Effects of Religion Essay

Organized religion is a subject that has been around for years and also is very controversial and can cause some problems with people that want to talk about other religions since people take offence to what they believe. In society there are very good effects of religion and there also is are negative effects but that goes with anything because you have the people that wont to do and be free with no worries of persecution. I would say who cares who is right and wrong look how much better life would be if we lived by a good religion that teaches love forgiveness tolerance which are all good tools for combating social issues.. Religious groups can be invaluable to all levels of society because churches are willing to offer financial support, counseling and to help people in need. A great example of this is the ministry of Franklin Graham. His â€Å"Operation Christmas Child brings joy and hope to children in desperate situations around the world through gift-filled shoe boxes and the Good News of God’s love. Since 1993, more than 61 million shoe boxes have been packed, shipped, and delivered across the globe† (Graham, Franklin, N. D). Unfortunately Religion has also played a major part in some of the most devastating events in world history. It has caused hatred, segregation, confrontations and friction where divided groups feel superior and want to wipe out entire nations. Throughout our history there have been many events in which individuals or groups have been persecuted for their choice of faith. One such event was the systematic mass murder of European Jews, Catholics, Protestants, Jehovah’s witness’ and many others by the German Nazi Party during World War II known as â€Å"The Holocaust†. The Germans felt superior and that Jews along with other groups were inferior. They sought to eradicate any impurities or what they thought were wrong. The main premeditated focus of the holocaust was to wipe out the Jews. Over six million Jews were murdered purely for the fact they were of Jewish faith and at the same time many other people from other religious groups were killed also. ? References Graham, Franklin. N. D. Operation Christmas Child. Samaritans purse. Retrieved September 15, 2010. (n. d). Religion, economics and demography; the effects of religion on education, work, and the family. (Brief article)(Book review). Reference & Research Book News, Retrieved from Gale: Opposing Viewpoints Resource Center (PowerSearch) database.

Mixed Ability Grouping

MIXED ABILITY GROUPING Ana Redondo I/ INTRODUCTION: The main purpose of this module is to present to you some general evidences of different researches about method of mixed ability grouping versus other forms of organising pupils in MFL teaching and learning perspective. II/CONTENT 1/ Political context (in England and Wales) * 1944 the educational system in Britain streamed into diferent types of secondary schools, student with special educational needs being educated in special school. Since 1980s central government break up the Local Education Authorities by introducing Local Management of School * 1991-1993, chidren with special education needs into mainstream school, private school: 20-25%, conprehensive school being skew. * Throughout 1990, setting had proved to be effective in many secondary schools for mathematics, science and language. Pupils grouping are cosidered under such pressures: Student’s achievements (examination results), policy and society, local needs and parental choice. / Mixed ability grouping * In the title clerly indicates: ‘Mixed ability grouping’ also refer to a group in which children of varied ability are taught together rather than being set apart. * -No group of pupils is ever homogeneous. Differences in areas: ability, gender, self-concept, self-estem, ethnic background. a. Advantages of Mixed abilitiy grouping * Mixed ability grouping provides all pupils with equality of opportunity and reduces the negative results often associate with homogeneous grouping. It avoids the problems associated with allocating pupils to homogenous groups. * It promotes a good relation among pupils, between teachers and pupils. * Reduce competition and the labelling of pupils. * Low ability pupils are supported more benefit. b. Disadvantages of mixed ability grouping * It is hard to ensure that higher ability Ss are stretched sufficiently. * The meeting the needs of high and low ability pupils can result in failure. Teachers need to be sensitive to aware the differences of in order to set appropriate work, maximize learning outcomes and avoid conflicts between teaching and learning. * Mixed ability grouping makes unrealistic demands on teachers' pedagogical skills. * The majority of the class is often poorly supervised. Mixed ability grouping pose particular difficulties in MFL. 3/ Other forms of organisind pupilss – MFL teaching and learning perspective * Students have multiple intelligences, there for, some are better at certain things than others. Homogeneous groupings are likely to alow teachers a greater opportunity to meet the individual’s needs of students. * Homogeneous groups of pupils can achieve more efficiently in MFL. * Homogeneity of teaching groups- when classes share a greater similarity of learning qualities and characteristic, allows the techer to carry out their teaching more effectively. * It is difficult to allocate students to the appropriate group, no stigma is attached. Both ‘mixed ability grouping’ and ‘ability grouping’ have advantages and disavantages.III/CONCLUSIONS * I suggest here to consider ‘homogeneous groups’ and ‘within -class groups’ as pragmatically feasible options. Seated group work, collarborative project work, co-coperative learning, flexible learning, task-based learning or carousel work can all be applied in various different ways to ensure academic and social learning. (Ana Redondo) * The grouping of pupil is only one of several factors affecting the learning environment of the classroom. The quality of instruction and the curriculum are central. (Halam, 1996:2)

Approaches in Psychology Essay

We can also describe the definition of developmental psychology as â€Å"It is the study in which behavior develop and change during a life span. Special areas of interest include the development of language, social attachments, emotions, thinking and perception† More In Developmental Psychology: Developmental psychology is the scientific study of age-related changes throughout the human life span. A discipline of scientific inquiry, developmental psychology recognizes humans of all societies and cultures as beings who are â€Å"in process,† or constantly growing and changing. There’s a special device or you can say that there’re special cells in the brain of a baby and has the specific period by which baby learns the language and this type of thing is not available in the minds of animals. The development of emotions and thinking are also based upon the development of mind and language. When a baby learn the language he also try to act and shows emotions like hunger, pain and something like that. 2- Industrial Psychology: What is Industrial Psychology? Industrial and Organizational Psychology is a specialist rea that applies psychological knowledge and skills to work, with the aim of improving organizational effectiveness and the quality of work life. More In Industrial Psychology: Psychologists in this field advise businesses and organizations on a variety of subjects: the selection and training of workers; how to promote efficient working conditions and techniques; how to boost employee morale, productivity, and job satisfaction; and the b est ways to evaluate employee performance and create incentives that motivate workers. I-O psychology first became prominent during World War II (1939-1945), when it became necessary to recruit and train the large number of new workers who were needed to meet the expanding demands of industry. The selection of workers for particular jobs is essentially a problem of discovering the special aptitudes and personality characteristics needed for the job and of devising tests to determine whether candidates have such aptitudes and characteristics. The development of tests of this kind has long been a field of psychological research. Once the worker is on the job and has been trained, the fundamental aim of the I-O psychologist is to find ways in which a particular job can best be accomplished with a minimum of effort and a maximum of individual satisfaction. The psychologist’s function, therefore, differs from that of the so-called efficiency expert, who places primary emphasis on increased production. Psychological techniques used to lessen the effort involved in a given job include a detailed study of the motions required to do the job, the equipment used, and the conditions under which the job is performed. These conditions include ventilation, heating, lighting, noise, and anything else affecting the comfort or morale of the worker. After making such a study, the I-O psychologist often determines that the job in question may be accomplished with less effort by changing the routine motions of the work itself, changing or moving the tools, improving the working conditions, or a combination of several of these methods. Industrial-organizational psychologists have also studied the effects of fatigue on workers to determine the length of working time that yields the greatest productivity. In some cases such studies have proven that total production on particular jobs could be increased by reducing the number of working hours or by increasing the number of rest periods, or breaks, during the day. I-O psychologists may also suggest less direct requirements for general improvement of job performance, such as establishing a better line of communication between employees and management. 3- Child Psychology: What is Child Psychology? It’s the study in which we study how children grow and issues related with their upbringing, physical and psychological health. More In Child Psychology: Child Development, physical, intellectual, social, and emotional changes that occur from birth to adolescence. Although people change throughout their lives, developmental changes are especially dramatic in childhood. During this period, a dependent, vulnerable newborn grows into a capable young person who has mastered language, is self-aware, can think and reason with sophistication, has a distinctive personality, and socializes effortlessly with others. Many abilities and characteristics developed in childhood last a lifetime. Some developments in behavior and thought are very similar for all children. Around the world, most infants begin to focus their eyes, sit up, and learn to walk at comparable ages, and children begin to acquire language and develop logical reasoning skills at approximately the same time. These aspects of individual growth are highly predictable. Other aspects of development show a much wider range of individual differences. Whether a child becomes outgoing or shy, intellectually advanced or average, or energetic or subdued depends on many unique influences whose effects are difficult to predict at the child’s birth. A variety of factors influence child development. Heredity guides every aspect of physical, cognitive, social, emotional, and personality development. Family members, peer groups, the school environment, and the community influence how children think, socialize, and become selfaware. Biological factors such as nutrition, medical care, and environmental hazards in the air and water affect the growth of the body and mind. Economic and political institutions, the media, and cultural values all guide how children live their lives. Critical life events, such as a family crisis or a national emergency, can alter the growth of personality and identity. Most important of all, children contribute significantly to their own development. This occurs as they strive to understand their experiences, respond in individual ways to the people around them, and choose activities, friends, and interests. Thus, the factors that guide development arise from both outside and within the person. Why is the study of child development important? One reason is that it provides practical guidance for parents, teachers, child-care providers, and others who care for children. A second reason is that it enables society to support healthy growth. Understanding early brain development, for example, means that parents can provide better opportunities for intellectual stimulation, and society can reduce or eliminate obstacles to healthy brain growth. Third, the study of child development helps therapists and educators better assist children with special needs, such as those with emotional or learning difficulties. Finally, understanding child development contributes to self-understanding. We know ourselves better by recognizing the influences that have made us into the people we are today. 4- Educational Psychology: What is Educational Psychology? Educational Psychology, application of scientific method to the study of the behavior of people in instructional settings. Although the behavior of teachers and students is of greatest interest, educational psychologists also study the behavior of other groups, such as teacher aides, infants, migrants, and the aged. The areas covered by educational psychologists inevitably overlap with other areas of psychology, including child and adolescent development, social psychology, psychological testing, and educational counseling. There are different theories of child psychology which are as follow: †¢ Learning (Different theories of learning help educational psychologists understand, predict, and control human behavior. For example, educational psychologists have worked out mathematical models of learning that predict the probability of a person’s making a correct response; these mathematical theories are used to design computerized instruction in reading, mathematics, and secondlanguage learning. Different psychologist have their contribution in this field. Ivan Pavlov and B. F Skinner are prominent) †¢ Motivation (Attribution theory describes the role of motivation in a person’s success or failure in school situations. Success on a test, for instance, could be attributed to luck or hard work; the theory predicts the behavior of students depending on their responses. ) †¢ Development (The theory of the Swiss psychologist Jean Piaget that intellectual ability is qualitatively different at different ages and that children need interaction with the environment to gain intellectual competency has influenced all of education and psychology.

Immigration Research Paper Example | Topics and Well Written Essays - 500 words - 1

Immigration - Research Paper Example We can call it a safe country. One feels comfortable in any part of the country without the threat of terrorism or violence. People are guaranteed protection even in bigger cities like Washington and Florida. They do not feel as if they are being neglected because they are not in their own homeland. There is American social help system which does not make you feel unaccompanied when you are facing difficulties settling down. There are a lot of government sponsored programs and courses that support you in your hard times. For example, if you lose your job, you will be supported through a government funded program to back up your finances until you find a new job. America is one of the developed countries whose economical infrastructure is very strong. One can be sure to find a suitable paying job in this country, although â€Å"Illegal immigrants in the United States represent a significant portion of the workforce† (Fuqua 213). Most of the jobs are well rewarding making one feel comfortable with one’s life in America. Even if one’s family is not living in America, one can fully support them through the American job income. Moreover, there are loving and caring communities in America which make your life even more pleasant. American people welcome the immigrants with open arms and make them feel at home. So, the new comers feel secure and protected. Immigration to U.S. is relatively harder than immigration to any other country. You have to fulfill various document requirements under the Immigration and Nationality Act (INA) (Garcia). But after the immigration, the immigrants occupy different occupations, thus, enhancing the already stable economic system. Those who take admissions in reputed universities come out as educated professionals and get high paying jobs. This also benefits the country’s financial and social structure. Thus, the immigrants also play their part in strengthening the

The Human Rights Act and life sentence prisoners Essay

The Human Rights Act and life sentence prisoners - Essay Example There was a powerful presumption against the retrospective application of the Act, and in relation to transactions that had taken place prior to the coming into force of the Act; there could be no question of interpretation under s 3 and accordingly no power to grant a declaration under s 4. 1 (Human Rights, Article 7) Three decisions of the House can be cited to illustrate the strength of the interpretative obligation under section 3(1). The first is R v A (No. 2) [2002] 1 AC 45 which concerned the so-called rape shield legislation. The problem was the blanket exclusion of prior sexual history between the complainant and an accused in section 41(1) of the Youth Justice and Criminal Evidence Act 1999, subject to narrow specific categories in the remainder of section 41. In subsequent decisions, and in academic literature, there has been discussion about differences of emphasis in the various opinions in A. What has been largely overlooked is the unanimous conclusion of the House. The House unanimously agreed on an interpretation under section 3 which would ensure that section 41 would be compatible with the ECHR. The formulation was by agreement set out in paragraph 46 of Lord Steyn's opinion in that case as follows: "The effect of the decision today is that ... o the importance of seeking to protect the complainant from indignity and from humiliating questions, the test of admissibility is whether the evidence (and questioning in relation to it) is nevertheless so relevant to the issue of consent that to exclude it would endanger the fairness of the trial under article 6 of the Convention. If this test is satisfied the evidence should not be excluded." (Lord Steyn, 2006a) Case: Re S Care plan 2002 UKHL 10 House of Lords and Starred Care Plans Re S (Minors) 3 The House of Lords did not uphold the Court of Appeals creation of starred care plans, a bold attempt to devise a way for care plans which were not being implemented coming back to court; instead they stressed the need for the government to urgently review this - power of section 3 HRA limited, court must be mindful of outer limit. Interpretation up to courts but enactment and amendment matter for Parliament - starred milestones departed substantially from Parliamentary intentions so far as it is possible to do so, primary legislation must be read and given effect in a way which is compatible with convention rights . (Child adoption) Lord Nicholls of Birkenhead 4 The Torbay case: The appeals concern four children, two in the Torbay case and two in the Bedfordshire case. The cases are factually unrelated. In the Torbay case the mother had three children: P, who is a boy born in August 1987, M, a boy born in January 1991, and J, a girl born in January 1992. The children are now 14, 11 and 10 years old. The appeal concerns the two younger children. The father of P, the eldest child, played no part in these proceedings. The mother met the father of M and J in 1987. They started to cohabit in 1989. Serious problems emerged in May 1999 when P ran away from home and

Social network marketing Research Paper Example | Topics and Well Written Essays - 1500 words

Social network marketing - Research Paper Example A good communication network can give an organization an upper hand in the advertisement sector; this can either be marketing or conveying urgent information to the public. In an education institution for example, it is very useful in educating people, a good communication network can be used efficiently in conveying information to the students. It attracts even those people who are not even directly involved in the institution hence it reaches out to a large area network. In the past the means of communication were not so advanced and it took long to convey information to a wide area network, this, however has changed over time and the communication network is getting more and more efficient such that you can reach anyone you like , anywhere and with very minimal time (Bosari, J. 2012, pp 53). The social media has been the core of communication in this era, hence for an institution it is very recommendable that there is a social media means of conveying information to the members an d public. Social media is the best tool for marketing available to the people right now, communication is simplified, and there are minimal delays. However for one to come up with an efficient social networking site it takes a lot of dedication and patience, it is not built in a day and one has to work hard to make their social network site efficient in the field. Social media marketing is a branch of internet marketing that entail the use of the internet to reach out to other people. Social network marketing therefore is a fundamental tool for an organization aiming to maximize on their marketing chances. Social media networking is open to many different form of communication, this include; the use of video calls, audio or voice messages, and written messages. This is possible when using social sites to convey information (Cambia, E. Et Al. 2011, pp 59). It goes without doubt that social media networking is the most efficient method for educational institutional marketing, in addit ion to the many advantages of social media; it also gives the liberty to navigate through different links and access more information from the internet. It can be used as a way of uniting other communication networks. The advantages of social media marketing are almost limitless; this mode of communication gives room for even very small corporate or business entities to, market their products without any form of victimization so long as they have an effective social media account, one that can be easily accessed by many individuals. Engaging in online conversations is a very effective way of using the social media to convey information to individuals (Deis, H. & Kyle, H. 2010, pp 87). One could also use the social media to combine it with other promotional brands to better their products; it gives room for research on the products and gain extra information on the marketing strategies. This is done in an entertaining and more interactive way such that you have direct access to your target audience. It is like having a personal conversation, but from very different geographical positions. Having online conversations is the most effective way of having a basis for a better background in making a reliable social site. It helps one to gain the confidence of other institutions such that they can give you access to some of their internet products hence expands the range of potential contacts and audiences. Social media network is no longer a trend, it is a necessity in the marketing industry and a must have for every serious institution. Research has it that more than 94% of all institutions in the world use social media network as their preferred marketing option. social media not only

Human Cancers Essay Example | Topics and Well Written Essays - 1750 words

Human Cancers - Essay Example The paper describes different types of cancer by human beings. There is one experience which consists of reading about a disease, and another to see the cadavers on display with the vivid details of their disease made transparent to the world as in â€Å"BODIES†¦The Exhibition.† Even the most detailed photos in medical textbooks fail to carry the full impact of disease that the cadavers at â€Å"BODIES†¦The Exhibition† communicate to the crowd. As the majority of the viewers of this display appear to be students and not medical professionals, the information presented and graphic detail of disease offers a preventative message for lifestyle choices that can assist in the national development of anti-cancer initiatives. For this reason, The American Cancer Society, Breast Cancer and Lung Cancer awareness groups have all joined together with â€Å"BODIES†¦The Exhibition† to use the facilities of the displays in alignment with their anti-cancer messag es. Whereas lung cancer, liver cancer, and colon cancer are related in some ways to lifestyle choices, there is not always even in these instances a direct relationship between personal mistakes or individual faults and the onset of disease. Rather, deep genetic issues, environmental exposures, immunity, cell regeneration, and old age all combine in ways that continue to elude scientific research to find a cure in the causation of cancer. One effect of the â€Å"BODIES†¦The Exhibition† display should be to encourage participants or viewers to increase their resolve to find a cure for cancer.

Homework Assignment Number Two Essay Example | Topics and Well Written Essays - 250 words

Homework Assignment Number Two - Essay Example hn) is arrested and arraigned after a thorough investigationsculminating to seizing the flash drive from the library, the existence of an elaborate investigation leading to discoveries of evidence points to a legally conducted investigations, arrest, and preference of charges which points to due process. The exclusion rule here therefore, will concern itself with how the evidence was acquired rather than its prove for commission of crime. An illegal action by police to gain incriminating evidence is inadmissible as evidenced by Oaks (6). In the second situation, the police stop the suspect (John) for speeding, then they go ahead to seize the flash drive. Here, the evidence should be suppressed because the search is obviously illegalas it is circumstantial to the speed ticket. The evidence in the flash drive and the charges thereof would be excluded because the acquisition of it is illegal.Evidence collected in violation of the defendant’s constitutional rights is sometimes inadmissible for prosecution in a court of law. This in effect protects citizens from illegal searches and seizures.In conclusion therefore,the exclusionary rule is addressing itself to a mischief where law enforcers would carry unreasonable searches arbitrarily in breach of laid down rules and procedures governing such

Logistics - Transport and Inventory Essay Example | Topics and Well Written Essays - 3000 words

Logistics - Transport and Inventory - Essay Example However, with the advent of technology, the complexity of logistics has been greatly reduced (Ault, 2003). There has recently been development of requisite simulation software to handle the complications involved. Inventory (also known as stock) is the name used to refer to the materials and goods a business establishment keeps to ultimately resell (or repair). Inventory management as a science is concerned with the specific percentage amount of goods in stock, along with their shape. It may be required at various locations in a facility or in different locations of one supply network (Button, 2011). Factors to consider in this field involve replenishment time, available inventory space, carrying costs, management of assets, forecasting and valuation of inventory, inventory visibility, physical inventory, future forecasting of inventory prices, quality management, defective goods, replenishment and returns. It is necessary to balance these requirements for the business establishment to run optimally. An establishment set aside for the storage of such goods is known as a warehouse (Montano, 2004). Warehouses can be used by manufacturers, wholesalers, importers, exporters, customs, transport businesses, etc. For many years, storage and retrieval of goods from warehouses has been physically done and controlled. This means that a great deal of human resource has been used. This has led to delays, more expenses along with common preventable human mistakes. With this in mind, most major business establishments have nowadays put in place an automated storage and retrieval systems (ASRS). These systems are computer-controlled and they place and retrieve loads from particular defined locations (Eden, 2002). Such systems were formally applicable to many business facilities that produce large scale goods. With time, however, the size of goods has slowly grown smaller. It is now easier to install

Competitive Advantage and Objectives Analysis Essay Example for Free

Competitive Advantage and Objectives Analysis Essay Competitive advantage and objectives analysis go hand in hand in determining how marketers will determine product positioning. The main goal of a marketer is to create the image of the company or the product brand. Then the job becomes establishing or positioning the same image or brand into the target market. Positioning is putting the concept into the minds of the prospective consumer. It is important for a marketer to understand the different types of analysis and know how to compare the strengths and weaknesses of each type of analysis. In the following paper a comparison of this analysis will be introduced and explained. Different Types of Analysis Used Product Positioning Product positioning analysis is an important step in the marketing plan. Product positioning is when marketers design and image and value so that consumers in the target market understand how the product is important to them. The goal of marketers is to develop the image so it appeals to consumers and builds the competitive advantage. Product positioning is like the tactical factor or analysis that is part of the overall marketing strategy. It is important when developing the positioning strategy that each part of the mix is incorporated including price, how the product will be distributed, what type of advertising will be used, and most important how well will after sell customer service be generated. Level Two Heading Replace the level two heading with the words for your heading. The heading must be in bold font. Read more about APA headings on the APA Style Blog. Conclusion The closing paragraph is designed to bring the reader to your way of thinking if you are writing a persuasive essay, to understand relationships if you are writing a comparison/contrast essay, or simply to value the information you provide in an informational essay. The closing paragraph summarizes the key points from the supporting paragraphs without introducing any new information. References This is a hanging indent. To keep the hanging indent format, triple click your mouse on this line of text and replace the information with your reference entry. You can use the Reference and Citation Examples (Center for Writing ExcellenceTutorials and GuidesReference and Citation Examples) to help format your source information into a reference entry. The reference page always begins on the top of the next page after the conclusion.

Purpose And Objectives Of Meeting Social Workers Social Work Essay

Purpose And Objectives Of Meeting Social Workers Social Work Essay The purpose of this meeting was to carry out an update SAP assessment, under Section 47, NHS and Community Care Act 1990, because Dianes needs have changed. Diane is a 69-year-old White British Female who has been living in Critchill Court since her discharge from hospital in Jan 2010. Diane had a Sub Arachnoids Haemorrhage, which has caused memory loss, confusion and depression in 2009. Earlier review in Feb 2010 reveals that Diane expressed a wish to return to independent living. Since then, an OT has supported Diane in re-learning independent living skills. Prior to the meeting, I went to social service to discuss with Dianes social worker to initiate information sharing and ask advice. We agreed on the need to complete the assessment before Dianes review in May 2010. I also obtained permission to have this meeting from Diane, and her daughter and their agreement that my placement supervisor would attend the meeting but only to assess me. My aim was to identify Dianes current and future needs with her and her daughter, who specifically stated her wish to be involved during earlier casual conversation. To do this I gained permission from Diane and her daughter during the meeting that I would seek the views of other professions, (OT, key worker, and CPN) to fill in some parts of the assessment. Diane has also given permission for me to share the information that she provided with others on a need to know basis. My role as a student gave me flexible time to commit in more supportive work with Diane. I had been working in partnership with Diane, her daughter, OT and social worker for 3 weeks before the meeting. I have taken Diane out, building her confidence in accessing local resources, and importantly, a relationship based on empathy, trust, and confidence. Authority/requirement for carrying out this piece of work (Legislative context/ agency policy/ government guidelines) The NHS and Community Care Act 1990, Section 47, which requires a needs-led assessment when appropriate and services provided accordingly if practicable. The Mental Health Act, 1983 and the Mental Capacity Act, 2005 apply because Diane has Sub Arachnoids Haemorrhage, which has caused memory loss and confusion. Particular attention is required, as these laws require that one must assume a person has capacity to make decisions unless established otherwise, and that one may not treat a person as unable to make a decision unless established otherwise. In my casual interactions with Diane, I have observed considerable ability to take decisions with regard to her life. The National Occupational Standards for Social Work (2002) and The GSCC Code (Code 1 for social workers) require the social worker to empower the service user by informing them their rights and entitlements and listening to what they have to say to involve them in taking any decision that may affect them. The Code also requires the social worker to recognise the users expertise in their own lives and make informed choices about services they receive. The Disability Discrimination Act 1995/2005 defines discrimination as, treating an individual less favourably than treating another. This legislation is important because it states what the government expects and requires of local authorities in relation to good practice (Trevithick, 2005: 17). Macdonald-Wilson et al (2001) defines disability as the condition of being unable to perform, because of physical or mental unfitness; to this extent, this definition follows the medical model. In the case of a person with a disability, a person is being discriminatory if they fail to comply with a duty to make a reasonable adjustment in relation to the disabled person. Higgins (1980: 123) defines stigma as a deeply discrediting trait, which may also be called a failing, a shortcoming, or a handicap. The Equality Act 2006 and the Care Standards Act, 2002 also have bearing on this case as it involves assessment of the care provided against need. Community Care (Direct Payments) Act 1996 enables local authorities to make direct payments (cash payments) to individuals to enable them to secure provision of care in lieu of social services provision. The Data Protection Act 1998, which requires the express consent of the individual prior to sharing any personal information obtained on individuals and shared with others. Additionally, all the information gathered should be kept in accordance with the data protection guidelines. Diane and her daughter had given me consent to collect and share information with other agencies if required. Knowledge (e.g. legal, psychological, sociological, political, socio-political, procedural, social work method) applied In undertaking this meeting I carefully prepared by brushing up on my knowledge of the relevant laws, guidelines, and different perspectives on empowerment, anti-oppressive, and anti-discriminatory practice. Besides these laws, my reflection on the case before the meeting showed me the values that would help in obtaining a positive outcome of the meeting. Theory and guidelines on best practice in social work required that I adopt an approach that would place Diane in a position where she feels empowered to make decisions. This approach requires me to work with the person-centred theory (Rogers, 1959) that requires me to work on the premise that Diane is an expert on her own life, and to focus on her strengths i.e. what she can do rather than on what she cannot (Saleebey, 2006). Using the person centred method enables the creation of a comfortable environment where the caseworker demonstrates genuineness through a non-judgmental and non-directive approach that bases itself on empathy and unconditional positive regard (Rogers, 1957). Therefore, my approach had to demonstrate feelings of warmth, liking, caring, and being drawn to Mary instead of aversion and anger (Barett-Lennard, 1986: 440) I also reflected on Egans recommendations (SOLER) that help display an encouraging and open attitude towards Diane. In considering the assessment process, I have adopted Milner and OByrnes five state model of assessment (1998). These are preparation, data collection, weighing up the data, analysing the data and utilising the data. I used Systems Theory in the assessment process, for example, in preparation stage I sought information not only from the service user but also from family members, other professionals, etc. In data collection stage, I used brief solution focused techniques, which allowed me to use supportive questions aimed at enabling Diane to recognise her own strengths and abilities. I particularly chose to use scaled response questions, asking Diane to score the present, when she was came to Critchill and what she hope to achieve on a scale of 1 to 10. By using this technique, I was able to support Diane to identify the successful strategise she has used in the past and this gave her confidence to apply her own strategies to improve her situation now and for the future. The brief solution focused therapy has been useful when I addressed one of the problems in the running records about the use of language to others. Diane has acknowledged this issue and was able to identify an occasion when all the triggers were present that could have caused the problem but she was able to deal with it herself and prevent the problem occurring. Erik Erikson (1950) says that when the person is aged about 60 years old or more, The person has time for reflection and as they look back on their life, they may have a sense of satisfaction; this will lead to a feeling of integrity. If the persons reflection results in them feeling they missed key opportunities, then there is an increased risk of experiencing despair In his article, Rogers (1957) quotes a study by Kinner that found that the client who sees his problem as involving his relationships, and who feels that he contributes to this problem and wants to change it, is likely to be successful. The client, who externalizes his problem, feeling little self-responsibility, is much more likely to be a failure. This highlighted the need for me to help Mary see that change in her life situation is more likely if she feels responsibility for at least a part of the problem and make her want to change. A complaint that Diane has voiced is that people (particularly her social worker) treat her like a child. Thompson (2006) says that this happens when a younger person sees an older person not able to make her own decisions and takes decisions on the older persons behalf thinking this is natural and normal without realising the discrimination and oppression this causes. It is often the case that the social worker or the carers see the older person as disabled to take decisions, particularly if the person suffers from some disability. The medical model of disability focuses on physical deficits and individual health needs, and it is a challenge for the worker not to fall into disablest [sic] perceptions by accepting this model (Parker Bradley, 2005: 76). The individual may experience loss and bereavement (Kubler-Ross, 1976), feel they have suffered a personal tragedy, and therefore label themselves as disabled as has happened in Dianes case. It was therefore essential that I approach the assessment with this knowledge and ensure non-discriminatory practice, not attaching any stigma to Dianes needs and disability caused by her medical condition. The social model of disability switches focus away from any physical limitations the impairment to physical and social environmental limitations, thus requiring promotion and empowerment of disabled people (Oliver Sapey, 2006). Additionally, the social workers own attitudes and values affect how he/she applies theoretical models of disability (Crawford Walker, 2004). The social model of disability is inclined to focus on cultural or structural aspects of disability (Priestley, 2003) and is the predominant model of disability used in social care. This is because social work approach does not look at mending something that is broken, but relies on overcoming societal barriers, which enables the treatment of a person with a disability just as others are (DDA, 1995/2005; Davies, 2002). While it is easy to comprehend the difficulties faced by an individual with a visible disability (e.g. using a wheelchair), it is also easy to ignore the wider cultural and structural factors that affect a person with a disability (Thompson, 2001). Herein lies the problem of seeing the disability as a problem with the person themselves (ibid). What Skills did you use for this piece of work? (please distinguish between those you have and those you need to develop) I used Planning and preparation, research, information gathering skill before the meeting and this has helped me to carry out the meeting well In terms of working anti-oppressively I think I have made Diane feel less oppressive by reducing the power imbalance. I have involved her daughter whose presence has been a great comfort to Diane as she sometimes looks at her for answers due to her short-term memory. I have successfully conveyed my respect and understanding of her strengths and limitations by adopting Egans empathy skills, active listening, summarising. I used Rogers person centred to focus my attention on Diane and this in term helping me to forget that I was assessed by my placement supervisor. I used unconditional positive regard to make Diane feel a sense of acceptance of herself when addressing an issue. I need to develop assessment skills as I feel I dont feel comfortable with the forms which have so many questions. Also some of the questions are very sensitive to ask for example the section of assessment of physical health there are questions like bladder control, bowel control, etc Also I need to develop liaising skill, sharing information with other agencies. As evident prior to the meeting, there were some miscommunication between different agencies. Which aspects of anti-oppressive practice were relevant to this piece of work? In terms of working anti-oppressively, I was aware my role as a student social worker this may have lead Diane to feel oppressive and not valued because she may think that she was not good enough to have a qualify social worker. To reduce this potential oppression, I have involved Dianes daughter and have been open and honest to tell them that I was inexperienced and has never carry out a SAP assessment before. I also offered them opportunities to decline or cancel the meeting. My ethnic origin as a non-white British may have attributed discrimination or oppression to myself from Diane or her daughter. However, this has never been an issue in the meeting or prior to my engagement with Diane and her daughter. the black perspective has made clear that racism is based on white European/ white north American ideological beliefs about the claimed superiority of white people over non-white people (Maclean and Harrison 2008:58). Considering my gender, which is different from Diane may present a difficulty for both of us. From the feminist perspectives if I had not recognise the extensive inequalities in society based on gender with men consistently being dominant, I may act oppressively unaware. Women is socially constructed to be a better carer as a wife, mother and daughter and the fact that the majority of social worker are female. As a male student social worker, my role may present oppressive to Diane. the feminist perspective has noticeably failed to adequately address structural inequalities within social care and social work organisations. In employment terms some 75% of the workforce in social care organisations are women. The proportion of men in senior management has remained stubbornly high and has only recently dropped below 75% of all senior managers (Maclean and Harrison 2008:56) there has been a recognition that societal developments and social policy initiatives affect men and women differently (because of their gender). The role of women as unpaid carers of family members with personal care needs is one example (Machean and Harrison 2008:55) If I have not used Social vs medical model to see Dianes depression, I may have not recognised the negative stigma associated with the labels applied to people and may have act in an oppressive way, overseeing the facts that her depression may be attributed by her despair for her current environment and loss of her abilities, eg, health and memoey,etc In what ways would the service user and or carer have preferred your practice to be different After the meeting, I apologised to Diane and her daughter that the outcome of this meeting may not have been as productive as they had expected and I told them that I would like to have another meeting again with them in the near future to discuss a plan to support Diane. (as I feel I have failed to conduct the meeting well, because my placement supervisor joined our discussion in the midway, and this i think should not be happen because she was there to assess me, unless she think she I needed help.) However, Diane, her daughter said they were happy with the outcome and she especially appreciated what I have done for her mother. My placement supervisor said to me. What do you mean this meeting is not productive she said I did very well. The only thing that Dianes daughter asked me was to inform her of anything I do for her mother. As there was an incident the week before that I took Diane out but forgot to ask her to check her daily. Dianes son and daughter in law came to visit when we went out and as a result they have not spent much time together that day. I asked Dianes daughter how she would like to be contacted and she gave me her email address as she may not be convenient to answer her mobile in her workplace. My placement supervisor also told me that I need to share the information with her about what I do or who I have contacted for Diane. Which key Roles, units and Values/Ethics do you think were demonstrated in this piece of work and how? (these must refer to practice discussed within the direct observation) In making a thorough preparation for the meeting with Diane, where my placement supervisor would observe me, I demonstrated delivery of all the units of Key Role 1. I had reviewed the case notes, spoken with the staff at the Home, her social worker, and daughter to carefully evaluate my involvement. My efforts to build a trusting relationship with Diane during my placement, and discussions with her about her preference for those elements of her care plan she likes to be included, show that I achieved important aspects of Key Role 2 (Unit 5 and 6). In my thorough research on best practices, legal and practice guidelines, and reflection on the best way to achieve my aim showed that I have responded well to the requirements of Key Role 6 (Unit 18 and 19). With regard to the values and ethics, I demonstrated awareness of my own values, ethics, dilemmas, and conflicts of interest (VEa). I have shown respect for and promotion of the wellbeing of Diane (VEb). I have also responded with oral and non-verbal communication skills in a way not to make Diane feel oppressed (VEc). Finally by showing my ability to build and maintain a relation of trust with Diane I have met the need identified by (VEe). What evidence did you use to evaluate your practice?(e.g. supervision notes, user feedback etc) In evaluating my practice, I have used two resources. The first is a feedback from Diane, whom I asked to judge how I had done. This feedback, in the form of a written response to a questionnaire I prepared for this specific purpose. However, the feedback given by my placement supervisor after the meeting has been valuable for me in terms of understanding my performance and identifying ways to improve in future practice. Give your evaluation of this piece of work (e.g. what went well, what did not go well, what if anything would you do differently next time?) I have learnt from my previous mistake in my first direct observation. I have used a mixture of open and close questions. Also I have used paraphrasing, clarifying techniques appropriately. In terms of choosing a place for the meeting, I have considered the noise and disruption and asked Dianes opinion where she would like the meeting to be. The location of the meeting in her room turned out to be a good choice. I feel I have reduce the potential of oppression by involving Dianes daughter whose presence has been great comfort to Diane as Diane has short-term memory and she feel more confident as she could get answer or help from her daughter. Also, I feel that working together we have achieved more than I had expected, as I have made the meeting like informal discussion rather than a job interview or assessment. I have achieved the aim I set for myself and completed parts of the assessment, by working in partnership with Diane and her daughter. However, I have achieved more by building a open and trusting relationship with them, this would in term enable me to devote my supportive work with Diane in the future. I did not complete the SAP assessment in the meeting as I have not planned or anticipated. I will continue to work on this assignment with Diane, her daughter and other professionals. I have however, failed to share the information about what I do with Diane with my placement supervisor. This has resulted in miscommunication between different agencies. I need to develop skill in liaising and sharing information with other professionals in the future. What additional learning, in relation to knowledge, skills or anti-oppressive practice and values and ethics, would enhance your performance in the future? In terms of working professionally I need to work in accountability way within agency, sharing information with others. System theory will help to improve my practice in the future. I also need to use my supervision session to discuss theories, values, dilemmas and anti-oppressive practice I have improved considerably about the use of interview techniques but with more practice I will be able to communicate in more confidence. Signed Placement Supervisor_________________ Date _____________ Student ____________________ Date _____________

Factors for Successful Behaviour Change Interventions

Factors for Successful Behaviour Change Interventions Critically assess the key elements that contribute to successful behaviour change interventions. The need for change Everyone wants a long and healthy life although some young people claim that they do not wish to be old. This is because of the negative connotations of old age. It is also a flippant opt-out of taking responsibility. The rationale behind a healthy style of living is unassailable. So why is it difficult to get people to change their ways? For many people, simply getting them to change at all is a major obstacle. As Niccolo Machiavelli observed more than 500 years ago,[1] â€Å"It must be considered that there is nothing more difficult to carry out, nor more doubtful of success, nor more dangerous to handle, than to initiate a new order of things.† It is not only innate mule-like conservatism that hampers change. There are also positive attributes to the status quo. The tobacco industry has long attempted to portray smoking as cool, sophisticated and sexy. To the rational person, spending vast amounts of money to ruin your health and smell like an old ashtray cannot be cool, sophisticated or have any trace of sex appeal. Over many decades Hollywood has connived to portray smoking in a positive light and this does have at least a subliminal effect.[2] Simply giving people information about the risks of adverse lifestyles and the benefits of changing their ways is not enough. The relationship between smoking and lung cancer has been public knowledge since the report of the Royal College of Physicians on Smoking and Health in 1963 although the association was first suggested in 1950[3] and the association with other diseases in 1956.[4] There has to be a sustained approach with a solid theoretical background. Models for change The two theories that are most commonly employed in health promotion are the Transtheoretical Model (TTM) and the Health Belief Model (HBM). Both are most commonly employed to produce changes in health promotion but the TTM model can be used to produces changes in other fields including industry. Both these models focus on the decision making process of the individual. Other models include the Theory of Reasoned Action (TRA) and the Theory of Planned Behaviour (TPB). All four have been reviewed by NICE.[5] Transtheoretical Model The Transtheoretical Model was devised in the 1980s. It sees five stages of action. Stage 1 is the pre-contemplative stage. It is defined as having no intention to change in the next six months. To use smoking as an example, the person may not appreciate the true level of risk. They may be aware that there is adverse publicity about tobacco. Perhaps some people around them are giving up but they have not taken it seriously enough to think of doing so themselves. Any desire to change is still at a subconscious level. Stage 2 is the contemplative level. It is defined as intention to change in the next six months although it may take longer. The people involved are aware of the benefits of changing but they are also acutely aware of the challenges. They must decide the balance between costs and benefits. Stage 3 is the preparation phase. There is intention to take action in the near future and preparation is in hand. The people involved have already taken some significant steps to prepare for the change. Action is planned for the next month or so. With regard to smoking, they may have discussed it with other people. They may have sought out support groups and discussed prescription of nicotine replacement therapy (NRT) or bupropion. They may have set a date to quit. Stage 4 is action. The people involved have modified their thinking and behaviour. In this case, they have actually stopped smoking. Stage 5 is maintenance and focuses on sustaining the success. It is important to ascertain that the people involved do not relapse into the old behaviours and are confident of maintaining the new ones. They may focus on money saved, feeling healthier and enjoying food more. It is also necessary to address negative aspects such as possible weight gain. Health Belief Model The Health Belief Model is quite popular amongst healthcare professionals. It was developed in the 1950s in the USA to examine why there was a low uptake of a screening programme for tuberculosis. There are five steps: The first is perceived susceptibility. It relates to an individual’s feeling of how likely he is to suffer from a condition. It may run in the family or affect a friend. Many people seem to regard themselves as immune to certain illnesses. We all know the smoker who refuses to give up because he knows someone who smoked all of his life without any overt problem. Perceived seriousness is the next step. This is similar to susceptibility. Does the patient see lung cancer as curable? Does he see other smoking related diseases as manageable? The third step is perceived benefits and barriers. Patients weigh up the benefits against the costs of taking action. This means implication rather than financial costs. Fear of being excluded from his group of smoking friends may be a barrier. Uptake of cervical smears may be impaired by potential embarrassment. Self efficacy is step four. It is sometimes called health motivation. It describes how a person sees the ability to change behaviour. If a person thinks that he is unable to stop smoking this is a barrier. The fifth stage is cues to action. This is the trigger that initiates change. It may be an intervention from a health professional, an illness or a life event such as a new baby. Becoming pregnant can be a strong cue for women. Curtailing smoking Smoking cessation is a particularly relevant area to analyse. Smoking is the greatest avoidable contributor to ill health and premature death. Everyone knows of the dangers although perhaps they choose to underestimate them. Even young people still take up the habit. A Cochrane review found limited support for the effectiveness of multi-component interventions in the community to help prevent the uptake of smoking in young people.[6] Smoking tends to be most prevalent in deprived communities. A NICE public health guidance called â€Å"Identifying and supporting people most at risk of dying prematurely† focused mainly on smoking cessation and the provision of statins as being cost effective and clinically effective.[7] Both NICE[8] and CKS[9] have extensively reviewed the evidence and made recommendations with regard to smoking cessation. There are also plenty of Cochrane reviews.[10] NICE regards those of lower social class and pregnant women as a priority. Before the dangers of smoking were publicly known there was no difference in smoking habits between social classes. Now there is a distinct gradient[11] and it is said that smoking accounts for a significant amount of the decreased health and increased mortality through the social classes.[12] This is known as health inequalities. Key elements in changing behavior The first element of change has to be to implant in the individual’s mind that there is a need for change. With regard to smoking this may come in many ways. Public health messages often preach the wisdom of quitting. Health issues are raised whenever tax is increased and the price of cigarettes rises. This does reduce consumption.[13] Possibly milestones in life such as a 40th or 50th birthday may spur consideration of one’s health. Pregnancy is often a strong incentive to quit and both partners should do so to allow the baby a smoke free home. A Cochrane review was unimpressed at the evidence that getting both of a couple to quit together increased the success rate.[14] However, lack of evidence of efficacy and evidence of lack of efficacy are not the same and it does seem a good idea. The matter may arise during a consultation with a health professional. This may be when reviewing a directly relevant disease such as diabetes, coronary heart disease, hypertension, ast hma or COPD or it may simply be brought up as it comes to light on the health promotion template. It has been shown that if GPs simply raise the issue during a consultation this can have an effect.[15] NICE suggests that people who are not ready to quit should be asked to consider it and to seek help in the future. Some people fail to understand the concept of risk. They need it explained in terms that they can understand. There is no certainty that a smoker will die of a disease related to his habit nor that a non-smoker will have a long and healthy life. It is useful to have some simple figures. About 1 in 5 non-smokers die before 65 years old compared with 2 in 5 smokers. Half of all smokers die of a smoking related disease. If you do the National Lottery in the hope of winning the jackpot the chance of doing so is 1 in 14 million. For young people who cannot imagine being as old as 30, a different approach is needed. Smoking accelerates the aging process in arteries, in the lungs, in bones and in the skin. For those who fear old age, they are bringing it on. Money, fitness and smelling fresh are also positive attributes. Nicotine is highly addictive.[16] There are other components to the urge. There is the ritual of lighting up and something to do with the hands as well as the image. All these must be addressed to help the individual to cope. Many people find it helpful to set a date to quit. This allows for some counselling before the event and for such matters as NRT or bupropion to be discussed.[17] The forum in which this is done may well be a smoking cessation clinic within primary care. It is usually nurse led. There may be one-to-one counselling but groups may also be helpful.[18] The members give each other mutual support and tips for how to cope. Having brought the person to the point of quitting it is important to give support through the potentially difficult time ahead. In the early days motivation is high. This must be sustained. Congratulate the person on the achievement. Make him feel good about himself. Reinforce the positive aspects of quitting. Some people collect the money that they would have spent on tobacco each day and put it towards their holiday. NRT can give a slow release background level of nicotine in the blood to help ameliorate withdrawal. It is very important that the individual does not smoke. Inhalation of nicotine gives a rapid surge and this surge contributes greatly to the addictive mechanism. Some people test that their patients have been abstinent by using a carbon monoxide meter.[19] Carbon monoxide is present in tobacco smoke and it binds to haemoglobin with 210 times the affinity of oxygen. Therefore, carbon monoxide is released slowly for a while after smoking. At what stage has a person successfully quit? Is it after a week, a month or 6 months? There is a joke that goes, â€Å"Giving up smoking is easy. I’ve done it many times.† This emphasises the great problem of recidivism. It is a problem with smoking, alcohol and drug abuse. Those who counsel drug addicts and alcoholics continue for a long time after abstention to ascertain that it continues. Alcoholics Anonymous will invite people to their meetings even years after they last had a drink. They know how precarious the position is. People who stopped smoking may restart 6 months, a year or even a couple of years after they quit. It is often said that ex-smokers are the most intolerant of the smell of tobacco smoke and this is good. People may choose to start again in times of stress or crisis. A typical scenario is when out drinking. Smokers often try to undermine those who have successfully quit. Perhaps they emphasise their own inadequacy. â€Å"Go on. Just have one. It will do you good!† are the sort of thing that alleged friends say. In the words of Alcoholics Anonymous, â€Å"One is too many and 100 is not enough.† One night out drinking can lead to complete reversion. This is less likely to happen now that smoking in pubs and bars is illegal but it is still a risk and should be discussed in counselling. Forewarned is forearmed. Reflection on learning in health promotion It is easy enough to read and learn the theories of health promotion but putting them into practice is another matter. There will always be surprises and there will always be areas to learn. No isolated incident comes to mind but there are a number of issues that have emerged with accumulated experience. Any reasonable person will look at the health issues involved and will conclude that the healthy way of life is the logical option. This applies particularly to not smoking. However, not everyone is reasonable and this includes highly educated people. Matters that are not much emphasised in health promotion advice and the literature are peer pressure and denial. It used to be said that the prevalence of smoking was higher amongst nurses at the completion of their training than at the start although the true incidence of smoking amongst nurses is uncertain.[20] There is no doubt that peer pressure within a school of nursing is high. Stress is also given as a reason for smoking.[21] However, stress is a subjective experience and it may be used as an excuse to conform to peer pressure. Practice what you preach is a common proverb. An obese healthcare professional who advises weight loss or one who advises cessation of smoking whilst be known to indulge personally, lacks credibility. However, the â€Å"sinner† is also less likely to attempt health promotion.[22] Nurses who smoke are less likely to believe the compelling arguments about the dangers of smoking.[23] This is unlikely to represent an objective scepticism about the evidence but simply denial. If all this applies to nurses, it is unsurprising to find that it is at least as true when dealing with patients. People have to be ready to change. The mere noting of the fact that a patient smokes and the raising of eyebrows is another cue for it to sink in. There is no point in trying to pressurise the person who is not yet ready but leave an invitation to return when the time is right. What makes a person believe? It is not the level of evidence. People will find all sorts of excuses to doubt the overwhelming evidence about smoking or to pretend that it does not apply to them. On the other hand it seems much easier to convince people that the MMR vaccine causes autism when there is not a shred of evidence to support the allegation.[24] The convenience of a belief is important. We must lead by example. The â€Å"sinner† as a â€Å"preacher† is unconvincing although the reformed â€Å"sinner† may be more credible. It is important not to appear as sanctimonious with a â€Å"holier than thou† attitude. We need to show empathy with those we try to help. This applies not just to the physical addiction to nicotine but to the demands of peer pressure. The latter is especially important for young people. It is very easy for the non-smoker to see only negative images of smoking. Ask the patient to make a list of all the good things about smoking and all the bad things about it. A similar technique is used when counselling drug abusers. There must be something positive about taking drugs or no one would do it. Similarly, there are positive aspects to smoking. This shows that there is empathy towards the positive aspects. It also allows the patient to see the balance and to believe that he is making his own decision. He is not being coerced or bullied. It is also important to be realistic about the negative attributes of smoking cessation. Honesty gives credibility. It is often not so much the nicotine addiction that is a problem. This wanes with time. It is the gain in weight.[25] Weight gain is much more visible than damage to lungs or arteries. Many teenage girls say that they smoke to aid weight control. In fact, starting to smoke as a teenager probably does not help at all whilst the later in life that smoking is stopped the more marked weight gain is likely to be. Exercise rather than smoking is much healthier and much more effective. Nicotine has a nauseating effect and so when it is withdrawn there is likely to be increased appetite. Food now tastes better and some people suck sweets to occupy their mouth. It is important to discuss the matter. Weight gain is bad for health but unless the gain is enormous the benefit of smoking cessation will greatly outweigh the dangers of weight gain. If the patient decides to start smoki ng again the result will be a fat smoker. The weight will not melt away. Health promotion is a very personal matter. It requires a relationship on a one-to-one basis. It requires trust and respect. The health promoter must be seen as an honest broker rather than an evangelist. This requires empathy and it requires respect of the patient too. It is an important and difficult decision and he needs help and support. 1 [1] Niccolo Machiavelli. The Prince. 1532. Translator: W. K. Marriott http://www.sonshi.com/machiavelli.html [2] Tickle JJ, Sargent JD, Dalton MA, Beach ML, Heatherton TF. Favourite movie stars, their tobacco use in contemporary movies, and its association with adolescent smoking. Tob Control. 2001 Mar;10(1):16-22. http://www.ncbi.nlm.nih.gov/pubmed/11226355 [3] Doll R, Hill AB. Smoking and carcinoma of the lung; preliminary report. Br Med J. 1950 Sep 30;2(4682):739-48. [4] Doll R, Hill AB. Lung cancer and other causes of death in relation to smoking; a second report on the mortality of British doctors. Br Med J. 1956 Nov 10;2(5001):1071-81. [5] Behaviour change: Taylor et al models review. NICE 2006. http://www.nice.org.uk/nicemedia/pdf/Behaviour_Change-Taylor_et_al-models_review_tables_appendices.pdf [6] Sowden A, Stead L. Community interventions for preventing smoking in young people. Cochrane Database of Systematic Reviews 2002, Issue 3. Art. No.: CD001291. http://www.cochrane.org/reviews/en/ab001291.html [7] NICE. PH15 Identifying and supporting people most at risk of dying prematurely: guidance. September 2008. http://www.nice.org.uk/nicemedia/pdf/PH015Guidance.pdf [8] NICE. Smoking cessation. March 2006 http://www.nice.org.uk/guidance/index.jsp?action=byIDo=11375 [9] CKS Library. Smoking cessation. 2007. http://www.cks.library.nhs.uk/smoking_cessation [10] Cochrane Collaboration. http://www.cochrane.org/reviews/index.htm [11] Jefferis BJ, Power C, Graham H, Manor O. Changing social gradients in cigarette smoking and cessation over two decades of adult follow-up in a British birth cohort. J Public Health (Oxf). 2004 Mar;26(1):13-8. http://www.ncbi.nlm.nih.gov/pubmed/15044567 [12] Jha P, Peto R, Zatonski W, Boreham J, Jarvis MJ, Lopez AD. Social inequalities in male mortality, and in male mortality from smoking: indirect estimation from national death rates in England and Wales, Poland, and North America. Lancet. 2006 Jul 29;368(9533):367-70. http://www.ncbi.nlm.nih.gov/pubmed/11226355 [13] Leverett M, Ashe M, Gerard S, Jenson J, Woollery T. Tobacco use: the impact of prices. J Law Med Ethics. 2002 Fall;30(3 Suppl):88-95. http://www.ncbi.nlm.nih.gov/pubmed/12508509 [14] Park E-W, Schultz JK, Tudiver F, Campbell T, Becker L. Enhancing partner support to improve smoking cessation. Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD002928. DOI: 10.1002/14651858.CD002928.pub2. http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD002928/frame.html [15] Smoking cessation guidelines for health professionals: an update. Health Education Authority. West R, McNeill A, Raw M. Thorax. 2000 Dec;55(12):987-99. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmedpubmedid=11083883 [16] Russell MA. The nicotine addiction trap: a 40-year sentence for four cigarettes. Br J Addict. 1990 Feb;85(2):293-300. Review. http://www.ncbi.nlm.nih.gov/pubmed/2180512 [17] Guidance on the use of nicotine replacement therapy (NRT) and bupropion for smoking cessation. NICE technology appraisal no. 39 (2002). www.nice.org.uk/TA039 [18] Stead LF, Lancaster T. Group behaviour therapy programmes for smoking cessation. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD001007. http://www.cochrane.org/reviews/en/ab001007.html [19] Middleton ET, Morice AH. Breath carbon monoxide as an indication of smoking habit. Chest. 2000 Mar;117(3):758-63. http://www.ncbi.nlm.nih.gov/pubmed/10713003 [20] The incidence of smoking amongst nurses: a review of the literature. Rowe K, Clark JM. J Adv Nurs. 2000 May;31(5):1046-53. Review. http://www.ncbi.nlm.nih.gov/pubmed/10840237 [21] Rowe K, Macleod Clark J. Why nurses smoke: a review of the literature. Int J Nurs Stud. 2000 Apr;37(2):173-81 http://www.ncbi.nlm.nih.gov/pubmed/10684959 [22] McKenna H, Slater P, McCance T, Bunting B, Spiers A, McElwee G. Qualified nurses smoking prevalence: their reasons for smoking and desire to quit. J Adv Nurs..2001 Sep;35(5):769-75. http://www.ncbi.nlm.nih.gov/pubmed/11529979 [23] The effect of training on knowledge and opinion about smoking amongst nurses and student teachers. Elkind AK. J Adv Nurs. 1988 Jan;13(1):57-69. http://www.ncbi.nlm.nih.gov/pubmed/3372886 [24] Bandolier Extra. MMR vaccination and autism. http://www.jr2.ox.ac.uk/bandolier/Extraforbando/MMRextra.pdf [25] Filozof C, Fernà ¡ndez Pinilla MC, Fernà ¡ndez-Cruz A. Smoking cessation and weight gain. Obes Rev. 2004 May;5(2):95-103. http://www.ncbi.nlm.nih.gov/pubmed/15086863

Weapons & Tools Depcited in Art :: essays research papers fc

Tools and Weapons in Art Since the dawn of mankind, humans have crafted tools to assist them in their daily lives. From the first rock thrown in anger, to the first tree branch used to dig, society’s relationship to tools and weapons has been represented in all of the visual arts. Throughout our textbook I have interpreted the recurring theme of tools and weapons in the arts. From the opening chapter we examine â€Å"Perseus Holding the Head of Medusa† Fig. 0.1 (Sporre 12). His relationship with his weapon appears both proud and protective as he positions his sword away from his body opposite it’s target – the head of Medusa. It almost seems as if Perseus has stepped in between a fight amongst two quarreling school children, holding his weapon aside as the innocent party and the head of Medusa as the instigator. And though this piece is anatomically from a distance, a closer look reveals many details were left out; nipples, eyebrows, etc. However, the handle of the sword seems to have an abundant of detail in the decoration. This indicates the artist put considerable thought into this weapons appearance. Later in chapter one, we are reminded that cavemen did not invent the wheel. In â€Å"Ashurnasirpal II killing lions† Fig. 1.6 (Sporre 37), the rendering of an early Sumerian chariot clearly highlights the magnificent tool as utilized for transportation. Note the fine lines, the intricate detail on the hub of the wheel, and even detail on the spokes. When taken as a whole, the wheel in this carving is more prominent than the people riding in the chariot. Again, in chapter two, we find another piece where the weapon ends up being the center of focus. It is difficult to tell if any one work of art intended for the weapons to figure so prominently, but collectively there is certainly a subconscious emphasis on them. In â€Å"The Pan Painter, Attic Red Figure Krater† Fig. 2.7 (Sporre 58) the weapon is clearly the focal point. The vast negative space contrasting with the thin, but balanced bow and arrow draw ones eye right to the area. Furthermore, the weapon in this particular vase painting is the impetus for the entire scene. Without the weapon, Artemis would not be shooting Actaeon. It is difficult to look at these weapons without noticing the great detail in both the weapon and its accessories. In this particular piece the artist went so far as to include a detailed arrow quiver complete with strap.

Childhood Obesity in The United States Essay examples -- overweight, c

Over a half-century ago obesity, and overweight has become a silent monster that creeps from within. Americans have been preoccupied in the last fifty years with countless numbers of problems that it seems that we have forgotten about our very own waistline. But, what is the difference between overweight and obesity? According to the Center for Disease for Control and Prevention overweight means that a person has a body mass index or BMI between 25 through 29 and anything higher than a 30 is consider obese. In 2009 and 2010 the CDC stated that, â€Å"more than 35% of U.S. men and women were obese†¦Ã¢â‚¬ (Carroll, Flegal, Kit, Ogden p.2). The obesity epidemic has reached 1/3 of the United States adult population; as a result many have considered that the only way to manage this epidemic is by implying a fat tax. This tax will target people who fit a specific profile, if they tip the scale they must pay. But the weight is not only targeted at adults, obesity has targeted the mos t vulnerable people of our society, our children. According to the CDC obesity and overweight affects â€Å"17% (or 12.5 million) of children and adolescents aged 2—19†¦Ã¢â‚¬ (p.1.) One day this generation of children will be adults and they should not be paying a tax because of their weight. Drastic measures need to be taken to treat childhood obesity and avoid a fat tax. Food consumption is a common body function that everybody must fulfill. But why do we eat? According to Levine and Billington, the authors of â€Å"Why do we eat? A Neural Systems Approach,† we â€Å"eat for a variety of reasons, including energy needs, time of day, social setting, stress, boredom, palatability/reward, and food availability at little or no cost. Historically, studies of energy metabolism have focused ... ...Sabrina Morrison a RN points out that, â€Å"teasing or negative verbal feedback is a risk factor for the development of body dissatisfaction and eating disturbances such as bulimia, anorexia, and binge eating disorders (Lunner et al., 2000)† (p. 203.) According to Morrison being bullied and teased will cause a child to develop bulimia, or anorexia. It is not a unknown fact that in severe cases where the persecution comes to such a cases that many children think of â€Å"†¦suicidal ideation and attempts associated with weight-biased teasing were two to three times higher among those teased then their nonteased peers. (Eisenberg et al., 2003)† (p. 203.) Sadly children are having suicidal thoughts because of their weight and how much they are bullied at school. However, many think that the obesity and overweight epidemic is a â€Å"problem† that has been overrated and exaggerated. Childhood Obesity in The United States Essay examples -- overweight, c Over a half-century ago obesity, and overweight has become a silent monster that creeps from within. Americans have been preoccupied in the last fifty years with countless numbers of problems that it seems that we have forgotten about our very own waistline. But, what is the difference between overweight and obesity? According to the Center for Disease for Control and Prevention overweight means that a person has a body mass index or BMI between 25 through 29 and anything higher than a 30 is consider obese. In 2009 and 2010 the CDC stated that, â€Å"more than 35% of U.S. men and women were obese†¦Ã¢â‚¬ (Carroll, Flegal, Kit, Ogden p.2). The obesity epidemic has reached 1/3 of the United States adult population; as a result many have considered that the only way to manage this epidemic is by implying a fat tax. This tax will target people who fit a specific profile, if they tip the scale they must pay. But the weight is not only targeted at adults, obesity has targeted the mos t vulnerable people of our society, our children. According to the CDC obesity and overweight affects â€Å"17% (or 12.5 million) of children and adolescents aged 2—19†¦Ã¢â‚¬ (p.1.) One day this generation of children will be adults and they should not be paying a tax because of their weight. Drastic measures need to be taken to treat childhood obesity and avoid a fat tax. Food consumption is a common body function that everybody must fulfill. But why do we eat? According to Levine and Billington, the authors of â€Å"Why do we eat? A Neural Systems Approach,† we â€Å"eat for a variety of reasons, including energy needs, time of day, social setting, stress, boredom, palatability/reward, and food availability at little or no cost. Historically, studies of energy metabolism have focused ... ...Sabrina Morrison a RN points out that, â€Å"teasing or negative verbal feedback is a risk factor for the development of body dissatisfaction and eating disturbances such as bulimia, anorexia, and binge eating disorders (Lunner et al., 2000)† (p. 203.) According to Morrison being bullied and teased will cause a child to develop bulimia, or anorexia. It is not a unknown fact that in severe cases where the persecution comes to such a cases that many children think of â€Å"†¦suicidal ideation and attempts associated with weight-biased teasing were two to three times higher among those teased then their nonteased peers. (Eisenberg et al., 2003)† (p. 203.) Sadly children are having suicidal thoughts because of their weight and how much they are bullied at school. However, many think that the obesity and overweight epidemic is a â€Å"problem† that has been overrated and exaggerated.

Apple Swot Analysis – 2

Apple SWOT Analysis II Cesar Diaz MGT/521 Management October 31, 2011 Erick Espinosa Abstract Apple is a company that concerned of the environment and has been working for more than 20 years to minimize the impact their products have on the environment. Apple has developed and formulate an environmental policy in 1990 and since then, Apple has continue making their products more energy efficient, eliminating toxic substances. Apple is also the only organization that all the products they sell not only meets but exceeds the firm energy guidelines of the ENERGY STAR specification. In 2009 become the first company to report their total carbon footprint giving the opportunity to their clients to see Apple progress and efforts. Studying the financial statements of Apple investors and also costumers can determinate the health of the company, with the statements investors can decide if is a good investment risk by studying them in depth because the financial statements inform all of the business assets and liabilities and also include information about how much shareholders would receive as dividends from each share of stock. Companies calculate the earnings per share by dividing their net income by the total number of outstanding stock. Apple SWOT Analysis The environment of Apple is unique in this type of industry, because they focus on all the steps that their products pass through, Apple calculate their carbon footprint establishing the impact the company has in the planet. The footprint of Apple is divide in 46% on Manufacturing, a 6% on Transportation, a 45% on Product use, 1% of Recycling and the last 2% in Facilities The vast majority of our carbon emissions come from the manufacturing, transportation, use, and recycling of our products. The rest — 2 percent — come from our facilities. The way Apple minimize the impact of their growth is designing the products using less material, ship with smaller packaging and been as energy efficient and recyclable as Apple possible can. Apple remains committed to creating products that have the least amount of impact on the environment. Since 2008, as our revenue grew 74 percent, our greenhouse gas emissions grew only 57 percent. In other words following Energy Star qualification all products of Apple go beyond the USA Environmental Protection Agency`s strict ENERGY STAR guidelines for efficiency and has become the only company that can make that claim. In the past few years has made notable reduction in carbon Emissions (http://images. apple. com/environment/ images/manufacturing_ emissions_20110909. jpg) also the CO 2 Emissions per hour of products have considerable reduce (http://images. apple. com/environment/images/product_graph_20110909. pg) Apple continues to install state-of-the-art digital controls, high-efficiency mechanical equipment, and monitoring technology and Apple have a commitment to recycle, that also have Recycling Program and with this increasing their goal all year. The goal for 2010-2015 is a 70% of weight Recycled per year. (http://images. appleinsider. com/apple-e-waste-perc-070502. gif) Apple Inc. is an American based multinational company whose stocks are listed in the  New York S tock  Exchange and NASDAQ (National Association of Securities Dealers Automated Quotations) under the symbol AAPL. The company specializes in the design, development and manufacturing of electronic equipments like computers, software and smart  phones. The hardware related product line of the company is well known to everyone; including iphone, Macintosh and ipad and ipod respectively. While there are multiple range of software`s offered by the company to its customers that ranges from operating system to the entertainment and educational based software suits. There are several statements that can be analyzed to establish the health of Apple each one with different meaning and purpose. The income statement is for measures a company's financial performance over a specific accounting period. This is one of the three major financial statements; it also  shows the net profit or loss incurred over a specific accounting period, typically over a fiscal quarter or year. The income statement of Apple is In the last quarter the Revenue (in billion) of three of Apple products Ipod, Mac and iPhone) is of 28. 23 and the cost of Revenue is 16. 89. The gross profit is 11. 38, which leave us between the selling, administration and expenses, also the department of research and development a total operating expense 19. 56. so after taxes the income available Is 6. 62 with this information investor can identify how Apple has been growing despite the death of their executive chief. The balance sheet will give the summarize of a company's assets, liabilities and  shareholders' equity  at a specific point in  time. Knowing what Apple owns and what owes and also the amount invested by the shareholders. Seen the graphic, it’s enough to appreciate that Apple does not owes nothing and the assets are increasing more each quarter Cash ; Equivalents 9,815. 00 Short Term Investments 16,137. 00 Cash and Short Term Investments 25,952. 00 Total Receivables, Net 11,717. 00 Total Current Assets 44,988. 00 Long Term Investments 55,618. 00 Total Assets 116,371. 00 Total Liabilities 39,756. 00 Total Equity 76,615. 00 Total Liabilities ; Shareholders' Equity 116,371. 00 Total Common Shares Outstanding 929. 28 And the last statement to study is cash flow, this is a A revenue or expense stream that changes a cash account  over a given period. Cash inflows usually  arise from one of three activities – financing, operations or investing – although this also occurs as a result of donations or gifts in the case of personal finance. Cash outflows result from expenses or  investments. This holds true for both business and personal finance. This statement provides aggregate data regarding all  cash inflows a company receives from both its ongoing operations and external investment sources, as well as  all cash outflows that pay for business activities and investments during a  given quarter. As we can see in the graphic and confirm with the numbers Apple has increase their operating activities but the investing are dropping fast enough to realize that even is a good market rentable their stock are not valuable right now, we can say that one of the reason that their value have decrease in stock is because of the death of Steve Jobs. After reviewing each statement I can understand that the company is financial speaking, healthy because it have values that makes the company special, such as the quality in their products and cares about the planet, also the revenue are increasing and is a solid business because is always improving for increase the profit and reduce the cost. That concern to me because as an young entrepreneur learn to measure an investment`s risk. Management use this information to see the weak points have to strengthen and how is the company doing, is the duty of the manager make the revenue of the company always increase and find a way to reduce the cost. The stocks of Apple have a value of 404. 78 and a valuation change of -0. 04% Apple has 929. 28M of Shares and 70% of the installations Apple is the owner, comparing Apple with other companies is simple to appreciate that (see table) Apple is the most stable for investment and with more market capital to invest, also is the most active in dollar volume improving in technology and research, certificating the quality of Apple products. Key stats and ratios | Q3 (Sep '11) | 2011 | Net profit margin | 23. 43% | 23. 95% | Operating margin | 30. 81% | 31. 22% | EBITD margin | – | 32. 87% | Return on average assets | 23. 81% | 27. 06% | Return on average equity | 36. 40% | 41. 67% | Employees | 46,600 | – | Carbon Disclosure Rating | – | 80/100| In terms of technology advancement Apple is pioneer because have the brains of Steve Jobs, Jonathan Ives and other top visionaries at the company But it would be a mistake to think that only these few drive all of Apple’s vision and long term strategy. Indeed, as I understand it, the visionary conclusions they come to that drive Apple is quite a collaborative effort. A good example of technology advancement is the iPhone, that product began when some engineers showed Steve Job’s a larger touch screen version of an iPod they created in 2004, It took three years to pull off but in 2007, Apple introduced the iPhone and its apps eco system and as you know, this changed the course of smart phone history. Since then, every handset maker and PC vendors has been playing catch up with Apple. It has taken at least two years for the competition to pull alongside Apple but with each new generation of the iPhone, Apple seems to raise the bar. The 4th generation of the iPhone introduced the retina screen and a front facing camera and who knows what will be in the next generation iPhone when it comes out this summer. What Apple does is use its cash hoard to pay for the construction cost (or a significant fraction of it) of the factory in exchange for exclusive rights to the output production of the factory for a set period of time (maybe 6 – 36 months), and then for a discounted rate afterwards. This yields two advantages: First Apple has access to new component technology months or years before its rivals. This allows it to release groundbreaking products that are actually impossible  to duplicate. And second Eventually its competitors catch up in component production technology, but by then Apple has their arrangement in place whereby it can source those parts at a lower cost due to the discounted rate they have negotiated. Once those technologies (or more accurately, their mass production techniques) become sufficiently commoditized, Apple is then able to compete effectively on cost and undercut rivals. It's a myth that Apple only makes premium products – it makes them all right, but that is because they are literally more advanced than anything else (i. e. the price premium is not just for design), and once the product line is no longer premium, they are produced  more cheaply  than competitor equivalents, yielding higher margins, more cash, which results in more ability to continue the cycle. There is one other strategic advantage that Apple has that does not make them happy and that is Apple’s $60 billion cash in the bank. Although there has been suggestion from stockholders that some of that be given back to shareholders, Jobs and team have argued that they need it for acquisitions and other competitive issues. Well, it turns out the competitive issue they are talking about is the ability to pre-buy components in large quantities and at big price breaks. One example was the $500 million purchase of flash memory Apple did three or four years ago that almost wiped out the entire supply of flash at the time and drove the price f flash for competitors up. Apple is currently working on the differentiation strategy by putting unique elements in the design and development of its products. The differentiation strategy is defined as a strategy that aims to develop the products and or services that have unique characteristics that are well liked by the customers and are valued by them. This strategy enhances the market position of the companies with respect to their counterparts (Porter, 1998). Moreover, the company strategies also involve the expansion of its distribution network  in order to improve its global reach by providing high quality products and services with after  sales services to their customers. Therefore, the company is positioned uniquely in the markets to offer superior and integrated digital technologies and productivity solutions. The company faces aggressive competition from the other market players. According to Hoover (2011) the top three competitors of Apple Inc. in United States are Fujitsu Technology Solutions (Holding) B. V. , International Business Machines Corporation and Media Net Digital, Inc. respectively. The needs of the markets it caters are highly competitive in nature due to the ever changing and advancing technological environment and the rapid introduction of new technology based products. The main competitors of the company are following cost leadership strategies by reducing the prices of their products or by maintaining low profit margins to maintain their market share. There are various forces that can impact the business and profitability of Apple. These factors may include the marketing mix  ± product, price, place, promotion strategies, product  performance, the quality and reliability of the product, innovative designs as well as the availability of up to date software services. Currently, the management of the company is focusing on the expansion of its business markets related to the smart phones and other media and communication devices. Therefore, it is expected that the competition in these markets will tend to increase for the company. Conclusion Apple competitors delight in going head-to-head with Apple in hardware, because they can compete with them at this level. But it’s the combinations of its hardware that’s created specifically to be a vehicle for its software and the software itself that really sets Apple apart. And, there is another element to Apple’s â€Å"blank screen† strategy that adds to its competitive advantage. It makes Apple driven content a cornerstone of its extended software offerings. Also the study result showed that the company is doing pretty well in the global markets due the integrated resources and operative capabilities that are outcome of globalization. Apple Inc. lags only in its outsourcing associations with the other company’s at different countries of the world. In order to improve the outsourcing practices ethically, Apple can strictly ask its outsourcing partners to comply with the ethical rules, and regulations. References Apple Finance (2011, October 18). Apple Financial Result [Audio podcast]. Conference Call. Retrieved from http://stream. qtv. apple. com/events/oct/earnings/earnings_11/earnings_ref. mov Apple Inc.. (October 21, 2011). Environmental Policy. Retrieved from http://www. apple. com/privacy/ Apple an the Enviroment. (2011, Summer). Environmental Progress. Retrieved from http://www. apple. com/environment/progress/ Bajarin, T. (2011, March 5). Apple`s Strategic Advantage. Retrieved from http://technologypundits. com/2011/03/apples-strategic-advantage/ Google Finace. (2011, Octuber 31). Apple Summary Statement. Retrieved from http://www. google. com/finance? q=NASDAQ:AAPL McHugh, N. W. (2010). Understanding business (9th ed. ). New York, NY: McGraw-Hill/Irwin..

Alcoholism And Rehabilitation

Alcoholism, also known as alcohol dependence, is unfortunately a widespread ailment which spans people of all age groups and socioeconomic levels. The health risks of this disease, and alcoholism is a disease, are as widespread as the individuals who contract it. In addition to these health risks, alcoholism is also an influencing factor in another problem plaguing societies, domestic violence. Thus, alcohol and anger create a sometimes fatal combination. As a result, rehabilitation success rates are vital in the ridding alcoholism and its negative effects from society.Alcoholism is a disease which can be described by degree. Alcohol dependence describes individuals who have developed a â€Å"maladaptive pattern† of alcohol consumption which is characterized by a developing alcohol tolerance, withdrawal symptoms, or hangovers, and the inability to stop drinking. It doesn’t stop there People with alcohol dependence may progress to alcohol abuse which can significantly in terfere with their social lives, their work or their interpersonal relationships.In addition, this abuse can also cause a host of related issues including â€Å"major depression, dysthymia, mania, hypomania, panic disorder, phobias, generalized anxiety disorder, personality disorders, any drug use disorder, schizophrenia, and suicide† (Cargiulo 2007). According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), drinking up to 14 drinks in a week for men or seven drinks per week as a woman could indicate alcohol dependence. In addition, the NIAAA estimates that up to nearly 18 million Americans could be considered alcoholics (Lauer 2006).That amounts to way too many individuals who are addicted to a drug that is both physically and mentally harmful, not to mention the effects on society as a whole. Despite the many mental and physiological problems that are associated with alcoholism, some of the most frightening are the health problems associated with the brai n. Evidence exists that shows the damage that alcohol consumption does to the brain. Brain imaging studies have revealed that people with alcoholism have significant differences in parts of their brains than those without alcoholism.The brain volume is reduced in alcoholics as well as the blood flow to the brain. The reduced blood flow has been linked to a lowering of inhibitions and memory, impaired cognitive function in general and even damage to the corpus callosum (Cargiulo 2007). Thus, alcoholism can directly translate to serious problems with the mind. These problems can lead to long term brain damage. Lesions in the brain form in those with long term patterns of alcohol abuse. This can translate into Korsakoff’s disease which is characterized by motor impairment and thinking impairments which can affect a person’s ability to care for himself.In the end, the individual may have to be cared for institutionally. Alcohol affects the neurotransmitters in the brain. A s the disease progresses to chronic status, the brain cells begin to adapt to the alcohol that seems to reside permanently in the brain. As a result, the brain becomes reliant on the alcohol to work. If alcohol is removed, the symptoms of withdrawal take longer and longer to subside. Ultimately, the brain tissue will rebel, in a way, and the withdrawal symptoms can be severe, even fatal. Once the cells in the brain die, they cannot be regenerated (Shoemaker 2003).These effects seem to affect males to a greater degree than females. This fact can be explained by differences in drinking patters, choice of alcoholic drinks, rate of alcohol metabolism and the protective effects of hormones such as estrogen (de Bruin, 2005) As such, alcohol dependency and abuse is three times more prominent in men as it is in women even though evidence suggests that for both genders, the numbers are underreported (Cargiulo 2007). As if the physical effects on the body were not bad enough, the behaviors of individuals who are addicted to alcohol are also quite dangerous.The drinkers find themselves to be less inhibited and more willing to engage in risky behaviors. Many of these behaviors can be characterized as aggressive and violent. In addition to the money that society has to pay for the medical care, it is also very costly to sort through all the social issues that alcoholism may create. Galvani (2004) gives several possible reasons why this risky and damaging behavior may occur in drinkers. Physiological theories argue that ethanol, the drug in alcohol increase aggression biologically.A theory known as Disinhibition Theory notes the earlier link between alcohol and cognitive function, specifically the portion of the brain mentioned above that regulates levels if inhibition. The Deviance Disavowal theory argues that the abusers use alcohol as a reason for their behavior and consciously drinks so that they can blame the alcohol for their actions. Social Learning theories explain that people will act in a way based on their experiences around others. Therefore, parents and societal expectations can lead to alcoholic abuse and abusive behaviors (Galvani, 2004).As with many ailments, more than one option for treatment exists. Many of these options can occur in conjunction with others. For years, behavior modification such as one might find in various 12 – Step Program or other similar programs have been the way of choice. These programs focus on the addicts significantly changing the way they behave in society including the people with whom they associate. Either a professional or a group of individuals led by a former addict facilitate the alcoholic’s recovery.Alcoholics Anonymous (AA), is an organization most known for its success rates for alcoholics’ recovery. It is available to anyone who desires its services. Lately increasing research evidence has found that a 12-step program affiliation is not only effective on its own, but even mo re effective along with professional, medical treatment, including residence based programs. The truth is, â€Å"Involvement with AA is consistently and positively associated with improved drinking outcomes, replicated across a large volume of studies using a variety of treatment methods† (Cloud, Zeigler and Blondell, 2004).The reason for this success is the three core items of AA: identification of self as a member, the number of steps completed, and the quantity of meetings attended (Cloud, Zeigler and Blondell, 2004). It can be a tiring process for an already worn individual. Because so many of these types of programs rely on frequent attendance by the alcoholics. One study sought to find the correlation, if any, between the duration of treatment and the level of intensity of the treatment. Moos and Moos (2003) conducted a study of 276 alcoholics who began formal treatment for alcohol abuse.These patients were involved with out-patient programs, residential programs, or a combination of the two. The average length of treatment was 20. 7 weeks, and the average intensity, or number of contacts, was 2. 8 contacts per week. These researchers first note that the individuals who had longer duration of treatment usually had less intense treatment. They found that patients who had a short treatment duration, which is considered 1-8 weeks, were more likely to abstain from alcohol than those who received no help whatsoever.If the treatment lasted for nine weeks or more, then the patient was even more likely to abstain from alcohol. This seems to suggest that the longer the treatment duration, the better the individual may respond to the treatment (Moos and Moos, 2003). However, recently the question has arisen as to whether or not recovering alcoholics must completely abstain from alcohol or not. Most programs, such as AA, or other groups perhaps affiliated with churches or in-patient and out-patient residential programs, build potential and motivation for suc cess on complete life changes.These changes includes huge behavior shifts which focus on completely eliminating alcohol. Unfortunately, many people do not seek treatment because they don’t want to completely give up the occasional beer or social glass or wine. Humphries, Weingardt, and Hoyst (2005) agree and have encouraged programs like Moderation Management which do not force individuals to part with alcoholic beverages forever. Allowing a choice of goal may be one effective way to increase the numbers of people willing to enter alcohol treatment.It is estimated that as few as 10% of individuals with alcohol use disorders attend treatment; more flexible goals may appeal to a wider range of these people. There is also evidence that therapy can move people toward choosing a realistic drinking goal for themselves (Humphries, Weingardt, and Hoyst, 2005). On one side of this debate are those that argue in favor of abstinence. They say that the disease controls the individual and that this person will definitely lose control of they are exposed to alcohol, even a small amount . (Humphries, Weingardt, and Hoyst, 2005).Never drinking again is the surest way to â€Å"cure† this disease. Alcohol recovery patients are constantly reminded that they are and always will be an alcoholic, just like a diabetic always will be a diabetic. Opponents to the abstinence-only argument argue that people and their problems with alcohol are all different with different times of drinking and different levels of drinking. The researchers use the common phrase â€Å"different strokes for different folks† in describing this philosophy. While they agree that some problems require abstinence, but they allow that other individuals could moderate their drinking and still improve.They call this a â€Å"harm-reduction orientation toward alcohol problems† which â€Å"focuses less on the amount of alcohol consumed and more on helping individuals decrease the harms rel ated to alcohol use. Although abstinence may be desirable, it is not the primary measure of successful outcomes† (Humphries, Weingardt, aned Hoyst, 2005). Some of the personal demographics of individuals who are more likely to experience success on non-abstinent programs include younger people, those with social and psychological stability, those who are regularly employed, and those who believe that they can seriously manage a moderate drinking program.However, if the patients are pregnant, experiencing liver problems, or are in the advanced stages of alcoholism, they may be forced to consider only the abstinence route (Humphries, Weingardt, and Hoyst, 2005). Another reason that some people avoid seeking treatment for alcoholism is their reluctance to commit to residential or in-patient treatment. Luckily, recent studies have indicated that outpatient treatment is effective in treating alcoholic dependency. Studies of this type have reported abstinence rates of 34-59% for 6 m onths post-treatment, 48 % for 19 to 24-month post-treatment and 52% for the 49-month post-treatment mark.In Bottlende and Soyka’s study of 2005, their rates were slightly higher for the six month mark at 64% abstaining, and 14 % significantly reducing their alcohol intake with a 22% rate of serious relapse. Perhaps, if people understood that they could get good results with a outpatient program, they would be more inclined to seriously consider treatment. Additionally, alcoholics do not need lengthy terms of treatment. Perhaps a brief commitment would do the trick for many with alcohol problems.â€Å"Brief interventions targeting alcohol consumption have been found to be very effective in changing clients’ consumption levels† (Roche and Freeman, 2004). One study cited by these researchers noted that heavy drinkers were likely to reduce the amount of alcohol they consumed six and twelve months after a brief intervention as compared with similarly heavy drinkers who received no interventions whatsoever: A WHO study conducted in eight countries involving over 1600 participants found that brief interventions reduced daily alcohol consumption on average by 17% and intensity of drinking by 10%.Brief interventions also reduce the number of alcohol-related problems, health-care utilization and associated treatment costs and the number of emergency department admissions. Brief interventions are also highly cost-efficient due to the minimal cost of the intervention and the breadth of scope for prevention of more serious and more costly problems (Roche and Freeman, 2004). However, the same benefits were not noted for women or for low consumers of alcohol who occasionally drank at very hazardous levels, also known as binge drinkers.Evidence suggests that â€Å"the majority of alcohol-related harms† affect these moderate to low drinkers who binge (Roche and Freeman, 2004). This study just shows that people do react differently to alcohol. One h uge area of research in alcohol rehabilitation right now is in the area of gender. The above study mentioned that women do not receive the same level of benefits from brief interventions as men receive. This has led many researchers to fill the research gap between studies that focus on only males or on mixed genders and females. While women have a lower rate of substance abuse, those that are alcoholics suffer just as men do.In fact, women actually suffer more severe effects in some cases than men do. For example, women have more alcohol related health issues, â€Å"mental disorders, death rates, quicker addictions and greater social isolation and stigma† (Najavits, Rosier, and Nolan, 2007). This is unfortunate because women have become increasingly more addicted to alcohol at younger and younger years of age. However, studies also indicate that while in treatment, women show more rapid improvement and are more able to control impulsive behaviors that are so problematic for men (Najavits, Rosier, and Nolan, 2007).Of course, one rehabilitative method that is often overlooked in the search to rehabilitate alcoholics is the pharmacological method. While drugs are frequently use to aid in helping alcoholics avoid painful and dangerous withdrawal symptoms, others are now being marketed as treatment methods themselves. One such drug is Acamprosate which is a synthetic compound with a similar structure to that of the neurotransmitter GABA and the neuromodulator Taurine† (Scott, Figgitt, and Keam, 2005).Once the patient is detoxified, Acomprosate helps the patient maintain abstinence in the place of rehabilitation programs. This way, individuals can maintain his social and professional life. Several studies found this to be true a year after use had begun â€Å"irrespective of disease severity or the type of psychosocial support† (Scott, Figgitt, and Keam, 2005) the patient received. Also, the drug appears to pose few tolerance issues such as naus ea, diarrhea or the like. A second prescription medication is available for the treatment of alcoholism.Naltrexone has also produced very positive results in promoting abstinence among recovering alcoholics. This drug has also had several positive research trials and works better in conjunction with behavioral therapy. One way this drugs works is to result in a reduced urge to drink and negative physical side effects if it is taken in conjunction with alcohol (Rohsenow, 2004). Alcoholism is a horrible, addictive disease that leads not only to medical problems such as brain and liver problems, but also to psychological problems, social problems and even violent behavior.The disease affects individuals differently, and new approaches are always being considered to treat each sufferer. While abstinence only and residential programs seem to have prevailed in the past, the new approaches are leaning to more brief, outpatient programs and interventions that support both abstinence and mod eration when it comes to alcohol consumption. These new programs also take into account differences that result from race and gender. With hope, this disease will soon be tamed, or even eradicated, with better and better rehabilitation programs.. References Bottlender, M. & Soyka, M. (2005). Efficacy of an Intensive Outpatient Rehabilitation Program in Alcoholism: Predictors of Outcome 6 Months after Treatment. European Addiction Research 11 (3): 132-137. Cargiulo, T. (2007). Understanding the health impact of alcohol dependence. American Journal of Health-System Pharmacy 64: S1-S17 Cloud, RN, Ziegler, CH, & Blondell, RD. What is Alcoholics Anonymous Affiliation? Substance Use & Misuse 39(7), 2004: 1117-1136 Galvani, S. (2004). Responsible disinhibition: Alcohol, men and violence to women.Addiction Research & Theory 12 (4): 357-371 Humphreys, K, Weingardt, KR, & Horst, D. Prevalence and predictors of research participant eligibility criteria in alcohol treatment outcome studies, 197 0-98. Addiction 100(9), Sep 2005: 1249-1257 Moos, RH & Moos BS. Long-term influence of duration and intensity of treatment on previously untreated individuals with alcohol use disorders. Addiction 98 (3), March 2003: 325-337. Najavits, LM, Rosier, M, & Nolan, AL. (2007). A New Gender-Based Model for Women's Recovery From Substance Abuse: Results of a Pilot Outcome Study.American Journal of Drug and Alcohol Abuse 33(1), 2007: 5-11 Roche, AM & Freeman, T. (2004). Brief interventions: Good in theory but weak in practice. Drug and Alcohol Review 23(1):11-18. Rohsenow, Damaris J. (2004). What Place Does Naltrexone Have in the Treatment of Alcoholism? CNS Drugs 18(9): 547-560. Scott, LJ, Figgitt, DP, and Keam, SJ. (2005). Acamprosate: A Review of its Use in the Maintenance of Abstinence in Patients with Alcohol Dependence. CNS Drugs 19(5): 445- 464 Shoemaker, W. (2003). Alcohol’s Effects on the Brain. Nutritional Health Review: The Consumer’s Medical Journal 88: