Monday, March 16, 2020
The number of children diagnosed with Obsessive Compulsive Disorder The WritePass Journal
The number of children diagnosed with Obsessive Compulsive Disorder INTRODUCTION The number of children diagnosed with Obsessive Compulsive Disorder INTRODUCTIONAIMS AND OBJECTIVESà à à à à à à à à à à à à à à à à à à à à à à à à à à à à à RESEARCH AIMS RESEARCH QUESTIONSLITERATUREà REVIEW UNDERSTANDING OCDOCD UK STATISTICSCOMPARISON OF CHILDREN AND ADULTS LIVING WITH OCD RESEARCH METHODOLOGYCONCLUSION AND RECOMMENDATIONREFERENCESRelated INTRODUCTION Daily, the number of children diagnosed with Obsessive Compulsive Disorder (OCD) is on the increase. OCD has been shown to affect at least 2% of young people (OCF 2009).à As defined by the NHS clinical guide 2005, ââ¬Å"obsessive compulsive disorder (OCD) is characterized by the presence of either obsessions or compulsions and most commonly bothâ⬠The NHS further describe an obsession as any thoughts, imagery or urge which is unwanted and intrusive, repeatedly bogging someoneââ¬â¢s mind. Also compulsion, are behaviors or mental activities repetitive in nature which a person feels need or is driven to perform. These definitions embody the reality encompassing people suffering with OCD. The symptoms which cause significant functional impairment and distress coupled with the fact that it can either be overt and observable by others (for example, checking that a door is locked repeatedly) or covert mental act like repeating a particular phrase in ones mind tend to affect suff erers, physically, psychologically, socially and academically as would be expounded in this study. Obsessions or compulsions can negatively impact on the lives of young people within their family environment, school and with friends. Nearly all children have little worries or fears as a normal part of growing up (Pridmore, 2010). This then makes OCD in children difficult to diagnose thus removing early identification and treatment in effect leading to a more developed situation in adult hood. Research into the early diagnosis forms the crux of this study. AIMS AND OBJECTIVESà à à à à à à à à à à à à à à à à à à à à à à à à à à à à à RESEARCH AIMS This research is aimed at scaling more light on ways of early detection of OCD in children with a view to early diagnosis and early treatment by way of research to investigate the relationship between OCD in children, adolescents and adult, thus ensuring translating the cognitive processing of threat across age groups, magnitude of symptom and how this is usually shown by sufferers with age. Furthermore it also aims to add knowledge to what is currently known about the import of age on OCD and the best approach in detecting and treating OCD early in life. OBJECTIVES Interpret how OCD symptoms begin and are displayed across age groups. Assess level of symptom in sufferers across different age groups. Analyze critically the best practice for early detection and best approach to treatment. Make recommendation based on research finding into OCD across varied age groups. RESEARCH QUESTIONS Important to this research are the following questions, which make up the body of the research: How are the symptoms of OCD exhibited in children? What role does age play in the repression or otherwise of OCD in children? How does comparism of OCD symptoms across age groups affect current knowledge of OCD in Children? What conditions affect the repression of OCD symptoms across the test age groups? Can the success of repression across any of the age groups be used as tool to treat OCD in children? These questions would form the building blocks of the research, as the findings would formulate points of discussion. LITERATUREà REVIEW UNDERSTANDING OCD Previously, OCD was thought to be a rare psychiatric illness (Paige, 2007), however, research into the causes and symptoms into the condition, points out that the condition or disorder clearly characterized by cycles of obsessions and ââ¬Ëritualsââ¬â¢ or compulsions causing extreme malfunction, fear and distress to its sufferers. It is proposed and more likely that in the near distant future, OCD would be grouped in a field of disorders with various treatments. The proposed OC spectrum disorders might include OCD, body dysmorphic disorder (Bjornsson et al, 2010), hoarding (Pertusa et al, 2010), pathological gambling (Black et al, 2010), certain eating disorders, and autism. The current position of OCD differs in the two major diagnostic systems. OCD is perceived as an anxiety disorder In the DSM-IV, while ICD-10 lists it as an entity, which is separate from the anxiety, disorders. As stated above, proposals for the removal of OCD from the anxiety disorders and placed in an independent grouping of ââ¬Å"OC spectrum disordersâ⬠is currently under discussion (Bartz Hollander, 2006). OCD is yet to be fully understood thus various theories flourish which link it to different conditions such as a connection to disgust which is a basic human emotion, which may have an evolutionary function that encourages the avoidance of contamination and disease. Husted et al, (2006), explained that functional imaging indicates that the neurocircuitry of OCD and disgust are similar conceiving OCD as a malfunction in an appraisal process. This would fit with OCD in which there are contamination concerns. However, this ideology does not tally with another theory that observes indecision as a feature of OCD and proposes the disorder is a result of disturbed decision-making strategies, which has been discussed by (Sachdev, et al, 2005). In another instance, functional imaging supports the theory that decision making involves the dorsolateral, orbitofrontal and anterior cingulate cortices (CHANGE THE WORDS) which interact with limbic structures to retain memory of emotional rewards, an d the basal ganglia which is involved in behavioral execution, the same structures that appear to be involved in OCD. These are shrouded with other theories that include ââ¬Å"not just right experiencesâ⬠(Coles et al, 2010), inability to terminate improbable but grave danger concerns (Woody and Szechtman, 2010) and ââ¬Å"an inflated sense of responsibilityâ⬠(Smari et al, 2010) OCD involves obsession that are involuntary, leading up to thoughts that are unwanted and recurring result in feelings of anxiety and many at times dread hence they are not simply cases of meticulousness or over worry. There tend to be much worse, they make the sufferer seem irrational, interfere with normal thinking and are time consuming in some cases taking up to two hours per day (Fruehling J, 1999). They compel sufferers to make repeated attempts to try and control arising obsessive thoughts all to no avail. The ââ¬Ëritualsââ¬â¢ performed by sufferers tend to bring temporary relief from the anxiety brought about by the thoughts as there exist a clear the relationship between most obsessions and the compulsions that follow. for example, contamination and washing. Sometimes the opposite is the case as not clear relationship can be attributed to (WHAT)for example, counting behaviors in a bid to prevent harm to others (Paige, 2007). The symptoms of OCD have been shown to grow stronger over time in cases where certain performed compulsions appear less effective in bringing relief. More elaborate measures could be taken to provide a sense of relief effectively ensuring that these become time consuming and thus interfering with everyday functioning. There have been cases of delayed indulgence so as not to appear abnormal socially, but this is nearly very difficult and the urge to perform the rituals always tends to grow. For example, students who tend to and are able to delay their compulsions while in class often tend to go to private places later on to perform set rituals during school hours. The concept of delusion cannot be attributed to sufferers of OCD, more adult sufferers often tend to recognize that such thoughts and behaviors that follow are unreasonable, however, that lack the will or ability to control them. In the face of illness or stress, OCD symptoms worsen. The causes of OCD border around three major areas, psychological, biological and the roles of neurotransmitters. Biologically Studies have linked patients with childhood onset OCD to first-degree relatives, than among patients with later onsets to first-degree relatives (Starcevic, 2005). However, statistical inconsistencies have been shown to exist among twins demonstrating a higher concordance among dizygotic pairs. Upon statistical analysis further more, Grootheest et al, 2005 explained that if a dimensional approach is employed, studies amongst twins suggest heritability of obsessive compulsive symptoms. Early onset of OCD is traceable to strong genetical contributions however, this is not definitive (Pridmore, 2010). Role of Transmitters In another study, neurological images implicate disturbances in pathways between the cerebral cortex and thalamus as pathogenesis of obsessions while pathogenesis of compulsion along with repetitive motor acts results from abnormalities in the striatum (Insel, 1992). When comparing sufferers of OCD and other anxiety disorders, Ruda et al, (2010) observed common and distinct neural substrates as both showed a decreased level of bilateral grey matter volume in the brain. OCD like disorders caused by childhood streptococcal infections has been termed Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. It has been observed that a large percentage of children who have suffered this complication of rheumatic fever have antibodies directed against the caudate (Swedo et al, 1994). Psychologically ââ¬â OCD are shown by the symptoms explained upon earlier in this study. OCD UK STATISTICS Torres et al reported in 2006 that the survey of British National Psychiatric Morbidity revealed the prevalence within the general population of OCD was 1.1%. The same statistics also showed that the percentage decreased with increasing age (1.4% within 16-26years and 0.2% within 65-74 years). These statistics also revealed that the condition was slightly higher in females than males. Amongst sufferers of the condition, it has been identified that 55% suffer from only obsessions while 11% have only compulsions with 34% having both obsessions and compulsions (Pridmore, 2010). Further statistics show that 62% patients suffer from mental disorder in particular depression and anxiety, with 20% having alcohol dependence, 13% on drug dependence and 25% with a history of attempted suicide. The above statistics points to the prevalence of OCD in children who very often are ignorant of the existence of the condition and or where conscious are often very afraid to inform parents. In a 9 year s urvey where 142 adolescents and children where followed, Heyman et al, 2010 revealed that 41% of this population had persistent OCD, a very considerable number of those without the condition showed signs of other psychiatric conditions. This reveals that OCD is a chronic disorder amongst the younger generation with a guided prognosis. CHILDREN LIVING WITH OCD Childhood onset of OCD may result in children demonstrating washing; checking rituals, and preoccupation with disease, danger, and doubts inter aliaà (Swedo et al 1989), with an approximate 2%ââ¬â3% of people (including adolescents) having OCD. Notwithstanding this may be an underestimate because many symptoms are kept secret, OCD can emerge as early as preschool. During puberty and early adulthood, the number of children who develop the disorder peaks (National Institutes of Mental Health, Pediatric Obsessive- Compulsive Disorder Research, 2006). Studies by Paige, 2007 show that one-third of adults have OCD developed from childhood. As stated earlier, children and adolescents often tend to hide the symptoms of OCD for fear of being tagged ââ¬Ëcrazy or weirdââ¬â¢ this often takes its toll on the severity of the condition in sufferers later on in life. The stigma often associated with OCD come to the full understanding of most adolescents who go through extreme lengths to avoid showing the symptoms. These steps could see them seek ways to avoid situations, which tend to trigger symptoms or young sufferers become clever in devising explanations for their behaviors. Snider et al, 2000 preach that compulsive behavior begins very often gradually and the trend is inadvertently supported by unsuspecting parents at the outset, for example, in cases where children and adolescents show rituals or compulsions that tend to be developmentally appropriate such as wearing a lucky shirt to a game or lining up stuffed animals in a particular way or show healthy behavior such as appear healthy washing of hands after bathroom use, parents may not initially be concerned by such OCD symptoms thus resulting in not seeking medical treatment at the outset until behaviors have become disruptive. Study by Zohar (1999) reveal that following childhood onset, OCD has a complete remission rate of 10 to 50 percent by late adolescence and without treatment tends to become chronic affecting normal function adversely. Considerable effects on adolescents include decreased performance qualities, impaired relationships, depression, problems associated with poor academic performance and so on (Paige, 2004). Expounding further on the effect of OCD on child or adolescent school performance, OCD often at times has a considerable and significant effect on child or adolescent learning; this tends to worsen if left untreated at the earlier stages. Academic problems associated with OCD in children or adolescent include poor attendance often similar to school avoidance, perceived weird behavior as young sufferers tend to avoid situations and places that increase obsessive thoughts as they may spend more time in secret places where rituals or compulsions are performed, this often results in increased social isolation and missed learning. Other problems may include loss of concentration, which is similar to symptoms associated with Attention Deficit Disorder (ADD) as a dir ect result of obsessive. The consequences of such behaviors often result in victimization or bullying of students suffering from OCD while obsessive thoughts create social problems. COMPARISON OF CHILDREN AND ADULTS LIVING WITH OCD In a study to unearth the developmental differences in the cognitive processing of threat across children, adolescent and adult groups of individual sufferers of OCD by Farrell et al in 2006, some evidence showed that age accounted for differences in the cognitive processing of threat associated with OCD. As this study was the first to examine this relationship, it demonstrated that children suffering from OCD experienced lower anxious and intrusive thoughts in direct comparism to both adolescents and adults. Children experienced lower levels of sadness, worry, disapproval and removal strategies associated with OCD as determined by Farrell et al, (2006) when compared to adolescents and adults. The research also pointed that the intrusive and depressive thoughts experienced by children with OCD was less distressing and less difficult to resist in comparison to the other two groups. These finding where consistent with reports by Salkovskis (1985, 1989) and others (Freeston et al., 1996 ; Rachman, 1993). Similar results were obtained when responsibility was the factor being tested for. The results showed that children report significantly less responsibility on a self-report responsibility attitude measurement in comparison to the other two groups. This suggested effectively that by adolescent, sufferers ten to have increased attitudes regarding personal blame for harm as is also in the case of adults suffering with OCD. RESEARCH METHODOLOGY CONCLUSION AND RECOMMENDATION The cognitive theory of OCD has in the past been heralded as the most widely accepted account of maintenance of the disorder in adults however; it remained to be seen if evaluation across children, adolescent and adult comparison portends any trend. To this end, research was undertaken to investigate developmental differences in symptoms displayed by OCD sufferers across the age range, the results obtained demonstrated that symptoms evinced increased across the grouping (children ââ¬â adolescent adult). This therefore suggests adoption of strategies for treatment of the condition. Importance is placed of the early discovery of the condition in an individual so as to ensure that whatever treatment is required is provided to stem increased conditions as the individual matures. Furthermore, in managing and ensuring recovery from OCD, early identification and requisite treatment remain imperative. Various strategies to manage and control the condition amongst children within the sch ool environment and at home have to be employed. At schools, staff should be alert as to the symptoms of the disorder in any pupil and to achieve this there is need for adequate enlightenment of staff about the disorder. Advice should the sought from the school counselor as unexplained agitation in pupil, prolonged and or frequent absence from class etc could be pointers to the condition in a pupil. Also, indirect observation such as raw or bleeding hands could give required clues. Stigmatization should also be eliminated. Conclusively, parental involvement remains utmost in the management and recovery process. Some parents may require education on how to identify and support children suffering with OCD. More research is required to fully grasp the role of responsibility, life experiences and exposures on the display and repression of OCD symptoms. This research study however, recommends a more details research into the symptoms showed by sufferers across different age groups and the roles which various factors would play. REFERENCES Bartz J., and Hollander E., (2006) ââ¬ËIs obsessive-compulsive disorder an anxiety disorder?ââ¬â¢ Progress in Neuropsychopharmacology and Biological Psychiatry, vol. 30. pp. 338-352. Bjornsson A, Didie E, Phillips K., (2010) ââ¬ËBody dysmorphic disorderââ¬â¢ Dialogues in Clinical Neuroscience, vol. 12, pp. 221-232. Coles M., Heimberg R., Frost R., and Steketee G., (2005) ââ¬ËNot just right experiences and obsessive compulsive features: experimental and self-monitoring perspectivesââ¬â¢ Behavior Research and Therapy, vol. 43, pp. 153-167. Freeston, M. H., Rheaume, J., Ladouceur, R. (1996) ââ¬ËCorrecting faulty appraisals of obsessional thoughtsââ¬â¢ Behaviour, Research and Therapy, vol. 34, pp. 433ââ¬â446. Insel T., (1995) ââ¬ËToward a neuroanatomy of obsessive-compulsive disorderââ¬â¢ Archives of General Psychiatry, vol. 49, pp. 739-744. National Institutes of Mental Health, Pediatric Obsessive-Compulsive Disorder Research. (2006) FAQs about OCD. Retreived May 31, 2007, from http://intramural.nimh.nih.gov/pocd/ pocd-faqs.htm#FAQ-1 National Health Scheme NHS (2005) ââ¬ËObsessive-compulsive disorder Obsessive-compulsive disorder: core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorderââ¬â¢ National Institute for health and clinical excellence. www.nice.org.uk. Obsessive Compulsive Foundation (OCF) (1999) ââ¬ËOCD in Childrenââ¬â¢ Obsessive-Compulsive Foundation. (2006) ââ¬ËWhat is OCD?ââ¬â¢ Retreived June 1, 2007, from www.ocfoundation.org/what-is-ocd.html Paige L. Z., (2004) ââ¬ËObsessive-compulsive disorder: Information for parents and educatorsââ¬â¢ In Canter, A. S., Paige, L. Z., Roth, M. D., Romero, I., Carroll, S. A. (Eds.), Helping children at home and school II: Handouts for families and educators. Bethesda, MD: National Association of School Psychologists. Pertusa A, Frost R, Mataix-Cols D., (2010) ââ¬ËWhen hoarding is a symptom of OCD: a case series and implications for DSM-V. Behavioral Research and Therapy 2010; in press. Pridmore S., (2010) ââ¬ËOCD ââ¬â download of Psyciatryââ¬â¢ Chapter 13 Rachman S., (1993) ââ¬ËObsessions, responsibility, and guilt. Behaviour Research and Therapy, vol. 31, pp. 149ââ¬â154. Radua J., van den Heuvel O., Surguladaze S., and Mataix-Cols D., (2010) ââ¬ËMeta-analytical; comparison of voxel-based morphometry studies in obsessive-compulsive disorder vs other anxiety disordersââ¬â¢ Archives of General Psychiatry, vol. 67, pp. 701-711. Smari J, (2010) ââ¬ËPathways to inflated responsibility beliefs, responsibility attitudes and obsessive-compulsive symptoms: factor structure and test of mediational modelââ¬â¢ Behavioral and Cognitive Psychotherapy, vol 38, pp. 535-544. Snider L. A., and Swedo S. E., (2000) ââ¬ËPediatric obsessive-compulsive disorder. The Journal of the American Medical Association, vol. 284, pp. 3104ââ¬â3106. Starcevic V., (2005) ââ¬ËAnxiety Disorders in Adultsââ¬â¢ Oxford University Press: Oxford. 2005. Swedo S. E., Rapoport J. L., Leonard H. L., Lenane M., and Cheslow D., (1989) ââ¬ËObsessivecompulsive disorder in children and adolescents: Clinical phenomenology of 70 consecutive cases. Archives of General Psychiatry, vol. 46, pp. 335ââ¬â341. Salkovskis P. M., (1985) ââ¬ËObsessional compulsive problems: A cognitive-behavioural analysisââ¬â¢ Behaviour Research and Therapy, vol. 23, pp. 571ââ¬â583. Salkovskis, P. M. (1989) ââ¬ËCognitive behavioural factors and the persistence of intrusive thoughts in obsessional problemsââ¬â¢ Behaviour Research and Therapy, vol. 27, pp. 677ââ¬â682. Zohar A. H., (1999) ââ¬ËThe epidemiology of obsessive-compulsive disorder in children and adolescentsââ¬â¢ Child and Adolescent Psychiatry, vol. 8, pp. 445ââ¬â460.
Friday, February 28, 2020
Leadership and Change Essay Example | Topics and Well Written Essays - 2750 words
Leadership and Change - Essay Example Although there is no universal definition of the structural behavioral interviews, these can be employed to produce strong outcomes that are similar to proven techniques such as, assessment centers and ability tests. The structural interviews can be conducted in phases, involving peer discussions and telephonic interview. The third phase or reference checking is necessary for quality purposes. Leadership is referred to the process of initiating, enabling, developing, implementing and maintaining change with the management structure of an organization, group or team. In a continuously evolving environment, the role of leaders is critical for managing and maintaining organizational performance. According to the Path Goal theory, effectiveness of a leader is greatly dependent on the circumstances wherein an individual works and the leaders tend to adopt various strategies to find the best solution so as to cope with the situation (House, 1996). Leaders exhibit different managerial styles to induce change management in an organization in order to keep pace with the radical changes occurring in the external environment. However, this fact does not explain that effective leadership is driven by subjective preferences. Along with the Path goal theory, the situational aspect of leadership is supported by Fiedlerââ¬â¢s contingency model. The contingency model states that rigorousness in the relationship between leadership style and effectiveness can be reduced by increasing the ability of leaders to control a particular situation. The contingency model has proposed three components that influence situational favorability, namely leader-member relationship, task structure and power of the leader (Offermann, Kennedy & Wirtz, 1994). In context of the current paper, the organization in subject is Procter & Gamble, where questions regarding employee satisfaction and retention
Wednesday, February 12, 2020
Consanguineous Marriages among Arabs Essay Example | Topics and Well Written Essays - 2500 words
Consanguineous Marriages among Arabs - Essay Example Thus beginning should focus on the significant of this research to our largest society since the marriage as it definition stated above is mainly adapt by blood relations. To this end, readers are expected to gain a lots from the digging that would made of the merit and demerit of the said marriage, so that they would either practicing it if any, or else reduce, based on the lessons they grab from the writing. It should be noted however that consanguineous marriage is not only practicing by Arab in this world, it is a general phenomenon among humanity. Since it is a marriage that exists among biological relations, for example, first cousins, uncle's son marries auntie's daughter and others. It is a union between male and female among al, races irrespective of where they came from. For example, "around the globe consanguineous marriages have been practiced by many societies from time immemorial. It is widely practiced in Asia, North Africa, Switzerland, Middle East, some parts of China, Japan and fishermen communities in Europe and America. One in two rural marriages in Tamil Nadu and Andhra Pradesh are consanguineous". (Problem with consanguineous marriage) Since the said marriage is a general phenomenon among all races, as long as they contracted marriage based on blood relations. Thus this research would explore all channels towards knowing much about the marriage, and what are the positive and negative implications that would befall on any society that remain only on contracting consanguineous marriage. By doing so, societies would be able to taker a stand on what they should do if it happens they are very much deep in it. While academically, this research would add lots to knowledge seekers especially in the field under discussion, to know much about consanguineous marriage, how it is practicing and it positive and negative impact to the societies. To this end, after the research, they would use what they might have learn toward inculcating to their societies, especially who are practicing the type of that marriage in shading more light to them, so they can adjust where necessary. Since the research on the above mention marriage is primarily focusing on its practices among Arabs, there is the need to make an assessment on the rate of it practices in the Arab countries to further clarify the issue. CAUSES OF CONSANGENEOUS MARRIEGE AND ITS EFFECT At this point there is the need to research on what are the causes of consanguineous marriage Why some societies continue to remain firm on practicing this marriage despite the fact even if it has positive, it also has it negative effect One of the researches conducted has shows that one of the causes of practicing consanguineous is said to enhance cordial relationship among families, it is said to also increase the nature of political relationship, being religious or cultural.In Middle East for example, it is found that one of the vigor reasons of engaging in consanguineous marriage is for enhancing political development among Arabs people. The ties of relations in marriage affairs in that part of the world is very significant in continue being under one umbrella. A writer name Kurtz, write about why Arab people of the Middle East prefer consanguineous ma
Friday, January 31, 2020
Nursing Practice in Minnesota Essay Example | Topics and Well Written Essays - 750 words
Nursing Practice in Minnesota - Essay Example Center of discussion in this paper are Nursing Practice in Minnesota. Healthcare services are making rapid progress across all parts of the US and so are the nursing practices to keep pace with that development. It becomes necessary to have more clearly defined responsibility and accountability norms between RNs and LPNs so that a nursing practice, which is considered one of the most critical element to the healthcare services does not become an impediment for the improved outcomes. In fact, not only Minnesota but all major states in the US are in the process of refurbishing their nursing acts so that healthcare services could make great strides and fulfill the aspirations of the patient. RNs and LPNs both are in the healthcare system since long in the state. LPNs begin practicing after finishing their one year Practical Nursing Program. In contrast, a registered nurse is graduated with a more intense 4-year nursing program. Though qualifications differentiate them clearly but in act ual practice at many places their jobs has obscured demarcation line due to several reasons such as nursing shortages or economic challenges. The Minnesota Nurse Practice Act is in force to serve the nursing practices in the state. In 2010, The Institute of Medicine issued a report about the future of nursing and made several recommendations that nurses should practice during their education and training. Subsequent to this report and in view of the increasing complexities due to changes in techniques and technology in healthcare practices, Minnesota Board of Nursing decided to review the Nurse Practice Act so that the duties of registered and licensed practical nurses can clearly be defined. RN versus LPN ââ¬â Role Differentiation As per proposed changes to the Minnesota Nurse Practice Act, registered nurse (RN) is defined as nursing practice that provides caring to all patients in any settings with or without compensation. The RN has extensive roles under Nursing Practice Act to perform. The definition differentiates from the licensed practical nurse (LPN) that carries out nursing practice under the supervision of an RN, physician, or advanced practice registered nurse (APRN) as authorized by the state. The scope of an RN encompasses full or extensive assessment that includes biopsychosocial aspects of the patient. The roles that an RN is supposed to undertake can be described in brief as per the following (Minnesota Board of Nursing 2011). a. RN will perform a comprehensive assessment of the health status of the patient. Comprehensive assessment by an RN means collecting extensive data for an individual to ascertain the actual health needs of the patient. This also takes into account any change in patient's health condition such as psychological, social, spiritual or biological so as to evaluate the impact of nursing care in reference to the various alternatives available. RN will also determine if other team members of health care team is to be consult ed. b. RN will develop an integrated plan of care in collaboration of health care team. c. RN may delegate the task to implement the plan of care so that it is effective and safe. d. RN will evaluate the outcomes of the interventions to decide about the effectiveness of the plan of care. e. RN is supposed to communicate and collaborate with other health care professionals to establish total health care plan in different settings. The RN is supposed to be aware about new techniques and practice them with full competency. f. RN will also have the responsibility to teach the theory and practice of nursing. g. RN will be accountable to Nurse Practice Act. They are expected of planning for managing situations that goes beyond the RN's expertise. Against this, an LPN will focus on the situation at hand. LPN's responsibility is to implement the plan of care as developed by the RN. It is not the responsibility of an LPN to develop a comprehensive plan and that purely rests with RNs. A focus ed assessment by an LPN is centered on appraising patient's current status; monitoring changes in patient condition; contributing to the nursing care plan; determining nursing interventions;
Thursday, January 23, 2020
Inevitability of Change in Stephen Cranes The Bride Comes to Yellow Sk
Inevitability of Change in Stephen Crane's The Bride Comes to Yellow Sky Humans are creatures of habit. In his work "The Bride Comes to Yellow Sky," Stephen Crane considers this apparent truism as well as its sometimes unfortunate consequences. In the story, Scratchy Wilson and Jack Potter face a dramatically changing society. Although their actions and emotions concerning the changes in their town differ, Scratchy and Potter are both very fearful of the inescapable easternizing influences. Through Scratchy and Potter's embracing of the Old West, their responses to the East, and their optimism, Stephen Crane illustrates that whether attachment or resistance exists, change is inevitable. To emphasize the difficulty and inevitability of change, Crane displays the characters' attachments to the Old West. Scratchy, the sole survivor of an old gang, plays out his beloved past by rampaging Yellow Sky with his long revolvers and drunken curses. His "creeping movement of [a] midnight cat," chants of "Apache scalp-music," and "terrible invitations" all portray Scratchy's devotion to the Old West. Scratchy's loyalty to his past clearly emphasizes his resistance to change and foreshadows that change will defeat him no matter how long or how hard he plays the game. Potter also plays along by acting as the town marshal who must save Yellow Sky and heroically put an end to the town "terror." Nevertheless, though Potter is attached to the Old West, he embraces the new West with his marriage. Unlike Scratchy, Potter accepts that Yellow Sky is changing and decides to change with it. Crane uses this acceptance to show that change is sometimes easier for some than for others. Potter c ontinues to struggle and worries what his hometown will d... ... forever. The future is now unreachable for him. On the other hand, Potter, though apprehensive like Scratchy, slowly opens his heart to the changing world. Through Scratchy and Potter, Crane establishes two choices: one can either resist change as Scratchy does and remain unhappy until the end, or one can accept change as Potter eventually does and further his future and happiness. Humans are creatures of habit where stability and comfort come first. Ironically, though fully aware of it, humans are always surprised at and afraid of change and how to handle it. Through his work, Stephen Crane brilliantly sets forth that one has no control over what is to come but only how he or she chooses to face it. Works Cited: Crane, Stephen. ââ¬Å"Bride Comes to Yellow Sky.â⬠Literature: The Human Experience. 8th ed. Ed. Richard Abcarian and Marvin Klotz. Boston: Bedford, 2002.
Wednesday, January 15, 2020
River Valley Civilizations of the Middle East Vocab
1. Pastoralism- the practice of raising livestock 2. Bronze Metallurgy- the study of the chemicals of the metal Bronze 3. Iron Metallurgy- the study of the chemicals of the metal Iron 4. Nile- gives people fresh water and is a major source for Egypt. The yearly activity is that it floods the river valley and moist fertile land is left behind. The resource the Nile has is the floodplain full of fertile land 5. Cataract- an unnavigable stretch of rapids and waterfalls 6. Delta- at one of the ends of rivers where the river spreads into many different streams 7.Silt- fine sand or clay that is easily carried by water 8. Papyrus- another type of paper that early civilizations used to write impotant info. It is thicker than paper 9. Irrigation- a process of saturating the land to be able to grow crops on it 10. Amun-Re- god of state and to whom common people turn to for adversity 11. Osiris- god of the underworld; his brother killed him and spread his body parts everywhere. His wife recover ed them and gave him a proper burial. The gods were impressed and brought back to life Osiris, but as a spirit, or god of the underworld 12.Seth- god of chaos; brother of Osiris who killed Osiris 13. Horus- son of Osiris; associated with the pharaohs and the Sun 14. Ptah- the chief god of the ancient city of Memphis; he is a creator god and god of architecture and crafts 15. Isis- wife of Osiris; goddess that dealt with speaking to the dead, bring n]back the dead to life, curing the sick, and magic 16. Hathor- Cow- goddess of love and music 17. Maââ¬â¢at- goddess of physical and moral law of Egypt, order and truth 18. Aten- god of the sun as in a solar disk that had rays coming towards earth which represented human hands reaching for ankh the pharaoh 19.Upper Egypt- up river or up the Nile river that reached the cataracts to Memphis 20. Lower Egypt- from Memphis to the delta part of the Nile River 21. Menes- king of Memphis in Lower Egypt 22. Theocracy- a type of government where the priest rules the name of God or a god 23. Pharaoh- an emperor that ruled Egypt 24. Vizier- a high official 25. Bureaucracy- a type of government where important decisions are decided by state officials rather than elected representatives 26. Hieroglyphics- Egyptââ¬â¢s writing that showed events that happened 27.Nubia- Country below Egypt that competed and fought with Egypt for land and who is more powerful 28. Old Kingdom- the first kingdom of Egypt were the Pharaohs forced workers to build huge pyramids 29. Middle Kingdom- Pharaohs became less powerful and they mostly were concerned about foreign affairs and they lived during a time of great prosperity or surplus 30. Intermediary Periods- the first intermediate period was between Egypt and Nubia. They both fought over land and about politics and they had five wars. The second one was the fight between Egypt and the Hyksos, or horse riding nomads.The Hyksos had bronze weapons that they obtained from Hittites and the Mesopota mians. Once again, they fought over land but in the end, Egypt obtained bronze weapons and pushed the hyksos out of Egypt. 31. New Kingdom- the Pharaohs in this era had lesser power than their ancestors, but they did build palaces, temples, and monumental statues to show off their power. They did work to extend the land occupancy of Egypt beyond the Nile delta. 32. Hyksos- horse-riding nomads who had bronze weapons obtained from the Hittites and the Mesopotamians.They dominated Egypt for a while, but Egypt finally obtained bronze weapons also and pushed the Hyksos out of Egypt. 33. Hatshepsut- First woman pharaoh who forced workers to build a statue of her 34. Fertile Crescent- the Middle East; the area where the land was very fertile to farm 35. Mesopotamia- the land between the rivers, or the land in-between the Tigris river and the Euphrates river 36. Tigris and Euphrates rivers- the significance of these rivers were that Mesopotamia had very little rainfall, but these rivers sup plied a great amount of fresh water.The resources the rivers supplied were the ability to grow wheat, barley, and peas. 37. City-State- the early people had to control internal and external problems so they created a city-state. Within the city they controlled order and authority and prevented problems with urban citizens causing civil disorder. Externally from the city, you need a government to control foreign affairs such as agriculture in surrounding regions and authority in neighboring territories 38. Ur- a Sumerian city-state that dominated (with others) public affairs 39.Ziggurat- distinctive stepped pyramids that housed temples and altars to the principal local deity 40. Cuneiform- a form of writing used in Mesopotamia, Persia and Ugarit that involved wedged shapes on clay tablets 41. Sargon of Akkad- a talented administrator and a brilliant warrior who conquered all the cities of Sumeria. His life span was from 2370-2315 b. c. e 42. Epic of Gilgamesh- the story of a hero, wh o killed an evil monster, rescued Uruk from a ravaging bull and matched his wits to the gods. Enkidu, a cherished friend of Gilgamesh, offended the gods and he was sentenced to death.He wanted to cheat death and have a eternal life so he found a magical plant that granted that, but a serpent stole it and this made Gilgamesh realized the death is the ultimate fate for all human-beings 43. Hammurabiââ¬â¢s Code- if a person is an offender, or someone who does something morally wrong, he/she shall face a fierce punishment such as death, or cutting your hands off. 44. Sumeria- first civilization of Mesopotamia which prospered with its many different cities 45. Babylonia- dominated Mesopotamia because of its great culture.The king was Nebuchadnezzar who built famous buildings. Babylonia was great until the Assyrian empire took over 46. Assyria- they were interested in enforcing laws and expansion. After they took Babylonia, they expanded much of southwest Asia. They conquered Syria, Pa lestine, most of Anatolia, and most of Egypt. They believed in Hammurabiââ¬â¢s laws. King Assurbanipal had a library that saved great literature that survived to present day. 47. Neo Babylonia/Chaldean- a Babylon soldier named Nabopolassar wanted to overthrow Assyrian rule, but Egypt supported the Assyrians.There were many battles and Babylonia was starting to win and they captured the capital of Assyria. Meanwhile, Babylonia captured Jerusalem and there were peace treaties between the Cilician and the Syennesis leaders. In the end Babylonia dominated over Assyria 48. Hittites- they migrated to Anatolia where they imposed their languages and ruled the people there. They built a power kingdom which had close relations with Mesopotamia. They traded with Babylonia and Assyria and they adopted cuneiform writing. Later the Hittites conquered eastern Anatolia, northern Mesopotamia, and Syria all the down to Phoenicia. 9. Patriarchal- a type of government in which the eldest male has al l the power and male descendants will get the power eventually. 50. Hebrew- a language and a religion that people from early times to present day practice 51. Phoenicians- an early Greek society. They did not have a monarchy, but rather different city-states with local kings. They interest in state building and their military. They deeply influenced other civilizations because of their industry and trade networks. They traded overland and they traded goods such as raw materials, or textiles, decorative items, pottery, etc.They also created their own alphabet which indicated their interest in literature, religion, and historical writings. 52. Indo-European- Common languages were Old Persian, Greek, and Latin in Europe because indo-Europeans migrated all over Eurasia. The origin of Indo-European was in present day Ukraine and southern Russia. They built their society in 4500 to 2500 b. e. c. They raised cattle, sheep, goats, and they domesticated horses. They used horses for wagons, c arts, and chariots for travel. The Indo-Europeans migrated south, east, and west distributing their language.
Tuesday, January 7, 2020
Kanye West s New Album - 923 Words
Kanye Westââ¬â¢s new album is soon upon us and fans have high hopes. Apparently, it will not only be the album of the year but the album ââ¬Å"of the life.â⬠For a self-proclaimed God, this might not be the craziest statement to make. Of course, Yeââ¬â¢s claim of divinity is dubious at best. As a human being, Kanye has consistently released commercially successful and critically acclaimed albums. Will the new release be the best album ââ¬Å"of the lifeâ⬠or just pretty good? Could it even be a rare misstep for Kanye? We will find out soon enough. In the meantime, let us take a look back at Kanyeââ¬â¢s storied musical career. The following list will examine one song from each of Kanyeââ¬â¢s major solo album releases. 1. Through the Wire Year: 2004 Album: The College Dropout Notable line: ââ¬Å"And I still wonââ¬â¢t grow up, Iââ¬â¢m a grown-ass kid.â⬠ââ¬Å"Through the Wireâ⬠symbolizes Kanyeââ¬â¢s transition from a producer with a dream to legitimate MC. The track opens with a pitched up Chaka Kahn sample, ââ¬Å"Through the Fire,â⬠alongside a lively beat. On the track Kanye is literally rapping through the wire. The rapperââ¬â¢s jaw was wired shut after a horrific traffic accident in 2003. Recorded while Kanye recovered, the song represented something new for hip hop. It is a clever and funny song chock-full of cultural references. The production is soulful and complex. Kanye set himself up us as a figure between worlds. He was a new kind of rapper that looked forward, but also respected the past. ââ¬Å"Jesus Walksâ⬠may haveShow MoreRelatedThe Life Of Kanye West1714 Words à |à 7 PagesThe Life of Kanye ââ¬Å"Yo Taylor, Iââ¬â¢m really happy for youâ⬠¦Iââ¬â¢ll let you finish. But Beyoncà © had one of the best videos of all time!â⬠(West). Most people if they donââ¬â¢t know anything about Kanye West, they know this quote. When anybody hears his name everybody always has an opinion. Some people love him, while a lot of other people hate him, each for a variety of reasons. Though most people only see the arrogant and egotistic side of Kanye, the more important side that people donââ¬â¢t always see isRead MoreWest Is An Artist, Rapper, And Producer That Has Changed Rap And Hip Hop882 Words à |à 4 Pages Kanye West is an artist, rapper, and producer that has changed rap and hip hop for ages to come, with his different style of rapping and beats which has set the bar the highest for any upcoming rapper. Kanye West was born in Chicago Illinois on June 8th, 1977. His mother and father were divorced when he was just a baby. His Mother Donda West was a Professor at Clark Atlanta University, and the Chair of the English Department at Chicago State University. While his Father Ray West was a former BlackRead MoreAnalysis Of The Biography Kanye West Essay2472 Words à |à 10 PagesKanye West, born June 8, 1977, is a world renown rapper, songwriter, record producer, fashion designer, and entrepreneur. among the most acclaimed musicians of the 21st century, and is one of the best-selling artists of all time, having sold more than 32 million albums and 100 million digital downloads worldwide. He has won a total of 21 Grammy Awards, making him one of the most awarded artists of all time. (Kyles, 2013) Kanye was born to Donda West, an English professor, and Ray West, a formerRead MoreAnalysis Of Travis Scott s Ascension Of Fame930 Words à |à 4 PagesBeats (as a producer), the label imprints of hip-hop juggernauts T.I. Kanye West. Since then he has released a solid project in Days Before Rodeo, Rodeoââ¬â¢s predecessor and has boasted countless credits, producing for many of musicââ¬â¢s biggest acts such as Drake, Jay-Z, Kanye West Rihanna, thus gaining respect and support from fellow musicians and fans alike. The expectations for this album were high and I evaluated the album in terms of Scottââ¬â¢s individuality and the albumââ¬â¢s lyrics, features, productionRead MoreThe Music Of Music Sampling1684 Words à |à 7 Pagesan original recording and is inserted, sometimes repetitively, in a new recording. A sample can be any type of media that is pre-recorded, from classical pieces of music, to rock guitar riffs. The origins of music sampling predate the 1980 s, when hip-hop was first brought on the scene. Some say that sampling has been around much longer than some think, steering to the fact that jazz musicians have always imitated each other s riffs. In 1961, after being influenced by many other musicians who hadRead MoreMy Beautiful Dark Twisted Fantasy1333 Words à |à 6 Pagesthat can rank as the best hip hop verses of all time. It was an album filled with legendary moments that music fans will remember for ages, and moments Kanye fan boys will yell at his concerts. This reaction by hip hop fans for My Beautiful Dark Twisted Fantasy was immediate. For Yeezus, it was different. Yeezusââ¬â¢ minimalistic approach threw fans and critics off due to the very left field and experimental approach he took for this album, both sonically and thematically. In spite of this, Yeezus stillRead MoreThe Music Of Hip Hop1116 Words à |à 5 PagesFrank Sinatra, Madonna and many more that has changed and established cultures of different genres. However the artists that I feel has changed the culture of hip-hop genre are still in control of it still today. The artists are Jay-Z, Nas, and Kanye West, some of the greatest of all time. To me they remind of Kobe Bryant, Tim Duncan, and Paul Pierce because theyââ¬â¢re some of the greatest that are still relevant in todayââ¬â¢s hip-hop gam e. All of them have their own unique style while still adaptingRead MoreThe Music Of Kanye West2119 Words à |à 9 PagesKanye West Every generation has their musical icons. In Todays time, you hear the name Kanye West the self proclaimed voice of this generation. He worked for many years to reach his current status. Kanye has influenced more than music with the resurrection of the soul sound and emergence of auto-tune after the passing of his mothe; he has had an influence on pop culture as well. Whether he is interprutting the teenage white girl or making hits songs, Kanye West can not be denied his greatness orRead MoreExamples Of Top 5 Albums1393 Words à |à 6 PagesIts around that time of year where some of us music enthusiasts ponder what albums were most thankful for. The albums you choose doesnt necessarily express that you think theyre greatest albums ever made. Of course, some might, but not the majority. If youre someone that appreciates music as much as myself, then you do this every year around Thanksgiving. Simply because its always exhilarating to reminisce about albums and once again experience how they made us feel when we first heard them.Read MoreThe Essence Of Kanye West2204 Words à |à 9 PagesThe essence of Kanye West is a contradiction; he embodies two opposite sides of the hip hop spectrum: the conscious and the ignorant. One side of the spectrum embodies the ideals of brotherhood, collective being, and addresses the social and political aspects affecting the people of society as Kanye explained formerly as ââ¬Å"spoken word.â⬠The other side demands the artist to live through the art of self-gratification by any means necessary or as Kanye put it, being able to ââ¬Å"buy 80 gold chains and go
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