Coming of Age Essay Example for Free

Coming of Age EssayAround the world there are many themes that we find over and over in many cultures and from many periods in time. One of the reoccurring themes that everyone goes through in the lifetime is the theme of coming of get on with. This occurs when a young person goes through the transition from childhood to adulthood and has life finds that matures a person. We all have experienced a coming of age story by reading them in books, seeing them on TV or in movies, or maybe in time personal experiences based on ones culture. Its clear that coming of age is a essential element of our self-representations and conceptions. Generally, all of living is a cognitive operation of coming of age as seen in the novel, Catcher in the Rye. Holden Caulfield, who is sixteen-year-old boy with the mind of a ten dollar bill year old. He thinks of innocence as important in the beginning of the novel. But later on in the book, Holden slowly grows to be an adult. For example, when Hold en gets soaking rigorous by rain when he is watching his little sister ride the carousal he felt so damn happy all of a sudden(213).This symbolizes Holden entering adulthood because he realizes the happiness in life. He realizes that he is too big for the carousel and is happy that his sister is happy. Holdens girlish personality continued to wash away as he reached a stage of maturity. Over the course of the novel, To Kill a Mockingbird, Scout is taken from a position of innocence, in which she believes that she is safe and that there arent many bad people in the world, to the position where she has witnessed some of the bad things that have happened but realizes that she is not entirely safe.That is tested at the end of the novel when Scout was attacked while walking home with her brother Jem. Similarities were show in The Adventures of Huckleberry Finn. Hucks maturity begins to grow as he first starts to show emotions toward a runaway slave, and by the end of the novel, has gro wn up to the point where, when Jim, is captured, Huck decides to give up playing games afterwards Tom is shot to ensure that he would get medical attention that he needed.In an episode of Malcolm in the Middle it revolved around Malcolm stressful to help his classmate Dabney get into a paintball match despite the resistance of Dabneys overbearing mom. Once Dabney unleashes years of repressed aggression, his mom comes around to try to quilt him off. Dabney reacts back by saying Im no longer your little boy anymore. Im your little man showing that Dabney has fledged and stands up and says what he believes. In the movie Edward Scissorhands, Edward is taken in by a family who he depends on.The family teach him how to think for himself so that one day he can gain the independence that is necessary for him to go out on his own. Edward living off of the familys support and trying things for himself is a coming of age process in itself. When he starts acting out and making his own decis ions he is transitioning into an independent mindset that eventually allowed him to make the choice of living alone and contend for himself. Roman Catholics believe that Confirmation .. completes the process of initiation into the community and it matures the soul for the work ahead..During confirmation divinity the Holy Spirit comes upon the person, accompanied by God the Father and God the Son, just as he did at Pentecost. (Acts 214) Those who have been confirmed are called Soldiers of God. This refers to their spiritual duty to bout evil, darkness, and Satan. In Nigeria, young girls known as Iriabo spend several weeks in fattening rooms being pampered and wearing copper coils around their legs to restrict causal agent as part of a ritual marking their official transition into womanhood.In Senegal, Bassari boys undergoing the Kore rite and are taken into a sacred forest where they experience a symbolic death and a return to infancy, a state of ritual purity from where they are reborn as mature members of the community. (Hipple) Ultimately, the coming of age experience is a very much so significant time in ones life. People have to continue to find themselves and explore who they are even after the coming of age experience. It has lasting effects on a person as it has an impact on our dreams and desires that we want to fit into our world.

Kant and the Categorical Imperative Essay Example for Free

Kant and the Categorical Imperative EssayThe possibility of the existence of compensate and wrong has been a subject of discussion among philosophers for centuries and many theories halt been presented to answer the question of whether morals exist. Immanuel Kant (1724-1804), the great German philosopher is one who has contributed profoundly to the world of philosophy and especially in regards to his thought on the subject of morality. Kant disagreed with Hume that morality is objective and non inhering.Kant wanted to propose a pure moral philosophy, one of absolute necessity and breakaway of all human feelings, because if it non so, it depart not be absolute and binding upon every person. The purpose of morality is to affect our behaviour and that it is reason that makes valet moral and not feelings or preferences. We shall explore some of the a priori foundations of morality paying special attention to Kants two-dimensional jussive mood and what exactly this was desi gned to lap in moral theory.To have moral worth, an act must be through in the name of ones duty, the moral worth of this act is taken from the article of faith from which its determined, not from what it aims to accomplish and that duty is necessary when one is playacting out of respect for the law. A shopkeeper giving the buyer the right amount of counterchange because the law states one must not steal, this is an example of a legal action because rules ar being followed but for the wrong reasons.A shopkeeper returning the correct amount of change because it belongs to the customer is an example of a moral action because the action is being done for the right reasons. Kant adopts the view of morality as an unconditional ought, as opposed to a conditional ought By this he means that one should perform an act without considerations of the merits that that act may produce, in par with acting in order for something else to happen. This implies that acts that are moral are tho se that are done without being done for the sake of the merit or reward that they may bring to the person.Kant claimed that moral behaviour does not guarantee the attainment of happiness rather that keen provide is crucial for actually deserving happiness. Nothing in the worldindeed nothing even beyond the worldcan possibly be conceived which could be called good without qualification except a good will (Kant 1964 p. 27). By the good will Kant means that a good will is not good because what it performs or what it effects but that it is simply good in itself.The good will is the will which acts out of respect for the moral law and from freedom, but actions such as these, if motivated by selfish or emotional eventors, will then have no moral worth. There is a great deal of stress placed on the intention behind the act, consider giving money to munificence for the sake of helping out, without any need for any ego gratification or such self-serving purposes, this is an instance of g ood will. Kants most well cognise contribution to ethical discussion is the categorical controlling. There are three key propositions that form the basis of Kants ethics.They are act only on that truism (principle) through which you can at the same time will that it should become a universal law, act in a way that you never administer humanity as a means to an end and that you act as if you were a lawmaker member of a kingdom of ends. These three principles form the categorical imperative. For Kant the source of moral justification is the categorical imperative. It presents a method to determine whether or not an act may be considered to be morally correct. An imperative is either categorical or hypothetical.Kant writes, If now the action is good only as a means to something else, then the imperative is hypothetical if it is conceived as good in itself and consequently as being necessarily the principle of a will which of itself conforms to reason, then it is categorical . . . . (Kant 1989 p. 31) As humans we all have subjective impulses desires and inclinations that may contradict the dictates of reason. These desires, whether they are material objects or gratify us in a sexual or psychological way, may in fact contradict the dictates of reason.Therefore we experience the claim of reason as an imperative, a command to act in a particular way. Kant views a person to be most free when they can overcome their temptations and it is this freedom that helps us make sense of morality. The categorical imperative emphasises the means for completing an action and places little mean on the end result of an action, whereas the hypothetical imperative places much emphasis on the end result of an action. It is an imperative because it dictates what we should do, disregarding our desires.As rational beings we are guided through life by laws and principles, in the form of an imperative which simply orders us you must do this regardless of any desires which we may have. hypothetic imperatives apply to us if we have a particular desire, go to university if you want to become a philosopher. An act becomes imperative when it ought to be applied to everyone, hence the prefatorial statement of the categorical imperative being to act only on maxims that you could will to become universal laws of human nature (Kant).A categorical imperative would command you to do X inasmuch as X is intrinsically right, that is, right in and of itself, aside from any other considerationsno ifs, no conditions, no strings given up . . . a categorical imperative is unconditional (no ifs) and independent of any things, circumstances, goals, or desires. It is for this reason that only a categorical imperative can be a universal and binding law, that is, a moral law, valid for all rational beings at all times. (Miller 1984 p. 462) Immorality then would be to make exceptions for ourselves by acting only on maxims that we cannot universalize out of our own will.It is those who act in such a way and then expect others to act different to our way, who are immoral. The categorical imperative acts as a formula for universal law by stating the prerequisites that an act must have to be considered moral, it presents a comparison for good deal to be able to see if they are acting morally, this being to act only on principles that you could will to become universal laws by which all who tender to act morally must comply with. It determines whether any act is right or wrong, so to do the opposite would be contradictory and this would then be an act that is not morally correct.An example that Kant puts forward in Good Will, Duty, and the Categorical Imperative, (1989) to depict this is of a man who is in extreme despair and contemplating suicide. By taking his own life he would be universalizing the principle that in order to love himself he should end his life (by doing this he is trying to mitigate his life by ending the despair he is feeling). Killing himself would in fact do nothing to improve his life because he would have no life at all So you see how these contradictory acts undermine those that may be classified as morally right.Although Kants categorical imperative has been astray read and accepted by some it has had criticism. Some philosophers have thought of it as absolutist, being too black and white. But when thinking of humanity and smart set in which we reside, looking at at morality according to the categorical imperative allows a standard rule for everyone to follow. If it was alright for some people to steal and not others this we could not call a moral and fair society. There needs to be a rule or comparison so that what acts are right and what are wrong may be differentiated from each other and the wrong acts then dealt with accordingly.Some have asked how only an action which one had no desire to do could ever have any moral worth. This to me does not seem to be what is trying to be expressed in Kantian ethics. It is not the desire per se that makes an act immoral, I think it seems that it is more the fact of this desire being the reason the act is conducted in the first place. If the act is done to fulfil a personal desire or attain that which one desires, then the act is immoral, but if the act is done for the good of the act in itself, for example donating money to an orphanage because one desires to help, then this is still what Kant would regard as a morally right act.Although Kantianism has had a profound effect on some people, producing many elaborations, translations and thought, for some it is not feasible once placed together as a whole. Kant had some very profound ideas but looking at society tody I would think he was definitely on the right thought pattern. Society and we as humans, with our impulses whether good or bad, need a clarified ethics to follow to help us separate what may be considered right and wrong in a moral sense, and it must be fair and the same for everyone, thi s is what Kants categorical imperative has done by creating a universal law or rule of thumb for morality.References Kant, I. 1989 Good Will, Duty, and the Categorical Imperative. ed. Serafini, A. morality and Social Concern, the categorical imperative. New York Paragon House Publishers Kant, I. 1964 Groundwork and the Metaphysics of Morals, ed. Herbert J. Paton, New York HarperCollins. Miller, Ed. L. 1984 Questions that Matter An Invitation to Philosophy, 3rd ed. Colorado McGraw-Hill, Inc. http//sguthrie. net/kant. htm (accessed on 12/10/04).

Chronic Non-communicable Diseases (CNCD)

Chronic Non-communicable Diseases (CNCD)Chronic Non-communicable Diseases(CNCD)Non-communicable diseases are chronic conditions that do not result from an acute infectious process, which know to be an instant progress, however, they lead to death, physical dysfunction, or impairment in the quality of life. In addition to that, chronic condition develop over comparatively long period at first without causing sign and symptoms, but after while the diseases manifestations develop over time, there may be a period of protracted impaired health condition. Commonly, non-communicable diseases are considered to have characteristic of non-transmissible from person to person by contact or any other appoint of transmissions. Also chronic non-communicable diseases are the leading cause of death glob all(prenominal)y, killing more people each(prenominal) year than all other causes combined. Thus, Chronic non-communicable diseases are vastly becoming the international core of health issue and aw areness toward them is instantly put into identifying solutions to the problem globally. According to WHO, the four main types of non-communicable diseases are cardiovascular diseases mainly heart attacks and stroke, followed by cancers, chronic respiratory diseases such as chronic obstructed pulmonary disease and asthma, and lastly diabetes. This paper describes a framework, establish on an ecological model, for addressing the major risk factors that contribute to chronic non-communicable diseases. Moreover, constructing ways to reverse and modify getting contact with chronic non-communicable diseases. CNCD prevention and control interventions leave behind be incorporated into the hygienic settings approach from the government to the man-to-man train exit lessen the overall critical CNCD globally.In addressing risk factors in each different sector from the ecological model can lessen the chances of getting Chronic Non-Communicable Diseases. The ecological model is categorized in decreasing ecological surface order start with public policy, flowed by community group, institutional group, interpersonal group, and individual level. Each group of ecological model impart play a key role to preventions and appropriate intervention on CNCD.To begin with, the action of public policy on development of a system to establish targets, sentence responsibility, and conduct performance management will gain success in prevention and intervention. Specifically, the developments of policy has focus on all theatres on overall objectives and declare priorities into account in order to develop local prevention and treatment plan in every annual period. Thus, it requires careful research on policies and measures that will facilitate the achievement of the goals, and effectively solve the problems and difficulties in CNCD prevention and treatment. Followed by, put into place policy guarantees, personnel staffing, capital investment, supervision and incentives will streng then accessible mobilization. Moreover, make efforts to form a prevention and treatment synergic effect among the government and the society. For preferences of improvement, policies shall be introduced to enhance the quality of the environment, by increasing supported coverage area such as fitness facilities to build a level-headed environment, to promote balanced diet, regular exercise, as well as tobacco free and alcoholic beverage consumption control area, result in avoidance of major risk factors of CNCD.Secondly, working in addressing from the community group such as organizations, community leaders, citizens will enhance the avoidance of risk factors affecting the populations. The ministry of health plays a key role in this coverage, revising existing and develop new guidelines, manuals and preparedness modules for all of the activities showing the interaction between the ecological models of institutional and community group. In addition to that the departments of science and technology, industry and information technology, agriculture, protection of environment, commerce, radio film and television, stub out and publication, food and drug administration, etc. shall closely cooperate in accordance with their functions as well as perform their set obligations and accomplish their responsibilities. The essential contrast of communities, schools, worksites and healthcare sites can support and promote healthy behaviors through policies and environmental factors such as smoke-free workplaces, healthy cafeteria meals, sidewalks bike paths, incentives for bicycle and pedestrian commuters, worksite wellness programs, insurance coverage for preventive services like tobacco cessation. In addition to that, strengthening of the School Health programs to include a component involving the family and community, in both health education and health-promoting activities such as increasing and enhancing physical education program, stimulate extracurricular physical activity time to time, provision of healthy food at schools, sensitively conducts inspections to unhealthy food at schools, and school-based CNCD risk factor screening and intervention.Thirdly, interpersonal group plays a role in primordial prevention and intervention of the major risk factors that contribute to the CNCD health problems. Group of family, friends, and social networks plays a role in addressing the critical case and helps out to avoid the preventable diseases. For example, Training of teachers and members of Parents-Teachers Association to raise awareness of the issue of increasing obesity and other CNCD risk factors in children under the school health program, high spot the CNCD risk factors in particularly obesity and healthy diet. Also, providing lectures on prevention and management of childhood obesity will be another choice, whereas healthy ingest physical activity exercise includes additional training for implementation of school-based programs for CNCD man aging risk factors. On top of that, ministry of health, part of institution group is responsible for producing the necessary guidelines, manuals and training modules also seeing interconnected relationship within ecological model. As the result bring on progressive in training community members in particular in healthy eating, physical activity and exercise, also avoiding risk factors that contributes to CNCD within interpersonally.Lastly, in solving the way improving factors such as knowledge, attitudes and skills of individual level can bring extra contributions to lessen the severity of global critic of death due to the major risk of chronic non-communicable diseases. Take on self-care responsibilities and commence a resource for themselves and others in disease prevention and management will be further expanded. NCD prevention and control interventions will be incorporated into the healthy settings approach this will include expanding the school health services to include nutr ition and exercise promotion, cardiovascular risk and early intervention. To be informative, critical ascription resulted unhealthy lifestyle or modifiable behaviors like tobacco use, sedentary lifestyle, poor diet, however, the most effective models of eliminating risk factors focus on changing individual behaviors start from itself.

Falls in Older Adults With Mental Illness

Falls in Older Adults With psychogenic IllnessAimThe aim of this research paper is to examine the solecisms of exits in honest-to-goodness adults mainly due to the cordial illness. The decreasing level of psychic health in older adult is a primary reason of inclination leading to multiple drab injuries. The research paper will analyze the role of affable illness in causing the come acrosss in older adults.ObjectiveThis take up establishes the fact that mental illness in older adults is responsible for a authorise causing major injuries, which can prove fatal. This study get on investigates the various preventive measures which can be adopted to prevent the fall of mentally older adults.IntroductionHuman personify is the complex mechanism ever made. Like machines, Human body is also prone to wear tear. The phenomenon of whileing in human being is universally known. With step-up in age, bodys resistivity decreases, thus many old age problems arises. With the advance ments of medical technology, human life expectancy has been increased from 50 years to 65 years. The surmisal of leading a healthier life after 50 years is possible which was not possible in earlier days (Rowe kahn 1987 1997). Increased health education, various financial programmes better care of human body has increased the average life of a human to 70 or 80 years. barely with increased age, certain chronic diseases are bound to happen. It is true that due to best medical practices human life has increased tho human body being a part of nature has its own fate. With increased life expectancy, we can see a lot of older active members in our nowadayss society. With increase in active older adults, there is a subsequent increase in adults with mental physical problems as rise (Zarit, Johansson Malmberg 1995). kind problems are the result of social dilemma in older adults. Many contingencys are recently divorced male female, sometimes the loss of near and love ones plunges one into darkness. Despite all the best of technological advancements and innovative medical treatments, the mental well being of older adult people is declining (Zarit Zarit 2012). The solidarity living, unable to socialise are also seen as few causes of mental illness. Older adults, sometimes divorcee or single suffering from mental disorder become dupe of fall, due to losing of consciousness. The fall is a major reason of unintentional injuries (Sattin 1992). A faller is a person who falls, which is usually more than once in case of mentally ill people. The fall, induces by mental illness is increasing day by day. Hospitalization due to fall is increasing in the age gathering of 55-65 years (Heslop et. Al. 2012). Fall resulted to mental disorder leads to major injuries. Depression due to single living style is a major reason causing the mental imbalance. The loss of confidence due to multiple falls in patient with high level of mental disorder is seen in patients who fall at to the lowest degree three times in a year. Due to singular living style being popular these days, people are unable to mingling socially, a patient suffering from mental disorder will remain unhealthy until his atmosphere gets changed. Easing out the feeling of depression in people is the showtime cure of mental illness which doesnt usually happens these days until you visit a doctor.Literature reviewThe social confinement of living alone is a major cause of increasing mental illness and subsequent fall of patients (Treas 1995). Although, the fall is a solution of both external factors as well internal. exchange in environment, Affect of Drugs or any labour intensive activity performed under harsh condition can also lead to fall (Nyberg 1996). Mental well being is often attributed to heavy drug intake, which leads to dizziness. Intuitional admittance is often regarded as a remedy to prevent any fatal injury but falls are in increasing number by two third to those people who ar e under institutional care (Bergland et. al. 1998). Mental well is often regarded something which comes with age, but that is not the usual case. Certain minor or mid aged adults too have shown sign of mental illness, although number of fall accidents in not serious in this age group. Mental illness deteriorates with increasing age resulting in increasing number of fall as age increases, which increases the number of hospitalized cases due to fall (Mathers et. al. 1998).Prevention is the best remedy to cure the mental illness as well as to prevent any serious injury due to fall. The mental illness can be caused to various factors including generic inheritance (Sellers et. al. 2012). Although several researches have been done on the cause of mental illness but nothing specific is researched on fall as a result of mental instability. Also fall is not the direct resultant of mental illness, its the after affect of various drugs that patient take as a cure of mental illness. A recently concluded study find interrelateages of mental illness with other age related diseases also (Griffin 2013). luck judgement should be the specific case while dealing a patient with multiple disorders. Considering the less neighbourhood friendly nature of our modern living, a single person is always prone to mental imbalance. A cleaning lady who is a divorcee and now lives single is more prone to mental illness (Schoevers et. al. 2006). The risk of depression is much greater than compared to the one living in a joint family. Fall in the case of single living patient is more serious. Delay in hospitalization can lead to wipeout of a patient in case if nobody reports to the hospital which usually can happen if you are living alone. A faller falling at multiple times in a year is more prone to neurological disorder (Nevitt et. al. 2006).Fall is often related to the depression and mental stupefaction of a person. A subsequent increase in the order of fall can increase the mental depr ession (Krishnaswamy n.d.). The Australian Commission of Safety whole step in Health care has established that treatment of fall can be useful in treating multiple illnesses. The guidelines issued by them include the risk assessment test to be done for person crossing a threshold level of age. Certain literature focuses on preventive measures with regard to spacial planning, firing ambiance user friendly approaches of the houses to be designed for older adults.Identifying the gapsAlthough separate studies and researches have been done on various effect of fall, the specific reason of fall in mental disturbed patient is not been studied. A direct link inevitably to be established between the mental illness and fall. This further should be analyzed on the increasing rate of mental illness with age groups and duration of fall period. Moreover, the physical assessment of a faller needs to be done as to what is he doing at the time of fall, whats the mental stress level during his falls at what time of the day is the fall occurring. Any literature which can establish direct link of mental illness on a fall of a person is not been done. A study needs to be focused on establishing preventive measure which can be under taken by the patient at spatial level in order to minimize the injuries. This gap is to be answered by the medium of this research paper, with specific need of establishing time occurrence of fall in mentally ill people. Although separate qualitative analysis needs to be done for patients live in the institutional care and those living in man-to-man homes.Formulating research questionHow mental illness linked to the fall of older adults people?Specifying the significanceThe cases of fall are increasing with the increase of age life expectancy. Increasing level of segregation at neighbourhood level has become a way of living. Reporting of fall in case of mentally ill people living single is more important. This research study is important as it will establish a direct link between mentally ill people to their fall, considering the fact that mentally ill people often dont relate their fall to the mental illness. Risk assessment is also a main focus of this study, as the fall cases are often increases with the increase of age. The research is important owing to the fact that mental illness goes unnoticed despite subsequent fall, that too for the patients living in the institutional care.Bibliography

Communication In Chronic Obstructive Pulmonary Disease Palliative Care Nursing Essay

communion In Chronic Obstructive Pulmonary Disease alleviative C are Nursing EssayThe following is an evaluation of enhanced communication techniques in mitigatory charge for patients with chronic obstructive pulmonary disease (COPD) with propagation to a case study.COPD is a debilitating terminal condition that is distinguished by a growthive airflow obstruction, primarily caused by smoking. It is usually non fully irreversible (NICE, 2010).For an airflow obstruction to qualify, post bronchiodilation FEV1/FVC is less than 0.7 ( FEV forced expiratory volume in one second, FVC forced vital capacity). The course of COPD is highlighted as being an illness characterised by a long inexplor competent disease, punctuated with protracted periods of disabling breathlessness, reducing exercise tolerance, causing recurrent hospital admissions and premature death (Buckley, 2008). diagnosing of COPD is not entirely dependent on severity of breathlessness but in any case account, physic al examination and as well as spirometry confirmation of airway obstruction (Buckley, 2008 NICE, 2010). Because of the hassle with the prognosis of COPD, it presents a challenge for physicians and health guardianship practitioners to provide adequate superintend to patients (Curtis, 2006 NICE, 2010).Due to the nature of symptoms associated COPD (such as dyspnoea), patients more often die with COPD or relate than from it (NICE, 2010) with mortality rate for men steadily reduced from 1970 while womens has seen a small but steady rise, although COPD mortality is on the general rise. Buckley (2008) reported that on that point was a relatively higher proportion, (72%) of COPD who die in hospital care, compared with 12% at habitation and none in hospices.Palliative CarePalliative care has several definitions but has similar concepts according to Campbell (2009). NICE (2010) guidelines define palliative care as active holistic care of patients with advanced progressive illness. Curti s (2006) defines palliative care as the goal being to prevent and relieve suffering and support the best possible loyalty of life for patients and their families and their families, regardless of the state of disease or the need for other therapies.The general aim of palliative care is to improve the quality of care through alleviation of symptoms and promoting comfort over discussion as some treatment involve mechanical aids which patients might find taxing (Curtis, 2006). This has brought about the suggestion for the need of specialised centres (Curtis, 2006) considering how little prudence palliative care quality has received. Curtis (2006) then went on to report that there was a very low number of patients who talked about end of life care with their physicians, which can be made even more difficult with loss of emotional control or fear of having little training (Wittenberg-Lyles et al., 2008). There is also a need for patients to show more confidence in their carers (Curtis, 2006).The Gold Standards Framework GSF (2006) Prognostic Indicator Guidance (PIG) lists the criteria that would assist in making a prognosis for requirement of palliative care asSeverity of disease, such as FEV1 being less than 30% predictedRecurrent hospital admissionsLong term oxygen therapyShortness of breath with 4/5 grade on the Medical Research Council (MRC) Dyspnoea scaleSigns and symptoms of right heart failure early(a) factor such as non invasive ventilation (NIV)The GSF (2006) PIG summarises which three steps are key to determine which patient needs palliative care. They areIdentifying patient based on criteriaAssessing needsPlanning administrationThe above steps are dependent on patients satisfying chronic condition criteria listed earlier.CommunicationCommunication is the process of enhancing thoughts or information between individuals through different media spoken or written and through body language gestures (Payne et al., 2004).Buckley (2008) states that good commun ication is the key to the delivery of effective supportive palliative care services as it has an interpersonal perspective that is about health professionals and patients engaging emotionally (Wittenberg-Lyles et al., 2008).Delivering magnanimous bare-asseds is not an easy or comfort open feat. The United States EPEC (Education for Physicians on End of life) is a training program based on SPIKES model (Setting, Perception, Invitation, Knowledge, Empathy, and dodging/Summary), that has listed steps to follow that in the delivery of bad news, summarised belowPreparing to meet i.e. location settingAssess what patient knows about conditionDetermine sum of information to give patientDelivery of newsRespond to any questions from patient and/ or familyMake follow up planCase depicted object Patient profileThe vitrine used in the case study was an eighty year old man in a nursing home who presented as generally quiet, with long standing chronic obstructive pulmonary disease (COPD). Co nsent was obtained from him to participate in the study with the potential benefits explained to him. The subject had memorial of chain smoking and was diagnosed with heart murmurs in 1986. Long term smoking causes the damage to the lung tissues and repeated authority infections (NICE, 2010) and is a major contributor to COPD. The subject was inflict bronchodilator salbutamol 2.5mg/2.5ml nebuliser liquid unit dose vial, administered by mask one or two ampoules four times a day. It was used as and when it was required although he did not usually exceed three doses daily.The subject had shortness of breath with basic living tasks and dependent on staff. The subject had several GP visits for COPD associated chest infections in the last twelve months and had to be supported by pillows in an almost upright position to sleep to reduce the discomfort caused by the dyspnoea. The subject was chosen as he satisfied most of the criteria from the GSF (2006) in terms of shortness of breath, r eliance on the bronchiodilator, several GP visits for chest infections and long history of smoking. The do not resuscitate (DNR) forms were filled in passed on to the multidisciplinary team that include the Ambulance service with the family aware.Communication in Palliative care with COPDDifferent communication techniques were employed when it came to dealing with the subject to reassure him and the family skills i.e. maintaining appropriate eye contact, low tone of voice is the key to the delivery of effective supportive palliative care service (Buckley, 2008). A SPIKES model approach was employed with the current case study.DiscussionIt is essential for nurses to establish a therapeutic relationship with patients as they act more with the patient, employing strategies such as empathy, spending more time listening and being more initiative (Edwards, et al 2006). Communication sometimes can also been limited by workplace policies or insufficient training (Edwards, et al 2006), whic h raises the need for proper training to better these relationships (Davidson et al., 2002). The current case study was able to overcome the difficulties of communicating with the patient and family as they had been there already offering support, and hence during the meeting to discuss the end of life they stated that they were satisfied with the progress as part of the continued care.The subject did not seem to be happy with the nebulisation therapy at first and he expressed fear and anxieties because it was a new therapy, which was not unusual (Stevens et al., 2009). Curtis (2006) study argues that health care for patients with COPD was often initiated proactively based on a previously developed plan for managing their disease. The subject was given a choice if he wanted a member of his family to be present and if the time was appropriate to which he had no objection, being emotionally functional and able to make his decisions (Lemmens et al. 2008). It was also noted that the sub ject became more relaxed when the nebulisation therapy was explained to him that it would reduce the dyspnoea, rattly chest, symptoms that he acknowledged made his breathing difficult and other symptoms such as reedy and sleep disturbance.It is authoritative to have a suitable location where there would be few disturbances when breaking bad news (Stevens et al, 2009 Wittenberg- Lyle, 2006). In the case study, the subjects family was contacted in order to arrange a meeting to discuss his diagnosis, the way forward regarding his treatment and control of his symptoms and also make them aware of any changes that would need to be made in terms of his care. This afforded the subject and family to be to be reassured that the patient would be made as comfortable as possible to palliate the symptoms of his condition through to end of life and bereavement.ConclusionPalliative care for COPD has not received much attention until recently. Communication is a very important aspect for high stand ards of care particularly in end of life care. Nurse to patient relationships are even more important as they wager a major role liaising with the family and multidisciplinary team to make the end of life as comfortable as possible. There is still much to be make in terms of communication training for nurses and also getting more physicians involved. The role of a multidisciplinary team is highly valued as it helps streamline the provision and administration of palliative care. The current case study found that the patient was happy with the way that the way that his care was planned.

Assessment Issue Rubrics Essay -- Teaching Education

Assessment Issue form of addresss This word takes on a bit of a different perspective when it comes to the issue of using rubrics as a tool of assessment. When the topic of rubrics has come up in the professional life of this writer, it has been followed with a negative connotation. This article speaks positively of the use of rubrics. The writer of the article Heidi Andrade uses rubrics not only to justify school-age childs grades, but also to assist the students in properly completing an assignment. What the author of the articles says makes a lot of sense. A rubric shows a student exactly what is needed to obtain a high score on any given assignment. A good rubric will effectively do this task. The rubric can also serve as a reminder to a student that might be having difficulty recalling an item for an interrogatory or for a paper. The author refers to rubrics as Instructional Rubrics. According to the author An Instructional Rubric is usually a one- or two-page do cument that describes varying levels of quality, from polished to poor, for a specific assignment. It is usually used with relatively complex assignment, such as a long-term project, an essay, or a research paper. When an Instructional Rubric is used, a student is now given the knowledge of what is expected from them, all to often this does not occur. Sometimes educators, without meaning to do harm, just expect the student to know how to do a task without directions. This is almost certainly settin...

An Analysis of Yeats’ An Irish Airman Foresees His Death Essay

An Analysis of Yeats An Irish throwaway Foresees His DeathIt is an unspoken assumption that when a country goes to war the men fighting are honored and also that there is a large amount of support given to the soldiers from that particular community. What is often over-looked is the fact that galore(postnominal) of the men, who are partaking in battle, are in fact, boys who do not even know what they are fighting for. Also, the community is not always supportive and stabilising unless they see a personal benefit that provide affect them in a positive way as an outcome of the war. In An Irish Airman Foresees His Death, Yeats introduces us to a man who is fighting in the war, not knowing what he is fighting for. Yeats also shows us, from a soldiers mountain point, how a soldier feels while defending a country he does not feel any loyalty to, and how a soldier views the community he is laying his life on the line to protect. It is apparent immediately in the beginning of the poem that this airman has a very bad attitude nearly the way this war is going. I know that I shall meet my fate, Somewhere among the clouds above (Yeats 154). The airman is saying that he knows, or senses, the fact that he will not make it out alive of this war. The reference made to the clouds above is simply reinforcing the fact that he is an airman in the war. These first two lines truly set the tone for a poem that turns out to be a very somber, depressing piece of work. These two lines are symbolic of the airmans attitude and take on life in general. The third and fourth lines of the poem, Those that I fight I do not hate, Those that I guard I do not love (Yeats 154), tell us how he feels about the soldiers he is fighting against, and also how he feels a... ... signs on life worth sprightliness in himself and sees no hope for a world where young men can sacrifice themselves for the good of their country, and in response, get virtually no response from the citizens at large. Th is poem was written in memory of Lady Gregorys son, Major Robert Gregory, who died on the Italian front in January of 1918. Its purpose is to show how negatively charged war can be and how unjust much of what happens during a war actually is. It does not make sense that a soldier may not even like the people he is fighting next to, and that he may be able to relate better to the enemy than to his own troops. Yeats, by writing this poem, made the reader conscious of the negative aspects of war. Works Cited Yeats, William Butler. An Irish Airman Foresees His Death. Contained in, Norton Anthology of Modern Poetry, 2nd ed. New York, New York 1988.