Friday, February 7, 2020
Ethics of Gene Therapy - Case Study Example The term cloning encompasses three different procedures leading to different results. These are embryo cloning (artificial twinning), adult DNA cloning (reproductive cloning) and therapeutic cloning (bio medical cloning). Of these three, therapeutic cloning seems to hold the maximum potential to breed humans (read human cloning). Human cloning is most aptly described as breeding humans for the purpose of harnessing tissues and organs from their bodies. Therapeutic cloning begins with the insertion on a human DNA into an ovum. A pre embryo is formed by giving electric shocks to the resultant ovum. The stem cells from the developed pre embryo are then extracted and subsequently provided an suitable environment where they develop into the required tissue or organ. These experiments are yet to produce any significant results. Once accomplished, the aim of developing organs or tissues which perfectly match with the recipient will be realized eliminating the fatal risk of rejection because the organ will be based on the recipient's genetic material. Human cloning is also expected to make new breakthroughs in rejuvenation, heart attack reversals, diabetics, leukemia, genetic disorders and even cancer. Despite the broad spectrum of benefits that human cloning offers, according to a poll, "63% believed that human cloning is against God's will and 90% considered it to be a bad idea" (Times, 2001). A Morgan poll conducted during November 2001 found that 70 percent of Australians aged 14 and over approved of extracting stem cells from human embryos to treat disease and injury. Seventy percent also believed that couples with excess embryos after infertility treatment should be able to donate them to research rather than discard them. However, when it came to using a patient's own genetic material to create a cloned embryo to be used as a source of stem cells (i.e. therapeutic cloning), just over half (55 percent) of the respondents approved, with 32 percent disapproving and 13 percent undecided (Morgan Poll, 2001).Animal cloning application as a regular process should be prevented and breeding of humans should also be strongly opposed to maintain the natural uniqueness of each individua l (Church of Scotland, 1997). These objections are not absolutely without any reasons. They do have apt explanations and sufficient grounds. Human cloning would produce a gamut of clones with reduced mental abilities and enhanced physical strengths which would make then highly susceptible to exploitation. Producing designer babies with enhanced skills would also lead to an excess of skilled persons thus decreasing the importance of talent and skill. Human cloning may also lead to emotional difficulties in the clone human's life. A child born from his father's DNA would in effect be a twin of his own father. This can also lead to a high degree of conundrum. There is no guarantee that human clones would be normal and they might even be suffering with life long disabilities. Any minor flaws while incorporating certain characteristics could as well create fictional monsters. Tampering with nature to an
Wednesday, January 29, 2020
Crystals Research Paper Essay Crystals form in the depths of the Earth to the extension of the clouds in sky. Some think that crystals elude the sight of peopleÃ¢â¬â¢s eyes everyday in life, but they are everywhere including ingredients for food, construction materials, and even in ice-cold weather. The crystals in this experiment are ammonia-generated crystals that can be created right in a home. The experiment will be testing the different effects and products on crystals in different temperatures and forms of light. Different measurements will be recorded throughout the experiment such as mass and length. But first the crystals must grow. The scientific study of crystals and crystal formation is called crystallography. All over the world, though the different ages of man, crystals have been found to take their place throughout different cultures, countries, and religions. Not only were crystals used for a part in the currency of some ancient economies, but also they date back as far as 1500 BC as a source of healing and medicinal uses. Ã¢â¬Å"The ancient Egyptians strongly believed in the healing and protective power of crystals. Many pharaohs wore crystals on their headdresses and many crystal amulets have been found in their tombs.Ã¢â¬ Pharaohs of ancient Egypt often believed that the use of crystals in the masks and jewelry gave them the effect of bettering their rule. Amazonite and Lapis were reoccurring crystals found in the tombs found in Egypt, particularly King Tut where Lapis was actually apiece in the famous mask he wore. CleopatraÃ¢â¬â¢s favorite jewelry was supposed to be a ring made of the crystal am ethyst. The ancient Chinese are also found to be users of the healing purposes of crystals. In two hundred different occasions, crystals are referred to in the bible. New Jerusalem, GodÃ¢â¬â¢s heavenly city, was said to be built on top of crystals. Ã¢â¬Å"And the building of the wall of it was of jasper: and the city was pure gold, like unto clear glass. And the foundations of the wall of the city were garnished with all manner of precious stones. The first foundation was jasper; the second, sapphire; the third, a chalcedony; the fourth, an emerald; The fifth, sardonyx; the sixth, sardius; the seventh, chrysolite; the eighth, beryl; the ninth, a topaz; the tenth, a chrysoprasus; the eleventh, a jacinth; the twelfth, an amethyst. Tibetan monks also viewed quartz crystal spheres as holy objects and worshiped them. The monks often referred to quartz as the Ã¢â¬Å"crystal of enlightenmentÃ¢â¬ . Alexander The Great included a large emerald crystal encrusted in his battle helmet to insure a victory in the battle. The Shah Jahan, monks who built the Taj Mahal, wore talismans similar to Alexander The Great. Overall, There is a reoccurrence of crystals used for different purposes such as healing, sacred items, and fine jewelry. There are many different structures of crystals based on the formation of them. The different forms are Cubic, Isometric, Tetragonal, Orthorhombic, Hexagonal, Trigonal, Triclinic, and Monoclinic. Cubic and Isometric are similar but donÃ¢â¬â¢t always have to be cubes. They can be found in forms of octahedrons and dodecahedrons as well as cubes. Tetragonal form double prisms and double pyramids due to one axis being longer than the other. Orthorhombic form dipyramids and rhombic prisms. Hexagonal are six-sided prisms and when viewed from a certain angle, the cross section is a hexagon. Trigonal, instead of having a 6-fold axis like the hexagonal, it has a 3-fold, thus making it trigonal. Triclinic has no set shape so these kinds of crystals can come in any shape and strange ones as well. Monoclinic are very similar to tetragonal crystals except they are skewed a bit so they donÃ¢â¬â¢t form good angles. These formations of the atoms and molecules in a crystal are all part of what is called the crystal lattice. The crystal lattice is the repetition of a pattern in three dimensions. The atoms and molecules of crystals form in such a way that in all three dimensions, they are repeating a certain pattern. The shapes of the microscopic atoms can determine the shape of the macroscopic crystal. So, Cubic, Isometric, Tetragonal, Orthorhombic, Hexagonal, Trigonal, Triclinic, and Monoclinic atom formations repeat in different crystals to make them the shape they are. Crystals can also be grouped by their properties. The property arrangements include covalent, metallic, ionic, and molecular crystals. Covalent crystals have many true covalent bonds connecting all the atoms in the crystal. Covalent crystals tend to have very high melting points. Some covalent crystals include zinc sulfide and diamonds. Metallic crystalÃ¢â¬â¢s atoms sit on a lattice, therefore the outer electrons of the atoms in the crystal are free to move around and float whichever way they want. Metallic crystals have a high melting point like covalent crystals but just not as high. Ionic crystals are bonded together by ionic bonds just as covalent crystals are held together by covalent bonds. Ionic crystals have high melting points like the other crystals and are usually very hard. An example of an ionic crystal is salt (NaCl). Molecular crystals are very recognizable in terms of their molecular structure. They are bonding by hydrogen bonds or non-covalent bonding. Molecular crystals are usually soft and have lower melting points compared to the other crystals. Relating the properties of crystals to the atom structure (crystal lattice) will allow one to realize how the structure correlates to the property. TheyÃ¢â¬â¢re ere 2 different types of structure in the crystal lattice, crystalline and non-crystalline. Crystalline structures are the atom structures that contain the repeating patterns. While non-crystalline structures contain miniscule faults in the patterns and are not perfect. Ionic crystals contain a crystalline structure and therefore are very hard and dense. The more crystalline the structure, the more compact the atoms are arranged. And the more the compact the atoms are, the more dense and hard the crystal becomes. Molecular crystals tend to have a weak, non-crystalline structure of the atoms. This results in the Molecular crystals being weak with low boiling points. The atoms in Molecular crystal tend to be spread out over farther distances in contrast to ionic crystalÃ¢â¬â¢s structure. Different wavelengths and colors of light can affect the color of the crystal itself and the wavelength output of the crystal. Different crystals are different colors due to the different chemicals in each one and how each one absorbs light. Many crystals reflect a certain color of light depending on the chemicals. So, crystals absorb one color of light or wavelength of light, and reflect a different color of light. So the idea of complimentary colors comes into play. Complimentary colors are the colors that the crystals absorb to then reflect a different color of light. There are many examples such as if a crystal is yellow, it is reflecting yellow light but the light it absorbs is blue. Also, if a crystal is red, it is reflecting red light but it is absorbing green light. Normally, crystals will grow much faster in the light, but these crystals will be much weaker than crystals grown in the dark. This is due to the time it takes for each to grow. In dark rooms crystals grow at a much slower rate but are significantly stronger than crystals grown in light. Crystals are found all over and all inside the Earth. In some rock cavities, whether it is close to the surface or deep and closer to the core of the Earth, mineral-rich solutions contain the essential elements to grow crystals. Thus, in these rock cavities, many different crystals can be found, and some are very old. Crystals can also be found around volcanoes and past eruption areas because after a volcano erupts, the cooled magma forms crystals. In many caves, rock walls contain similar solutions as rock cavities and form similar crystals. Crystals can also be found where there are mineral-rich vapors present, such as deep caves and rock formations. Many different crystals can form in various environments. Such as the location of turbulent water such as pipes and quick paced streams. Also, crystals can be found in the presence of evaporating salt water, where salt crystals will form. Crystals are also formed in the process of condensation, or in clouds for that matter. Every time it snows, the water has frozen into microscopic ice crystals that are the snowflakes. Also, Crystals can form under water and many on the Earth have not been seen because of this. Crystals grow and form in different and various ways. Crystals begin growing in a process called nucleation, which contains 2 different types, unassisted and assisted. Unassisted nucleation occurs when a Ã¢â¬Å"proto-crystalÃ¢â¬ forms in the solution that has been added to a solute. The solute is the solid and the solution is the liquid surrounding the solute. When molecules in the solution begin to attract to one another they combine and sometimes are separated by intermolecular forces but sometimes they stay together. When these molecules stay together they begin to attract different molecules of the solution to join and this is the Ã¢â¬Å"proto-crystalÃ¢â¬ . The Ã¢â¬Å"proto-crystalÃ¢â¬ then attaches itself to a couple other molecules or other Ã¢â¬Å"proto-crystalsÃ¢â¬ in the solution and the actual crystal begins to form. In assisted nucleation, the solution is provided with a solute that the molecules of the solution can attach or adsorb to. When this occurs it attracts molecules just as in unassisted nucleation and the crystals begin to form. Because of the ability for crystals to grow from the build up of the solute molecules in the solution, crystals are able to grow at their highest when the solution being used is saturated with the solute being use. The more material to build up, the more the crystals are going to be able to grow and grow to full extent. Crystal formation is very slow, so it must be given a long geological process to form. Depending on the kind of crystal, the times of formation vary, so some form faster than others. This is where super saturation comes into play. Super saturation is the presence of more dissolved material in the solvent that could be dissolved in normal conditions. When a solution is supersaturated, it contains many particles and molecules of material to begin the nucleation process. When the supersaturated solution is under the correct conditions, crystallization begins to occur more rapidly. But this is not the case for all liquids or solutions. Some solutions may be saturated at one temperature but supersaturated at another so temperature is able to affect this as well. Temperature plays a huge part in the growth and the rate in which crystals grow. The growth rate of crystals changes depending on the temperature they are in. But some crystals grow faster in warm temperatures than in cold temperatures. This is because of the process of evaporation. When a saturated solution is in a warm environment it begins to evaporate. When the liquid begins to evaporate, overtime the material that was once dissolved in the solution will begin to bunch up and crystallize the more the liquid evaporates. But this process is a lot quicker than in cold environments so this leads to less stability and weaker crystal strength. In colder environments, the opposite process is used to begin the crystallization process. The process of precipitation is used. This process takes a much longer time than the evaporation process. Since this process takes a much longer time, it has the ability to create well formed and high quality crystals that are much stronger than crystals formed in hotter temperatures. Mainly crystals grown in the dark take much longer to grow. Because of the absence of light, there is not as much heat than crystals in light. Crystals in light receive much more heat. But this is not the case for all types of crystals; in some cases the rules for temperature are switched. For example Borax, these are crystals that usually generate faster in colder temperatures. If the Borax solution is saturated at room temperature or at any temperature higher than room temperature, the crystals grow faster in colder temperatures. This is due to the molecular structure of the Borax solution and the movement of the molecules causes the saturated solution at room temperature to become a supersaturated solution at colder temperatures. And the super saturation leads to faster crystal growth. So growth rates vary depending on temperature, kind of crystal, and kind of solution being used in the experiment. Bibliography 1.Crystal. Wikipedia. Wikimedia Foundation, 13 Dec. 2012. Web. 15 Dec. 2012. 2.History of Crystals. History of Crystals. N.p., n.d. Web. 15 Dec. 2012. 3. A Brief History of Crystals and Healing. History of Crystals and Healing. N.p., n.d. Web. 15 Dec. 2012. 4.Basic History of Crystals. Holistic Apothecary. N.p., n.d. Web. 15 Dec. 2012. 5.Types OfÃâ Crystals. About.com Chemistry. N.p., n.d. Web. 15 Dec. 2012. 6.The Structure of Crystals. The Structure of Crystals. N.p., n.d. Web. 15 Dec. 2012. 7.ScienceDaily. ScienceDaily, n.d. Web. 15 Dec. 2012. 8.Temperature and Crystal Growth. Temperature and Crystal Growth. N.p., n.d. Web. 15 Dec. 2012. 9.UCSB Science Line Sqtest. UCSB Science Line Sqtest. N.p., n.d. Web. 15 Dec. 2012.
Tuesday, January 21, 2020
An Application of Relational Dialectics Leslie Baxter and Barbara Montgomery are interested in the communication that occurs in close relationships. I am going to focus on the three relational dialects which consist of connectedness-separateness, certainty-uncertainty, and openness-closedness. These three dialects are central to Baxter's and Montgomery's theory but they want to go more indepth than previous theorists have on these specific dialects. I will discuss this theory in the context of "When Harry Met Sally." Connectedness-Separateness: Billy Crystal plays "Harry," a man who believes that women and men can not be friends. Men always have sex on their minds so it interferes with the chance to be plutonic friends with women. He shows a separateness from women because he doesn't want to get to close to Meg Ryan who plays "Sally," a woman who believes the exact opposite. Their relationship starts out with contraditions and continues throughout the movie. As years pass, they meet up with one another again and continue their argument over the relationship between men ...
Monday, January 13, 2020
A Critical Evaluation of the Engagement and Psychosocial Asessment of a Client Living with Psychosis in the Health and Social Care Practitioners Work Setting.
INTRODUCTION This assignment is a critical evaluation of the engagement and psychosocial assessment of a client living with psychosis in the community. It provides a critical and analytical account which encapsulates assessments, psycho education, problem solving, implementation and evaluation of strategies used. I will also use Gibbs (1988) model of reflection to reflect on my assessment process and how learning can be taken forward in terms of my own practice development and that of the service setting. My client l shall call Emily a pseudo name used to maintain confidentiality in accordance with the Nursing and Midwifery Council (NMC) 2002 Code of Professional Conduct that outlines guidelines of confidentiality. Emily was initially on the acute ward where l started the process of engagement with her before she was discharged under our team in the community to facilitate early discharge. Emily was suitable for psychosocial based interventions (PSI) and this was identified as part of her care plan in order to provide support in adapting to the demands of community living and managing her illness. PSI should be an indispensable part of treatment and options of treatment should be made available for clients and their families in an effort to promote recovery. Those with the best evidence of effectiveness are Cognitive Behavioural Therapy (CBT) and family intervention. They should be used to prevent relapse, to reduce symptoms, increase insight and promote adherence to medication, (NICE 2005). Emily is 33 year old woman with a diagnosis of schizophrenia. She was referred to my team to facilitate early discharge from the ward as part of her discharge. She lives in supported housing and had had several hospital admissions and some under the mental health act. Emily was being maintained in the community on medication but it was felt that there was still an amount of distress in her life and that her social functioning was suffering as a result. Emily presented with both delusional and hallucinatory symptoms and as part of her treatment cognitive approaches were considered to help alleviate the distress and modify the symptoms. Emily was brought up in a highly dysfunctional family. Both her parents had problems with drugs and the law. Emily had been introduced to drugs at an early age but due to her illness she had stopped using them at the age of 30 when she went into supported accommodation. There was family history of schizophrenia as her grandfather had it and he had killed himself. Emily identified that her problems started in 2007 when her grandfather passed away as she was close to him and had lived most of her life with her grandparents. I completed a time line to look back at while she talked about her life history (see Appendix 1). It is vital that the client is allowed to tell their story with the minimum intervention from the practitioner and the timeline can be used to examine if there are any links to their relapses and psychotic episodes (Grant et al 2004). In the community setting we have a variety of patients with different diagnosis of mental health problems. The rationale for choosing this patient is that she had had various interventions such as medication changes and a lot of experience with the mental health professionals including compulsory treatment under the mental health act (1983). All these factors are likely to have an impact on the individualÃ¢â¬â¢s degree of willingness to engage in psychological interventions (Nathan et al, 2003). Hence initially it was a challenge to engage Emily and establish a relationship and build rapport. (Nelson 1997) states rapport is built by showing interest and concern and be particularly careful not to express any doubts about what the patient tells you. The development of a therapeutic relationship is critically important in work with persons with schizophrenia, which maybe difficult with patients struggling with mistrust, suspicion and denial (Mhyr, 2004). Rapport took some time to develop and was established by core conditions of genuineness, respect and accurate empathy (Bradshaw 1995). I met with Emily to set the agenda and explained to her that she was free to terminate the session anytime should she feel it necessary. It was also vital to ensure that the sessions were neither confrontational and totally compliant with EmilyÃ¢â¬â¢s view of the world ( Kingdom & Turkington, 1995) I encouraged Emily to describe her current problems and to give a detailed description of the problems and concentrate on a more recent problem. l was directive, active, riendly and used constructive feedback, containment of feelings to develop the relationship(Tarrier et al,1998). l used her interest in Christianity to engage her and because l showed an interest this became a regular point of conversation and strengthened the connection. I also demonstrated some flexibility in response to EmilyÃ¢â¬â¢s needs and requirements at different stages of the t reatment and intervention. It is not possible to maintain a sound collaborative therapeutic relationship without constant attention to the changing situation and requirements of a patient (Gamble and Brennan, 2006). Since the development of antipsychotic medication and dominance of biomedical models during the 1950`s mental health care has changed and evolved. The dependency on the sole use of medication was found to have left patients with residual symptoms and social disability, including difficulty with interpersonal skills and limitation with coping (Sanford&Gournay, 1986). This prompted the return of PSI to be used in conjunction with medication management. The aim was to reduce residual disability and to include in the treatment process social skills and training rehabilitation (Wykes et al, 1998). As part of my assessment process l carried out a comprehensive assessment using CPA 1, 2, and 4 in conjunction with the Trust Policy. This was to establish what her problems were and formulate a clear plan. A process of structured, comprehensive assessment can be very useful in developing an in-depth understanding of issues surrounding resistance to services (Grant et al 2004). I carried out a Case Formulation (CS) using the 5W`s What? , Where? , When? , With Whom and Why, and Frequency, Intensity, Duration and Onset ( FIDO) model to explore and get a detailed explanation of the problem and explore the `Five aspects of your life experiences` (Greenberger and Padesky 1995) (see Appendix 3). CS maps out the relationship on how the environment impacts on your thoughts, emotion, behaviour, physical reactions (Greenberger and Padesky,1995). While the assessment helped to form a picture of EmilyÃ¢â¬â¢s suitability for PSI it also provided a scope for further work on her coping skills. Given the assumption that a person may feel reluctant to give a particular way of coping as this maybe the only means of control (Gamble & Brennan, 2006), the exploration was collaborative. From the assessment and case formulation EmilyÃ¢â¬â¢s goal was to go out more and reduce the frequency and intensity of her voices or even have them disappear. l explained to Emily that we had to be realistic about her set goals and having voices disappear was unlikely. Kingdom (2002) states that though patients desire to make voices disappear are unlikely since voices are, as far as reasonably established, attributions of thoughts as if they were external perceptions. Goals are positive, based in the future and specific (Morrison et al 2004) and the golden rule in goal setting is to be SMART, Specific, Measurable, Achievable, Realistic and Time Limited. Emily then rephrased her goal statement to that she wanted to reduce the intensity of her voices in the next few weeks by using distraction techniques that she had not tried before. I used the KGVM Symptom Scale version 7. 0 (Krawieka, Goldberg and Vaughn,1977) to assess EmilyÃ¢â¬â¢s symptoms which focuses on six areas including anxiety, depression, suicidal thoughts and behaviour, elevated mood, hallucinations and delusions. A KGV assessment provides a global measure of common psychiatric symptoms (feelings and thoughts) experienced with psychosis. The framework ensures that important questions are asked and a consistent measure of symptoms is provided. The KGV is a valid tool with a considered level of high reliability (Gamble and Brennan, 2006). Assessment is a process that elicits the presence of disease or vulnerability and a level of severity in symptoms (Birchwood & Tarrier, 1996). This gathering of information provides the bases to develop a plan of suitability of treatment, identifies problems and strengths and agree upon priorities and goals (Gamble & Brennan,2006). l also used the Social Functioning Scale (SFS appendix 6) (Birchwood et al,1990) which examined EmilyÃ¢â¬â¢s social capability and highlighted any areas of concern. Emily was a loner and though living in supported accommodation she was hardly involved with the other residents or joined in with community activities. She expressed that she was afraid people could hear her voices and were judging her at all times and used avoidance as a coping strategy. On using the KGV assessment and from the results (see Appendix 2) Emily scored highly in four sections hallucinations, delusions, depression and anxiety. It appeared during assessment that her affective symptoms were econdary to her delusions and hallucinations, which were initiated and exacerbated by mostly stressful events in her life. Her hallucinations were noted to be evident at certain times and were followed by sleep deprivation. Emily expressed fleeting suicidal thoughts but denied having any plans or intentions. She also experienced sporadic moments of elation which appeared to be linked to stress. It was important for Emily to understand how life events had an impact on her difficulties an d the use of the Stress Vulnerability Model SVM (Zubin and Spring 1977) demonstrated this (see Appendix 4). Practical measures arising from an assessment of stress and vulnerability factors seek to reduce individual vulnerability, decrease unnecessary life stressors and increase personal resistance to the effects of stress. One of EmilyÃ¢â¬â¢s highlighted problems was a lack of sleep and this could be linked to the stress vulnerability and her psychotic symptoms. Normalisation was used to illustrate this to Emily. Her increase in psychotic symptoms could then be normalised through discussing about the effects of sleep deprivation on her mental state and reduction of the associated anxiety. Emily was able to recognise how stress impacted on her psychosis. Emily identified the voices as a problem from the initial assessment. She was keen to talk about them but listened to suggestions l made to tackle the voices. The assumption of continuity between normality and psychosis has important clinical implications. It opens the way for a group of therapeutic techniques that focus on reducing the stigma and anxiety often associated with the experience of psychotic symptoms and with diagnostic labelling. Kingdom and Turkington(2002) have described such approaches as normalising strategies, which involve explaining and demystifying the psychotic experience. They may involve suggesting to patients that their experiences are not strange and no one can understand, but are common to many people and even found amongst people who are relatively normal and healthy. Normalising strategies can help instil hope and decrease the stigma and anxiety which can be associated with the experience of psychotic symptoms. This rationale emphasises the biological vulnerability to stress of individuals with schizophrenia and the importance of identifying stresses and improving methods of coping with stress in order to minimise disabilities associated with schizophrenia (Yusupuff & Tarrier, 1996). (Grant et al 2004). The problem l encountered when applying and using this model with Emily was that she realised and understood that she was not the only one experiencing voices but she wanted to find out why she experienced the voices. I used the belief about voices questionnaire (BAVQ-R appendix 5) which assesses malevolent and benevolent beliefs about voices, and emotional and behavioural responses to voices such as engagement and resistance (Morrison et al 2004). We identified the common triggers of her voices such as anxiety, depression and social isolation. During my engagement with Emily l emphasized enhancing existing coping strategies (Birchwood& Tarrier, 1994); (Romme &Escher 2000). The idea was to build on EmilyÃ¢â¬â¢s existing coping methods and introduce an alternative. We agreed upon distraction as a coping strategy. The plan was for Emily to listen to music or carryout breathing exercises when the disturbing voices appear and to start interacting with them by telling them to go away rather than shout at them. Emily used this plan with good effect at most times as it appeared to reduce the psychological arousal and helped her gain maximum usage of these strategies in controlling the symptom (Tarrier et al, 1990). To tackle EmilyÃ¢â¬â¢s social functioning we identified activities that she enjoyed doing and she enjoyed going to church but had stopped due to her fears that people could hear her thoughts and found her weird. I suggested that she could start with small exposure, like sitting in the lounge with her fellow residence and going on group outings in the home as these were people she felt comfortable with as she knew them. This would then hopefully lead to Emily increasing her social functioning and enable her to attend church. Emily expressed that she felt more in control of her voices REFLECTION My work with Emily was made easy as she agreed to work with me although l did face some reluctance initially. As my intervention and engagement with Emily started while she was on the ward this made it easier for me to engage her in the community. We developed good rapport and she felt she could trust me, which made the process of engagement easier. Through my engagement and assessment process l improved on my questioning and listening skills. Emily was clearly delusional at times and working with the voices present proved a challenge at times, but l realised that l had to work collaboratively with her and gain her trust and not question her beliefs. At times though l felt l was interrogating her and did not follow a format and also because of the constraints on time l did not allow much time to recap and reflect and could never properly agree the time of next meeting. I also worked at her existing strengths and coping strategies that she had adapted throughout her life and this empowered her and made her feel like she was contributing. At times though l felt we deviated from the set goals and l lost control of sessions. On reflection this is an area that l will need to develop and improve on and be able to deviate but bring back the focus to the agreed plan. My interventions were aimed at EmilyÃ¢â¬â¢s voices and increasing her social functioning. This l discovered was my target areas and not necessarily EmilyÃ¢â¬â¢s. n future l will aim at concentrating more on what the client perceives as their major problem as this will show client involvement in their care. This will also help me have a clear and rational judgement and appreciate every improvement the client makes no matter how small. I did not focus much on EmilyÃ¢â¬â¢s family which l realised was a topic that she wanted to explore but l felt l was not equipped in exploring this part of her life in relation to her illness. The other difficulties l faced was because of my working pattern l had to cancel some of our meeting appointments. As part of the set agenda l had to reintroduce myself and the plan and goals that we had set out in the initial stages and this always proved to bridge the gap. It was also difficult for continuity in the team that l work in as one did not carry a personal caseload so delivering interventions was not always easy and there was not always continuity as some of my colleagues were not familiar with some applications of PSI. This highlighted as a service that there was a need for us as nurses in the team to have PSI training in order to continue with the work if the main practitioner was away and also as a team we hardly ever sed assessment tools and were therefore not confident and competent in their use. l also had difficulties in completing assessment in time due to constricted time frames. l could not always spend as much time with Emily because l had other clients to see in a space of time. In future l will have to negotiate my time and improve on my time management. In this assignme nt l had to carry out a critical evaluation of the engagement and psychosocial assessment of a client living with psychosis and carry out a critical self reflection on the assessment process and how this could be improved on. From my case study l deduced that use of some applications of PSI remains highly experimental and requires considerable research and more theoretical models. Furthermore discussion is also lacking on the details as to ways in which symptoms improved or social functioning enhanced in behavioural terms in relation to social context. However the interventions used in this case study highlighted considerable strength in supporting claims that PSI can work and does help reduce symptoms of psychosis. REFERENCES Birchwood M and Tarrier N (eds) (1996) Psychological Management of Pschizophrenia. Wiley Publishers Bradshaw T (1995) Psychological interventions with psychotic symptoms; a review. Mental Health Nursing. 15(4) Birchwood, M, Smith, J, Cochrane, R, Wetton, S, Capestake, S (1990) The social functioning scale: development and validation of a scale of social adjustment for use in family interventions programmes with schizophrenia patients, British Journal of Psychiatry,157, 853-859 Chadwick, P, Birchwood, M, Trower ,P (1996) Cognitive Therapy for Delusions, voices and paranoia, Wiley & Sons. Gamble,C, Brennan,G (2000) Working with serious mental illness:a manual for clinical practice. Grant, C, Mills, J, Mulhern, R, Short, N (2004) Cognitive Behavioural Therapy in Mental Health Care, Sage pub. Greenberger,D, Padesky,C A(1995) Mind over mood: A Cognitive Therapy Treatment Manual for clients. Guilford Press. Krawieka, M, Goldberg,D, Vughn,M (1977) A Standardised Psychiatric Assessment scale for rating chronic psychotic patients. Acta Psychiatrica Scandinavica 1977;55: 299-308. Kingdom , D and Turkington,D (1994) Cognitive Behaviour Therapy of Schizophrenia. Hove Lawrence Erlbaum. Kingdom, D and Turkington (2002) The Case Study Guide to Cognitive Behaviour Therapy of Psychosis. Wiley. Mhyr, G(2004) Reasoning with Psychosis patients; Why should a general psychiatrist care about Cognitive Behavioural Therapy for Schizophrenia. Morrison,AP, Renton, JC, Dunn, H, Williams, S, Bentall, RP (2004) Cognitive Therapy for Psychosis, Brunner- Routledge. Nathan, P, Smith, L, Juniper, U, Kingsep, P, Lim, L (2003) Cognitive Behavioural Therapy for Psychotic Symptoms, A Therapist Manual, Centre for Clinical Interventions. Nelson H (1997) Cognitive Behavioural Therapy with Schizophrenia. A Practice Manual. Stanley Thornes. National Institute for Clinical Excellence (2003) Schizophrenia: core interventions in the treatment and management of schizophrenia in primary and secondary care, NICE publications. Nursing & Midwifery Council, Code of Professional Conduct (2002). Romme M and Escher A Eds (1993) Accepting Voices. MIND Publications Sanford T and Gournay K (1996) Perspectives in Mental Health Nursing. Bailliere Tindall. Tarrier, N, Yusupoff, L, Kinney C, McCarthy E, Gledhill A, Haddock G and Morris J (1998) Randomised controlled trial of intensive cognitive behaviour therapy for patients with chronic schizophrenia. British Medical Journal 317,303-307. Zubin, J, & Spring, B (1997) Vulnerability: A new view on schizophrenia. Journal of Abnormal Psychology, 86, Topic: Students will carry out a critical evaluation of the engagement and psychosocial assessment of a client living with psychosis in the health and social care practitioner`s work setting. Word Count: 2826
Saturday, January 4, 2020
Ch.3 dbqÃ¢â¬â¢s DOCUMENT A: * How would tens of thousands of settlers immigrating to New England with this image of their own purpose shape the development of that colony? * Winthrop wants them to be a city in which everyone can copy, and look up to. They want to be a city upon a hill, literally where they can control everyone around them. They want to be a prosperous yet very close minded estate with no religious tolerance. * What kinds of settlers arrived in Massachusetts Bay, Plymouth Plantation, and Connecticut? * The puritans and Pilgrims arrived there (New England Colony). They were very religious. Pilgrims wanted to separate from the church completely and the Puritans wanted to reform it because they wereÃ¢â¬ ¦show more contentÃ¢â¬ ¦They had small farmers, with 1-2 slaves each. * How was the environment of Virginia and the other Chesapeake colonies different from that of New England? * South was un-urbanized, had mainly farming, and no seaports. New England was very urbanized and had seapor ts, and trade. * How did this make the development of colonies along the Chesapeake different from the evolution of those in New England? * New England was focused on family and religion mostly. They donÃ¢â¬â¢t live apart like the Southern Colonies and the South were also very competitive with agriculture. * How did the rivers of the Chesapeake impact the development of communities? * South wanted to be by rivers. They then had contact with the Indians who were there, and eventually kicked them out. * Why was slavery considered a viable labor system in the colonies of the Chesapeake while it did not gain much of a foothold in New England? * They used slaves for exports and labor; New England didnÃ¢â¬â¢t need labor like the South for agriculture. * How would this impact the development of different societies in Virginia in contrast to Massachusetts? * Because of social structure and security. * They are over a hundred years apart, but what do these two paintings tell you about th e society which evolved in the puritan town of Boston against the society of a plantation in Virginia? * South was not
Friday, December 27, 2019
In chemistry, pH is a scale used to measure the relative acidity or basicity of an aqueous solutionÃ¢â¬âthat is, one in which a solute (salt, sugar, etc.) is dissolved in water. Because only aqueous solutions have pH levels, vegetable oil has no pH value. Likewise, other oils such as animal and petrochemical oils also have no pH value. Acidity as it relates to flavor should not be confused with an oils fatty acid content. Fatty acids are organic molecules often found in foods, including vegetable oils. Olive oil consists primarily of oleic acid, with smaller quantities of palmitoleic acid and linoleic acid. The purest olive oils have a very low volume of free fatty acids (less than 2%). These acids, again, have nothing to do with pH levels.
Thursday, December 19, 2019
WOOSTER Ã¢â¬â So, what will voter turnout be this year and who will show up to the polls? Those questions have election officials and political pundits scratching their heads as they try to predict who will head to the polls and who will win the presidential election Tuesday. Lisa Welch, director of the Holmes County Board of Elections, offered a big and bold prediction: 70 percent, or 12,560 of the countyÃ¢â¬â¢s 17,944 voters, will cast votes. Ã¢â¬Å"I just have a feeling,Ã¢â¬ Welch said, citing anecdotal evidence to support her hunch. A husband and wife, both in their 70s, registered for the first time this year and voted early. An 80-year-old man who never registered to vote did so this year, and his wife, who hasnÃ¢â¬â¢t voted since she cast a ballot for John F. Kennedy, voted. Ã¢â¬Å"Something is bringing them out, and I am not sure what it is,Ã¢â¬ Welch said. Julie Leathers, director of the Wayne County Board of Elections, is predicting a 55 percent turnout on election day. About 20 percent of the countyÃ¢â¬â¢s 74,797 registered voters have already cast ballots, either through mail-in or in-person absentee voting. Ã¢â¬Å"I think there is so much interest in this election,Ã¢â¬ Leathers said. Ã¢â¬Å"We have so many new registrations. People are interested.Ã¢â¬ Leathers said this election cycle is such a Ã¢â¬Å"volatile environment, and everyone is so opinionated that I think it is going to be a large turnout.Ã¢â¬ From everything Jim Bird, vice chairman of the Wayne County Democratic Party, is reading, voter turnout is expected to beShow MoreRelatedThe About Electoral System : Australia Uses Alternative Voting1496 Words Ã |Ã 6 Pages1 About Electoral System Australia uses Alternative Voting (AV), AV is where voters are asked to rank their preference for the candidates from 1, 2, 3 etc. If a candidate receives a majority than the candidate wins, but if the candidate did not get the majority than the candidate with the lowest average preference is dropped than those votes are redistributed to the next candidate with the next highest preference. This keeps on going until there is a majority. 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It appears that the peoples increasing cynicism about politicians that they lie to get elected and the perception that people have no respect or confidence in the two major political parties contributes to voter apathy and lower voter turnout. (CVD, 2004) Background There are many reasons why voter turnout varies among groups andRead MoreElectoral System For The Country956 Words Ã |Ã 4 Pagesplurality which is also called Ã¢â¬Å"First-pass-the-postÃ¢â¬ while Germany has a proportional representation than is a mixed member system. These are just some of the electoral system examples. This could be interesting to see what is going on with elections if electoral system plays a factor in the outcome of voter turnout. Figure 2 shows a diagram of the different electoral families and their subset of the electoral families. 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