How Television Has Impacted Technology Essay Example for Free

How Television Has Impacted Technology Essay Television was introduced in 1949 but very few people had it because it was extremely expensive. The only channels people could watch were NBC and CBS. Television became increasingly popular because it was entertainment without going and sitting in the movie theaters. As TV became more popular, it became more affordable. People would hear about television through word of mouth, news, radio and newspaper. Everybody liked the idea of being entertained and staying at home. By the 1960s most families has TV sets in their living rooms, depending on if they liked being entertained at home. Television in the United States has grown year after year and has made a big impact on American culture in many ways. TV has taken a big part in violence in society, the news, how people are stereotyped, childhood obesity, family values, social interaction, and so much more. In my opinion one of the biggest impacts that television has had on American culture is childhood obesity. Obesity is considered a form of malnutrition in which food energy is stored as fat due to being unused. Child obesity is bred within the home and the television is a major contributor to it. The energy we consume from food needs to be used up by the body on a daily basis through physical exertion. An overweight child devoting a major portion of time to watching television is at risk to becoming obese. Television is certainly a contributor to that obesity. Kids these days are getting bigger and bigger, while television shows are growing and growing. To me, that is a big issue and television affects it a lot. Back in the day children enjoyed going outside to play, getting involved in sports or just anything outdoors. I feel like as of today there are now only about a quarter of the kids that enjoy doing outdoors stuff like that. The other 75% of kids choose to stay inside because most likely there favorite TV show is on or there is a movie that they just have to watch. Those kids are losing their time to play outside and mainly burn and lose calories because they are just sitting there watching TV for hours and hours. Obesity is known to be one of the major health concerns among both children and adults in the United States today. It is suggested by certain groups that children should not watch more than two hours of television a day. This in my opinion is already too much because that is where childhood obesity all gets started. The average child n the United States regularly watches between 2-3 hours of television a day and many children now days have their own television set in their bedroom. Not only are children inactive while they are watching television, they often snack on unhealthy food choices. And like I said, establishing unhealthy food habits as a child can often continue into adulthood. Investi gators have hypothesized that television viewing cause’s obesity by one or more of three mechanisms: (1) displacement of physical activity, (2) increased calorie consumption while watching or caused by the effects of advertising, and (3) reduced resting metabolism. The relationship between television viewing and obesity has been examined in a relatively large number of cross-sectional epidemiologic studies but few longitudinal studies. Many of these studies have found relatively weak, positive associations, but others have found no associations or mixed results; however, the weak and variable associations found in these studies may be the result of limitations in measurement. Even studies for reducing the amount of television intake have been completed. They do not test â€Å"reducing television time† directly, but the results that they get may help to reduce the amount of risk for obesity or help promote weight loss in obese children. â€Å"An experimental study was designed specifically to test directly the causal relationship between television viewing behaviors and body fatness. The results of this randomized, controlled trial provide evidence that television viewing is a cause of increased body fatness and that reducing television viewing is a promising strategy for preventing childhood obesity. † I really think parents need to take a stand to their children by limiting the amount of time they spend in front of the television, before it gets too late and they have an obese child. Removing televisions from children’s bedrooms and putting time limits on the TV may be a good way for parents to reduce the risk of obesity in children. Parents must serve as role models because their television viewing habits influence their children’s. Parents should also limit the frequency of television viewing. Overweight and obese children need to be encouraged to do more physical activity such as walking, playing and limiting their television time. Children may also need structured physical activity times to divert them away from television. â€Å"Although the increase in childhood obesity is not caused solely by television watching, Dr. Reginald Washington points out in the editorial that accompanies the articles, Society, as a whole, must realize that to effectively control and prevent this obesity epidemic, all risk factors must simultaneously be reduced. A study by the University of Liverpool psychologists has shown that it is to be true that obese and overweight children increase their food intake by more than 100% after watching food advertisements on television. Children all over the world are exposed to a huge number of TV advertisements, primarily for fast foods and sweets. Some say that it is not the amount of TV; it is the number of junk food commercials that advertise unhealthy foods and constantly play over and over. It is miserable that people blame television as a result to childhood obesity but the United States is starting to get very lazy when it comes to situations like this, therefore I truly believe TV is one of the dominate reasons of why children are becoming obese. I feel like this impact has been mainly negative on American culture. Television advertisers get talked down to by research groups, wanting them to take away all the unhealthy food commercials. Childhood obesity coming from television watchers makes American culture look very bad. When you find out that all it takes is television sets in a kids bedroom and high-quality shows that make children sit, stare and snack to become obese. It really puts a depressing look on America. In my opinion it is a very negative result because it used to not be this way at all. The parents and children put themselves in the situation to becoming obese and television just is an excuse for whenever they actually are obese. I know I will never let my children or close friends get this way due to excess amount of television watching. I have time to watch all my shows I like during the day and still get a good exercise in. I believe that all people can watch their weight and not become obese if they really try. So I really hope the culture changes and fix its look on television with obesity. I do believe that the internet will be used more wisely than television as a medium for delivering content. Television is an older and dull way of showing and sharing shows, movies and advertisements, while now days the nternet can do the same plus a whole lot more. Internet is a lot easier to get to because so many people have smart phones or laptops to be able to quickly access it. I feel like even now I start to see more and more people of all ages on their laptop/computer/smart phone rather than sitting down and watching television shows. Internet is a new (compared to TV) and entertaining way to access World Wide Web. News and broadcast stations are all starting to put their information and ideas on the internet even before they send them to television. While putting the internet into question about my topic, as much as I hate seeing younger kids run around with their own smart phone and/or laptop, it would really help society. Internet will help a lot more in this situation because children that do have smart phones will be able to play outside and exercise with their phone in hand. If the kids do go outside while on their phone it will stop them from sitting in front of a television set, sitting, staring and snacking. Therefore, it will lower the childhood obesity rate in the United States. Childhood obesity is a very heartbreaking yet occurring thing that television influenced and started in the U. S. It has been a very big impact on television and American Culture. After all, we are all hoping and praying that parents help their children get back to how it was back in the day. Have the children exercising, playing outside, and getting involved in sports that way they only spend approximately one hour watching television. We have to lower the childhood obesity rate and will continue to try and stop every way that is involved in it.

The One That Works Best Essay Example for Free

The One That Works Best Essay There are a lot of factors that influence how one grasps information. Each and every person is unique in their ability, interest and background knowledge and it is safe to assume that there is a preferred style of learning that works best for them. The common styles of learning are visual, auditory, and kinesthetic but a style can be determines in further depth through many different evaluations. I have learned a few things about myself and my own personal learning style which I will share with you in this essay. There are three basic learning styles which are visual, auditory, and kinesthetic. Visual learners retain information best through visual aids such as graphs, pictures, films and demonstrations. Auditory learners absorb the most from hearing the material through lectures or oral discussions. The last of the three is Kinesthetic learners who learns best through physical demonstrations rather than seeing or hearing. Based on the completion of Learning Style Inventory (Bixler, 2010), I have determined I am a Kinesthetic learner also known as a tactile learner. My preference of learning is through a hands-on method. When I reflect on my study habits I found that this is true. I retain information better through moving, doing or touching. How can I make this learning style work best for me? I can make studying a more physical task. Instead of sitting down and reading I could stand, or snack while listening to lectures. Playing music in the background is something I often do and is also a useful habit to acquire for kinesthetic learners. One of the down falls of being a tactile learner is that I am easily distracted but allowing myself frequent study breaks will help with staying on track with any assignment. Through the Index of Learning Styles Questionnaire (Felder Soloman, n.d.), I have determined that I am not only a well-rounded learner but I also have very strong learning preferences that may affect my grasp on content. My results reflected that I am an active learner. I use a â€Å"Let’s try it out and see how it works,† study mentality. The questionnaire also reflected that when it comes to sensing and intuition I am a little bit of both. I like learning facts as well as theories. I have discovered through this questionnaire that  I am also well rounded when it comes to being a visual and verbal learner. Visual and verbal learning is the primary method of learning in today’s school system. I believe I reflected being fairly balanced in both because this is the learning style I’ve known based on the teaching style offered. Last, the questionnaire showed me that I am a sequential learner as well as a global learner. This result is accurate because different topics require a different way to complete or learn them whether it is step by step or absorbing bits and pieces to get the big picture. I have always known that I learned things better through hands-on experience. After taking both evaluations I realized I actually prefer many different learning styles but I am predominately a kinesthetic or active learner. I am sure this has changed many time based on my situation. Understanding what style works best for me is the first step in success. Being a physical learner will make taking online classes a bit difficult because online learning isn’t a hands-on kind of learning environment. My style may change throughout this course based on the situation or I will adapt my current learning style to somehow work with this environment. Throughout life we evolve and adapt to the different situations we are put in. This type of evolution occurs when it comes to our learning styles. As learners we adapt to the learning environment because it is more likely that our learning style will change before the teaching style changes. Every individual has a preferred learning style that works best for them based on their current situation. Each and every one of us is different and every different person has a different situation from the other which brings us to the conclusion that everyone has a different learning style. References Bixler, B. (2010). Learning style inventory. Retrieved from http://www.personal.psu.edu/bxb11/LSI/LSI.htm Felder, R. M., Soloman, B. A. (n.d.). Index of learning styles. Retrieved from http://www.engr.ncsu.edu/learningstyles/ilsweb.html Reiner, C. Willingham, D. (2010). The myth of learning styles. Retrieved from http://www.changemag.org/Archives/Back%20Issues/September-October%202010/the-myth-of-learning-full.html

Management of Self-harm Patients in AE

Management of Self-harm Patients in AE The acute incident was a case of ‘deliberate self-harm’ (DSH), admitted to an A E unit. DSH incorporates deliberate non-habitual acts of self-harm that are not fatal, and may or may not involve attempted suicide (Repper, 1999). Emergency departments provide the main ‘entry point’ for such patients (NICE, 2004). The patient in this case had slashed his wrists in several places, severing a key artery. He was bleeding profusely, and in a semiconscious state on arrival. There was a history of psychopathology dating back several years. He was unmarried, lived alone, and had recently undergone treatment and observation at the forensic mental health unit of a local NHS Hospital Trust. Reppers (1999) review of the relevant literature on the management of self-harm patients in A E units highlights several key issues for nursing care. It is essential that the qualified nurse is cognisant of the relevant Codes of Professional Conduct specified by the Nursing Midwifer y Council (NMC, 2002), including ethical concerns such as respect, confidentiality, and trust. This is particularly crucial when dealing with self-harm patients because research suggests that emergency department nurses often hold negative attitudes towards this type of patient (McAllister et al, 2002). Furthermore, self-harm patients have reported dissatisfaction with the care provided by nurses and other health care staff. The empirical literature on the management of self-harm patients in A E highlights the value of problem-solving approaches to patient care (Repper, 1999). The basic problem-solving model incorporates five principles, outlined in Table 1. These tenets are consistent with protocols for effective decision-making, for both individuals and groups (Janis Mann, 1977). They are also consistent with NICE/DOH guidelines for caring for the mentally ill (NICE, 2004, Clinical Guideline 16). NICE guidelines recommend immediate assessment of risk, and mental, physical, emotional stability, once a patient arrives at A E. Staff are then required to account for underlying emotional factors that may have precipitated the self-harm episode, as well as evaluating the seriousness of the injury, before deciding the most appropriate treatment for the patient. Reesal et al (2001) highlight some of the key principles of management that are relevant to nurses working with mental health patients. These relat e to assessment, phases of treatment, psychiatric management, goals of treatment, psychotherapeutic management, the management of medication and self-harm/suicide, and medical-legal issues (also see DOH, 1999; NICE, 2004). Nurses need to conduct a comprehensive psychosocial assessment, in full cognisance of the biological, psychological, and social context, and also precipitating and perpetuating factors. Mental health problems can often be long-term/chronic, rather than short/acute, and self-harm is no exception. An underlying condition like depression can be conceptualised in terms of three treatment phases – response, remission, and relapse. Principles of psychiatric management dictate that consent must be obtained prior to treatment. A good psychiatric-patient rapport is essential, and treatment must involve a multidisciplinary team, of which nurses are an essential part. Goal setting is paramount as it facilitates the development of a treatment plan and allows the patien ts progress to be evaluated more accurately. Psychotherapy can be based on any one of several models (e.g. cognitive-behavioural, interpersonal, dynamic). Recovery must be closely monitored – patients who have not recovered within 2 months may require a change in treatment modality. Some knowledge of pharmacology is essential for effective medication management, but it is usually up to a psychiatrist to prescribe the necessary medication. In managing suicide/self-harm cases, it is important for the nurse to establish whether the patient â€Å"feels desperate, hopeless, helpless, or is tired of struggling with life. Has the patient not wanted to go on living? Is there active suicide ideation? How strong are the thoughts? How frequent, persistent, and irresistible are they? Is there a plan? Do the means and opportunities exist? How impulsive is the patient?† (Reesal et al, 2001, p.25S). Since self-harm episodes are generally unpredictable, there are bound to occur irrespective of psychosocial assessments and psychiatric management. Salient issues for inpatient management (see Table 2) include safety, crisis intervention, di agnosis, patient response to treatment, level of depression, inability to live effectively at home, and the level of social support (i.e. friends, family). Medical-legal issues include confidentiality, risk assessment, information sharing, truth telling, and liability. Some of these are considered later in this essay. Overall, patients must believe they are receiving equity, justice, and consideration, and that clinical management is set up to facilitate good quality care. Ethical and legal issues in the management of mental health patients are outlined in the Nursing and Midwifery Council’s codes of conduct (NMC, 2002), the National Service Frameworks (NSF) Modern Standards and Service Models for mental health patients (DOH, 1999), and the National Institute for Clinical Excellence (NICE, 2004). There is currently strong emphasis on evidence-based nursing practice (NICE, 2004). Clinical decisions, where possible, should be based on good quality empirical research. The NICE Clinical Guidelines No.16, for the care of self-harm patients, are rooted in scientific evidence. It is therefore incumbent on nurses to ensure that decisions about all aspects of patient care comply with these standards. Thus, for example, nursing staff are compelled to consider using an integrated physical and mental health triage scale, establish physical risk and mental state, and offer psychosocial assessment at triage. The problem here concerns the practical realities of guidelines adherence in a busy A E unit. Due to time constraints and hectic work routines, nurses may be unable to check adherence to standards. Senior nurses may rely more on their clinical experience in certain instances, whereas younger nurses finding it easier to consult colleagues for clarification, rather than locate and check practice standards. While guidelines will help ensure that this patient receives good quality health care, nurses and other health professionals will ultimately responsibility for clinical decisions. It is therefore essential that staff are adequately trained and resourced to make informed choices that are in the best interests of the patient. Decision theorists Janis and Mann (1977) propose that such informed decision making requires that a viable clinical solution is perceived to be available, to deal with the patients problem, and that there is adequate time in which to find it. If a nurses is uncertain what to do, perhaps due to inadequate training, lack of guideline information, or unfamiliarity with self-harm patients, then he or she may resort to ineffectual decision strategies, such as delaying treatment, looking for another nurse to take responsibility, or even discounting the severity of the patients condition. Time constraints can be a serious problem in emergency depart ments, where patients arrive with life-threatening injuries, and nurses are required to make multiple clinical decisions, in quick succession. Severe time limits may induce panic or frantic behaviour in clinical staff, leading to hasty clinical decisions that fail to account for all aspects of the patient’s clinical condition. In 2005 the Department of Health published its Patient Led NHS (DOH, 2005). Central to this discourse is the notion of empowerment – enabling patients to have more say in clinical decisions about their care, by providing them with the all relevant information, support, and guidance. This is consistent with the 1983 Mental Health Act which states that patients are provided with all necessary and correct information by an informed health care professional, for example on the nature, purpose and probable effects of treatments, and detention, renewal, and discharge. Thus, the patient in A E will have to be treated accordingly by nursing staff. The Department of Health has encouraged the faster emergence of best practice guidelines (DOH, 2005), as this is key to successful empowerment. Currently there are no commissioned best practice statements for the care of mentally ill, or specifically those who self-harm. Since the devolution of responsibility from health authorities to loca l primary and secondary care trusts (DOH, 2002a, 2002b), nurses have assumed greater responsibility implementing national guidelines on mental health. An important part of this empowerment is to liase or network with relevant multidisciplinary professionals, agencies, and local communities. Nurses working in mental health view networking as a major area of responsibility (Rask Hallberg, 2005). Thus, emergency department staff dealing with this particular will be required to contact social services, and the patients’ GP/PCT, friends, family, employment, and other relevant parties. Where necessary, partnerships can be set up, for example with local primary care or social service units, to arrange particular aspects of care, such as home visits, 24 hour access, and development of care plans. The NMC Code of Professional Conduct (NMC, 2002) states that nurses are to behave in a way that enhances trust and confidence in the patient. In other words it is incumbent on a nurse to be truthful and keep his or her patients’ confidence (Tschudin, 1992; Rumbold, 1999; Reesal et al, 2001). Yet in reality this may pose a very difficult ethical dilemma. During psychosocial assessment nurses often need to obtain personal information from the patient, information that the patient will not normally share with anyone. Patients may divulge information on the understanding that it would be kept in confidence. However, serious problems arise if a patient expresses an intention to reattempt self-harm, or even suicide. Is it ethical for the nurse to share this information with other staff and relevant authorities? The NMC (2002) Codes of Conduct are inherently contradictory, because on the one hand they require nurses and midwifes to â€Å"protect confidential information† (p.11 ), but on the other hand mandate that staff â€Å"must act to identify and minimise the risk to patients and clients† (p.11). Crow et al (2000) argue that effective handling of this dilemma requires an understanding of the patient’s own cultural background and general worldview. It is essential for a patient to sign release forms stating that he or she wishes to be present during information-sharing, and takes responsibility for the clinical consequences of such information. Nurses must take extra care when dealing with patients whose cultural backgrounds denotes different understandings of truth and presents linguistic barriers, â€Å"Frequently, when patients from other cultures are asked if they understand something, they nod yes and smile amicably. However, do they really understand what is being stated.., and does it make sense from their cultural perspective of truth?† (Crow et al, 2000). A break down of trust, through truth telling without consent, may aggravate the patients’ psychological state, precipitating the very outcomes the nurse is trying to prevent. And trust can be difficult to generate if nurses fail to develop a good rapport with patients. Long (1998) points out that nurses are often expected to apply nursing models, such as the Activities of Daily Living (ADL) (Rask Hallberg, 2000), in developing and executing a care plan. Such frameworks of care seem at odds with experiences of someone who wishes to commit self-harm a nd possibly suicide. Normal daily activities would be anything but ‘normal’. Moreover, the application of academic models to such situations creates a sense of detachment from the patient, so that an â€Å"‘I-It’ relationship, takes priority over the person in need of care, and in need of developing a therapeutic ‘I-thou’ relationship† (p.5). RISK ASSESSMENT STRATEGIES NICE (2004) guidelines stipulate that self-harm patients undergo a comprehensive risk assessment. This must include an identification of the fundamental clinical and demographic factors that are implicated in the risk of further self-injury. According to Reesal et al (2001) these may include staff attitudes, the presence of anxiety, agitation, panic attacks, persistent global insomnia, anhedonia and poor concentration, feelings of hopelessness/helplessness, substance abuse (alcohol, drugs), impulsivity, being male and aged between 20-30 years or over 50 years, or female aged between 40 and 60 years, being older, having a history of self-harm or suicide attempts, and/or a family history of self-harm, or suicide attempts. The NICE (2004) also require an identification of depressive symptomatology. Nurses carrying out risk assessments must always use a standardised risk assessment scale. Decisions about referral, discharge and admission are partly based on the outcome of risk evaluation s. Crowe and Carlyle (2003) argue that risk assessment in mental health care reflects a form of clinical governance, driven more by organisational, financial, political, and legal considerations, than by concern for patient welfare. For example, risk assessment forms part of professional standards for nurses, and failure to adhere to this requirement in patient care increases clinician liability if a patient (or their family) decides to sue for negligence (Samanta et al, 2003). The result is that the welfare of the patient may not be accorded the priority it deserves. QUALITY ASSURANCE Central to quality assurance is the notion of clinical governance (Ayres et al, 1999; NHS Executive, 1999; Hungtington et al, 2000). The purpose of clinical governance is to maintain the quality of service delivery. This is particularly crucial in A E units, where critical incidents, such as the mismanagement of a badly injured self-harm patient, can easily lead to death. As Huntington et al (2000) point out, this situation, combined with a proclivity for staff to protect their reputation, can engender a culture of blame, scapegoating, and secrecy, all of which may hinder improvements in the quality of patient care (NHS Executive, 1999). Governance typically entails organisational change, from a ‘blame culture’ to a ‘learning’ orientation. Of course such change is subject to the usual organisational restraining factors that Kurt Lewin (1951) refers to in his model of change. These include excessive staff workloads, a â€Å"not another cha nge† attitudes, and general reluctance to give up ‘tried and tested’ practices, time constraints, and patient inconvenience. The critical issue in an A E is whether staff consistently adhere to professional standards of care, as prescribed by NICE (2004), the Royal College of Psychiatrists, and the National Service Framework for Mental Health (DOH, 1999). Nurse attending to a self-harm patient will need to ensure that they are familiar with these guidelines before attending to the patient, or at least have quick assess to relevant information, and/or are supervised by a more experienced colleague with better knowledge of professional standards. This is essential as failure to adhere to professional standards has major legal implications (Samanta et al, 2003; Wilson, 1999). Although clinical governance leaders within acute and community NHS trusts have a responsibility to ensure that nursing staff deliver good quality care, such governance can only be effective wi th adequate resourcing (Huntington et al, 2000). For example, there needs to be clarity from professional bodies about best practice (there are currently no best practice statements for the care of mentally ill/self-harm patients), as well as support from health authorities, and clinical governance leaders at regional office, professional, and local district levels. This essay considers nursing issues in the management of a self-harm patient admitted to an emergency department unit of an NHS Trust. Salient issues for the qualified nurse include ethical dilemmas, associated with conflicting codes of conduct, important management issues relating to assessment, diagnosis, psychological and medical treatment, in-patient care, and medical-legal considerations. Nurses now command greater empowerment in the modern NHS, and but must somehow adhere to strict professional standards, while simultaneously exercising good clinical judgement. Additionally, they must also manage to overcome the unique clinical and psychological circumstances of deliberate self-harm. Support from clinical governance leaders, and adequate training in management, decision making skills, and clinical practice, are essential, if nurses are to delivery high quality patient care References Ayres, I.L., Cooling, R. Maughan, H. (1999) Clinical governance in primary care  groups. Public Health Medicine. 2, pp.47-52. Crow, K., Matheson, L. Steed, A. (2000) Informed consent and truth-telling:  cultural directions for health care providers. Journal of Nursing  Administration. 30, pp.148-152. Crowe, M. Carlyle, D. (2003) Deconstructing risk assessment and management in  mental health nursing. Journal of Advanced Nursing. 43, pp.19-27. DOH (1999) National Service Framework for Mental Health: Modern Standards   Service Models. London: Department of Health. DOH (2002a) National Service Framework: A Practical Aid to Implementation in  Primary Care. London: Department of Health. DOH (2002b) Improvement, Expansion Reform – the next 3 Years: Priorities and  Planning Framework 2003-2006. London: Department of Health. DOH (2005) Patient Led NHS. London: Department of Health. Horrocks, J., House, A. Owens, D. (2004) Establishing a clinical data base for  hospital attendances because of self-harm. Psychiatric Bulletin, 28, pp.137-139. Huntington, J., Gillam, S. Rosen, R. (2000) Clinical governance in primary care:  organisational development for clinical governance. British Medical Journal.  321, pp.679-682. Janis, I.L. Mann, L. (1977) Decision Making: A Psychological Analysis of Choice,  Commitment. New York: Free Press. Lewin, K. (1951) Field Theory in Social Science. New York: Harper Row.   Long, A., Long, A. Smyth, A. (1998) Suicide: a statement of suffering. Nursing  Ethics. 5, pp.3-15. McAllister, M., Creedy, D., Moyle, W. Farrugia, C. (2002) Nurses attitudes  towards clients who self-harm. Journal of Advanced Nursing. 40, pp.578-586. NICE (2004) Self-Harm: The Short-Term Physical and Psychological Management  and Secondary Prevention of Self-Harm in Primary and Secondary Care  Clinical Guideline 16. London: National Institute for Clinical Excellence.   NHS Executive (1999) Clinical Governance in the new NHS. London: NHS  Executive (HSC 1999/065). NMC (2002) Code of Professional Conduct. London: Nursing Midwifery Council. Rask, M. Hallberg, R. (2000) Forensic psychiatric nursing care – nurses  apprehension of their responsibility and work content: a Swedish survey.  Journal of Psychiatric Mental Health Nursing. 7, 163-177. Reesal, R.T., Lam, R.W. the CANMAT Depression Work Group (2001) Clinical  guidelines for the treatment of depressive disorders: Principles of Management  II. The Canadian Journal of Psychiatry. 46 (Suppl 1), pp.21S-28S. Repper, J. (1999) A review of the literature on the prevention of suicide through  interventions in Accident and Emergency Departments. Journal of Clinical  Nursing. 8, pp.3-12. Rumbold, G. (1999) Ethics in Nursing Practice (3rd edition). London: Balliere Tindall. Samanta, A., Samanta, J. Gunn, M. (2003) Legal considerations of clinical  guidelines: will NICE make a difference? Journal of the Royal Society of Medicine. 96, pp.133-138. Tschudin, V. (1992) Ethics in Nursing: The Caring Relationship (2nd Edition).  London: Heinemann. Wilson, J. (1999) Best practice guidelines. British Journal of Nursing. 8, pp.293-294.

Marriage in Shakespeares The Taming of the Shrew Essay -- essays rese

Marriage is presented in Shakespeare?s play The Taming of the Shrew, in a complex manner allowing readers to view the play literally as a brutal taming or ironically as a subversive manifesto. Yet, Shakespeare intends to present marriage to be full of mutual love where neither male nor female dominate but compliment each other thriving together in a loved filled relationship. The portrayal of a deep understanding, which exists in an analogical relationship and the gentle transformation, which occurs in marriage, clearly outlines marriage in the play to be a celebration of a mutual love relationship within the patriarchal foundations of society. Initially, Shakespeare highlights the importance of transformation in a relationship in order for it to be of mutual love where both the male and female transform each other for the better. In the play, Petruchio takes this role but he doesn?t brutally tame Katherina, but rather tenderly teaches her in order to liberate her from her shrewish mindset. Petruchio begins teaching Katherina immediately on her wedding day where he proudly walks in late in strange, informal apparel. When questioned he replies, ?To me she?s married, not unto my clothes (3.2)? symbolizing to Kate and the audience of how appearances can be deceptive and that he truly loves her underneath and bears no brutal intentions of abusing her. Despite Petruchio living in a patriarchal society he never abuses his power and even as he starves his wife he states, twere better that both of us did starve (4.1).? This line spoken by Petruchio distinctly outlines that the play is not a celebration of patriarchal power as ?both ? symbolizes that both must suffer in order for a successful transformation to occur. Petruchio?s ideolo... ...es the mutual understanding between her and Petruchio and emphasizes the reciprocity of duty in a marriage of mutual love and understanding. Thus, Shakespeare outlines how a unique understanding within the relationship guarantees the play to be one showing both genders to love and compliment one another?s virtues. In conclusion, Shakespeare?s play The Taming of the Shrew distinctly portrays marriage to be full of mutual love and understanding where neither gender dominates. Hence, views of masculine brutality and feminine subversion are dislodged by the analogical love-filled relationship between both genders. The relationship between Katherina and Petruchio is exactly this, where mutual love is not only presented, but rather celebrated by Shakespeare who declares that such a successful marriage can exist anywhere ? even in the patriarchal framework at the time.

Don DeLillos White Noise :: Free Essay Writer

Don DeLillo's White Noise WHITE NOISE is probably Don DeLillo's most popular novel, largely because most readers see it as DeLillo's warmest and most human book. In this story, the ideas that seem to captivate DeLillo are fleshed out in real life in a way that none of his other books quite achieves. Of course, there are a few stubborn souls (like me) who still feel THE NAMES, or one of his other books is better. But I think everyone agrees, WHITE NOISE is a winner. It won DeLillo the National Book Award in 1985, and it also won a larger reading audience for a great American writer. DeLillo has said that Ernest Becker's THE DENIAL OF DEATH was a book that influenced him at the time he wrote WHITE NOISE. There's certainly no denying that death, and the many things we do to avoid facing it, is a major focus of DeLillo's novel. Becker's book, which won the Pulitzer Prize for General Nonfiction in 1974, has as it's thesis the assertion that "the idea of death, the fear of it, haunts the human animal like nothing else; it is a mainspring of human activity---activity designed largely to avoid the fatality of death, to overcome it by denying in some way that it is the final destiny for man." Becker's point is that this is *the* driving force in the human psyche today...which I think is overstating the matter a bit...but it certainly is a reality that all of us face in some way, sooner or later. As I looked through Becker's book last month, I was surprised to discover that it's actually an exposition of the work of Otto Rank. Rank was the third of the three famous defectors from Freud's inner psychoanalytic circle early this century (the others being Alder and Jung), and he's known in the literary world to a certain extent because of his intimate involvement with Anais Nin. Like Jung, Rank developed a psychology of mythology and religion...and, in particular, Rank's emphasis was "The Hero" motif. This is what Jung called "the puer aeternus" (or the female "puella")---the eternal youth...who never ages...who never dies...to whom death is nothing. In psychology, this idea is linked closely with that of narcissism, which is considered prevalent in society today. Just look at all the things we do to avoid the appearance of aging! Jack Gladney is, at best, an unlikely Hero, I think.

Maturation in Bless Me, Ultima Essay -- essays research papers

In Bless Me, Ultima, Rudolfo Anaya defends the assertion, â€Å"for in much wisdom there is much grief, and increase of knowledge is increase of sorrow,† from Ecclesiastes. Tony endures many trials throughout the novel, therefore increasing his knowledge of life but also increasing his grief and sorrow. After witnessing Lupito’s death, Tony realizes that people are not always what they appear to be. Tony also begins to question his religion because of trials in the novel, some of which include Lucas’ cure and the sighting of the golden carp. In his trek during the blizzard, Tony learns of his brother’s sinful doings and he witnesses the death of a good man. Tony gains much knowledge in these scenes, but, unfortunately, with this knowledge comes grief. Lupito’s death marks the first scene in the novel in which Tony’s grief is a direct consequence of his knowledge. Tony’s naivetà © causes him to take people at their face value, not realizing that they may not be as they seem. Narciso is the town drunk, yet he is the only man on the bridge that maintains his common sense. â€Å"’I...

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Summary of the story Weekend is a short feminists story depicting traditional middle-class family, consisting of the mother- Martha and the father of three- Martin, going for the weekend to their cottage near Stonehenge, where they will meet their friends. On Friday, Martha is preparing some things, food and complaining Nearly) about her life. Martin wants her to be perfect, as she says â€Å"he Likes women with small hips and big bosoms, that's Incredible. † She has a suspicion that her husband has an affair with his secretary, who looks exactly that way.Martin has a small sport car, but they take Marsh's car for the trip, since it is bigger, although it is the older one. Martha can ‘t drive, because her driving license was taken away for drunken driving. The whole Journey, Martin Is Joking about the car, but Martha takes It personally, whilst she has got the feeling, he Is ambiguously talking about her. Late at night, their friends- Colic and his girlfriend Katie, arri ve to visit them in their cottage. His previous wife, Janet with whom he has two children, was a nice woman and Martha liked her, however she was not so stunning like the new one.Martha prepares mushroom omelets In her night, sets the table, cleans everything after the late supper and goes to bed at 2 a. M. Katie sits and has a good time, without any intention to help her. The other day Martha sleeps longer than usually and has the consumptions, because everything in the kitchen stays exactly in the same place, where the consumers had left It. She should ‘t sleep so long. Glamorous Katie did not help with anything. Again. The rest of their friends, Harry and Beryl, come for the lunch. They bring fresh artichokes. Ill Martha Is preparing the artichoke soup, the top of the blender flies away and the kitchen is full of artichoke puree. Awkward Martha. Jenny starts her first period and Martha is impressed and cries. She is not her little child anymore, but a little woman. To sum u p the story, a woman must be always perfect. Great wife, mother, babysitter, awesome cook, successful careerist, best friend, psychologist, teacher, doctor, dishwasher, cleaner with bottomless sexual appetite. While exhaustion, influenza, migraine or other illnesses are mission impossible.And naturally, you would do it all in high heels, scented, with exquisite hair, flawless make- up and smile on your face. 2) Characteristics of the mall characters wants to be a perfect woman and tries to manage everything, what in her eyes woman should manage; however, her husband does not see that. She feels undervalued by him as long as he is criticizing her and looks back to the other women, young, childless, with big bosoms and little hips. She is also helping pretty much with house expenses, the thing, she's not very satisfied with, because a good husband of his good wife should manage that.Martin- husband of Martha; iconic example of a man who comes home, extremely exhausted after all day in work and awaiting the house to be clean, children calm and that his wife will be neat, scented, smiling and ready to make him a supper according to his wishes. He is not satisfied with his wife. She should be slimmer, nicer, make healthier meals, and use plenty of perfumes he keeps buying her. Jenny, Jasper, Colony- children of Martha and Martin. We don ‘t know much about them. Jenny dries off her hair with Katie ‘s Yves Saint Laurent towel and gets the erred for the first time at the end of the story. Jasper has hay fever.Katie- a glamorous, childless, scented chick in her middle thirties; kind of a â€Å"modern wife†, who came to the relationship with one bag of clothes, intelligence and free mind. Colic- boyfriend of Katie, he loves her very much and wants to marry her. He has two children from the previous marriage. Katie does not like his ex-wife Janet and their children; he can meet them Just once per month. He is a successful businessman. Harry and Beryl- friends of Martin and Martha; Beryl is a secretary and Harry is an artist. She falls asleep during the visit and Harry gets drunk and is going to drive. He has scar on his temple from the car accident.Mrs†¦ Hooded- came in twice a week to clean and Martha paid her from her wages 3) The story is described from Martha ‘s perspective. Would it be the same, if the narration would be done by Martin? No, definitely. It would not be the same. As far as l' m concerned, Martin perceives the whole situation completely differently than Mart does. He is looking onto problems and situations with a â€Å"man's eye†. He does not feel that Martha does too much around the house, children etc. He feels that she should cook better, have smaller hips and try to be fresher. 4) What are Martha ‘s main worries? Why does she obey Martin in everything?Why does she never object? She wants to be an amazing wife of her great husband that's why she obeys him. She feels that it is her dut y in the role of a woman, mother and wife to behave that way. She is afraid of losing of Martin and fail in all her roles. Martha cannot imagine her life without a husband – she does not realize she could live a different life, because this is what she knows. That is why she is trying to keep Martin at all costs although she is not happy with him. Martha is a prototype of housewife and Katie is her opposite. Martha has a husband, three children and her family is something sacred for her.But she works and keeps her own money that means, she can get by from her wages. Katie has different attitude to these things. She hates to be in the traditional position of a woman, like Martha is. Katie is divorced twice and doses t have children. From my point of view, she is that kind of woman, who needs husband to take care of her in general, mostly from the viewpoint of expenses. Although Katie appears as a confident woman, we also witness her insecurities – she realizes that Coli c is tied to Janet because they have children together and that her position might not be that stable. ) How is the story narrated? Are there long descriptions or dialogues? Why not? The story is narrated as Mart ‘s train of thought. Her mind is important. She is describing the situations from subjective point of view, not like the omniscient narrator. There are no long descriptions, nor dialogues, because they are not necessary (and Martha does not have time for them since she rushes from one task o another – so the narration reflects her state of mind); the reader understands from the situations the whole context. Anyway the direct speech is used for being more authentic.Her descriptions make the story more personal than the universal third person narrator or â€Å"the eye of the camera†. If any woman reads it, she finds herself in many similar situations and that is the aim, to personalize the story and give the percipient the space to make his point of view a bout the piece and given problem. 7) Look at Martin ‘s comments which are inserted in the brackets. What do they suggest? They suggest Martin's dissatisfaction or ironical view on Martha and her acts. They are not formulated as direct criticism, but are rather indirect.Though he might appear as a kind husband, Martha takes his remarks personally as a form of criticism and thus puts even more pressure on herself. 8) What is author's opinion on women like Martha? Who is responsible for their unhappiness- is it men or the women themselves? A woman should love her family and her husband, but should not obey him in the way like Martha did. She gave her win â€Å"Self† and life to her family, but doses ‘t get it back from them. She doses t feel intrinsic fulfillment, which she should feel, living this pattern of life.They are both responsible for their unhappiness – males and females. Because if Martha doses ‘t want to, she din ‘t have to behave this way. As long as, we are concerning on feminist fiction, then men are responsible for the woman's unhappiness 0. Weldon is critical not only to men, but to women as well. She points to the fact that they have power in their hands and they should be active in pursuing happiness. Martha, forever, only relies on her husband, not on herself so it is her own fault that she leads an unhappy life. ) Why does Martha cry at the end of the story? Because her only daughter is becoming a woman. From this important hoar stone in her and they will cause troubles to her woman being and gain control over her whole life, like Martin does to Martha. Martha realizes that her own daughter is now entering the period of womanhood with all its responsibilities. The ending also shows that Martha feels powerless and does not realize that her own daughter does not have to have the same life as she does.