, dyslexia. Some people who are identified as having learning difficulty by education s ervices may also be considered to have a learning disability, but this is not necessarily the case. ‘Mild’, ‘moderate’, ‘severe’ and ‘profound’ are terms to describe different degrees of disability (Figure 1). A person with mild learning disabilities might communicate effectively, learn, live and work with little support.However, a person with profound learning disabilities will require support with activities of daily living, for example, communication, dressing, feeding, washing and mobility. A diagnosis of ‘mental illness’ is not the same as having a learning disability, but people with learning disabilities may have mental health issues as well. Not everyone with learning disabilities requires a social worker or a community nurse. People with learning disabilities may have multiple diagnoses resulting in complex health needs. People with the most profound physical or sensory impairments do not always have the most profound cognitive impairments.NURSING STANDARD april 5 :: vol 20 no 30 :: 2006 59 learning zone nursing attitudes group. The briefing paper produced by the NHS SDO (2004) provided key action points for removing barriers and improving access to health care, which included: Using specialist learning disability teams to aid adaptation of mainstream services to meet the needs of patients with learning disabilities. Developing strategies for health education and health checks for people with learning disabilities that promote timely access to health care.Families and paid carers have an important role in helping people with learning disabilities to access health care. Some people will need assistance to recognise mental health problems and to identify gradual changes in health. Time out 2 Make a list of the ways that you communicate with patients about their health, for example, through appointments and telephone calls. Take three examples from your list and consider reasons why communi cation with a person with learning disabilities might be difficult.Give an example of effective communication between a practitioner and a person with learning disabilities. Policies should address the use of technology to support communication, and the development and dissemination of accessible information. Jones (2003) suggests that managers and commissioners of services should liaise with health, social care and education agencies to ensure consistency in communication policies throughout the lives of people with learning disabilities. Communication can be broadly defined as the exchange of information between a sender and a receiver (Figure 2).Where a person has learning disabilities they may be communicating with an intention to attract a communication partner and commence a two-way dialogue. However, for some people with profound learning disabilities sending a message might be a response to their body and feelings. Their level of cognition might be such that they are unaware of possible communication partners and of how to take the communication further. This is called pre-intentional communication, in which the individual says or does things without intending to affect those around them.It is important to remember that everyone communicates and that the role of communicator and communication partner swaps from one person to the other so that a conversation can develop. The challenge for health professionals is to develop skills that enable them to interpret the messages they receive and make the messages they send understandable. Communication is not only about verbal communication; it is also about nonverbal communication, for example, the use of body language, words and pictures. CommunicationRecommendations have been made to improve communication and access to health services for people with learning disabilities. Jones (2003) states that services supporting people from birth to older age should develop communication policies. FIGURE 1 Estimated pe rcentage of people with learning disabilities according to level of severity Mild Moderate 12% Severe Profound 80% 7% 1% Augmentative and alternative communication systems Systems of communication, such as sign language, symbols and eye pointing, are known as augmentative and alternative communication systems (AACs).AACs can be used to enhance or replace customary pathways, such as speech or writing. The use of photographs of everyday objects, picture boards, line drawing and real objects are good ways to enhance communication with people with learning disabilities (American Speech-Language-Hearing Association (ASHA) 2005). You do not need to attend specialist training to be able to use AACs such as these. More formal AACs, such as Makaton (a form of sign language for people who have learning disabilities that uses keywords to enhance understanding), require preparation but learning a basic vocabulary does not require extensive training.Cognition and communication (Winterhalder 1997 ) Understanding complex information People with learning disabilities have a reduced ability to NURSING STANDARD 60 april 5 :: vol 20 no 30 :: 2006 understand new or complex information (DH 2001), and those who experience difficulties when processing information may find it hard to learn new skills. Intelligence can be quantified as a figure related to an individual’s IQ. However, it might be more useful to think about intelligence in relation to cognitive processes.Smith and Mackie (2000) describe cognitive processes as: ‘†¦the way in which our memories, perceptions, thoughts, emotions and motives guide our understanding of the world and our actions. ’ Intelligence exerts a powerful influence over the ability to process information, the capacity to learn new skills and to adapt knowledge to different situations. Intelligence is an attribute that can guide our understanding of the world, but it is not fixed or static. Teaching and learning strategies can be used to stimulate cognitive processes so that people can approach information, or potentially confusing situations, with more confidence.Similarly, complicated tasks and information can be broken down into small, simple steps so that people can approach them in stages. Attempting to understand another person’s cognitive processes can help practitioners to develop a more empathetic and person-centred approach to care, and can provide an incentive to develop the teaching and learning strategies that are best suited to the individual needs of patients. Coping independently People with learning disabilities may have a reduced ability to cope independently (DH 2001). Independence is defined according to levels of social functioning.Assessment of a patient’s strengths and needs in social functioning is a fundamental stage in developing planned care that is familiar to practitioners from all branches of nursing. Making an accurate assessment of social functioning provides val uable information about the range of activities that a person can undertake on his or her own as well as those activities where a person requires support. Some people with learning disabilities may require assistance with tasks such as washing and dressing, and many need help to have their mode of communication understood.Learning disability and development Learning disability starts before adulthood, affects people of all ages and has a lasting effect on development (DH 2001). A majority of younger people with learning disabilities are living in the community with their parents or carers. Older people with learning disabilities also live in the community but they may have periods of institutional care. Some people will have frequent contact with health services and others have irregular contact. People with learning disabilities are not a homogeneous group. Their perceptions of nurses, NURSING STANDARDFIGURE 2 A model for communication Person communicating: we take turns in this ro le of sender of information. Depending on the person’s cognitive ability, this may be intentional or pre-intentional communication Communication barriers: can be present in the environment as well as being caused by the communicator and communication partner Communication partner: we take turns in this role of the person who receives the information sent, makes sense of it and responds appropriately doctors, health centres, clinics and hospitals will have been shaped by their formative experiences with staff and services.Providing encouragement for people with learning disabilities to attend health checks and to make use of healthcare services can involve changing their perceptions of health professionals. Some people with learning disabilities have not received the treatment they need because they are reluctant to engage with services where they have had bad experiences in the past. To encourage people with learning disabilities to make effective use of healthcare services t hroughout their lives, practitioners need to use their communication skills to initiate and maintain positive relationships. Time out 3Think about the last time you communicated with a person with learning disabilities, or someone who has communication difficulties. Refer to the list you made in Time out 2 about the communication systems you use in your workplace. What are the main barriers to communicating about health with a person who has learning disabilities? How do you remove or reduce barriers to communication? Which environmental factors impede communication? Identify any barriers that you had not previously considered. april 5 :: vol 20 no 30 :: 2006 61 learning zone nursing attitudes Barriers to communicationThere are barriers to communication which can be identified in relation to the person with learning disabilities, the health professional and the environment (Box 3). When barriers have been identified, health professionals can start to think about ways of reducing or removing them. Health professionals exchange information by using terminology that reflects their specialised knowledge. Patients and other people who are not involved in the day-to-day delivery of health care BOX 3 Barriers to communication The person with learning disabilities may: Have limited understanding.Have limited vocabulary or difficulty speaking. Have sensory impairments that limit ability to hear requests or instructions. Have poor understanding of health and healthy living. Be scared of people in uniforms. Be stressed because of illness. Not like new places. Have difficulty waiting and may not understand the concept of time or queuing. Have limited literacy and numeracy skills to read health advice and information, for example, instructions, letters, dosages. Expect contact with nurses to be unpleasant because of previous experiences. The nurse may: Be rushed because of heavy workload.Have biases and assumptions about people with learning disabilities. Have poor listeni ng and attending skills. Be unable to understand augmentative and alternative communication systems. Have limited knowledge of the individual. Have insufficient time to develop a good relationship with the individual or carer. Not use visual aids to support understanding. Use technical jargon and/or long words. Provide written information without thinking of the patient’s ability to read it. Provide information about the next appointment in a way the patient will not understand or remember.The environment may: Be crowded. Busy. Uncomfortable. Have strange smells and noises. Bring back bad memories. Have limited physical access, for example, no hoists. Include unhelpful people. Have poor signage, relying on literacy skills and good sensory abilities. Have no area to sit quietly with limited sensory stimulation while waiting. Be filled with machines and instruments that a person with learning disabilities may not understand. may find it difficult to comprehend the terms and ide as they encounter in healthcare settings. They can find it hard to follow advice or instructions.This could result in patients making inappropriate decisions or exposing themselves to unnecessary risks. For example, patients with learning disabilities who take their own medication may be at risk of overdosing or taking an ineffectual dose, particularly if the route and dosage of a newly prescribed medicine has not been explained clearly and/or recorded in an accessible format. Time out 4 Consider the list of potential barriers to communication and categorise them according to: Barriers that have been addressed for patients with learning disabilities using the services you work in.Barriers that can be remedied quickly. Barriers that need planning to be reduced or removed. Barriers that require financial investment to be reduced or overcome. Discuss this list with your colleagues. Identify strategies for removing barriers and improving communication. Good practice in communication In South Warwickshire, health passports have been developed for people with learning disabilities (Leamington Spa Today 2005). These provide detailed information about an individual’s health, strengths and needs so that practitioners can provide patient-centred care.They are used to improve communication across a range of healthcare providers. Having an alert system incorporated into patient notes which provides individual communication needs could be beneficial, especially where staff do not know individual patients. Health practitioners may use and be involved in developing health action plans. These are plans specific to individuals and are developed to meet their access needs. Health action plans are a way of overcoming some of the barriers to high quality health care (DH 2001).Plans are produced by a group of people including the patient. They encourage the development of a shared understanding about an individual’s health needs. Where training in health action plann ing has been provided for GP surgeries, improvements have been shown in the health of patients with learning disabilities (Smith et al 2004). There are benefits to having a lead person to deal with learning disability issues. In primary healthcare services, a lead person takes an interest in learning disability issues, collates information, NURSING STANDARD 62 april 5 :: vol 20 no 30 :: 2006 ives support and advice to health staff and develops links with specialist services for people with learning disabilities and other agencies (NHS Executive 1999). Time out 5 Does your organisation have a lead person who is involved in initiatives such as joint communication policies and the development and sharing of accessible health information? If yes, find out how he or she is supporting your team to develop skills in communicating with people who have learning disabilities. If no, how might developing this role benefit your team and improve access to health care for patients with learning d isabilities?To improve communication with people with learning disabilities, more time should be allocated to appointments so that there is more time for them to express themselves and understand any information they have received (DH 1999). This is particularly the case if AACs are being used. Reception staff are often aware of people who have difficulties using services. Supporting these key staff to develop effective communication skills and flexibility can improve access to health services (NHS Executive 1999).For example, if staff in reception are aware that someone finds it difficult to wait in a queue, they may offer that person the first appointment. Several resources have been developed by trusts to improve communication. Some examples of these include: Hambleton and Richmondshire Primary Care Trust (PCT), in partnership with Mencap, has developed an accessible ‘Choose and Book’ guide for hospital appointments that uses a combination of pictures and words to ex plain how patients can make choices about hospitals and appointments.Bristol South West PCT, as part of its ‘Expert Patient Programme’, has developed plans that help prepare people with learning disabilities for a visit to the doctor. The Health Facilitation Team at Gloucestershire Partnership NHS Trust (2004) has produced a ‘traffic light assessment’ that conveys information about individuals on admission to hospital. This ensures that important information is clearly communicated to health professionals. Camden PCT (2005) has used this work to develop an online resource. Although people may appear to have limited communication skills, they should not be ignored.These patients should be addressed directly and NURSING STANDARD the information they receive should be provided in a simple way without being patronising. Effective communication often depends on how the information is delivered. Practitioners may have to talk to carers, but they should not forget to address the person with learning disabilities. Practitioners should examine their beliefs about people with learning disabilities and avoid making assumptions about an individual’s strengths and needs. This will help to make health assessments more accurate (DH 1999).It is useful to invite a speaker with learning disabilities to talk to healthcare staff about living with a learning disability and his or her experiences of accessing health services. Time out 6 What beliefs and values do you think society holds about people with learning disabilities? Some examples of negative beliefs and values are that people with learning disabilities: Have a poor quality of life. Have higher pain thresholds. Are dangerous and promiscuous. Will not understand anything. Should not get married or have children. Cannot care for their children. Need institutional care. Cannot work.Are like children not adults. What are your feelings about these statements? How might the presence of any or al l of these beliefs influence the care given to a person with learning disabilities? People with learning disabilities can have additional physical or sensory impairments that should be considered. They are also more likely to have more mental health needs than the general population (DH 2001). Where a patient has additional impairments or health issues these need to be considered during communication. The healthcare environment should be adapted to accommodate people with physical or sensory impairments.Time out 7 In your work place: Do you have a private area to talk to a person who has a large wheelchair? Do you have rooms where glare is controlled and the environment is suitable for people with limited vision? Do you consider the needs of interpreters/ carers and ensure they fully understand information before they pass it on? april 5 :: vol 20 no 30 :: 2006 63 learning zone nursing attitudes Accessible information Accessible information comes in many forms, such as videos, CDs, DVDs and audiotapes. Pamphlets can be produced with accessible information about the services offered.Written information needs to be in plain language, with short sentences and one subject per sentence. Photographs, drawings, symbols and other visual information can be used to support written information. It is important to keep pages uncluttered on plain backgrounds so that text does not detract from graphics. Letters should be large, 16-18 point type size, and fonts that do not have serifs, such as Arial and Comic Sans, should be used. Graphic text, underlining and italics should be kept to a minimum because they can impede readability. Many trusts are now producing resources to enhance accessibility.Some of these include: The United Bristol Healthcare NHS Trust has produced a leaflet called ‘You are coming to the Bristol Royal Infirmary about your heart’, TABLE 1 Using terminology that is easy to understand Health issue Common words that are used Epilepsy Investigat ions EEG (electroencephalogram) Strategies or words that improve understanding Find out more about This word would have to be used, but a photograph of someone having an EEG may help understanding Medicine tablets to help control your epilepsy Having two or more seizures straight after each other or whatever describes status for the individual Taking your medication as we have agreed Things that might make you have a seizure Not being able to have a poo for three days Things you feel in your head and body that make you think you will have a seizure Having a fit or turn, whichever word the person uses which uses pictures and words to introduce some of the staff and explain what happens when patients are admitted to the cardiology department.The Learning Disability Partnership Board in Surrey has developed ‘The Hospital Communication Book’ that combines words, pictures, signs and symbols. Trafford North and South PCTs have produced a toolkit for people with learning disab ilities called ‘Cancer and You’ (Provan 2004). Contact your local Community Learning Disability Team or People First organisation for information about local resources. Simplifying conversation When talking to people with learning disabilities, use approaches similar to those used for written text. Plain language, the use of keywords, short sentences and one subject per sentence should be used. Give people time to process what is being said and to formulate a reply.Use openended questions to assess a person’s understanding and rephrase the question if necessary, as repeating the same question rarely improves understanding. When information is presented during a consultation it is important to check that the person with learning disabilities has understood it. If there is insufficient time during the initial consultation, it may be necessary to make a further appointment to check what the person has understood and retained. For an individual who processes informat ion slowly this might be essential to ensure an accurate assessment and the effective implementation of a treatment plan. Examples of terms that are easier to understand are presented in Table 1.Such terms are only beneficial if the person understands them so, for example, ‘constipation’ could be described as ‘not being able to have a poo’, but the health practitioner needs to know whether the person uses this term to describe defecation. Anti-epileptic drugs Status epilepticus Drug compliance Triggers Constipation Aura Time out 8 Think of four common illnesses that are likely to make a person visit your service. Write these in the first column of a table (see Table 1). Identify the language you use when discussing these illnesses and record these words or phrases in column two. These might be medical terms, health terms or long words. Now spend some time identifying words that are easier to understand and record them in the third column. NURSING STANDARD S eizure 64 april 5 :: vol 20 no 30 :: 2006 ConclusionPeople with learning disabilities may have communication difficulties that have restricted their access to health care and prevented them from receiving the information required to maintain their health. In addition to learning disability, they are more likely to have complex healthcare needs leading to multiple diagnoses. Steps towards better health for people with learning disabilities can be made by providing encouragement and support to attend regular health screening and reviews, and by developing a range of strategies to improve communication between practitioners and individuals with learning disabilities NS RECOMMENDED RESOURCES British Institute of Learning Disabilities (2001) Factsheet No. 005 Communication. www. bild. org. uk/pdf/factsheets/communication. pdf (Last accessed: March 10 2006. British Institute of Learning Disabilities (2005) Your Good Health (a set of 12 illustrated booklets). www. bild. org. uk/publication s/your_very_good_health_details. htm (Last accessed: March 10 2006. ) Communication Matters (updates 2005) What is AAC? www. communicationmatters. org. uk (Last accessed: March 10 2006. ) Communication Matters (updated 2005) How to be a good listener. www. communicationmatters. org. uk (Last accessed: March 10 2006. ) Department of Health. www. dh. gov. uk (Last accessed: March 10 2006. ) Foundation for People with Learning Disabilities (2004) Communication and people with learning disabilities. www. learningdisabilities. org. uk/page. cfm? agecode=ISSICMMT (Last accessed: March 10 2006. ) Foundation for People with Learning Disabilities (2005) Patients with learning disabilities in South Warwickshire have been given a new type of passport to help with their medical appointments. www. learningdisabilities. org. uk/profilenews. cfm? pagecode=ISSICOLN&are acode=ld_communication_news&id=7231 (Last accessed: March 10 2006. ) MENCAP (2003) You and your health: a basic guide to being heal thy. www. mencap. org. uk/download/you_and_your_health. pdf (Last accessed: March 10 2006. ) Plymouth Hospitals NHS Trust (2005) Living with cancer. www. learningdisabilitycancer. nhs. uk/ (Last accessed: March 10 2006. ) Time out 9Complete a SWOT analysis (strengths, weaknesses, opportunities and threats) of your skills and knowledge when communicating with and supporting access to health care for people with learning disabilities. Time out 10 Now that you have completed this article, you might like to consider writing a practice profile. Guidelines are on page 68. References American Speech-LanguageHearing Association (2005) Introduction to Augmentative and Alternative Communication. www. asha. org/public/ speech/disorders/acc_primer. htm (Last accessed: March 9 2006. ) Bristol and District People First (2003) We are People First. (Film) People First, Bristol. Camden PCT (2005) What You Need to Know About Me in Hospital. www. camden. gov. k/ (Last accessed: March 17 2006. ) Cohen J (2001) Countries’ health performance. The Lancet. 358, 9285, 929. Department of Health (1999) Facing the Facts: Services for People with Learning Disabilities: A Policy Impact Study of Social Care and Health Services. The Stationery Office, London. Department of Health (2001) Valuing People: A New Strategy for Learning Disability for the 21st Century. The Stationery Office, London. Emerson E, Hatton C, Felce D, Murphy G (2001) Learning Disabilities: The Fundamental Facts. Foundation for People with Learning Disabilities, London. Gloucestershire Partnership NHS Trust (2004) Traffic light assessment. Unpublished document.Gloucestershire Partnership NHS Trust, Gloucester. Gravestock S, Bouras N (1997) Emotional disorders. In Holt G, Bouras N (Eds) Mental Health in Learning Disabilities: A Training Pack for Staff Working with People who have a Dual Diagnosis of Mental Health Needs and Learning Disabilities. Second edition. Pavilion Publishing, Brighton, 17-26. Jones J (2003) Th e Communication Gap. www. learningdisabilities. org. uk /page. cfm? pagecode= FBFMCHTP04 (Last accessed: March 10 2006. ) Leamington Spa Today (2005) Patients with learning disabilities in South Warwickshire have been given a new type of passport to help with their medical appointments. Leamington Spa Today. January 19, 2005.NHS Executive (1999) Once a Day One or More People with Learning Disabilities are Likely to be in Contact with Your Primary Healthcare Team. How Can You Help Them? Department of Health, Leeds. NHS Service Delivery and Organisation (SDO) Research and Development Programme (2004) Access to Health Care for People with Learning Disabilities. Briefing paper. NHS SDO, London. Nocon A (2004) Background Evidence for the DRC’s Formal Investigation into Health Inequalities Experienced by People with Learning Disabilities or Mental Health Problems. Disability Rights Commission, Stratford upon Avon. Provan K (2004) Cancer and You: Toolkit for Working with People with Learning Disabilities. www. cancerandyou. info/docs/ FullToolkitNov04. pdf (Last accessed: March 9 2006. Smith ER, Mackie DM (2000) Social Psychology. Second edition. Psychology Press, Hove. Smith C, Giraud-Saunders A, McIntosh B (2004) Healthy Lives: Health Action Planning in a Person Centred Way; Including Health in Person Centred Planning. www. valuingpeople. gov. uk/ HealthHealthyLives. htm (Last accessed March 10 2006. ) Winterhalder R (1997) An overview of learning disabilities. In Holt G, Bouras N (Eds) Mental Health in Learning Disabilities: A Training Pack for Staff Working with People who have a Dual Diagnosis of Mental Health Needs and Learning Disabilities. Second edition. Pavilion Publishing, Brighton, 1-6. NURSING STANDARD april 5 :: vol 20 no 30 :: 2006 65