Reflective paper The concept of the Dreaming Essay

Reflective paper The concept of the Dreaming - Essay Example It is the commonality tying all Australian indigenous groups and guiding them through all aspects of life. People see it as an embodiment of creation giving meaning to everything. It is said to establish rules that govern relationships between people, land and every existing thing for the aboriginal people. Edward refers to the dreaming as the time that the aboriginal people came to existence (Bingham, 2004). The dreaming is by far the most prominent views and ideals of the indigenous people despite the vast variety amongst the aboriginal people across Australia. Indigenous Australia was and is a multi-cultural society. Although quite a number of groups across the whole of Australia had their own languages distinct from each other also different life styles and dreaming stories, all of them had teachings concerning the natural and spiritual worlds, proper behaviors among themselves and also the laws that would govern the society(Caruana, 2003). There are three waves of migration into Australia. Edward termed the Ocean Negritos first wave’, with Murrayians being the second, and Carpentarians being the third. All the migrated people groups of the people that migrated had a diversified language. The number Aboriginal tongues were estimated to be 6000 in the entire Australia at that time. The diversity came up with different values and faith in the entire Dreaming era. The importance of Dreaming every bit of life forces the humans, the land, flora, fauna, the ancestral beings, and natural phenomena is inextricably and eternally connected to every other part (Buist, 2011). There are three key aspects of the dreaming. This includes the spiritual beings, kinships and dreaming stories. As seen earlier despite the differences in the languages or the land, they were born in the aboriginal people had common beliefs on the spiritual beings. They did have kinship systems but were not governed by chiefs or sub-chief as opposed to the case that came

IT support for virtual teams Essay Example | Topics and Well Written Essays - 500 words

IT support for virtual teams - Essay Example There are a numerous reasons why virtual teams are turning out to be so popular these days. The basic reason is the reality that we live in the information age, as different to the industrial age. In view of the fact that the information travels at the speed of light, and those who have access to the most modern and fastest communication and collaboration technologies are capable to send data quickly. The capability to transmit data and information at fast speeds, combined with the power of the web, has caused the formation of "virtual corporations." However, the most influential aspect of the virtual team is that it is not limited to their physical location. In addition, virtual teams are as well extremely efficient for the reason that they do not have any "off" hours. For instance, in case of a traditional business environment, where all their staff members are available at the same location, has an 8 hour-work per day. On the other hand, in a virtual environment virtual team membe rs have a 24 hour-work per day. For instance, when the workers in one time zone are inactive, the others are operational. Thus, virtual teams are able to get more done in a small period of time as compared to the traditional teams. A virtual team can contain members from all over the world. It can comprise knowledge and expertise from any culture and any country (Exforsys Inc., 2009). Traditionally, a project team refers to a social group of individuals who are collocated and mutually dependent in their jobs. In fact, they carry out and organize their tasks to attain common objectives and contribute to task for effective results. Virtual teams have objectives similar to the traditional teams, however, they use different infrastructure as compared to traditional project teams. In this scenario, they perform their tasks without having the limitations of time, organizational boundaries and geographical locations associated with

Reflective Essay on Smoking Cessation

Reflective Essay on Smoking Cessation This essay provides a reflective account of the delivery of an opportunistic smoking cessation intervention. In constructing this account, Gibbs (1988) model of reflection has been utilised, which incorporates the following components: description; feelings; evaluation; analysis; conclusion; and action plan. Description Whilst shadowing a practice nurse, I was provided with the opportunity to implement a brief smoking cessation intervention with a patient. The patients name will not be used, in respect of confidentiality (NMC Code, 2008; NHS Confidentiality Code of Practice, DH 2003), however, for the purpose of this reflection she will be referred to by the pseudonym Sarah. Sarah is a 65-year old female presenting with a number of health issues. She is an overweight smoker who has recently been diagnosed with chronic obstructive pulmonary disease (COPD), a lung disease characterised by the narrowing of the airways. COPD also refers to chronic bronchitis and emphysema, the latter of which Sarah has been diagnosed with. It is emphysema that is Sarahs primary health problem at present. The health promotion strategy adopted was a brief intervention comprising motivational interviewing (Rollnick, Miller and Butler, 2007), which took place within the practice surgery as part of Sarahs consultation. Motivational Interviewing is a directive patient-centered style of counselling designed to help people resolve ambivalence about behavior change, such as smoking cessation. Alongside motivational interviewing, some specific props and teaching aids were utilised, including the provision of evidence-based information, the creation of a COPD self-management plan (British Lung Foundation, 2010), and details of helpful resources Sarah could utilise for further support. This included the Surrey NHS Stop Smoking Service (www.surreyquit.net), which offers free NHS support tailored to the individual (i.e. weekly clinic visits or telephone contact). Feelings I was initially quite anxious about this health promotion opportunity, as I was not confident in my ability to provide constructive support in the limited time we had. However, on initiating a conversation with Sarah, using open questions as recommended within motivational interviewing, the anxiety disappeared as I listened to Sarahs story. Active listening requires concentration, which in turn focused me on how I might be able to help Sarah. In establishing that Sarah was concerned for her grandchildren, who stayed with her quite frequently and were thus around second hand smoke, this provided an anchor to facilitate the development of Sarahs motivation to change. In turn, this anchor also provided me with a patient-centred method for relieving my fears, since I had found a way of engaging Sarah in the process. Interestingly, as Sarahs motivation grew, so did my own motivation to ensure that Sarah gained as much from this brief intervention as possible. With every question that I could answer, I gained in confidence and enjoyed my role as educator and learner within the collaborative partnership between myself and Sarah. In this sense, the collaborative approach that underlies motivational interviewing and much of healthcare practice today can benefit both the patient and healthcare provider. My overall feelings regarding the interaction with Sarah are one of fulfilment. I feel I positively contributed to this patients increased resolve to stop smoking for both herself and her family. Evaluation Motivational interviewing was selected as the most appropriate health promotion intervention for Sarah for a number of reasons. Firstly, evidence regarding behaviour change and, in particular, smoking cessation, shows that level of motivation is an important factor in devising the best health promotion method or teaching plan for a patient (Prochaska, DiClemente, and Norcross, 1993). This approach takes into consideration humanist learning theory and the principles of self-directed learning. According to Prochaska et al.s (1983) five stages of behaviour change, Sarah currently resides in stage 2 of the following stages: Stage 1 (pre-contemplation) is when the individual does not intend to change behaviour; Stage 2 (contemplation) is when an individual is considering change; Stage 3 (preparation) is serious resolve to embark on smoking cessation; Stage 4 (action stage) is the first few crucial weeks and months where an individual is actively taking positive actions towards smoking cessation; and Stage 5 (maintenance) is about 6-months to 5-years after the initiation of the smoking cessation decision, where behaviour change has been sustained. Being in the contemplation stage suggests that Sarah still has some unresolved ambivalence about change and thus needs help moving to stage 3, where she can start to prepare for smoking cessation. If I had started to help Sarah plan for smoking cessation before she was ready, this could have been detrimental in both the short- and long-term. For example, it has been shown that overcoming the hurdles associated with smoking cessation can increase an individuals self-efficacy (i.e. confidence) in their ability to succeed at their quit attempt, which in turn acts to reduce the likelihood of a relapse and increase the likelihood of long-term sustained smoking cessation (Schnoll et al., 2010). If Sarah was pushed towards a quit attempt before prepared, her risk of relapse would have been high; this would have ultimately reduced her self-confidence to try again. The transition from the contemplation stage to the preparation stage has been cited as being critically important to the outcome of quit attempts (Prochaska, DiClemente, and Norcross, 1993), as has the fact that healthcare professionals can be extremely influential at this stage Long et al., 1996). I considered motivational interviewing to be key to influencing Sarahs decisions regarding smoking cessation since it was designed specifically to help people resolve ambivalence about behavior change, which is the main characteristic of people in the contemplation stage of motivation. Motivational interviewing can achieve the resolve of ambivalence by avoiding confrontation and guiding people towards choosing to change their behavior themselves. I was aware that motivational interviewing would need to be accompanied by detailed education about smoke-related health issues and the likely course of COPD, together with possible complications and its association with increased morbidity and mortality. Sarah is an intelligent individual and keen to receive such information and reading material. Unfortunately, however, I was unable to answer all of her questions. In particular, I could not answer her questions regarding the pathophysiology of smoking. Unanswered questions can act as a barrier to progress, something which I do not wish to produce in a patient who requires such barriers removing. Fortunately, I was able to answer Sarahs questions whilst referring to an educational information leaflet. I do, however, feel that I would have been able to engage with Sarah more effectively if it had not been necessary for me to focus my attention on the leaflet before me. It became apparent throughout the consultation that although Sarah was most certainly considering quitting smoking, she possessed some traits that might hinder her efforts. In particular, Sarah appeared to have an external health locus of control. This means that she attributes control over her behaviour to external factors as opposed to internal factors. It is well documented within the literature that an internal locus of control is more productive to behaviour change and healthier lifestyle choices (Wallston and Wallston, 1978; Tones et al., 1992). Taking this into consideration, I was mindful to acknowledge Sarahs control over her choices. In one instance, I used her husband as an example since Sarah had informed me that her husband had quit smoking. I asked her how he managed to achieve this and in recognising her husbands role in his own smoking cessation, Sarah appeared to be adjusting her locus of control towards a more internal one. Nevertheless, Sarahs self-efficacy remained low throughout the consultation despite attempts to boost her confidence. It is believed that increased self-efficacy, which can be achieved via motivational interviewing, is an important factor involved in the success of smoking cessation (Brown et al., 2003; Karatay et al., 2010), thus I felt this was an important aspect to include in Sarahs self-management care plan to set herself an achievable goal each week that would gradually build her confidence. Analysis The Department of Health have been working with the NHS, patients, and healthcare professionals since 2005 to develop a strategy to improve the care and outcomes of people with COPD (DH, 2010). This strategy places a large focus on the prevention and treatment of smoking, as well as the importance of providing patients who have COPD with behavioural support and access to stop smoking services. The Department of Health (2009) have produced guidance on effective stop smoking services, offering three levels of behavioural intervention: brief interventions (level one); intensive one-to-one support and advice (level two); and group interventions (level three). In terms of level one, brief interventions, the National Institute of Clinical Excellent (NICE) have published guidelines and recommendations for smoking cessation (NICE, 2004). Furthermore, previous UK guidance has emphasised the importance of offering opportunistic, brief advice to encourage all smokers to quit and to signpost them to resources and treatments that might help them (West, 2005). They Department of Health guidance states that all smokers should be advised to quit and asked if they are interested in quitting; this is unless there are exceptional circumstances such as other medical conditions that might hinder smoking cessation. Those who are interested in quitting should then be offered a referral to an intensive, level two, support service such as NHS Stop Smoking Services. Sarah was referred to the Surrey service and informed of the success rates found for NHS Stop Smoking Services. There is evidence that such services are effective in the short-term (4-weeks) and the long-term (52-weeks); indeed, between 13-23% of successful short-term quitters remain abstinent at 52-weeks (NICE, 2007). Conclusion Approximately 900,000 people in England and Wales have been diagnosed with COPD (NICE, 2004) and it is the fifth most common cause of death in the UK, resulting in over 30,000 deaths annually (National Statistics, 2006). By 2020, it is estimated that COPD will be the third most common cause of mortality worldwide (Lopez et al., 2006). Smoking is the largest risk factor for developing COPD, with 20% of long-term smokers eventually developing clinically significant levels of the disease and 80% developing lung damage (Garcia-Aymerich et al., 2003). These statistics highlight the urgency of grasping opportunistic health promotion and utilising brief intervention skills to help deliver the DH strategy and improve the care and outcomes provided to people with COPD. Delivering brief opportunistic interventions for smoking cessation requires an approach that does not create defensiveness but develops a patient/provider partnership conductive of the patient making their own decisions, with support, as to their lifestyle. Motivational interviewing and consideration of individual patient characteristics and traits (i.e. locus of control, stage of readiness to change, etc.) provides a method of achieving this partnership within limited time and resources, as is often the case in busy healthcare environments. Learning the skills within motivational interviewing will add to a healthcare professionals repertoire of techniques for supporting patients through behaviour change, as I found in the case reflected upon within this essay. Action Plan The UKCC Code of Professional Conduct (1992) proposes that nurses should maintain and improve her professional knowledge and competence. In relation to my own knowledge and competence in opportunistic health promotion, I have recognised that I need to increase my skills for nurturing patient self-efficacy. Patient confidence is fundamental to successful behaviour change and although I feel satisfied with my approach to Sarah, it would have been useful to have possessed a larger repertoire of techniques for enhancing self-efficacy. I could also benefit from a greater understanding of the pathophysiological mechanisms by which smoking causes COPD. Sarah was particularly interested in the physiological effects of smoking and whilst I could offer her basic information verbally, I needed to refer to information leaflets for more detailed insight, which disrupted the flow of conversation. I have started to explore these issues via a search of the literature on behaviour change and health promotion. As part of this search, I have come across the concept of implementation intention (Gollwitzer, 1999). The theory behind this concept is that in order for someone to implement a desired behaviour, it is necessary for them to devise a specific plan that will increase their intention to pursue that behaviour (Gollwitzer and Sheeran, 2006). This is an interesting technique that could be integrated into motivational interviewing and health promotion via the self-management care plans currently provided. I intend to explore this further and to discuss it with a superior. Using Gibbs reflective model to structure this account has helped me to recognise my strongest skills and those that require further development. I will endeavour to take a proactive approach to utilising this greater insight into my professional abilities.

Euthanasia Essay example -- essays research papers

Euthanasia, also known as mercy killing is a practice of ending a life to release an individual from an incurable disease or intolerable suffering. Euthanasia has been accepted both legally and morally in various forms in many societies but not in all. â€Å"In ancient Greece and Rome it was permissible in some situations to help others die. For example, the Greek writer Plutarch mentioned that in Sparta infanticide was practiced on children who lacked "health and vigor." Both Socrates and Plato sanctioned forms of euthanasia in certain cases. Voluntary euthanasia for the elderly was an approved custom in several ancient societies.† With the rise of organized religion, euthanasia became morally and ethically abhorrent. Christianity, Judaism, and Islam all hold human life sacred and condemn euthanasia in any form. Following traditional religious principles, Western laws have generally considered the act of helping someone to die a form of homicide subject to legal sa nctions. â€Å"Even a passive withholding of help to prevent death has frequently been severely punished. Euthanasia, however, occurs secretly in all societies, including those in which it is held to be immoral and illegal.† There are two main types of euthanasia, passive and active. Passive euthanasia is the deliberate disconnection of life support equipment, or cessation of any life-sustaining medical procedure, permitting the natural death of the patient. Active euthanasia is deliberate action to end the life of a dying patient to avoid further suffering; there are two types of active euthanasia. Active voluntary euthanasia is when a lethal injection is giving by a doctor into a dying patient to end life by request of the sufferer. Active involuntary is lethal injection by a doctor into a dying patient without that person's express request. Active involuntary is considered murder by most. Since euthanasia is illegal in 49 of the 50 US states it would seem that most people are against it. There are some people who have formed organizations that help to educate people about euthanasia and that In fact euthanasia may be a good thing. One such organization is ERGO the Euthanasia Research & Guidance Organization a nonprofit educational corporation, which was founded in 1993 to improve the quality of background research of physician-as... ...he end stage. Once these symptoms are alleviated the emotional pain becomes the focus and it takes great strength to watch a loved one die slowly day by day. I’ve seen families brought together and serve as a great comfort to each other and to the patients. Death to these people is not the enemy but a natural ending of life. I’ve also seen family’s fall apart, seemingly unable to hold up under such pressure. Are these the people who assist in another’s suicide? Is it a weak persons way out? It is done because of love or inability to cope? Only they know.† The writer of this paper feels that euthanasia should be accepted more then it is, but is not the answer. I think that most suffering can be deemed tolerable with proper medications. It seems that if the pain can be controlled with medication, that the person could pass on in a deep sleep and be comfortable. However there are other symptoms that accompany other illness that can not be changed by medication. Like Christopher Reeves no matter how much medication he is given he will never walk, ride a horse, or bath himself again. This kind of suffering I would find intolerable and would justify euthanasia. Footnotes

Does language affect thought? Essay

Thinking is possible without language because expressing a thought is often limited by words. As the famous saying says â€Å"a picture is worth a thousand words† this may also mean an idea a though or a picture in your mind, is worth a thousand words. Many times, people would like to express something they are imagining in their minds but do not have or know the right words to do so. Languages can create perspectives and be a mean to express and receive thoughts; however, thinking does not always require language. Language facilitates knowledge by not only giving us a way to express it but also providing us with a way of imagining something. It allows us to organize and simplify our ideas. For instance, it is easier to think in a table as the word â€Å"table† instead of imagining the entire three dimensional objects. A good example of this is a history book: through its words (language) it gives us a, sometimes clear, picture of a battle, a signing of a treaty or any historic event. Through its words the book is able to provide the reader with knowledge which is then transformed by the reader into an idea and a thought. The same can happen inversely, a though can be converted into language, as people do in everyday conversations. While this might be true, it does not mean that people cannot think, know, or have an idea without using language. A good example that proves this is a newborn; a baby that is hungry and wants milk, even though he does not know the words to express it, must be thinking â€Å"I am hungry† or â€Å"I want milk†. Some may argue that a baby’s hunger is an instinct, not a though, but in some cases kids do not learn how to speak until they are much older, does this mean they have lived on only instincts and not thoughts until they learned to speak. But children learn words little by little, not all at once which may lead the questions, where is the boundary? How much language must someone know to be able to think? Or, Can people only think the words you know? Is a baby’s first though â€Å"mommy† or â€Å"daddy†? Even though babies have not learnt any form of communication, they laugh think something is funny. Languages can extend knowledge and bring new perspectives together. To efficiently use 100% of language, you would have to know every single word of every single every language, but let’s keep it down to only English. English has an extensive vocabulary; the more English you know the more you expand your thoughts, since better use of language means thoughts can be expressed more accurately. Knowing the right words to put forth a thought is vital in order to let another person understand what you are thinking. This is evident when people struggle to say or write something because they cannot come up with the appropriate word or words to express their exact thoughts (as I have been doing while writing this paper). This leads us to further evidence that thinking without language is possible; when people fail to find appropriate words for any thought, it proves they their not able to put their thought into language. The thought is not put into language by its owner because it is not fully expressible through the language he knows, and even though he does not know the words the express his thought, he is still thinking it. Also, often, as time passes, new words are constructed to express new thoughts meaning the existing vocabulary is inadequate to express the thoughts you have. This indicates that language is created by thoughts, and to extend language, thoughts must already exist before they can be put into a language. As language is broadened by thoughts, people grow to become more restricted to language. Basically, once you know words, it is very difficult to think without using them; when you see the color white, you think â€Å"white†, when you see a ball, you think â€Å"ball†, when you see the sky, you think â€Å"air†, â€Å"blue†, â€Å"sun† and so on, all in the form of words. Language only restricts a thought to one way of thinking and limits it from expressing the thought to the full extent. While there is no limitation placed on thinking by language, because thinking does not necessarily require language. Thinking does not always require language; people are capable of thinking without language. When most people think rationally, they require language. When people think or even talk within themselves they do it through language. But when people think visually they do not need language to give them information about the visual world. For example; someone can look at a person’s face and know what they are feeling. Language is a mean of receiving or expressing though, it is not the though itself, thus if you do not have to receive or express a though, you do not need language, which leads to the conclusion that it is possible to think without language.

Risk Assessment

2. 1 Legislation The need for an employer to carry out risk assessment has been a requirement of health & safety legislation for many years. A summary of the risk assessment requirements is as follows: a) The Health & Safety at Work etc Act 1974 Sec 2 – Requires an employer to ensure the health, safety and welfare of his employees so far as is reasonably practicable. The process of risk assessment has therefore to be applied to determine what is â€Å"reasonably practicable† action in controlling any particular hazard. ) Control of Asbestos at Work Regulations 1987 Reg 5 – Requires an employer to carry out an adequate assessment of the exposure of employees to working with asbestos. c) The Control of Substances Hazardous to Health Regulations 1988 & 1994 Reg 6 – Requires an employer not to carry out any work liable to expose any employee to any hazardous substance unless a suitable and sufficient assessment of the risks created by that work has been undert aken and appropriate control measures are identified and implemented. ) The Noise at Work Regulations 1989 Reg 4 – Requires an employer to ensure that a competent person carries out a noise assessment when employees are exposed to noise levels above the action levels prescribed. Suitable control measures should be identified and implemented to reduce the risk of hearing damage. e) The Personal Protective Equipment at Work Regulations 1992 – Require an employer to ensure that personal protective equipment (PPE) is suitable for its purpose (regulation 4), which implies that a risk assessment should be carried out to match the level of protection provided with the hazard present. Risk Assessment 2. 1 Legislation The need for an employer to carry out risk assessment has been a requirement of health & safety legislation for many years. A summary of the risk assessment requirements is as follows: a) The Health & Safety at Work etc Act 1974 Sec 2 – Requires an employer to ensure the health, safety and welfare of his employees so far as is reasonably practicable. The process of risk assessment has therefore to be applied to determine what is â€Å"reasonably practicable† action in controlling any particular hazard. ) Control of Asbestos at Work Regulations 1987 Reg 5 – Requires an employer to carry out an adequate assessment of the exposure of employees to working with asbestos. c) The Control of Substances Hazardous to Health Regulations 1988 & 1994 Reg 6 – Requires an employer not to carry out any work liable to expose any employee to any hazardous substance unless a suitable and sufficient assessment of the risks created by that work has been undert aken and appropriate control measures are identified and implemented. ) The Noise at Work Regulations 1989 Reg 4 – Requires an employer to ensure that a competent person carries out a noise assessment when employees are exposed to noise levels above the action levels prescribed. Suitable control measures should be identified and implemented to reduce the risk of hearing damage. e) The Personal Protective Equipment at Work Regulations 1992 – Require an employer to ensure that personal protective equipment (PPE) is suitable for its purpose (regulation 4), which implies that a risk assessment should be carried out to match the level of protection provided with the hazard present. Risk Assessment 2. 1 Legislation The need for an employer to carry out risk assessment has been a requirement of health & safety legislation for many years. A summary of the risk assessment requirements is as follows: a) The Health & Safety at Work etc Act 1974 Sec 2 – Requires an employer to ensure the health, safety and welfare of his employees so far as is reasonably practicable. The process of risk assessment has therefore to be applied to determine what is â€Å"reasonably practicable† action in controlling any particular hazard. ) Control of Asbestos at Work Regulations 1987 Reg 5 – Requires an employer to carry out an adequate assessment of the exposure of employees to working with asbestos. c) The Control of Substances Hazardous to Health Regulations 1988 & 1994 Reg 6 – Requires an employer not to carry out any work liable to expose any employee to any hazardous substance unless a suitable and sufficient assessment of the risks created by that work has been undert aken and appropriate control measures are identified and implemented. ) The Noise at Work Regulations 1989 Reg 4 – Requires an employer to ensure that a competent person carries out a noise assessment when employees are exposed to noise levels above the action levels prescribed. Suitable control measures should be identified and implemented to reduce the risk of hearing damage. e) The Personal Protective Equipment at Work Regulations 1992 – Require an employer to ensure that personal protective equipment (PPE) is suitable for its purpose (regulation 4), which implies that a risk assessment should be carried out to match the level of protection provided with the hazard present.