The Role Of Forgiveness During Cbt Group Therapy Treatment...

Treatment Plans The role of forgiveness during CBT group therapy treatment with a child. The psychotherapeutic use of forgiveness can play an important role in decreasing or resolving the hostile feelings, thoughts and behaviors seen in children with abusive and aggressive natures. The acquisition of this virtue is most important and helpful for children to develop in order to control and resolve their anger. The following case study on the treatment of a defiant child which is taken from the book, Helping Clients Forgive: An Empirical Guide for Resolving Anger and Restoring Hope, demonstrates the effective use of forgiveness as a plan for CBT group therapy. Sean, a seven-year-old, became increasingly angry and rebellious with his mother after his father left the family. He regularly lost his temper, refused to listen to his mother, and provoked his sisters. He also became much more defiant and narcissistic and demanded that his mother buy him new toys several times weekly. In the sessions with his mother and sisters, Sean admitted, I’m really mad at Dad. He doesn’t care about us. All he ever did was watch TV anyway. Sean’s mother told him that his anger was hurting her and his sisters and that it reminded her of his father’s selfish temper tantrums. Sean became tearful and remorseful during the session and stated that he did not want to hurt anyone. He agreed to try to let go of his anger with his father on a daily basis and thus attempt to avoid repeating his dad’sShow MoreRelatedForgiveness Is The Final Form Of Love1732 Words   |  7 PagesForgiveness Forged Freedom â€Å"Forgiveness is the final form of love† (Niebuhr, 2017). Almost all worldly events are driven by one guiding force, human behavior. One might ask, â€Å"what then is the catalyst for human behavior?† Behavior is determined by thought, thoughts ruled by emotion. Following that same order, the lifeblood of the cosmos would then be human emotion. Generally, feelings are either pleasant or not; they are either good or bad. Some of the most pleasant types of sentiment include happinessRead MoreEtiology of Cognitive Behavioral Therapy (Cbt)7923 Words   |  32 PagesCognitive behavioral treatment (CBT) of depression is a psychotherapeutic treatment approach that involves the application of specific, empirically supported strategies focused on changing negative thinking patterns and altering behavior. In order to alleviate the symptoms of depression, treatment is directed at the following three domains: cognition, behavioral and physiological. In the cognitive domain, patients learn to apply cognitive restructuring techniques so that negatively distorted thoughts

Obesity The Prevalence Of Diabetes - 1877 Words

The prevalence of diabetes in America continues to grow. Information gathered from The Centers for Disease Control and Prevention (CDC) acknowledge that in the United States, one out of every eleven people has been diagnosed with diabetes and that one out of every four people are diabetic but not aware of it. Research has also shown that the medical costs and lost wages for those who have been diagnosed with diabetes is greater than two hundred billion dollars and that the mortality rate for diabetics is fifty percent higher than non-diabetics (Centers for Disease Control and Prevention, 2014). These alarming statistics show the increased need for essential education concerning the pathophysiology of diabetes as well as the treatment, benefits of diet, exercise, and what to do when something goes awry. This need was the determining factor for using diabetes education for the Health Information Technology (HIT) project. Project Development Description After being divided into groups for the HIT project, our first objective was to decide on a topic, we chose diabetes education with the target population being those newly diagnosed. We divided our topic down even further by choosing different areas of interest, so that each member would then be responsible for a page on the website. Members would be responsible for research and development of their topic for the website, which are detailed below. We next decided to use Google’s web builder, thinking that it would be easy toShow MoreRelatedGestational Diabetes : The Prevalence Of Gestational Obesity932 Words   |  4 PagesGestational Diabetes in Pregnancy According to the American Diabetes Association, the  prevalence  of gestational diabetes is as high as 9.2% in pregnant women due to obesity or being overweight. Not only can it be harmful to the mother, but it can also be harmful to her baby. Gestational diabetes can increase the chances of pregnant women delivering a baby that weighs more than 9 pounds. Having gestational diabetes can also increase the mother’s chance for needing a cesarean section delivery. SomeRead MoreEssay about The Rise Children with Diabetes in the United States641 Words   |  3 Pagesmany other countries around the world more children are being diagnosed with type 2 diabetes. In the past, children who were diagnosed with diabetes were diagnosed with type 1. Type 1 diabetes affects many children in which they are unable to produce insulin. However, as times have changed children are now being diagnosed with type 2 diabetes which is a chronic illness that usually affects adults. Type 2 diabetes de velops when the person is not able to produce enough insulin, and if insulin is beingRead MoreSurgeon General Project: Childhoudd Obesity1734 Words   |  7 PagesSURGEON GENERAL PROJECT Childhood Obesity Over the last few decades the prevalence of obesity in children and adolescents has been steadily increasing in the United States drawing immediate concern for the coming generations and the overall health and well-being for society. While addressing this concern, a matter of significance has to be reviewed to undoubtedly warrant the attention of the nation and propose factors of government, community, organizational, and individual involvement. AccordingRead MoreHealth Disparities: American-Indians and Diabetes1679 Words   |  7 PagesHealth Disparities: American Indians and Diabetes Introduction Type 2 diabetes mellitus (T2D) is the most common form of diabetes (American Diabetes Association, 2012). T2D is so prevalent that it is estimated to be the fifth most common cause of death worldwide (Yates, Jarvis, Troughton, and JaneDavies, 2009, p. 1). T2D manifests when the body is unable to metabolize glucose properly, resulting in elevated blood sugar, debilitating fatigue, and other serious complications such as distal limb amputationsRead MoreDiabetes : The Common Chronic Disorders1737 Words   |  7 PagesINTRODUCTION: Diabetes is one of the most common chronic disorders in UK [1]. According to Silverman, more than 2.6 million people in UK are diabetic as according to data collected from GP practices and more than 5 million obese people are registered to GP practices. So One in ten people are getting treatment for obesity and one in 20 are getting treatment for diabetes [2]. It is estimated that more than 5% men and more than 4% women in England are found to have diagnosed diabetes. While, 3% menRead MoreDiabetes in the Latino Community1648 Words   |  7 PagesIntroduction Diabetes is a prevalent health disparity among the Latino population. Diabetes is listed as the fifth leading cause of death among the Latino population in the website for Center for Disease Control and Prevention, CDC, in 2009. According to McBean, â€Å"the 2001 prevalence among Hispanics was significantly higher than among blacks.† (2317) In other words among the Hispanic or Latino community, there is a higher occurrence of diabetes as compared to other racial/ethnic groups such as BlacksRead MoreChildren And Type 2 Diabetes1533 Words   |  7 PagesChildren and Type 2 Diabetes Type 2 diabetes mellitus (T2DM) has been reported with increased frequency over the last twenty years in adolescents and children in the United States. As a result of T2DM glucose metabolism within the body of affected adolescents and children is severely compromised. Formerly known as adult onset and/or insulin resistant diabetes T2DM occurs due to the cell inability to properly use insulin which then results in lowered secretion of insulin as well as insulin resistanceRead MoreDietary Factors That Affect Obesity Essay1222 Words   |  5 PagesDietary Factors There are many dietary factors that may contribute to obesity in children. The major factors are increased consumption of calorie-dense foods, saturated fats, and sugar in combination with sedentary behavior 8. Consumption of refined grains and sugar-sweetened beverages have lead to increases in unhealthy eating habits resulting in the rise of obesity 4. These sugar-sweetened drinks are also associated with increasing BMI 11. The focus of this synthesis is the importance of physicalRead MoreEssay On St. Louis1597 Words   |  7 Pagesaverage of $6,815 (Health Care, 2013). Some of the behavioral health risk factors such as smoking is 15 percent, obesity is 27 percent and sedentary lifestyle is 22 percent, which are comparatively low prevalence compared to the United States average. According to the Community Health Improvement plan of June 2014 the major health disparities were cardiovascular disease, cancer, and diabetes (Health department, 2014). Heart disease and cancer accoun ted for 40 percent of the deaths in the city (HealthRead MoreObesity as a Disorder1110 Words   |  5 PagesObesity to some may not be technically a disorder or disease. Although those skeptics may have some excellent points the American Medical Association has officially reviewed and determined obesity to be a disorder. Obesity is simply just excess or extreme amount of body fat. Obesity is one of the most controversial health topics considering the amount of disagreements about it being an official disorder. One of the major disorder criteria’s that obesity meets is that it impairs the human body functions

Major Event That Contributed to the Intolerable Acts Free Essays

From Protests to Separation All of the events contributed in causing the Intolerable Acts in some ways but I think that the Boston Tea Party played the most influential role of all. To help the East India Company from losing money, Britain passed the Tea Act which allowed the company to have a virtual monopoly of the trade for tea in America. This angered the merchants and the smugglers and they called for a new boycott on tea. We will write a custom essay sample on Major Event That Contributed to the Intolerable Acts or any similar topic only for you Order Now Also on December 16, 30 -130 men dressed as Mohawks climbed aboard and threw 320 chests of tea overboard which took them approx. hours. This was the last straw. When the colonists threw the tea overboard, they also threw away Britain’s sympathy towards them. This angered Britain because in the past the colonist have done many protests and boycotts to tick them off and throwing 320 chests of tea overboard caused Britain a great loss. So to get revenge on the people of Mass. , G. B passed the Intolerable Acts or the Coercive Acts essay writer price. This means that the Boston Tea Party played a huge role in causing the Intolerable Acts. These Acts closed the Boston Harbor until the Bostonians pay off the company for the tea, allowed British officials to go back to Britain for trial by jury if they were accused of crime and also allowed the governor to house soldiers in suitable quarters. And finally to put fuel in the fire, Britain gave the land south of the Ohio River Valley to Quebec. To sum it up, G. B. passed the Tea Act which angered the colonists so they threw tea which angered G. B so they passed the Intolerable Acts. I think this event is the most influential because right after this, Britain passed the intolerable acts. How to cite Major Event That Contributed to the Intolerable Acts, Papers

Business Laws Working Regulations

Question: Discuss about the Business Laws for Working Regulations. Answer: Establishment of agency relationship: By agreement: When two parties mutually agree to create an agency, it is termed as the agency created by agreement. Since the agency relation is a contractually based relation, hence the relationship must be legal (Forde and Slater 2016). The expression of authority raised in an agency is some of the expressed instructions given by the principal to the agent. Turpin v Bilton (1843) is the matter where the agent was supposed to carry out the instructions of the principal to take out an insurance policy of the principals ship but ultimately forgot and the ship sank. It is necessary for the agent to do everything that has an effective execution portraying his duties. By ratification: The agency is said to be created by ratification when the agent purported to act on behalf of the principal and gets the authorization for the act. The ratification of the principle validates the agency relationship and thus relieves the agent from any personal liability. The formation of an agency through ratification means that the relation of the agency is authorized with legal obligations (Forde and Slater 2016). When the agency through ratification arises, the agent must have professed to work or act under the instructions of the principal. The agent is supposed to have a competent principal to provide such instructions to the agents to carry out any act, liable under the contract and must protect the entirety of the agreement. The transaction of the activity imposed or ratified over the agent must not be illegal or void but should be capable of authorization. Boston Deep Sea Fishing Ice Co Ltd v Ansell is a matter explaining the act of agent which must have le gal ratification with an absence of illegal content. By estoppel: When the party interested in the agency represents any third party as their agent and deals with the same then the agency is known to be formed with the doctrine of estoppel. Such kinds of agency arise when the parties do not hold any relation with the agency directly but one party represents the other as an agent, and the third party agency depends on upon the representation made by either of the parties in an agency. The estoppel agency gives the agent more authority than the acting principal in the agency. By necessity: The agency is created out of necessity when the circumstances demand the party to create such with the participation of another interested party, and one party acted as the agent of the other party (Forde and Slater 2016). The necessity agency arises from two circumstances namely commercial and domestic. Since the necessity agency has one party acting as the agent, hence it necessary for the party to act in good faith, Armstrong v Jackson (1917). When the agency arises there is a necessity of the presence of positive aspect to the party as in the necessity agency, it is not possible for the party to seek advice from any acting principle. The need of the agency only arises for those situations when one party is a dependent on the other party, and thus both the parties act under common benefit, Boston Deep Sea Fishing Ice Co Ltd v Ansell. Establishing negligence by the claimant: The duty of care owned by a defendant upon the complainant: to explain the duty of care owned by the respondent upon the claimant, it is important to take an illustration here, which is a court case law. Donoghue v Stevenson [1932], the claimant Donoghue went to a cafe with her friend who brought a bottle of ginger beer. While the claimant proceeded with the drink, she noticed the decomposed snail float in her glass which made her suffer shock, and she started vomiting after that. The matter is a highlight due to establishment of two reasons: Manufacturer owned a duty of care for the customers. The matter introduced the clause of a general principle of negligence liability. Another matter Home Office v Dorset Yacht Co (1970) explained that the application of the neighbour principle must be applied to the situation where the claimant suffered some harms. After the decision of the matter, the court came to the conclusion that the negligence must have these three components which are: Foreseeability Proximity Reasonableness The presence of breach of duty by the defendant: in Nettleship v Weston (1971), the claimant agreed to teach driving to the defendant. But, when the third lesson reason reached, the defendant hit a post and caused some injury to the plaintiff. In this matter, the court some of the facts to determine the presence of the breach of duty: Surety to reach harm: Bolton v Stone (1951), where the batsman hit the cricket ball over 100 yards also hit the claimant, which shows that the defendant should be more careful. The risk for serious injury: Paris v Stepney B Council (1951), here the claimant had only one eye and even there a piece of metal went inside from the bus, which shows that more the injury greater caution should be taken. The cost for avoiding harm: When the defendant avoids the cost of the harm, then it is better to take necessary precautions (Iacobucci and Trebilcock 2016). Latimer v AEC (1953) is a matter, where the factory was flooded, and the defendant put sawdust to cover the flood, but the defendant had a slip in one of the uncovered areas that reached his injury. The social value of the act of defendant when the defendant does some act for the social value and that is likely to reach him some harm then the risk taken is justified. Watt v Herts CC (1954), in this matter it is observed that the fire brigade carried a heavy jack to the place of the road accident where the lorry overthrew it, and that caused injury to the firefighter. It is observed that the lorry as not capable enough to carry the jack, but the breach of duty shall be observed here because the risk was taken for the social value by the lorry to reach the accident zone as soon as possible. Claimant received harm due to the breach of duty: The claimant must justify the causation even if there is a breach of duty towards the claimant (Nakar et al. 2015). The claimant must highlight the situation that caused the breach of duty and caused the injury and harm. Barnett v Chelsea Hospital (1969), in this matter the incident is about the three-night watchman who started vomiting after drinking tea after which they are taken to the Chelsea Hospital. But upon reaching there, they were told to go back and see their doctor. The negligence caused death to one of the watchmen after few hours. Common law duty for both employers and employees: Duties of the employee towards the employer: The common law explains that the employee must be reasonable to the act they do, and they must act by the situation where any faithful employee will act in the same manner. The employees are expected to stay loyal under the faith of the company and should not disrupt the business by taking part in any industrial action. It is the basic duty of the employee to disclose the wrongdoing of the other member to the concerned authority even that will result to incriminate the wrongdoers. The employee must never disclose the confidentiality of the employer to any outsider that may result in the misuse of the information. The employee must look after the property of the employer; this means that the office or outlet or any other place if they are using then that should be in proper position to be used afterward. The employees must not take any bribe gfrom outsiders in return for some favor which results in affecting adversely to the business. The employees must work for the employer and not compete with them. The employees must always stay prepared to accept the changes when brought into the office for efficient working in the business process. For example, when the employer introduces any technical update for the work, then the employee must cooperate to take the new adoption instead of opposing it. Duties of the employer towards the employee: The employers are liable to carry out their duties with ultimate good faith. The basic duty of the employer is to pay the employee the proper remuneration for the work they deliver to the company. The employer must not do such work that will spoil the reputation of the employee. The employer should assign only those works for which the employee is appointed in the organization. The employer must also take care of the health and safety measures of the employee. The employer and the employee must owe them the contract of duty of mutual trust and confidence. The employer must give reasonable chances to the employee so that complaints get heard. The employer must never harass the employee in front of other employees or any senior or junior ranked employee and that leads to lack of confidence and stress (Player 2013). The employees are liable to provide proper information about the rights and duties under the contract of employment (Freedland et al. 2016). No rights must be hidden, and that should not lead them to provide misguidance to the employees. The employer must take the employees as their assets who play an important part in the development and continuous growing of business. Case study 1: Adrian put an advertisement in Free-ads by the advertising law supervised and controlled by Advertising Standards Authority (ASA). The ASA recommends that every advertisement requires having legitimacy, decency, honesty and truthfulness. Hence, Adrian followed the norms of the advertisement rules and posted his interest to sell his laptop in Free-ads. Posting of the advertisement is an invitation or an intention to create a legal relation which is known as the contract. The contract may be social or domestic. The form of Adrians ad is social since it is a general invitation to anyone interested in buying his laptop, Balfour v Balfour (1919) (CA). Brian sees the ad and is interested in entering into a business agreement to buy the laptop since he considered the advertising stuff, Jones v Vernons Pools Ltd (1938). Brian wanted to buy the laptop at a price decided after negotiations which are accepted by Adrian, and he decided to sell the same to Adrian. He sends a notice to Brian, whic h was under the pile of paper unnoticed by Brian until Thursday, so he bought another laptop. Adrian claims that there was a breach of contract which is not applicable in this matter as the intention was not known to Brian regarding the buying of the laptop since Adrian did not mention anything in the first place. On the other end, Adrian can be told that he did not wish to enter into the contract with Brian, Rose Frank v Crompton Ltd (1925) (HL). There was no acceptance of the offer after the negotiations (McKendrick 2014). It is a matter of showing interest to the sell, but no consideration of the terms was observed in the first place (Furmston et al. 2012). There was not even any assurance from Adrian to Brian that he will sell the laptop to him only. Hence, in this matter, there was an invitation of an offer but no acceptance, Entores v Miles Far East Corporation (1955) (CA). Brian was silence about the acceptance like Adrian was silent about the acceptance of Brians negotiatio n in the first place. So silence is not acceptance and does not form a contract, Felthouse v Bindley (1862). Case study 2: Arnold can form a company by following the direction as discussed below: To form and register different company procedures are followed and the primary factor of the registration is that the business registered is identified as an artificial person existing separately from other acting members (Tant et al. 2012). The fact is observed in the famous matter Salomon v Salomon Co Ltd (1897). The formation of the company requires certain formality that includes: Formation: the formation requires certain documents that have to be sent to the Registrar of the Companies at the Companies House in Cardiff. The formation o the company required to pay the fees of 15. If the interested party pays 100, then the formation of the company will be complete within one day. After payment of fees, the Registrar of the company will issue the certificate of incorporation. A trading certificate is required in case of public company. Arnold will not need the document as he is interested in forming a private company, the documents are issued electronically. Memorandum: Till 2006, which means before the Companies Act 2006 came in; the memorandum was an imperative document for the starting of business. The memorandum of the association is combined with the articles of the association to create the constitution of the company. The memorandum still exists, and now it defines about the initial shareholders. Articles of Association: The articles are defined as the internal rules of the company. The company owns the right to form their internal rule. Otherwise, the company act offers the Table A to make the rules in such specified manner. The company even owns the right to change the rights necessarily. The articles are used to make the constitution and required to make the contract between the shareholders and company. The company name registration: The company must be registered with a unique that must not be similar to any existing names in the business. The name shall be recorded under the business names act 1985. Any existing company who finds that the new corporation uses the same name, and then they can sue against on the ground of tort law. Ewing v Buttercup Margarine Co Ltd (1917) is a matter that explains how similar name can mislead consumers which can lead to the spoiling of the good name. The company is liable to act within the clauses of the constitution and acting beyond that may conclude the Act as ultra vires, Ashbury Railway Carriage v Riche (1875). After the registration procedures get over, the company act explained about the necessity of the directors, auditors, company secretary, shareholders and resolutions (Mallin and Ow-Yong 2012). Since Arnold will make a private company, he will have the only director and need not have directors like the public company. He is liable to carry out the duties of good faith, Piercey v Mills (1920). It is even mandatory to keep a secretary so as to see that the rules and regulation are properly carried out. The accountants are required after the turnover reaches above 90,000 - 350,000 to send a report to the register of the companies (Hope et al. 2013). The company requires shareholders holding some of the shares of the company. The company often makes proposals in the form of resolutions to introduce something new in the provisions and that is done in three ways: Special resolution. Written resolutions. Ordinary resolutions. The various clauses mentioned here are some of the things that Arnold should consider while making the private company. References: Forde, C. and Slater, G., 2016. Labour market regulation and the competition state: an analysis of the implementation of the Agency Working Regulations in the UK.Work, Employment Society, p.0950017015622917. Freedland, M., Bogg, A., Cabrelli, D., Collins, H., Countouris, N., Davies, A.C.L., Deakin, S. and Prassl, J. eds., 2016.The Contract of Employment. Oxford University Press. Furmston, M.P., Cheshire, G.C. and Fifoot, C.H.S., 2012.Cheshire, Fifoot and Furmston's law of contract. Oxford University Press. Hope, O.K., Thomas, W.B. and Vyas, D., 2013. Financial reporting quality of US private and public firms.The Accounting Review,88(5), pp.1715-1742. Iacobucci, E.M. and Trebilcock, M.J., 2016. An economic analysis of waiver of tort in negligence actions.University of Toronto Law Journal,66(2), pp.173-196. Mallin, C. and Ow-Yong, K., 2012. Factors influencing corporate governance disclosures: Evidence from Alternative Investment Market (AIM) companies in the UK.The European Journal of Finance,18(6), pp.515-533. McKendrick, E., 2014.Contract law: text, cases, and materials. Oxford University Press (UK). Nakar, S., Weinberger, S. and Greenbaum, D., 2015. Legal and Social Implications of Predictive Brain Machine Interfaces: Duty of Care, Negligence, and Criminal Responsibility.AJOB Neuroscience,6(4), pp.40-42. Player, M., 2013.Federal Law of Employment Discrimination in a Nutshell, 7th. West Academic. Tant, M.R., Mauritz, K.A. and Wilkes, G.L. eds., 2012.Ionomers: synthesis, structure, properties and applications. Springer Science Business Media.

Film Analysis Amadeus Essay Example

Film Analysis Amadeus Paper At first glance of the film, my initial impression was that it would be a long and boring documentary about the life of Wolfgang Amadeus Mozart but to my surprise, the movie was nothing of the sort. It was not a formal documentary but a cleverly dramatized depiction of Mozart’s rise to fame and his relations to Antonio Salleri. Anyone would be discouraged after realizing a film they were assigned to watch three hours long, but the acting, the music, and the way the story flowed was enjoyable and well worth my time. â€Å"Amadeus† definitely gave me a completely new view on Mozart as a person. I had no idea the genius Mozart acted in such a way. I always thought since he made such remarkable music, his mannerism would be much more distinguished and professional, but certainly this film has shown me a deeper interpretation of his personality than mere words in a textbook can. At the beginning of the movie, I felt a bit ashamed that my reaction to Salerri’s efforts to play a recognizable melody was almost the same as the priest. The name Antonio Salleri did not ring any bells, but as soon as he played a melody from Eine Kleine Nachtmusik I quickly recognized it and felt impressed but, unfortunately, he was not the composer. I felt just as bad as the priest did for lacking the ability to recognize his music. As the story moves on and introduces Mozart, never would I have thought that this person was who Mozart really was. I understand his rebellious actions towards Emperor Joseph II and the Italian composers were made to further improve and remove limits in the art of music and to show the people of Vienna his maximum capability. His inappropriate comments, absurd laugh and misuse of money was questionable. After the film, my first question was â€Å"How much of this film was accurate?† I did my research and found a number of misconceptions p resented in the movie but in the end I realized the director still took bits of the truth and str We will write a custom essay sample on Film Analysis Amadeus specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Film Analysis Amadeus specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Film Analysis Amadeus specifically for you FOR ONLY $16.38 $13.9/page Hire Writer

Narrative Essay Essays - Free Essays, Term Papers, Research Papers

Narrative Essay Essays - Free Essays, Term Papers, Research Papers ESOL 0372 Prof. Leal 11.16.2015 Narrative Essay When I was a high school student, like most students, I also wanted to go to a well-known, prestigious university. Thus, I determined to apply to Viet Nam University, which is one of the most prestigious universities. I tried to pass the entrance exam, but I couldn't pass it. As a result, I went to Hong Ban University, and felt the first disappointment in my life. However, in the principals speech at the entrance meeting, he encouraged me. He said, "A college's fame is made by your effort. Our college is developing right now. Also, our college has many opportunities to develop and improve. You have the opportunity to help Hong Ban University." In this meeting, I learned how to live in school and society. I made my mind up to do my best at everything and found what I wanted to focus on. I knew that when our thinking changes, our vision clears. I began to go to Sai Gon, which is a circle for studying, and started my new life. In the circle, there were a lot of rules and friends. At the time, I was happy, because I had a good time with my friends and learned knowledge I did not know before. However, when I took the exam the first time, I scored only 22 points out of 100 on the exam. This was much lower than what I expected, even though I had studied for only one year, and was not ready enough to pass the exam. I felt disappointment again. After one year, I thought I was able to pass the exam this time, but when I took the exam a second time, I received 58 points, and still couldn't pass the exam. I felt disappointment once more. After that, I became a senior. I couldn't afford to spend my time any more for the exam. Because all men must go to the army in Viet Nam, I had only one year for the exam. The time was important to me, so I decided to spend the time efficiently. Before anything else, I set a goal for how much I would study, made specific rules including daily schedules, and bought a clock. I tried to keep the goal and my rules. Sometimes, I wanted to have a rest, but I always thought about my goal and overcame my desire. One night, I had studied hard for the exam in college and thought I did my best. When I was on the way home, I felt comfortable and could have self-esteem. As a result, I passed the exam. I also learned that to do my best brought happiness to me. Though the time was difficult, it was important to me and brought delight to me. I thought that achievement, self-content, and the development of me were real happiness. This time was one of the best times in my life.

The Relationship between Technology and Modern Life as a Double-Edged Essay

The Relationship between Technology and Modern Life as a Double-Edged Sword - Essay Example It is evidently clear from the discussion that for the most part, technology has become so common it is no longer thought of it as â€Å"technology.† The presences of these day to day items have become necessary and normal; like microwaves, cars, and computers. Technology has brought many benefits to science, medicine, and aids in advancing human potential; at the same time, it has, also, allowed the development of disastrous weapons shifted job markets away from manual labor, and creates human dependence. Over the last 300 years, technology has been developed, improved upon, innovated, made obsolete, and replaced. Most people today cannot imagine living in a time that predates medical vaccinations, telephones, and light bulbs. Research explains that there are â€Å"Four Developments in the Human Condition† that have allowed the advancement of humanity into its modern society filled with the technological sciences of the present. We have continuously proceeded to find n ew innovations and approaches. 1. Imagery & Symbols: The development of language, the arts, and religion; humanity began applying meanings to imagery and symbolism. 2. Universal Order & Theory: The emergence of philosophy (800 to 200 BCE) and concepts of creation, the divine, the universe as a whole; truth-seeking. 3. Experiment & Plausibility: The developments of modern science, beginning in the 1600s. Logical thinking focuses on probable answers. 4. Praxis & Plausibility: Essentially the practice of considering human and social ramifications of scientific and technological actions. From the steam engine in 1730 and the electric battery in 1800 to the automobile in 1885 and the telephone in 1839, the progress has been continuous; It is amazing to see how inventive and the level of ingenuity that human beings have managed to achieve, change, improve, and develop the altered quality of society and that of individual human life. There are many supporters of technology. There are some people who feel that scientific advancement and technological possibilities should be the focus of humanity. However many others believe that technology offers convenience, but also contributes heavily to air pollution, environmental contaminations, displacement of species within ecosystems, can cause psychological dependence among users, and are not worth implementing in the long run. In fairness and, as stated previously, there are a number of pros and cons related to technology and its presence and influence within modern society. Both sides make quality arguments concerning the positive and negative aspects and implications of modern technologies and its various applications. There are 10 highlighted contributions or influences of technology presenting its greatest benefits to modern human society; these contributions include 1. Easy access to information, allowing anyone to find answers to question and grasp concepts that they may not have previously had access to. 2. Improved communication, which has allowed greater exchanges and interaction between peoples across the world. 3.

Can international institutes prevent armed conflict between states Dissertation

Can international institutes prevent armed conflict between states Answer with reference to the theories of Neo-realism and Ne - Dissertation Example The objectives of all of them vary a great deal but they have one thing in common that is the will to strive for global or regional integration of resources in order to improve a particular region or a whole planet. The United Nations for instance is working to eliminate hunger, poverty and war from the face of Earth while South Asian Association for Regional Cooperation is working for economic growth of South Asian region. Recently major world population has initiated to consider international institutions as ineffective bodies that are not doing what they are supposed to do and due to this reason their trust upon them has significantly deteriorated over the past few years. All of the international and global institutions are working for achieving particular goals and objectives but what they lack is proper authority that is necessary for achieving their objectives. The global platforms are working in advisory capacity with all member nations and therefore the major decision power r esides with national governments. The national governments have the authority to dismantle all the operations and send the officials of so-called global platforms to their homes. In the light of above argument it can be established that United Nations along with other institutions cannot do much in terms of eliminating national conflicts among countries because it does not have the proper authority to do so. However international institutions have the power to arbitrate national conflicts while they cannot force the conflicting nations in the direction of a resolution. It is also important to note that global organizations are operating with the help of member nations and therefore financially and economically strong ones have a political influence over the decision making of them. Still global institutions have an authority to place economic and fiscal sanctions but they cannot influence internal politics and national issues of any country. Nevertheless the ability to place sanctio ns is used to enforce discipline on member nations that follow anticlockwise policies than those which are approved by international institutions. Ironically it is a historically proven fact that those countries such as Japan that had faced sanctions from the UN emerged as economic powers later. Thus the power of international institutions is limited to only advising national authorities on economical matters while the local administration is free to nullify their suggestions and recommendations. So the real power to demonstrate flexibility and eliminate national and political conflicts lies with individual governments and international platforms can facilitate the process of mitigation but cannot force member nations to resolve their issues. Interestingly the underlying problematic concepts that are causing national conflicts include racial and religious divides amongst nations whereas few of them are holding old and historical grudges dear and therefore they are willing to plunge their next generations into war in order to satisfy their psychological need of violence and bloodshed. If humanity wants to eliminate conflicts then firstly it has forego the outdated concept of nationalism and every individual must consider him or herself as the citizen of the globe. The need to embrace global citizenship is a crucial one due to the global nature of the challenges humans are facing nowadays such as global warming, recession and employment. The threat of global warming is so immense that in few centuries Earth may

Communication In Business case study Essay Example | Topics and Well Written Essays - 1000 words

Communication In Business case study - Essay Example The Indian subcontinent consists of nations which are demographically very different from the Oceanic countries – cities have the dense population, it is quite common to families to live together thus coining the word ‘joint families’, and feel at unease while calling their bosses by the first names. Communication is varied during different stages of the relationship. The first stage is the initiation phase wherein verbal and written communication in form of telephonic and online interaction precedes face to face interactions. It is here that it will be found necessary to dig a little into the history of India, as cultural implications play a major role in deciding the mode organization communication being followed in a particular nation (Roberts and Tuleja 2008, 474). The nation was, practically two centuries, a colony of the erstwhile British empire. Thus English customs may be found rooted in the manner of communications. Over time, however, local mannerisms have mingled with these habits to produce a different set of rules altogether. Meeting etiquette requires a handshake when one conducts business in India. Indians, on the other hand, use a traditional variant of greeting – The Namaste. This gesture consists of bringing the palms of the two hands together at chest level along with the utterance of the word ‘Namaste’ with a slight bow of the head. It has been noted, however, that people from outside the subcontinent often use this gesture beyond necessity – it must be remembered that India still suffers from a caste-based segregation in its societal structure. It will thus be judicious to decide beforehand to decide of the necessity of such a gesture.

Research into the history of klinefelters syndrome

Research into the history of klinefelters syndrome Many chromosomal abnormalities occur early in development and involve the sex chromosomes. Klinefelters Syndrome falls directly into this category. Klinefelters Syndrome is a genetic condition affecting the male population. The following information observes who discovered Klinefelters Syndrome and when it was first diagnosed. The etiology or genetic and environmental factors of the condition are discussed as well as complete description of the disability and the clear diagnostic criteria. The affects of Klinefelters Syndrome are more recognized in adulthood, when it is typically diagnosed. Many Klinefelters patients live out their entire lives without ever knowing they have the condition. Upon conclusion, there should be an adequate amount of information that will give you, the reader, valuable knowledge into the diagnosis and treatment of Klinefelters Syndrome. History Klinefelters Syndrome was first diagnosed in 1942 at the Massachusetts General Hospital in Boston Massachusetts (Schoenstadt, 2006). Dr. Harry Klinefelter was completing his fellowship at the Massachusetts General Hospital when he was assigned to work with Dr. Fuller Albright, also known as the father of endocrinology (Bock, 1993; Klinefelter Syndrome, 2006). Dr. Klinefelter came to examine nine adult men that had a common set of symptoms during the course of his fellowship (Klinefelter Syndrome, 2006). Dr. Klinefelter organized a case study that involved these nine men and their similarities and was encouraged by Dr. Albright to lead the study (Klinefelter Synrome, 2006). The Journal of Clinical Endocrinology was published in November of 1942 with the completed case study of these nine mens similar qualities, which Dr. Klinefelter identified as Klinefelters Syndrome (Klinefelter Syndrome, 2006). The report written by Dr. Klinefelter on these men described them as having testicular dysgenesis, elevated urinary gonadotropins, eunuchoidism, azoospermia, and gynecomastia, all of which have an effect on the underdeveloped size of the testes, the lack of the amount of testosterone produced by the testes, and infertility (Schoenstadt, 2006; Visootsak Graham, 2006). These adult males also exhibit enlarged breast and sparse facial hair (Schoenstadt, 2006). Two groups found out fourteen years after Dr. Klinefelters original description of the syndrome, that the buccal mucosal cells contained an extra chromatin mass or that the cells were chromatin positive (Klinefelter, 1966). Although the patients were described as having a positive female sex chromatin, Dr. Klinefelter states that the patients are phenotypic males and should never be considered otherwise (Klinefelter, 1996). Fourteen years after Dr. Klinefelter first diagnosed Klinefelters Syndrome, another case study was performed to further understand the characteristics that define the condition (Klinefelter Syndrome, 2006). In 1956, Dr. Joe Hin Tjio and Dr. Albert Lavan took the research further to determine the factors that made those men with Klinefelters Syndrome dissimilar from normal adult males through genetic research (Klinefelter Syndrome, 2006; Schoenstadt, 2006). With the advanced experimental methodology available, Dr. Joe Hin Tjio and Dr. Albert Lavan found that humans had 23 pairs of chromosomes, confirming 46 chromosomes, which prior to this time there was thought to be 48 chromosomes (Bock, 1993; Klinefelter Syndrome, 2006). This clarification by Dr. Tjio and Dr. Lavan is the basic foundation for modern cytogenetics, the study of chromosomes and diseases originating from numerical or structural abnormalities in chromosomes (Klinefelter Syndrome, 2006). Dr. Tjio and Dr. Lavan discovered that men with symptoms of Klinefelters Syndrome had an extra sex chromosome that created the chromosomal arrangement of XXY, which is distinct to the normal male chromosomal arrangement of XY (Klinefelter Syndrome, 2006; Schoenstadt, 2006,). Klinefelter Syndrome was still believed to be an endocrine disorder of unknown etiology at this time (Visootsak Graham, 2006). In 1959, just three years after Dr. Tjio and Dr. Lavan made their historical discoveries, an English researcher by the name of Dr. Patricia Jacobs and her associate Dr. J. A. Strong published a study supplementing earlier studies (Klinefelter Syndrome, 2006; Noble, 2003). Dr. Jacobs and Dr. Strong found the link between the endocrinal disease and the extra X sex chromosome (Noble, 2003). Dr. Jacobs linked forty-seven chromosomes in Klinefelters Syndrome males and determined it to be the X chromosome, which she considered an aneuploidy defined as an unusual number of chromosomes and labeled 47, XXY (Bock, 1993; Klinefelter Syndrome, 2006; Schoenstadt, 2006). The 1970s brought forth a larger examination of males born with Klinefelters Syndrome (Bock, 1993). During this time doctors began screening newborn male babies for the extra chromosome (Bock, 1993; Visootsak Graham, 2006). The most significant of the studies done at this time was sponsored by the National Institute of Child Health and Human Development (NICHD) whom examined over forty thousand infants for this extra chromosome (Bock, 1993; Visootsak Graham, 2006). This study was important for the reason that most studies done prior to the 1970s were biased and primarily done on adult males in mental institutions and the penal system (Visootsak Graham, 2006). At this time is when the prevalence of Klinefelters Syndrome was noticed as frequently as one in five hundred to one in one thousand male newborns (Bock, 1993; Visootsak Graham, 2006). Also observed in this study was the reduction in speech and language abilities as well as decreased reading and spelling achievement (Bock, 1993; Visootsak Graham, 2006). Along with these disabilities, Klinefelters patients are characterized by an increased tendency towards fertility, endocrinal, and psychiatric disorders (Noble, 2003). This study demonstrated that most but not all of these males born with the extra chromosome will have these characteristics, and many demonstrate varying degrees of the characteristics (Bock, 1993; Visootsak Graham, 2006). Based on this research it has been found that the extra X chromosome that causes Klinefelters Syndrome is very common, however, the symptoms and characteristics that are most recognizable are quit uncommon (B ock, 1993). Most males are not diagnosed as having Klinefelters Syndrome until they reach adulthood, and many that have the syndrome are never diagnosed as having this chromosomal defect at all (Bock, 1993). One pediatrician at the University of Colorado Medical School in Denver and the director of the National Institute of Child Health and Human Development (NICHD) during the major screening research referred to these newborn males as not having Klinefelters Syndrome because of the possibility that the characteristics may not develop into a syndrome (Bock, 1993; Visootsak Graham, 2006). Etiology and Genetic Factors Every normal human cell has 46 chromosomes that are made up of 23 pairs (Stewart, 2007). Of these 23 pairs, there are 22 that are exactly the same in both males and females called autosomes (U.S. National Library of Medicine, 2010). The 23rd pair of sex chromosomes is what makes males and females different in that the male will have only one X and Y chromosome whereas the female will have two copies of the X chromosome (Stewart, 2007; U.S. National Library of Medicine, 2010). During the formation of the egg and the sperm, or gametes, the chromosomes are halved through a process called meiosis (Stewart, 2007; The Dorsey, 2009). Cells that carry a single chromosome such as the X or Y chromosome are called haploid cells (The Dorsey, 2009). When the egg and sperm join carrying 23 chromosomes each they create the fertile egg, or zygote, which has two haploid sets of chromosomes (The Dorsey, 2009). Therefore, the baby receives two copies of each chromosome, 46 total chromosomes, just like the parents (Stewart, 2007). The extra X in Klinefelter Syndrome is caused from either nondisjunction or anaphase lag. Nondisjunction occurs when the chromosome pairs do not separate as they are intended in the meiosis I or meiosis II stage (Pineyard Zipf, 2003; Stewart, 2007). When this happens there may be a chromosome pair with 24 chromosomes instead of the 23 chromosomes (Stewart, 2007). If this chromosome pair of 24 joins with an egg or sperm with 23 chromosomes then it results in a karotype with 47 chromosomes (Stewart, 2007). In this case there will be three copies of chromosomes rather than the usual two copies of chromosomes (Stewart, 2007). The sperm or egg may donate the extra X chromosome at conception causing a chromosomal abnormality (Mayo Foundation for Medical Education and Research, 2008; Stewart, 2007). This forms the XXY chromosomal formation, which is diagnosed as Klinefelters Syndrome. At least half of 47, XXY conceptions are spontaneously aborted (Pineyard Zipf, 2003). The chromosomal abnormality is random and not known to be caused by any environmental factors (Genetic Science Learning Center, 2010; Mayo Foundation for Medical Education and Research, 2008; National Institute of Health, 2007). This anomaly happens entirely by chance and is unrelated to family history prior to the male childs birth (Mayo Foundation for Medical Education and Research, 2008). This is to say that the male embryos likelihood of being born with Klinefelters Syndrome is not increased or decreased by what the parent does or does not do (Mayo Foundation for Medical Education and Research, 2008). Klinefelters Syndrome is not affected by race (Chen, 2010). This is a completely random occurrence of the sex chromosomes not successfully separating during the formation of the egg or the sperm (Genetic Science Learning Center, 2010). Once this occurs the extra chromosome is then copied into every cell of the embryo (Genetics Science Learning Center, 2008). There are extremely rare cases when there may be three or four extra X chromosomes in all copies of the cells known as 48,XXXY or 49, XXXXY (Stewart, 2007). The 49, XXXXY mosaic is also known as Fraccaros Syndrome and is the most rare form of Klinefelters Syndrome (Duenas et al., 2007). This rare chromosomal abnormality results in more exaggerated features of Klinefelters Syndrome (Stewart, 2007). There are instances where an extra X chromosome is found in only some of the cells (Stewart, 2007). This can be found as two different chromosomal patterns (Stewart, 2007). One pattern occurs when some cells have 46 chromosomes and some have 47 chromosomes (Stewart, 2007). The other pattern is called the mosaic XXY syndrome, or chromosomal mosaicism, and affects approximately six percent of these cases, with the most rare cases being the 48, XXXY or the 49, XXXXY, or other arrangements of X chromosomes (Stewart, 2007). The mosaic XXY syndrome occurs only after conception from a mistake in cell division (Stewart, 2007). Anaphase lag is a result of a gamete lacking a sex chromosome (Klinefelter, 1966). When this chromosome lags it is not incorporated into the new cell during the mitosis stage (Kinefelter, 1996). Anaphase lag is thought to be a reason for the mosaic variations of Klinefelters Syndrome (Klinefelter, 1966). Although the chromosomal abnormality of 49, XXXXY is considered to be a variant form of Klinefelters Syndrome, it appears to have a very independent, distinct phenotype (Duenas et al., 2007). Males that show the 49, XXXXY chromosomal structure have much more severe clinical features than that of a Klinefelters Syndrome male (Duenas et al., 2007). This is the most rare of the Klinefelters Syndrome variants and has been reported in over one hundred cases with the frequency being approximately 1 in 85,000 newborn males (Duenas et al., 2007). There have been reports of an even more extreme variant of Klinefelters Syndrome mosaic in newborn males (Duenas et al., 2007). This variant is a 47, XXY/48, XXXY/49, XXXXY mosaicism and has only been reported in three cases according to a researcher in Mexico (Duenas et al., 2007). This means that the male newborn would have the whole spectrum of XY variations. Another variant that affects only males is the 46, XX chromosomal variation (Bock, 1993). This condition occurs when individuals have two X chromosomes in each cell, but are male in appearance. These individuals have male external geniltalia. These individuals also have small, undescended testes possibly along with an urethra opening on the underside of the penis. A small amount of 46, XX Males have external geniltalia that dont clearly resemble either male or female genitalia. These individuals are typically raised male. Phenotypically, there are three groups of these sex-reversed individuals. The first group includes phenotypically normal XX Males, the second group includes the males with genital ambiguities, and the third group is the true hermaphrodites (Bock, 1993). Description of Characteristics or Traits Klinefelters Syndrome has only one constant physical description and that is the small testicular size (Visootsak Graham, 2003). Boys with Klinefelters Syndrome have variable phenotypic characteristics with no obvious facial dysmorphology (Visootsak Graham, 2003). The presence of gynconemastia, or enlarged breast, and other findings of eunuchoid body habits and sparse body hair vary (Visootsak Graham, 2003). Eunuchoid or eunuchoidism is defined as an abnormal condition in males, characterized by underdeveloped reproductive organs with some female characteristics, such as a higher voice or the lack of facial and body hair that results in the lack of male sex hormones (Eunuchoidism, n.d.). Gonadotropins are produced by glands, such as the pituitary, and can result in sparse body hair when not produced adequately (Gonadotropin, 2010). The medical dictionary states that eunuchoidism is marked by a deficiency of sexual development with the persistence of prepubertal characteristics, and often has the presence of characteristics that are typical of the opposite sex (Eunuchoidism, n.d.). Another likely characteristic is azoospermia (Schoenstadt, 2006; Visootsak Graham, 2006). Azoospermia is defined as having little or no sperm count (Azoospermia, 2010). Testicular dysgenesis, or gonadal dysgenesis, is another characteristic of Klinefelters Syndrome (Schoenstadt, 2006; Visootsak Graham, 2006). Testicular dysgenesis is considered a reproductive system developmental disorder that causes a progressive loss of primordial germ cells, or cells that create gametes, in the developing gonads of an embryo (Gonadal dysgenesis, 2010). This gonadal dysgenesis can lead to the extremely hypoplastic, or underdeveloped, and disfunctioning gonads mainly composed of fibrous tissues (Gonadal dysgenesis, 2010). Most infants and children with the 47, XXXY chromosomal abnormalities go through normal growth stages. It is not until puberty that the Klinefelters Syndrome characteristics or traits become more prevalent and noticeable (Visootsak Graham, 2003). There is a significant increase in height between the ages of five and eight (Visootsak Graham, 2003). Another characteristic of Klinefelters Syndrome is the elongated length of arms and legs (Klinefelter, 1966). There is a decrease in androgen production that causes the secondary sexual characteristics to not fully develop (Visootsak Graham, 2003). An androgen is any substance such as androsterone or testosterone that supports male characteristics (Androgen, n.d.). Typically Klinefelters males are infertile (Visootsak Graham, 2003). However, there have been cases of impregnation without the assistance of medical technology (Visootsak Graham, 2003). Autoimmune diseases such as juvenile arthritis can also be present in Klinefelters adolescents. Whereas boys with Klinefelters Syndrome are generally tall with long limbs and remain thin until puberty, they tend to suffer from obesity latter in life. Neurocognitive effects of Klinefelters Syndrome may be more subtle than that of the physical stigmata. Klinefelters males have been found to have relative deficits on verbal IQ subtests and have verbal IQ scores around 20 points lower than those of unaffected siblings. There are also deficits in articulation, word finding, phonemic processing, verbal memory, language comprehension, oral expression problems, as well as linguistic processing speed. It seems that the speech/language problems and some motor deficits are most common in Klinefelters males that have an extra X chromosome. Ninety-two percent of individuals with Klinefelters Syndrome confirm difficulty learning to read. Seventy percent had reading achievement discrepancies or absolute reading deficits on standardized testing. A group of boys with mental retardation and suspicion of fragile X were subject to a genetic screening and the results showed that eight of these boys had Klinefelters Syndrome. Most of the more extreme verbal, visuospatial, and motor skills, such as found in mental retardation and fragile X syndrome are typically spa red. However, some boys with Klinefelters Syndrome suffer from poor manual dexterity and are commonly found to be clumsy and below average in sports (Wodrich Tarbox, 2008). There are many different factors that may underlie linguistic and reading problems. One possibility is a dysfunction of the left hemisphere that may be related to diminished gray matter or a lack of hemispheric asymmetry, or both. It is also possible that executive and frontal deficits may be a cause (Wodrich Tarbox). There is evidence that language is a fundamental issue for Klinefelters children and this can result in further scholastic issues. This problem seems to manifest as dyslexia as defined by poor reading in the setting of normal intelligence. Klinefelters males have also been observed to have difficulties with arithmetical functions. The deficits in auditory processing and verbal memory are the two key cognitive processes that underlie these difficulties. These deficits are also true for normal chromosomal children with dyslexia. The findings are supportive of the concept that defects in frontal systems seem to be caused by a language-based, left frontal-systems problem (Geschwind Dykens, 2004). Adult Klinefelters males have reported to have difficulties with mental flexibility (Wodrich Dykens, 2004). Even with these studies, it should be noted that not all adults that have Klinefelters Syndrome show these classic patterns of verbal deficits that are observed in children (Geschwind Dykens, 2004). However, these findings are not appropriate for all Klinefelters males, many of which complete high school and move on to post-secondary education successfully (Wodrich Tarbox, 2008). Two characteristics that has been falsely associated with Klinefelters males in the past, is sociopathy and criminal behavior. There is, contrary to this belief, fewer psychiatric problems reported among these individuals. However, there are commonly traits of introversion, unassertiveness, and a paucity or lack of ambition. There are also possible traits of impulsivity and social inappropriateness (Wodrich Tarbox, 2008). A Reiss Profile of Fundamental Goals measurement was used to assess the degrees of which Klinefelters males were motivated in 15 domains (Geschwind Dykens, 2004). The Reiss Profile generates a profile that is based on the motivational sensitivities across the domains of aversive sensations, citizenship, family, curiosity, honor, independence, food, order, physical exercise, rejection, power, sex, social contact, vengeance, and social prestige. The Reiss Profile is a well-established psychometric measure that is being used more and more to assess people with and without mental retardation (Geschwind Dykes, 2004). The results suggested that the Klinefelters male group was not particularly motivated by the need for social prestige, independence, or the desire to seek vengeance. This group was also not motivated to avoid physical pain. The general motivator for all the Klinefelters males in this group was curiosity. There were no age effects to this study (Geschwind Dykes, 2004). Characteristics in Adulthood There is a persistent deficiency of androgen in adulthood that can result in the loss of libido, decreased muscle bulk and tone, decreased bone density, a propensity for thromboembolism (an obstruction in a vein or artery from a blood clot), and an increased risk of mortality from cardiovascular and diabetic complications. A common characteristic for Klinefelters adults is gynecomastia (Wattendorf Muenke, 2005). Gynecomastia involves the risk of developing breast carcinoma. There is 200 times more of a risk for Klinefelters males to develop breast carcinoma than other karyotypically normal individuals. This may be a result of the estradiol (the prominant sex hormone in females) to testosterone ratio being so much higher that karyotypically normal men. Another possibility is that it is caused by the increase of peripheral conversion of testosterone to estradiol (Visootsak Graham, 2006). There are different views as to whether Klinefelters adult males are more aggressive or have a greater chance of psychological issues depending on the resource. One study describes the differences as relative to individual testosterone levels and the age at which they received the diagnosis (Morris, Jackson, Hancock, 2009). Equally, there is an impact from the way the diagnosis is reacted to by the Klinefelters male, the family, and friends or peers. The seven major themes that emerged from this study were the diagnosis, the testosterone treatments, health care problems, appearance, self-identity, relationships, and school and education. Of the Klinefelters adults studied, 60 % reported clinical levels of anxiety and 34% had clinical levels of depression. The results of this study show that a prolonged lack of testosterone can have far reaching negative effects on the Klinefelters adult (Morris, Jackson, Hancock, 2009). The historical studies show a disturbingly increased risk for psychiatric disturbance, criminality, and mental retardation. However, these results are outdated and extremely questionable given the initial examinations were given to institutionalized populations (Chen, 2010). Differential Diagnosis Classic Klinefelters Syndrome, 47, XXY, cases make up approximately 80-90% of all Klinefelters diagnosis. There are approximately 6-10% of these cases that are mosaics, which are the cells with 46, XY/47, XXY; 46, XY/48, XXXY; and 47, XXXY/48, XXXY (Chen, 2010; Visootsak Graham, 2003; Visootsak Graham, 2006). In 5% of the cases there are two X chromosomes without a Y chromosome or 46, XX (Visootsak Graham, 2006). The other cases were karyotypes 48, XXXY, 48, XXYY, 49, XXXXY, and 49, XXXYY (Visootsak Graham, 2003). Approximately 1% of these cases are due to a structurally abnormal X with a normal X and Y chromosome described as kayotypes 47, X,i(Xq)Y and 47, X,del(X)Y (Chen, 2010). Klinefelters Syndrome variants occur much less frequently than the classic 47, XXY chromosomal abnormality (Bock, 1993; Visootsak Graham, 2006). Klinefelter variant 48, XXXY is characterized by being average or tall stature with ocular hyperterlorism, which are widely spaced or deep set eyes; flat nasal bridge; curving of the fifth finger, or clinodactyly. Other characteristics are small penis and testicles with hypergonadotropic hypogonadism, which is the absence or decrease in function of the male testes. Theses individuals intelligence quotients range from 40-60. Variant 48, XXYY is characterized by having a tall stature, an eunuchoid habitus with long legs, sparse body hair, small testicles and penis, hypergonadotropic hypogonadism and gynecomastia. These individuals intelligence quotients range from 60-80. Males with variant 49, XXXXY are severely affected. They have smaller than average head circumference also known as microcephaly, short stature with ocular hypertelorism, flat nasal bridge, and upslanting palpebral fissures. Cleft palates are present along with small geniltalia and a heart defect known as patent ductus arteriosus. These individuals intelligence quotients range from 20-60. (Visootsak and Graham, 2003). Klinefelters Syndrome 47, XXY, has no major physical signs, which explains why it may go undiagnosed or misdiagnosed throughout an individuals life. Also with no physical signs, it is truly only diagnosed when genetic testing occurs for a variety of unrelated reasons. Klinefelters Syndrome may be diagnosed prenatally or during early childhood, as an adolescent during puberty, or as an adult when there are recognized fertility problems (Bock, 1993). Klinefelters Syndrome can be diagnosed prenatally through amniocentesis or chorionic villus sampling (Bock, 1993). These tests are normally done if the pregnant woman is older than 35, if there is a family history of genetic defects, or when other medical indications exist (Bock, 1993). A pediatrician may suspect a male child as having Klinefelters Syndrome if there are delays in learning to talk or difficulties in reading and writing as well as physical abnormalities during adolescence (Bock, 1993). Treatments and Interventions All hope is not lost when it comes to the treatment and interventions of the undesirable traits and characteristics that males diagnosed with Klinefelters Syndrome may display or develop. It is recommended that Klinefelters males have a comprehensive neurodevelopmental evaluation as soon as they have been diagnosed. A multidisciplinary developmental evaluation can determine the appropriate treatments during infancy and early childhood. These treatments may include physical therapy, infant simulation programs, and speech therapy (Wattendorf, 2005). If the language difficulties are detected in childhood, then there is more of a possibility for intervention. The language barriers that Klinefelters males may have to cope with can not only affect their academics, it can obstruct their building of social relationships and learning social skills necessary for these relationships. Here is where the Klinefelters child could benefit from a social skills training program. In a social skills training program, the Klinefelters child will be able to practice talking and listening, observing childrens making friends processes, sharing of information, attitudes, and beliefs. This will also assist them in proper classroom behavior and playground behavior. Language disabilities and barriers can prevent Klinefelters males from fitting in socially, so this kind of intervention and assistance can benefit the child greatly. Hearing can be an issue if frequent ear infections occur. Hearing test and screens should be done to ensure that a hearing impairment is not a part of the language difficulties. If the Klinefelters child is not communicating effectively with single words by the ages of 18 to 24 months, then consultation with a speech and language pathologist will be very beneficial (Klinefelter Syndrome Information, 2002). Teachers should be informed of the difficulties that a Klinefelters child may be dealing with in the classroom. A teacher may consider the Klinefelters child to be lazy and daydreaming and a teacher may even forget the child is even in the room. This can result in the Klinefelters child falling behind and eventually being held back a grade. Under the Public Law 94-142, the Individuals with Disabilities Education Act, adopted by Congress in 1975, all children with disabilities have a right to a free, and appropriate public education (Klinefelter Syndrome Information, 2002). Once the Klinefelters male reaches puberty there is usually an inability to produce a normal amount of testosterone. This along with hypogonadism can result in impaired bone mineral density and skeletal muscle development. Also associated with testosterone deficiency is a decrease in libido and energy (Wattendorf Muenke, 2005). Androgen therapy or Testosterone Treatment should begin by time the Klinefelters male reaches middle school, approximately 12 to 14 years of age, based on the level of pubertal development (Klinefelter Syndrome Information, 2002; Wattendorf Muenke, 2005). Testosterone Treatment will ultimately increase the muscle size and strength, as well as, promoting the growth of body and facial hair. It must be noted that Testosterone Treatments can also bring on psychological changes. It is important to adequately inform the parent(s) and the child of these changes so that they can make the most informed decision (Klinefelter Syndrome Information, 2002). There are diff erent ways to receive Testosterone Treatment and that is through injections, transdermal (patches, gels, or creams), orally, or implantation. The kind of testosterone injection will depend mainly on the dosage used and the country in which you receive the injections. Some injectable testosterone esters are Testosterone enanthate, Testosterone cypionate, Sustanon, Testosterone propionate, Testosterone phenylpropionate, Omnadren, and Aqueous testosterone suspension. Types of transdermal patches are Androderm and Testosterone TTS. Two different kinds of testosterone gels and creams are Androgel, and Testim. A few oral supplements include Methyltestosterone and Testosterone undecanoate. The last form of Testosterone Treatment is the Subcutaneous testosterone pellet, which is delivered by implanting a pellet of pure, crystalline testosterone under the skin of the buttocks or abdomen (Testosterone Types and Delivery, n.d.). Adult males with Klinefelters Syndrome usually develop gynecomastia which predisposes men to breast cancer. Therefore, it is important that Klinefelters males do monthly breast examinations. If gynecomastia causes psychological or physical problems, then possible treatment would be cosmetic surgery to remove the breast tissue (Wattendorf Muenke, 2005). Swerdlow et. al (2005) stated that men with Klinefelter Syndrome have elevated risks of several cancers. Prostate cancer, along with breast cancer was more prevalent. Men with Klinefelter Syndrome are also at a substantially higher risk for non-Hodgkin lymphoma, and possibly lung cancer. Breast cancer risk is higher in 47, XXY mosaics. Adult males may face possible infertility issues due to the lack of testosterone production, but if diagnosed early on, this can be minimized and they will be able to reproduce without outside assistance. Summary Klinefelter Syndrome is one of the more recently discovered medical syndromes. Klinefelter Syndrome is not one that causes major dysfunctions and is usually only discovered during genetic testing for infertility or during prenatal testing due to maternal age or prior genetic issues within the family. Because Klinefelter Syndrome has not had a lot of research until the last few years, there is no federal funding set aside for this syndrome. Families with sons that are found to be affected by it have no real support system that is knowledgeable of this syndrome and have to research on their own and create resources to fit their situation as none are available in most areas.

Child Abuse and the Importance of Belonging Discussed in David Pelzers

A Child Called "It" explores the traumatic story of child abuse and how the choices made by one person affects another’s sense of belonging. The story is only from one point of view as it’s a biography, written by the man who experienced trauma at such a tender age. David Pelzer, as a child, dealt with rejection daily and not only from his mother but classmates, teachers and ultimately his biggest enemy, himself. A Child Called "It", as the title denotes depreciation and an impersonal relationship between the audience and the text, begins the biography with a dark and solemn theme as there is no definition for ‘it’ therefore titling a book ‘a child called it’ gives the audience the idea that the child doesn’t exist, or as it tells further in the story, a child who is treated like he doesn’t exist. The author contrasts his mother in different contexts from when his ‘mom’ was a good, caring mum to when his ‘mother’ changed into the abusive stage. Mom and Mother are used throughout the text to show the audience the different emotions he had carried for her. Mom is more personal and informal but suggests a close relationship between the two as it is used in the chapters that he is reminiscing about when his mom was a normal, caring mom. Mother is used in the chapters he was abused in and suggests a more distant relationship due to the formal language structure. When ‘Mom’ was used, the emotions carried out towards her by David Pelzer were none other than belonging to her. When a child is told something so often they start to believe it. In this case, David Pelzer was ordered to say over and over again â€Å"I’m a bad boy, I’m a bad boy...† which psychologically brainwashed him to believe that he was. That every time he was physicall... ...ejected, surrounding him as he says ‘I had readymade excuses mother made for me’. The ending doesn’t end on a ‘happily ever after’ note but rather a dull and gloomy tone as it is set throughout the text. Sarcasm, contrast and similes are the main language features presented in the book to evoke disgust, torment and shock throughout the audience showing them either how she saw the abusive behaviours inflicted upon him or the brainwashed ‘excuses’ he learnt from his mother. Not belonging is the struggle in this text that didn’t get resolved by the ending making it a dark, gloomy tone and the language features used also evokes a dark feeling within the reader. A Child Called "It" truly explores the meaning of struggling with belonging due to other peoples actions rather than their own and provides appropriate use of imagery to emphasise the meaning of the biography.

Employee Involvement Essay

The direct participation of staff to help an organization fulfill its mission and meet its objectives by applying their own ideas, expertise, and efforts towards solving problems and making decisions. From this definition, participation can include representative participation, direct communication, and upward problem solving. We will focus on the latter two categories because this article is more about understanding outcomes, tools, and methods. The direct participation of staff to help an organization fulfill its mission and meet its objectives by applying their own ideas, expertise, and efforts towards solving problems and making decisions. Based on the thinking that people involved in a process know it best, regular participation of employees in several planning and execution areas occur. Major areas are: (1) deciding how work gets done, (2) suggesting improvements, (3) setting goals, (4) planning, and (5) performance monitoring. That employees will improve their performance if t hey are more motivated by being more involved, is an observed trait. Borders on empowerment. Employee involvement means that every employee is regarded as a unique human being, not just a cog in a machine, and each employee is involved in helping the organization meet its goals. Each employee’s input is solicited and valued by his/her management. Employees and management recognize that each employee is involved in running the business. Employee empowerment is a somewhat different concept. It means that in addition to involving employees in running the business, employees and management recognize that many problems or obstacles to achieving organizational goals can be identified and solved by employees. Employee empowerment means that management recognizes this ability, and provides employees with the tools and authority required to continuously improve their performance. The management states its expectations about employees recognizing and solving problems, and empowers them to do so. Employee Motivation  is the â€Å"psychological forces that determine the direction of a person’s behavior in an organization, a person’s level of effort and a person’s level of persistence Using rewards as motivators divides employee motivation into two categories: intrinsic and extrinsic motivation. Intrinsic rewards are internal, psychological rewards such as a sense of accomplishment or doing  something because it makes one feel good.[7] Extrinsic rewards are rewards that other people give to you such as a money, compliments, bonuses, or trophies. â€Å"the willingness to exert high levels of effort toward organizational goals, conditioned by the effort’s ability to satisfy some individual need.† Theory XTheory x states that people are generally lazy. Since people are lazy they will try at all costs to avoid work. They will do what they can to waste time and find other things to do. Sigmund Freud the creator of this theory believed that the only way to get people to do work was to threaten them with punishment if they didn’t do their work. This idea is important because if it holds true, motivation becomes extremely important. If people don’t want to do any work it is necessary to motivation Theory X MIT Professor Douglas McGregor Theory X—assumes that people are basically lazy and will avoid working if they can. To make sure that employees work, Theory X managers impose strict rules and make sure that all important decisions are made only by them. Theory Y Theory Y assumes that people find satisfaction in their work. Theory Y managers believe that people are creative and will come up with good ideas if encouraged to do so. They tend to give their employees much more freedom and let them make mistakes. Theory Z is a business management theory that integrates Japanese and American business practices. The Japanese business emphasis is on collective decision making, whereas the American emphasis is on individual responsibility. McGregor’s Theories Theory X- Autocratic Dislike Work Avoid Responsibility Little Ambition Force/Control/ Direct/Threaten Motivated by Fear & Money Theory Y- Democratic Like Work Naturally Works Toward Goals Seeks Responsibility Imaginative, Creative, Clever Motivated by Empowerment

State Unit Study of California

State Unit Study of California These state unit studies are designed to help children learn the geography of the United States and learn factual information about every state. These studies are great for children in the public and private education system as well as homeschooled children. Print the United States Map and color each state as you study it. Keep map at the front of your notebook for use with each state. Print the State Information Sheet and fill in the information as you find it. Print the California State Map and fill in the state capital, large cities and state attractions that you find. Answer the following questions on lined paper in complete sentences. State Capital What is the capital?State Flag Who designed the flag?State Flower Where did the scientific name come from?State Bird How is this bird easily recognized?State Tree What is the average trunk diameter?State Song Who wrote the state song?State Seal What river is the miner working by? Heres a great picture of the state seal.State Animal How tall do these animals grow?State Marine Mammal How big do these whales grow?State Reptile What are the eating habits of this reptile?State Fish When did this fish become the official fish?State InsectWhat is the wingspan of this insect?State MineralWhat is the foundation of the economic history of California?State RockWhat is the coloring of this rock?State Motto What does this Greek word mean? California Printable Pages - Learn more about California with these printable worksheets and coloring pages. California Word Search - Find the California state symbols and other related words. Did You Know... List two interesting facts. California Landmarks - The state of California has designated nearly 1100 sites as California State Historical Landmarks. This site has pictures of many of them. Your Idea Becomes a Law - Learn how a bill becomes law in the State of California. San Diego Natural History Museum - Explore the activities at the Kids Habitat. Energy Quest - Energy education from the California Energy Commission. Big Orange Online - Learn about the California orange industry and create your own label. The California Gold Rush - Learn all about the California Gold Rush with this online student booklet. Odd California Law: It used to be illegal to peel an orange in a hotel room.

How to Work with an Indecisive Boss

How to Work with an Indecisive Boss There’s an unspoken truth in the world of work- although we usually get to pick our jobs we don’t get to pick our bosses. If we’re lucky, we get to work with the sort of boss whose a pleasure to be around- fair, pleasant, supportive, decisive, and encouraging. If this is your reality, then count your blessings and try to appreciate your situation. However, if you have a boss who’s something else, then it can pose some real challenges. One category of tricky boss includes the one who never seems to know what he or she wants. They either constantly waste time dragging their heels and delaying making any type of clear decision, or they’re forever changing what they tell you to do. Both of these types can be quite difficult to work with and can really impact your ability to perform your job effectively. But it’s not exactly easy to confront a boss who never seems to know what they want- so what do you do when you’re in this position?Learn your boss’s quirksTry your best to get to know your boss- including their decision-making behaviors and habits- as well as you possibly can over time. Although it can be tricky to expect the unexpected, as you get to know your boss more you may get better at anticipating how they’ll react to any given project or during any key decision-making moment, which may help minimize the ill-effects of their indecisive nature.Stay calm and kind, even when you want to screamYour best bet is to remain patient and do your best to anticipate your boss’s needs- and shifts- and try to work with them, not against them. First off, an indecisive boss is usually an anxious person by nature, and adding to their anxiety by developing an adversarial relationship with them will only serve to make matters worse. With the way many workplaces are structured, the fact is that you have to answer to your boss’s professional whims, as fickle as they may be. Once you know your boss oper ates this way, brace yourself and expect it. Knowing the madness is coming makes is a little easier to swallow.When you find yourself at a crucial point that requires a final decision from your boss, try and make the moment as stress free as possible. Also, do your best to reduce any external distractions that may make it challenging for your boss to concentrate and focus on the decision at hand. If it’s your job to present your boss with information so they can make a decision, be as clear and straightforward as possible. Always try to approach your boss in a calm and patient manner when a decision needs to be made- this will help put them in their best mindset to determine what they want at any given time.Keep a paper trailAlthough these strategies may prove helpful in a variety of decision-making moments, chances are it won’t completely fix the problem. The truth is, it’s hard for a leopard to change its spots. A boss who doesn’t know what they want wi ll likely remain this way- it’s just human nature to revert to your â€Å"core programming† and making lasting change is hard. That said, it would be helpful for you to get things from your boss in writing, so if they change their mind later on they can’t hold you accountable if projects go over budget and off schedule. Physical proof is always a good way to minimize the effects of their indecisiveness on your productivity and work reputation.A boss who never seems to be able to make up their mind and determine what they want when a decision needs to be made can be a challenging situation for you, but it doesn’t have to be an insurmountable obstacle. Use the strategies and advice provided here to make the best of a tough situation, and hopefully with a little time, experience, and luck, things will get better (or your next boss will know what they want and when they want it).

Leadership Case Study Example | Topics and Well Written Essays - 750 words - 1

Leadership - Case Study Example Therefore, it is imperative to identify leadership issues that usually arise when managing emergency situations. Personal style of leadership is an important aspect of emergency management since it entails issues like interpersonal communication (Comfort,Waugh, & Cigler, 2012). During the emergency, the leader must communicate with various including the outside agencies, the emergency management team, and the victims. The personal style of leadership must, therefore, take into consideration different personality traits that breed good communication skills. Communication during the crisis is also necessary thus there must be the right leadership approach in managing the situation (Khan, 2013). A leader has to make a myriad of decision during an emergency situation thus it is vital to identify some the attributes that lead to effective decision-making. The issue of decision making during emergency management requires the right models for implementing the process. In this case, it will be imperative to identify some of the models of decision making like the seven-step approach to decision-making and problem solving (Comfort,Waugh, & Cigler, 2012). Another important issue to consider is making decisions prior to the emergency situation. In this case, leadership attributes like the ability to forecast and anticipate situations help in managing emergencies (Khan, 2013). On the other hand, the leader must make decisions after the disaster or the emergency occurs. The decision-making stage raises issues like recovery initiatives by the leader and how he or she coordinates the activities to result in effective management of the situation. It will also be imperative to identify so me of the obstacles or challenges that leaders face while making decisions due to the dynamic nature emergency situations. Emergency management calls for the right approach

Report on TESLA case study Essay Example | Topics and Well Written Essays - 3750 words

Report on TESLA case study - Essay Example top managers, Tesla has been able to achieve success while at the same time adopting effective strategies such as the latest increment of more patents to more than 250. In addition, the partnership that the company has formed with companies such as Daimler makes Tesla to have a strong capital base. Tesla value chain analysis covers aspect such as inbound logistics, operations, and outbound logistics among others. Despite being a company with a strong support from the customers, Tesla was at one time involved in PR issue that involved poor batteries that lacked the information from the company on how to use them. Major business level strategies that are covered by the paper include use of extensive technology and innovation, formation of value-creating partnership, and production of cars that have different facilities as needed by the customers. Similarly, Tesla adopts corporate strategies such as expanding its market share, existing products into new markets such as Hong Kong, China and Australia among others, and production diversification among others. The major models that are covered to analyse Tesla operations include SAF and STAIR Models. Additionally, the paper provides some recommendation to the company such as penetrating emerging markets, establishing research and development centres in the developing countries, and continuing with product development among others. The purpose of using this analysis is to evaluate the risks and opportunities in the external environment that can have impact on the performance of Tesla. These include social, political, economic, environmental and technological factors. Tesla sells their cars in more than 17 countries in Asia, North America and West Europe. Protection laws are put in place for companies manufacturing cars to strictly meet the environmental laws on emission, thus the Tesla have to come up with the methods of dealing with the political pattern that can influence their business operations (Bernardez, 2005).

Media producer Essay Example | Topics and Well Written Essays - 250 words

Media producer - Essay Example A considerable and significant relationship is cropping up between the audience and media producers. The audience is actually playing the role of a media producer in a way. This is because television producers need the audience for their programmes. Without the audience, there no need to produce a media text. Hence, the taste, age, gender, lifestyles, income, and television watching and reading habits of the audience determine the choice of a media text (Wilson, 2011). Because of this, media producers seek to satisfy their audience in producing the media text in order to remain commercially active. Additionally, many media producers are also the audience and vice versa. The audience chooses and influences the media texts to consume through interactions and discussions. Thus, the audience dictates the media texts to be produced thus acting as a media producer. I have acted as a media producer in relevant ways. Through online forums, mobile phone, and physical interactions with fellow fans and people interested in my favorite media texts. Indeed, we discuss the progress of a certain programme, its content, and its timing. We consequently air our suggestions and possible disappointments to the media producers that are available online. In some occasions, we have complained on missed programme episodes, changed the programme airing time, and even requested for replays. In conclusion, the quality of the engaged audience dominates over the quantity of the audience in the modern media

Whu I Am going To Be A Succesful Teacher Essay Example for Free

Whu I Am going To Be A Succesful Teacher Essay In pursuing a goal or an objective, a profound level of commitment must first be assured.   I contemplate my dreams and purposes in life along such premise.   And then, I reckon and inculcate values that will equip me along the way.   As such, my goal to become a successful teacher will be achieved because of the prime values I consider my strengths.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   As I am sure of my commitment, I develop total patience in my total perception and pursuit of my goals.    The first step I take to sustain my patience is acceptance and acknowledgement of responsibilities towards a goal.   As I acknowledge what is the level and amount of responsibilities involved, I then work out the features involved to meet them.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Working towards a goal requires a very positive attitude.   Even though I immediately acknowledge the various ups and downs, I see to it that â€Å"hope springs eternal†.   I exert my best efforts to be unyielding and sustain persevering outlook towards the best there is towards a goal.   I keep the faith that I can find my way through any difficulty – even at an unknown length of time.   It is the inspiration of rewards and fulfillment that will make me endure.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The dedication and commitment towards a goal must be more than deep-rooted in my mind, it must be soul-felt.   My passion towards a goal is set not only because of the rewards due in achieving a goal, but more so because of the sense of completing my being.   It is the glory of an internal satisfaction that will give me a good night’s sleep.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Being effective and successful as teacher will enhance my creativity and originality.   Teaching and molding young minds to the universal sea of knowledge will keep me always on my toes to make my presentations interesting, efficient, clear and challenging.   And working out the plans to achieve the same will encourage me to ensure that my students will experience a unique, yet understandable, awakening to knowledge.

Prisons: Punishment and Rehabilitation

Prisons: Punishment and Rehabilitation In order to understand the nature of imprisonment, this chapter will briefly look at the historical origins of prison, and then it will move onto justify their theoretical legitimacy: punishment/retribution, deterrence, incapacitation, and rehabilitation. These theories/ideologies will re-occur through the thesis like themes- what we refer to them as meta-concepts. The final section of this chapter will examine the strategies employed by the Prison Service to reach its ultimate goal of protecting public and reducing re-offending. ORIGINS OF PRISON Prisons do not exist in a vacuum. They exist because society decided that they should be used as a method of responding to crime. The early 12th century prisons served a custodial function, mainly detaining people until civil debts were met. A prisons effectiveness was measured by its success in holding people (Muncie, 2001: 159). And in the 18th century, though the prison population remained mainly debtors, the rationale behind prison changed to one of punishment rather than containment. The end of the 18th century saw the rise of the penitentiary in which prisoners were categorised into groups in a regime of punishment, and were subjected to severe physical labour and moral reformation (Muncie, 2001: 164). Things changed drastically over time, and issues such as justice and rehabilitation ascended in the prison system. Benevolent societies were committed to ushering in better conditions, useful employment and good habits of behaviour through discipline and compassion (Muncie, 2001: 169). Perhaps this formed the inspiration of contemporary rehabilitative yet punitive National Offender Management Service (NOMS)- which is a law enforcement agency formed by the integration of the headquarters of prison and probation service to improve effectiveness and efficiency. JUSTIFICATIONS FOR IMPRISONMENT In his speech to the Conservative Party Conference, Michael Howard who was the Home Secretary in 1993, argued that for many crimes, imprisonment was the response demanded by victims in the interests of retribution. Hence, the first given purpose of imprisonment is to punish persons for the crime(s) they have committed. Punishment, in essence, is the practice of getting even with the wrongdoer. It is justified on the ground like a payment of what is owned: that is, offenders who are punished are paying their debt to society and offenders have a right to go free once they have paid their debt (McGraw, 2005:54). This is in some ways the complete antithesis of reductivism which justifies punishment on the ground that it helps to reduce the incidence of crime. Garland (1990:17) defined punishment as the legal process whereby violators of criminal law are condemned and sanctioned in accordance with specified legal categories and procedures. In Her Majestys Prison Services (HMPS) statement of purpose, which was adopted in 1988, punishment is defined as keeping in custody those committed by the court (cited in McGraw, 2005:39). There is a general agreement that the restriction of liberty would only be included for crimes like murder and other serious offences of violence against the person, such as rape. In the early times, systems of retribution favoured lex talionis, calling for an eye for an eye, a tooth for a tooth, and a life for a life (Hudson, 1996:38). It claimed that it is morally right to return evil for evil, and that two wrongs can make a right (Bean, 1981: 16). It looked only at the crime: it made no allowance for the mental state of the offender or for any mitigating or aggravating circumstances associated with the crime. Contemporarily however lex talionis is seen as a crude formula because it cannot be applied to many of todays crimes. For instance, what punishment ought to be inflicted on a rapist under lex talionis? The failure to inflict the same on the offender as the offender has inflicted on his or her victim has forced the retributive tariff to be considerably more lenient than it used to be in Biblical times (Hudson, 1996). Being required to stay behind the walls of a prison for the specified period, not permitted to go out from the prison other than in approved circumstances, is now the most punitive sentence which a court in England and Wales can impose. The criminal law is quite specific in restricting the courts authority to impose a prison sentence: The court must not pass a custodial sentence unless it is of the opinion that the offence, or the combination of the offence and one or more offences associated with it, was so serious that neither a fine lone nor a community sentence can be justified for the offence (Criminal Justice Act, 2003: Section 152 cited in Scott, 2007: 42) A sentence of imprisonment is imposed, in principle, to deprive the individual of his or her freedom. Although some would argue that the prison is a refuge from the pressure and severity of normal life, for many prisoners the pains of deprivation of liberty and separation from family are almost unbearable. Furthermore, the coercive punitive element of imprisonment extends beyond the mere deprivation of liberty: typically, the offenders family who have not been found guilty of a crime have also seen to be punished (McGraw, 2005). This is not a big concern for some ideologies. According to the utilitarian theory, moral actions are those that produce the greatest happiness of the greatest number of people (Hudson, 1996:54), inferring that if punishment is effective in reducing crime, then the pain and unhappiness caused to the offender and to the relatives may be outweighed by the unpleasantness to other people in the future which is prevented. Prison works because it ensures that we are protected from murderers, muggers and rapists (Howard, 1993 cited in Cavadino and Dignan, 2002: 67)- a reference to the second justification of imprisonment known as incapacitation. Incapacitation enables the prison service to protect public because offenders are in prison, and they are prevented from committing other crimes. In some respects this argument is valid, particularly in respect of specific neighbourhoods where a significant proportion of crime is committed by identifiable individuals. However, this type of crime tends to be low level, attracting relatively short prison sentences. The person concerned may be taken out of their community for a short period of time but they are likely soon to return. Some of them may still give indication that, if they were to return, they would continue to present a threat to the public. A more problematic group includes those who have not committed a serious crime but have been identified by expe rts as likely to do so. It may well be necessary that these people should be in prison for as long as they present a threat. However, in order to justify holding these men in custody, the state has to derogate from Article five of the European Convention on Human Rights (ECHR), which guarantees the right to a fair trial. Hence, although punishment for imaginary crimes in the future might not be essentially wrong for utilitarianism, it is a serious objection for retributivism and human rights theory. This is because, our powers of prediction are simply not up to the job, whether we use impressionistic guesswork, psychological testing, statistical prediction techniques or any other method (Ashworth and Redmayne, 2005: 206) inferring that a number of persons will suffer incapacitation who would not have committed further crimes if left free. The third justification of imprisonment is deterrence. There are two types of deterrence: individual and general. The former involves deterring someone who has already offended from reoffending where as the latter involves dissuading those who might be tempted. Becarria expressed his early conception of deterrence and argued that the aim of punishment can only be to prevent the criminal committing new crimes against his countrymen and to keep others from doing likewise (cited in Bean, 1981: 30). Michael Howard (1993 cited in Jewkes and Johnston, 2007:84), took a similar position to Beccaria and argued that prison works à ¢Ã¢â€š ¬Ã‚ ¦ it makes many who are tempted to commit crime think twice because people fear the punishment that they may receive if they offend. The greater the punishment, the greater the deterrent. It can be argued, for example, that the prospect of one month in prison might be enough to deter someone from stealing  £100 but not from stealing  £100,000. To dete r someone from stealing that amount of money, the prospect might have to be several years in custody. On the contrary to punishment, another justification for imprisonment is to rehabilitate. The rehabilitation of prisoners became a prime concern for the penal system in the late eighteenth century when the demands for labour were high. The rehabilitation of prisoners in the early years of its origin was unsophisticated. The development of human sciences of psychology, physiology and sociology enabled todays rehabilitative ideal to include an examination of the offence and the criminal, and a concern for the criminals social background. The rehabilitation of offenders to re-join society, as useful and law-abiding members of the community (House of Lords, 2004:12) is attractive on a number of counts. Firstly, it provides a positive justification for what would be an otherwise negative form of punishment of the criminal, although there are some who would argue that punishment has already got a rehabilitative effect on the offender; as a result of punishment is a change on offenders valu es and beliefs which refrains him or her from committing further offences (Cavadino and Dignan, 2002). Secondly, rehabilitation is reinforced by the notion that it can reduce crime by altering the individuals character or behaviour. The rehabilitationist theory regards criminal behaviour as a social disease rather than a personal choice and sees the reasonable solution as curing that disease through psychological therapy, education and training (Cavadino and Dignan, 2002). This is attractive to those who work in prisons and who wish to do more professional work than merely deprive prisoners from their liberty. However, unwarranted assumption that crime is related to a disease and that social experts can diagnose that condition is a weakness because treatment programmes are open-ended and do not always relate to the offence (Farrall, 2002). Furthermore, there is also a room for prisoners to cheat by participating in programmes they had no faith in, by expressions of remorse they did not feel, and of intentions to refrain from crime to which they had no commitment. UNDERSTANDING CONTEMPORARY PENALITY As can be seen, there is relative clarity that prisons are not merely to lock up particular types of offenders for specified periods. There also seems to be a relative clarity that there are problems with the functions of prisons- retribution, incapacitation, deterrence, and rehabilitation- when considering the high recidivism rates. Official figures show that when the Labour party came into power in 1997, more than a third of criminals reoffended within six months, 50% almost within a year, and 58% reoffended within two years of being released (Ford, 2005). More recent statistics showed that of the offenders who were discharged from custody in 2000, 20% had been reconvicted within three months, 43% within a year, 55% within two years, and 68% within five years (BBC News, 2010a). The offenders convicted of theft took the shortest number of days (90 days) to reoffend in 2000, where in 2008 it was offenders convicted of other (91 days) (MoJ, 2010a: 49). The official statistics based on the latest data show that the proportion of offenders reoffending decreased by 6.8% from 43% in 2000 to 40.1% in 2008 (MoJ, 2010a: 21). However, the number of reconvictions classified as severe within this period rose by 14.7% (MoJ 2010a: 9). Despite that however, the severity rate has remained broadly stable at between 0.6 to 0.9 offences per 100 offenders between 2000 and 2008: this is equivalent to less than one serious offence being committed per 100 offenders in the cohort (MoJ, 2010a: 9). The majority of the most serious reconvictions committed by the 2008 cohort were in the violence offence group, with 21% accounting for sexual-related crimes. The 80% of the most serious offences were committed by offenders who had never before committed an offence classified as serious (MoJ, 2010a:15). The reconviction rates for individual prisons published for the first time revealed that there are fourteen prisons in England and Wales which have reconviction rates of more than 70%. The Do rchester prison, in Dorset, has the highest at 74.7% for adult male prisoners and New Hall, in Yorkshire, has the highest reconviction rates for female prisoners at 76% (The Guardian, 2010). However, it is highly questionable whether searching for an association between recorded crime statistics and usage of official punishments can provide satisfactory answers to the question of whether prison works. This is partly because of the unreliability of crime statistics, and also because à ¢Ã¢â€š ¬Ã‚ ¦ there is every reason to assume that extralegal conditions play a major role in criminal etiology (Gibbs, 1988: 28). As can be seen, the statistics above underline a long-term ineffectiveness of the criminal justice system at diverting persistent offenders from a life of crime. Thus the emerging question is why prisons are not working? It would be fair to assert that prisons are impacted by developments, trends, and changes that occur with regularity in the larger society (Saunders and Billante, 2002). The complex set of changes in politics, economics, social and cultural life has had a fundamental influence on the way prisons operate. For instance, in the mid-1990s, escapes from prisons, particularly by highly dangerous offenders, emphasised on improving security, and thus enabled community safety to become a prominent political agenda at central and local level. Michael Howard prioritised public protection and thereby played a central role in the introduction of Prisons Works philosophy because It is a deterrent. Criminals fear it. And it takes criminals out of circulation(cited in Farrall, 2002: 5). This took much of the necessity of tackling prisoners behaviour and lessened the rehabilitation initiatives: the movement was all away from individualised, indeterminate sentencing which considered offenders circumstances towards standardised, tariff sentences, which valued consistency, proportionality and predictability. Consequently, this led to a rise in the prison population (Saunders and Billante, 2002). In May 1993, the prison population used to be 43,500 but this figure rapidly increased to 60,000 within four years (McGraw, 2005:9). The labour government did little to dispel the prison population but favoured tough regime and introduced harsher sentence outcomes for violent and non-violent offences. As a result, while it had taken four decades from 1958 to 1995 for the prison population to rise by 25,000 it had taken New Labour only eight years to match that 25,000 increase (McGraw, 2005:1). On 22 February 2008 the total population exceeded the useable operational capaci ty of the prison estate for the first time in history. The number of offenders in prison at the end of February stands on 85,206. Of the population in prison custody, 80% comprised males aged 18 or older while 16% were on remand either awaiting trial or sentence (House of Commons, 2010:2). Approximately one-third of the total sentenced prison population are serving sentences of more than 12 months, with a further 18% serving indeterminate sentences (House of Commons, 2010:4). Of the sentenced population, the violence against the person offence group accounts for the largest proportion (28%) (House of Commons, 2010:4). Importantly, unlike in the past, a higher proportion of the sentenced female population are now serving sentences for violence against the person offences rather than drug offences. At a glance, the incapacitation of offenders might be a good idea (as it removes offenders from circulation), but the truth is that it is an ineffective strategy towards crime. The public rightly expects someone who is convicted of a serious crime to receive a suitably severe punishment, and in particular expects protection, but the evidence about the incapacitation effect of prison has concluded that the degree of incapacitation resulting from a sentencing policy has a marginal effect on the crime rate (Blumstein and Farrington, 1986). The best calculations suggest that incapacitation effects of imprisonment are only modest partly because most criminal careers are relatively short: by the time offenders are locked away they may be about to give up crime (Green et al 2005 cited in Cavadino and Dignan, 2002). Where crime was once viewed as a social problem facilitated by the failure of the society to provide for its members, today the society is blameless and the individual offender i s seen as a wholly volitional creature who makes rational choices to engage in crime. When imprisoned, despite the existence Rehabilitation of Offenders Act 1974 which discloses criminal convictions, ex-offenders experience serious difficulty in readjusting to society after they have served their time and paid the dues that the law required of them because the stigma of imprisonment and long absences from work often puts employers off hiring ex-prisoners (Giddens, 1999). This exacerbates social exclusion and increases the risk of a return to crime and a life dependent on social benefits. Another effect of imprisonment, according to Western (1999 cited in Street, (no year:), prisoners are likely to develop certain attitudes, mannerisms and behavioural practices that on the inside function to enhance survival but are not compatible with success in the conventional job market. McGuire and Priestley (1985) told that to reduce the actual crime rates by one-third the prison population in England and Wales would have to rise to 300,000- an approximate fourfold increase. The capital and revenue costs of this enterprise would be enormous. To arrest the required extra numbers, many more police and prisons officers would be needed, and to process them through the courts there would have to be a rise in the numbers of court personnel. The law-and-order would not just be the biggest item of public spending; there might well be nothing left over for anything else. There also exist doubts about the effects of deterrence. According to Lefton (1991) freedom is the most valuable thing for every human being, and people will do anything to avoid putting that freedom at risk. Leftons claim may sound acceptable at first sight but there is little evidence that offenders are deterred by longer or more frequent prison sentences. Because the deterrence theory is based on classical criminology, ie, individuals must, before they act, weigh up the benefit of carrying out the offence against the possible disadvantage of going to prison, one of the problems is that we cannot calculate how many crimes are avoided because potential criminals are deterred by the prospect of imprisonment. But in terms of deterring those convicted from reoffending, the statistics do not give a great deal of cause for optimism, as discussed above. After carrying out a comprehensive review of studies, Beylebeld (1979 cited in Hudson, 1996: 23) concluded that implementing an official deterrence policy can be no more than a shot in the dark because much crime is committed on impulse, given the opportunity presented by an open window or unlocked door, and it is committed by offenders who live from moment to moment (The White Paper cited in Cavadino et al, 1999:186). An alternative deterrent strategy has been put forward by Bachman et al (1992 cited in Farral, 2002). They told that potential offenders are more likely to be deterred by the certainty of detection than the prospect of punishment. At the other end of the spectrum, for McGraw (2005), punishments that are designed as deterrents can increase, rather than decrease, delinquency. In support, Wests (1982:104) research study on boys growing up in London found that if a boy offends, the best way to prevent him from offending repeatedly is not to catch him in the first place. This research evidence may seem contrary to common sense, but such finding suggests that punishment has other effects which may cancel out and even outweigh its deterrent effects. The labelling theory, for example, contends that catching and punishing offenders labels them as criminals, and stigmatises them. To make matters worse, harsher penalties can change offenders self-image from that of a law-abiding person to that of a deviant because custodial institutions are notoriously schools for crime where offenders can meet each other, learn criminal techniques and enter into a criminal subculture. In support, Woolfs (2001) investigation into English prisons found that some prisoners who were not addicted to drugs before admission were later drug addicts by the time of their release (cited in House of Commons, 2005). This process upon release is sufficient to elicit pathological behaviour (Zimbardo, 1982:249) which can in various ways make it more difficult for prisoners to conform to a law-abiding life in future (Cavadino and Dignan, 2002). If labelling theory is correct, then an essential area which needs to be tackle d in order to lower the crime rate is to change the way the society interacts with criminals, including those released from prison, to avoid these stigmatised labels from sticking. An institutional transition from being soft on offenders to get tough agenda which incorporated retribution, deterrence and incapacitation does not mean that the rehabilitative ideal is totally taken away from the justice system. Contemporary imprisonment is also about helping offenders to lead a law abiding lives in custody and after-release (Crawley, 2004:65). Over 700 National Vocational Qualifications (NVQ) schemes are being implemented in prisons. Research-based offender rehabilitation programmes do not only offer viable alternative for reducing recidivism, but they have also shown to be an economically efficient strategy (Farrall, 2002). It is widely accepted that rehabilitation programmes give the opportunity to harness prisoners strengths, make amends to their misdemeanours, earn their redemption, and restore their relationship with the society (Maruna and LeBel, 2002). Today, many rehabilitative programmes are based on cognitive behavioural approach, which attempts to alter how offenders think by improving their cognitive and reasoning skills so that they change their attitudes towards breaking the law. Leading empirical reviews of the literature on prison based rehabilitative programmes (Lipsey and Wilson, 1998; MacKenzie, 1997) told that the most effective way to reduce offending and re-offending is through education and employment, along with behavioural or cognitive programmes. In support, Marques et al (1994:55) gave an encouraging result by reporting that offenders in their study who did not volunteer for treatment were 8.5 times more likely to be arrested for a violent crime in the first twelve months after release from prison or discharge from parole. Less dramatic but equally encouraging results were reported from Patrick Carter (2003): well-designed, well-run and well-targeted cognitive behavioural programmes can reduce reconviction rates by 5-10% (cited in House of Commons, 2005:24). However, despite the positive effects of rehabilitation on recidivism, rehabilitation remains secondary to the facilities primary functions: control and confinement. Carters (2007: 146) research into prisons found that more than two-thirds of prisoners did not agree that they were being helped to lead a law-abiding life on release in the community; and only 28% of prisoners agreed that sufficient efforts are made to help prisoners stop committing offences when they have been released from custody. On the contrary however, Linden and Perrys (1988) review of research studies on the effectiveness of prison education programmes showed that although inmates have made substantial alterations to their behaviour, the changes did not necessarily have an impact on post-release employment and recidivism rates (cited in Ryan, 1990). Crawley (2004) argued that the pessimism that nothing works and that whatever you do to offenders makes no difference (Martinson, 1974) has destroyed the reformative aim of the penal system by encouraging policy makers and legislators to abandon the idea of rehabilitation as an objective of punishment- not because it had been shown to be true, but more because the disappointment of the high hopes invested in reform led to an over-reaction against the rehabilitative ideal. Mental Health Case Study: Generalised Anxiety Disorder (GAD) Mental Health Case Study: Generalised Anxiety Disorder (GAD) Mental health, Amir Daud case study Later in your initial discussions with Amir you think he may be having an anxiety disorder. Identify the character of anxiety disorder Amir is likely to be experiencing and what constituents in his history indicate this type of upset. Amir is highly likely to be experiencing Generalized Anxiety Disorder (GAD) which results from too much sympathetic activation of the neural system. It makes the person experiencing it gets constant nervousness that leads to a negative impact on both physical and emotional health status. It significantly interferes with the normal behavior path of the individual at its mercy. Amir spent two years in torturous detention in Afghanistan, which was a time of constant uncertainty and anxiety followed by a perilous journey to Australia. While he was in detention, he witnessed many episodes of self-harm by fellow detainees who had lost hope and pessimistic about their future welfare which have contributed to increasing Amir’s trauma and anxiety state. The fact that he felt powerless in his situation aggravated his stress levels because he lacked hope or someone or something that would help secure it in that hopeless state of personal business. Amir is also battling with mild depression from worrying too much about the family he left behind as he says he feels guilty because he is aware they are still facing persecution. He blames himself for not being able to rescue them from that situation. In addition, Amir is required to secure himself employment, only he feels quite the opposite due to his impatience and poor absorption. The major symptoms of this disorder include restlessness, exaggerated startle response, sleep disturbance, difficulty in concentrating, irritability and tremor. The symptoms must have occurred days than not for at least 6months and must cause clinically important distress or impairment in social, occupational or other significant areas of functioning’ (APA, 2000). According to Sigmund Freud, His type falls under Neurotic category of which is defined as the anticipation of negative consequences that activate defensive processes. This is as a consequence of his experience in the detention which he says makes him sleep poorly and development of negative intrusive thoughts during his waking time in the morning. Possible Treatments that could be administered to Amir include pharmaceutical medication (SSRIs and Benzodiazepines) or herbal extracts made from a relaxant made from the root of the kava plant (Hall, 1998). References Derek Hayes, A. G., Suhaini, M. J., Kassim, K. K. (2014). Hope and Mental Health Nursing. LinkedIn Corporations. Hall, R. H. (1998). Anxiety Disorders. Psychiatryonline. (2014). Neurobiology of Anxiety Disorders. Retrieved March 31st, 2014, from www.psychiatryonline.org: http://psychiatryonline.org/content.aspx?bookid=29sectionid=1361949 School, I. S. (2008). Neurobiology of Anxiety Disorders. In I. S. School. Russia: St. Petersburg. Explain what is meant by the neurobiology of anxiety. Anxiety is a psychological and a behavioral state commonly characterized by avoidance behavior which affects a patient emotionally and psychologically. Neurobiology of anxiety is the classification of all anxiety disorders that affect the brain emotional states. These emotional states could be anxiety about the future, fear of the present or depression about events that occurred in the past. There are many different categories of the neurobiology of anxiety as listed below. Generalized anxiety disorder (GAD) which is most common in young adults like Amir. It’s the fear, anxiety and depression associated with reaction to any dangerous situation. (Psychiatryonline, 2014). GAD is more likely than not to be confused with other anxiety disorder types. For one to conclude that a patient has it, they must identify four symptoms from the first rank list and at least one from the second list. First rank Inability to relax or restlessness Fatigueability Exaggerated sudden response Muscle tension Poor sleeping habits Poor concentration Easily irritable Second Nausea or abdominal complaints A Dry mouth Tachycardia Tremor Stress disorders (Post traumatic stress disorder- PTSD) and Phobias which are divided into specific and social phobia. These are characterized by a general feeling of dissociation from reality. Panic disorders (With or without agoraphobia) -Attributes are manifested by intense apprehension, terror, fear often associated with feelings of hopelessness and intense physical discomfort. Attacks usually last for a short while and rarely take hours. In case they are accompanied by agoraphobia, there is a fear of being in places or Situations from which escape might be hard or in which help might not be available in the event of a panic attack (Diagnostic and statistical manual of mental health, 2000) Agoraphobia without history of panic disorder- The (Diagnostic and statistical manual of mental health, 2000) identifies the essential feature of this disorder as fear of being in places or situations from which escape might be difficult or in which help might not be available in the event of suddenly developing a symptom that could be incapacitating or extremely embarrassing. Obsessive-Compulsive Disorder (OCD) –This is characterized by involuntary recurring thoughts or images that the patient is not able to dispense. The victims feel powerless despite them knowing that it’s irrational behavior. The four general categories are: counting, checking, cleaning and finally avoidance. They happen frequently, which consequently interferes with normal daily activities. Acute Stress Disorder-It’s an anxiety disorder due to a general medical condition. Symptoms of are judged to be the direct physiological consequence of a general medical condition. They may include prominent generalized anxiety symptoms, panic attacks, or obsessions or compulsions (APA, 2000) References APA. (2000). Diagnostic and statistical manual of mental health (4th Ed.). DSM-IV-TR: American Psychiatric Assocaition press. Psychiatryonline. (2014). Neurobiology of Anxiety Disorders. Retrieved March 31st, 2014, from www.psychiatryonline.org: http://psychiatryonline.org/content.aspx?bookid=29sectionid=1361949 School, I. S. (2008). Neurobiology of Anxiety Disorders. In I. S. School. Russia: St. Petersburg. Why is hope relevant in mental health nursing practice? How might you incorporate this concept in subsequent therapeutic communication with Amir? What other elements of communication might you employ? Hope is a vital element in any human’s life and is a pivotal act in any mental health nurse. It helps people with any medical problem get assurance about their situation, whether or not the treatment or recovery is complete. Kylma and Vehvilainen-Julkunen (1997) described it as an experience, emotion or need. The term in nursing is regarded as being dynamic and helps in rebuilding a patients self-worth and how they regard themselves which acts as a complementary treatment. Amir needs to be shown unconditional acceptance, understanding and tolerance to help him overcome his disorder condition. A patient who believes that their situation can change through professional guidance and hard work from their end does find a way out of their situation. The reason the placebo effect is important when dealing with patients like Amir. The nurse-client relationship with Amir’s case needs to be on a personal level, to breed trust and a sense of value. Recognizing that Amirs case is difficult will be the first step to helping him since for him to feel inspired by the therapeutic communication; he must feel the same energy from the nurse. There are different ways in which one can inspire hope especially in Amir’s case. They include: Educating Amir of his condition, treatment and assuring him that he can still achieve all his goals and objectives like any normal human being. Group therapy –This is where the assessor tries to interact with the patient with a group of other patients with more or less similar anxiety disorders with the aid of a leader to help them resolve interpersonal problems. Groups bring a sense of security and trust that they not battling their condition alone. More often, this results in positive outcomes in almost all cases. Humor-Using humor to help Amir arouse happy thoughts and avoid the negative thoughts he gets during his waking time. Humor results to laughter which has been proven to be therapeutic. Spiritual aspect-Here one tries to introduce spirituality, faith in the patient, which is a form of faith in all religions. Psychoanalysis-The main goal will be to reduce his anxiety and guilt through verbal processes. Conduct Humanistic therapy to help him fulfill his full potential and improve self concept. Conduct Behavior and cognitive therapy to help him change unwanted abnormal behaviors and acquire desirable ones through revising his thoughts and behavioral training. Later, Amir can be engaged in the assessment of his hope level to monitor any progress. Use of Herth Hope Index (HHI) rating where higher rate shows a high level of hope and subsequent opposite are an indication of low self-worth and depression. Amir detachment from the normal world could drive him to commit suicide and thus the nurse need to do a full assessment on his level of hope. Effective communication of the management plan and encouraging self-help strategies will also play a big role during management discussion with Amir. References Derek Hayes, A. G., Suhaini, M. J., Kassim, K. K. (2014). Hope and Mental Health Nursing. LinkedIn Corporations. Psychiatryonline. (2014). Neurobiology of Anxiety Disorders. Retrieved March 31st, 2014, from www.psychiatryonline.org: http://psychiatryonline.org/content.aspx?bookid=29sectionid=1361949 Define what is meant by ethnicity. Given Amir’s ethnic background explain what cultural assessments you might make in planning his ongoing care. Ethnicity refers to a state in which an individual belongs to a certain social group which happens to share common national, customs or cultural traditions. Amir is ethnic Hazara. The Hazara people have for a long time been the victim of discrimination in Afghanistan. At the refugee camp the people there are more likely to be of the same ethnicity with Amir. This will make it easier for Amir since he will feel a sense of belonging while interacting with people who share his cultural values and origin. I would use a cultural assessment tool to help me get all the information about Amir cultural background. Details I would include in the assessment area include: The primary language spoken by Amir, how he communicates with other people who speak a different language, whether he requires an interpreter or not, the highest level of education he has attained, whether his condition has ever occurred before, if it did in what manner was it handled, what are his normal ways of coping with stress? Let Amir describe his family living arrangements, the major decision maker in the family, his religious beliefs and any religious requirements or restrictions that may place limitation to his care, any special belief and practices that may vary from the conventional ways, from whom has the family been seeking help from. Additionally, the following questions should help in cultural assessment. Are there any topics that are particularly sensitive or unwilling to discuss (because of cultural taboos) Are there any activities in which Amir is unwilling to participate (because of cultural customs or taboos) What are the Amir’s personal feelings regarding touch? What are his personal feelings regarding eye contact? What is his personal orientation to time? (Past, present, future) Any particular illnesses to which the Amir may be bioculturally susceptible? All the above questions will help gather any possible information regarding the Hazara ethnic group which will help in treatment program recommended to Amir while he is in Australia. It will also help the employer of his religious and ethnic practices to avoid stigmatization. References Mary C.Townsend, D.-B. (2011). Nursing Diagnoses in Psychiatry Nursing (8th Edition Ed.). Philadelphia, 1915 Arch Street: F. A Davis Company. Psychiatryonline. (2014). Neurobiology of Anxiety Disorders. Retrieved March 31st, 2014, from www.psychiatryonline.org: