Africa: the Unknown Continent Essay

Trice Riddle Mrs. Jennifer Sikes English 1020 11 February 2009 The Unknown Continent Many people know about it and have seen it on maps before but they still do not pay attention to detail or really care. People still say today that it is a country but it is a continent made up of countries. Many people describe it as the â€Å"dark continent† because it has not developed enough to be like an Asia or the Americas. Its hard to really discover what Africa is and how to define it. The land is rich and the people are full of life. Africa to many is Just a land of desert and is impossible to live in because f the harsh climate. The people of Africa may be struggling its hard to tell on their faces when you visit. They are all smiles and take everyday of life to its fullest. What people do not know is that Africa is one of the most richest in resources. Its hard to find and discover them because they do not have the equipment. Africa to me could be United States of America when they find the right tools and discover the natural resources they have. When I hear the word Africa I think of Egypt, deserts, and the Nile River. Also, South Africa has a couple of really famous golfers that play and ominate the PGA Tour in the United States. Africa needs to have a since of pride from their history and move forward to be a known continent. I want to discover what Africa is and finally put a name to it where people can see that it is a beautiful, strong continent. The history of Africa is priceless. The history is so amazing its hard to tell people about. The African tribes had to rely on each other in order to survive. One of the earliest languages was founded by African tribes. The villagers would communicate by making a clicking sound with their tongues. Even though it has no words, the ifferent sounds and lengths of the pitch was used to understand each other. They still do this today but it is rare. They have found one of the earliest human life forms in history. Since some of the land of Africa was undiscovered, rulers would send out explorers to find some of this land and claim it. Most of the land was claimed by European countries since they were the most powerful at the time. If there was any conflict between land it resulted in fghting. If there were tribes in the way, they would raid them and probably use them as slaves. Many European rulers sent ships o Africa for the slave trade. Slaves were put the bottom of the ship and would fit as many of the slaves as possible. Over 1,600 ships and over 150,000 slaves were boarded to European countries. Many of the slaves had houses to live in, but the other working slaves lived there and they all used and shared the same things. Some slaves were treated bad. They were not fed well and didn’t have houses to sleep in. This all ended in the mid 1800s when most of the African empires signed a treaty. Because of the end of slavery, empires were unable to adapt and some even caused ivil wars. Some of these countries are affected from these civil wars that happened about 150 years ago. Africa’s rich history makes it unique and one of the most The only history people knew about is from the great country of Egypt. A country of pharos and great Egyptian Kings like the most famous one, King Tut. In the ancient time of Egypt, it was one of the greatest countries on earth. It had advances that people today still wonder how it was built. The most amazing architect of this time was the Great Pyramid of Giza, one of the seven ancient wonders of the world. The only ancient wonder to exist. I think that if you could go visit one place with rich history that Egypt would be the place. Running through the middle of Egypt is the worlds longest river, the Nile River. Most of Egypt’s cities are built around it for water and nutrients. Everything there is so exciting and rich that you could stay there a year and still learn about the Egyptian culture. The land of Africa is considered rich but it has one of the worlds largest deserts. Africa is not technologically developed so finding these resources is next to impossible. This poor country suffers from food, diseases, and the lack of people to care for it like they do for other countries. We see all these little kids and families on television that are anorexic and have very little clothes and food. We try to help them but its hard when all the people around them are suffering Just as bad, if not worse. The richer of the African countries live around lakes and rivers. South Africa being one of the richest countries has its down side too. There is one huge thing thats comes from South Africa and thats PGA Tour golfers. Ernie Els, Retief Goosen, and the most famous one is Gary Player. These are guys who love South Africa and are proud of where they came from. Some of these golfers beat the most famous and number one golfer in the world, Tiger Woods. Gary Player has beaten the best golfer ever in Jack Nicklaus several times. It does not matter where you come from you can do anything you want and always remember where you came from. The home of some of the happiest people with the least to have or give. Africa is a country full of hope, pride, and rich history. This is a country with the poorest people, but they still find a way to look at the positive and enjoy the life they ave and what they have been given. Life is to short not to be happy. They have every reason to be down and to give up, but if we look closely at the details we will see that they survive on each other and each other’s pride. We need to see how they are living and try to do it. They know every moment they are given is a blessing not Just a another day. Coming closer will teach us about each other and from their we can make the lives around us better. Africa is an important continent that we all need to stop and pay attention to how beautiful it is.

Comparing Freedom of Expression in the Statutory Law and the Sharia Law Essay

Getting in touch with media law during the first semester of my Masters gave me a sense of the importance of law in general because it consists of acts and articles which organise most issues in the human’s life in a way that protects ethics and morals. Regardless of the hypocrisy and double-standards of the countries which raise high the slogan of Human Rights, I liked the Human Rights Conventions that were laid down by these countries. Therefore, I decided to research some points in these conventions that are related to my study in order to nurture my knowledge in this great field of the human sciences. Then, I thought deliberately about the benefit of exerting much effort to get such knowledge since it is existed, well-explained and well-organised, in handy books. But after looking by historical and religious study as far back as some centuries ago, I found that my own culture, Islam, had plenty of law provisions that helped its people not only to protect their ethics and morals, but also to spread them all over the world. Through deliberate and objective study, I found that many of the social reformers, whose thoughts led to the emergence of the modern criteria of human rights, were originally affected by the roots of the Islamic ulture. I also found a lot of those old and even modern reformers who praised the old provisions of the Sharia Law and they also praised the prosperity which was an outcome of implementing it. The Western writer Patricia Crone (2005: p. 218-219) said referring to how those old provisions of law were true bases of a moral society: â€Å"Medieval Muslims d id not write utopias in the sense of imaginary travel accounts or other descriptions of ideal societies which do not exist, †¦ they were not given to seeking ideals outside their own civilisation at all. But they did place a golden age right at the beginning of their own history, and their numerous accounts of this age add up to a detailed utopia of great emotive power†¦ It was a time when the Muslims had all the virtues of tribesmen and none of their vices, for thanks to Islam there was no feuding, no factionalism, and no disorder, just austerity, solidarity, and total devotion to the truth. Therefore, I decided to look for the provisions of that old law which are related to my study and compare them with their counterparts in the modern human rights’ conventions. In order to limit my research, I decided to take the articles related to my study, media law, in the Human Rights Act 1998 (HRA) of the British Law to represent the leading international human rights conventions. Part one: Preface Main Argument In this dissertation I am going to explain how both the HRA and the Sharia Law deal with the concept of freedom of expression. As long as such argument is new and uncommon because of the lack of references that studied it, which resulted in an ambiguous perception in the minds of people towards the Sharia Law and its sources, there must be a kind of primary definition of the Sharia Law, its sources and how the Sharia scholars (Sharia Jurists) deal with these sources to regulate law items. Sharia Law This expression is going to be referred to as a theological-historical concept since the Sharia was revealed through a prophet, this makes it a theological subject matter, and it is 15 centuries old, this gives it a historical background. Sharia (sari? ah) is all religious rituals that Allah (SWT) has imposed on Muslims, via his Prophet Mohammad (PBUH) regarding beliefs, rules and day-to-day life among Muslims themselves, and between Muslims and non-Muslims. It is â€Å"designed to govern the relations of Muslims with non-Muslims, whether inside or outside the territory of Islam. † Mahmoud Kamali says that Sharia is â€Å"the Islamic law as contained in the divine guidance of the Qur’an and the Sunnah. Yet, the expression Sharia Law is modern if compared with the word Fiqh, which historically used to mean â€Å"the awareness of Islamic rules from its sources by true inference. † Kamali defined the word Fiqh: â€Å"Islamic law as developed by Muslim Jurists. The term is often used synonymously with Sharia. † Therefore, like other contemporary researchers of similar topics, I am going to use the expression Sharia Law to mean the old word: Fiqh. Sources of the Sharia Law There is no difference between any of the Muslim scholars that the main sources of all information, not only about the details of the life of mankind, but also about the details of the whole universe are the Holy Qur’an, then, the Holy Sunnah. In addition, it is a matter of a universal belief among Muslims and many of non-Muslims that the Holy Qur’an in the hands of people is the real book revealed by Allah (SWT) to his Prophet Mohammad (PBUH) fourteen centuries ago. The same is the 100% authenticity of certain books of Hadith, i. e. Saheeh Al-Bukhari and Saheeh Muslim. These references are not considered comprehensive works; however, I feel that they could draw raw guidelines for me in my research in two ways: * They give me hints about how this issue is being taken by researchers who are not specialists in Sharia studies, but they are lawyers or journalists; like me. * They draw raw guidelines of the comparative methodology of research between articles of the Sharia Law and those of the statutory law. Throughout this dissertation, I am going to take articles of the British Media Law and compare them with the related provisions of the Sharia Law, giving enough examples in order to be able to make clear-cut conclusions about the main question of this dissertation which is: (The question of the dissertation) Can the modern Islamic movements, who are apparently going to rule the Arab countries after the Arab Spring, implement the Sharia Law and achieve the absolute justice which they raise as a slogan for their revolutions and electoral campaigns? Or would they worsen the already worsened situation of media law? Of course, regarding the other part of this dissertation, which is the statutory law, libraries are full of texts of law articles starting from the Declaration of the Rights of Man and of the Citizen in 1789, passing through the UN Universal Declaration of Human Rights, ending with daily huge volumes of books, journals and articles studying new amendments and proposing new laws regarding recent details of the life of people in general and the work of media specifically. Terminology In order to have a good understanding for the real meaning and connotation of the Sharia Law concepts and cases, they have to be denoted by their names. Therefore, it is necessary here to have a list of the original names of the Sharia concepts and their definitions. The Holy Qur’an: defined previously. Surah: one complete chapter from the Holy Qur’an. Sowar: the plural of Surah. Sowar are different in length. Some are 1/3 a page and others exceed 40 pages. Aya: one verse from the Holy Qur’an. Ayat: a plural of aya. The Holy Sunnah: defined previously. Hadith: a verified saying for the Prophet Mohammed (PBUH). Ahadith: a plural of Hadith. Tafseer: the interpretation of the Holy Qur’an and the Holy Sunnah by professional credible Muslim scholars. Fatwa: a certain judgement on a certain case by a Sahaba, Tabe’een or confident Muslim scholars in a certain time or place. Plural is Fatawa. Ibada: the act of worshiping Allah (SWT) whether by heart or body. Any act of heart or body needs to start with intention of solely worship for Allah in order to be a true Ibada. Da’wah: the flow of activities Muslims do in illuminating the teachings of Islam. Dhimmi: the name of a non-Muslim citizen in the Islamic State. Ahludhimmah or Dhimmiyeen: plural of Dhimmi. Jezyah: the name of the religious tax for non-Muslims in the Islamic State. It is equivalent to the religious tax taken from Muslims, but Jezyah is a lesser amount of money that has many exceptions. Part Two: The Situation of Freedom of Expression Historical Background It is very important, before starting writing about the situation of freedom of expression in the statutory and the Sharia Law, to explore the general historical climates which preceded the emergence of both laws. That will give a kind of understanding of how much the improvements on the situation of freedom of expression both laws have achieved. * A Glimpse on Freedom of Expression in the West before the Renaissance The period which preceded what is known in Europe as the Renaissance was full of conflicts among the different castes of the European communities in general. That conflict took several forms. A prime one was the conflict between the Church and scientists and that between authority and people. Howard Turner describes a side of such conflicts: â€Å"The Middle Ages in Europe had long been dominated by an unending conflict between Church dogma and a kind of humanistic and individual quest for intellectual liberation. † Church and authority used to be allies and each institution worked for the protection of the other at the expense of people’s lives. They used to impose restriction on freedom of expression and there used to be no respect for people’s privacy. There was also a kind of blackout on external knowledge, fearing that it might undermine their power or alliance. The Thirteenth century was an â€Å"age in which kings and barons reacted to an insult by lopping off the offending tongue- or head†¦ The crime of ‘scandalum magnatum’ expressly protected ‘the great men of the realm’ from any statements that might arouse the people against them. † In France, for example, the king used to say â€Å"I am the state† and gave no space for people to have control in running their own or private life. The Church used to control science. Therefore, knowledge it saw as right, used to be spread, and that it saw as wrong, used to be damaged. A blockage was imposed on scientists and thinkers. In 1614, Galileo was accused of heresy  by the Church for his scientific theories. Eighteen years later, in 1632, he was sentenced to life imprisonment which was reduced to permanent house arrest after he had been obliged to withdraw his theories before the public by the Church. That time was the worst for women’s freedom. Women were inferior to men, troubled with Eve’s sin. They were subject to the authority of their fathers or their husbands. Violence in marriage did occur and was even encouraged. † The dark life of that age pushed people to seek a kind of salvation through knowledge, especially, after the appearance of new thinkers affected by the Muslims’ civilisation. According to Turner, the â€Å"Christian West† inherited the â€Å"scientific legacy from Islam. Thanks to increasing cultural traffic with Muslim lands via the busy Spanish and Sicilian gateways, the thriving routes of Mediterr anean and overland commerce, and the contacts left over from the Crusades. People sought to reinforce the principles of freedom and justice, which was clear in the slogan of the French revolution which was: liberty, equality and fraternity. The revolution in real freedom of expression has been from the Renaissance until today. However, there are still some issues which emerge from time to time that necessitate amendments of the existing laws or constituting new ones. * Freedom of Expression in Arabia before the Sharia Law In Arabia, there used to be kind of freedom of expression, but there was no justice. For example, men used to sit with each other and think about issues related to their tribes. But that right to give an idea or express an opinion was only for masters. Societies there used to consist of three castes: masters, subjects or alliances and slaves. In addition, that right among the masters was only for men. Women used to be suppressed and were not allowed to share opinions either in public affairs or even in family affairs. Women were used in the same way as goods. There used to be a diversity of religions. Arabia included pagans, Jews and Christians. But the most common was paganism. Surely, that kind of diversity hints at a kind of freedom of religion, but the opposite was the norm. Paganism, represented in worshiping idols, was the religion of the mainstream Arabs in Arabia and they used to keep an eye on those who converted to other religions. If they were young, they used to be fought; if they were old, they used to be left free since they could not affect others. Of course, chiefs and masters of tribes used to be happy with that kind of life because it helped them keep strong control over their subjects. However, suppressed castes needed any kind of powerful justice to liberate them from the chains of the different forms of slavery. From amongst that darkness, the message of the Sharia was revealed to the Prophet Mohammed (PBUH) to spread the justice and freedom among people. It is widely known among historians that a reasonable number of the people who joined the Da’wah at the early stages were from the ordinary people or alliances and slaves. Some of the masters asked the Prophet (PBUH) to dismiss them from around him if he wanted them, the masters, to join the Da’wah. Of course, ordinary people always lead reforms. A group of Muslim emigrants fled the persecution of their relatives in Mecca to Abyssinia and there was a short dialogue in the court of Abyssinia’s king, who was a true Christian. Their representative described the situation of Arabs before the Sharia and what the Sharia came with: â€Å"O king! We were plunged in the depth of ignorance and barbarism; we adored idols; we lived in unchastity; we ate dead animals, and we spoke abomination. We disregarded every feeling of humanity, and the duties of hospitality and neighbourhood. We knew no law but that of the strong. At that time, God raised from among us a man of whose birth, truthfulness, honesty and purity we were aware, and he called us to the Unity of God and taught us not to associate anything with Him. He forbade us to worship idols and enjoined us to speak the truth, to be faithful to our trusts, to be merciful, and to regard the rights of neighbours. He forbade us to speak ill of women and to eat the substance of orphans. He ordered us to flee from vices, to abstain from evil, to offer prayers, to render alms, and to observe the fast. † Constituted Rights to Freedom of Expression * Freedom of Expression in British Media Law As I have mentioned from the beginning, I am going to take the British law as an exemplar to represent the statutory law in this research. Therefore; I see that I have to propose an overall look at the British law and to see the situation of freedom of expression through it. British Law Unlike other countries, Britain does not have a written constitution. Referring to Britain, Tom Baistow says: â€Å"This country is the only one in the EEC without a written constitution and the only one without the press laws that form one of the most important guarantees of freedom of expression. However, it has a good record regarding the respect of freedom of expression. It got this reputation throughout historical fights of the British nation to attain freedom and adopt democracy. And as an ideal example of the fight to reach this situation, journalism in Britain â€Å"went through a brave battle against constitutional restrictions on publishing in the 19th century and could extract the right t o comment and publish. † Freedom of expression became one of the most respected freedoms as a kind of a social norm among the British people. It is believed in Britain that free speech is a significant pillar of a free democracy. The Royal Commission on the Press in 1977 defined freedom of expression â€Å"as that degree of freedom from restraint which is essential to enable proprietors, editors and journalists to advance the public interest by publishing the facts and opinions without which a democratic electorate cannot make responsible judgement. † This definition shows how the British believe in the vital role that freedom of expression plays in educating the public to be able to take right decisions in elections. It means that it is the main guarantor of a free democracy which is the main principle of a free State. Therefore, Solaiman Saleh described the situation of freedom of expression in Britain, despite the lack of a written constitution, saying: â€Å"The principle of a free press is reinforced in the collective conscience of the British. That forms a better protection which outweighs any written constitution. † Saleh continued explaining that it became a part of the British understanding of freedom of speech that the government does not have the right to interfere in the workflow of mass media. It cannot issue warrants, for example, to close any news platform, have pre-publishing restrictions/instructions or suggest amendments in the administrative systems or editorial policy. This is how James Curran portrayed the British press after the Second World War: â€Å"The press became fully independent of political parties and hence government. † The independence of the press gave it a great deal of space for free speech as well as unlimited power against governments. This was clear when the best wartime leader, British Prime Minister, Winston Churchill, demanded an immediate closure of the Daily Mirror over its coverage of the conduct of war. That decision was followed by rough debates in the House of Commons and huge popular protests in Trafalgar Square and London’s Central Hall that pushed Churchill’s government to withdraw the decision against the Daily Mirror and, even, lift a ban previously imposed on the Daily Worker. Mass media regulation is only the role of the Parliament and Judiciary. In reply to the argument that the parliamentarian majority which forms the government may adopt any law suggested by it, Saleh argues that people who believe in the concept of freedom of expression will protest against the parliament and oblige it to stop the new law or to dissolve. The incident of the Daily Mirror mentioned above is a very clear example of that. The main pressure was represented by ‘organised protests’ in Trafalgar Square and London’s Central Hall. In addition, Hanna and Banks say in McNae’s Essential Law for Journalists: â€Å"Section 19 of the Human Rights Act created a requirement that a Minister introducing a Bill into Parliament must declare that its provisions are compatible with the European Convention, including thereby a commitment to freedom of expression. † Despite all the facts mentioned about the battles towards the freedom of expression in the English society, a sufficient protection for that freedom, which keeps up with the public-interest journalism, â€Å"from attacks for discomfiting the government or the judiciary or the wealthy private litigants† was not completely guaranteed. It is guaranteed by the adoption of international treaties, in which English writers and lawyers took a big part in constituting them, into the British law. Since then, clear articles of these treaties have become legal codes in the British law that guarantee a better freedom of expression. Throughout these facts, I can come to a conclusion that freedom of expression in Britain has certain principles that are clear. The main three principles could be summed up as following: 1. Government has no power against mass media. Robertson and Nicol explain how a government official does not have any privilege over the public in this regard. They say that if any official wanted to stop a news story, he has to go to the court the same as the public do. It means that government cannot control or suppress the voice of any single person directed to the public via any medium. It is believed that this is a sign of a free democratic State, but not in an arbitrary sense. Therefore, mass media have to be credible, and offenders should not escape punishment. John Whale quoted Sir William Blackstone, the eighteenth-century jurist, saying: The liberty of the press is indeed essential to the nature of a free State; but this consists in laying no previous restraints upon publication, and not in freedom from censure for criminal matter when published. † 2. Mass media are owned by the private sector and, therefore, it represents citizens before the government. However, citizens are stronger than the government in the democratic regimes; it means that mass media can publish any kind of opposite opinions without fearing suppression or oppression of the government. 3. Mass media turn to the public to face censorship. Robertson and Nicol say: â€Å"The best antidote to censorship is publicity. † When the government wishes to practice a kind of censorship, journalists can publicise that practice and the government does not have any power to punish them. The incident of the Daily Mirror mentioned above is a clear example on the three points mentioned. It shows how mass media are stronger than governments, how mass media speak on behalf of the public and how the public exerted pressure through protests that pushed the government to retreat from the closure warrant against the newspaper. Freedom of Expression in the Sharia Law The most prominent characteristic of the Sharia Law is that it is a religious law. It means that it has more emphasis, in all branches, on religious and moral values than other laws. Mohmmad Kamali says: â€Å"This can, perhaps, be clearly seen in reference to the Sharia rules pertaining to blasphemy, heresy and disbelief , where the dominant concern is to defend the dogma and belief-structure of Islam. † Muslim scholars and thinkers believe that this characteristic of the Sharia Law gives it a spiritual power, which is effective to keep stability of societies. Based on his understanding of the Islamic beliefs and to confirm that defending the dogma and belief-structure of Islam achieves social stability, 20th century Muslim thinker and reformer Sayyed Qutb, who interpreted the Holy Qur’an, says: â€Å"Social, economic and religious organisation goes side by side with a true ethical code and dogmatic belief†¦ in a complete, comprehensive, balanced and precise way. † Regarding freedom of expression and to show how much positive effect religion has on it, the Western writer, Patricia Crone, shed light on the way Muslim thinkers understand the relationship between freedom and religion. Patricia Crone reported Al-Ghazali, a famous medieval Muslim philosopher and reformer, explaining freedom in the Sharia as â€Å"no humans had the right to impose obligations on other humans, whether they were rulers, masters, fathers or husbands, or for that matter prophets; only God could do so. † Of course, Al-Ghazali’s understanding of that concept of freedom was based on the Holy Qur’an and the Holy Sunnah. Allah (SWT) asked his Prophet Muhammad (PBUH), in the Holy Qur’an, to tell people that he is a human like them.

Nitrogen removal from wastewater using anaerobic ammonium oxidation Term Paper

Nitrogen removal from wastewater using anaerobic ammonium oxidation (Anammox) process - Term Paper Example Generally, this bacterial can be found almost everywhere. Findings have shown that the contribution of this bacterium on the removal of nitrogen in the environment can be immense. The process, said to be chemolithrophic, is a very new loop in the biogeochemical nitrogen cycle hitherto unknown to engineering (Dong & Sun, 2007). While there is very little, that is known about the ecology, genetics, or even the physiology of the bacteria, this research project will be very important in shedding some light on the community structure of the Anaerobic Ammonium Oxidation bacterial and all their involvement in environmental parameters that include nitrate, ammonium, and the salinity levels. This project discusses the effects of pH and salinity on the anammox process with results showing that the salinity is among the few factors that are really affecting the effectiveness of the whole process. My thanks go to Mr. XXXX through whose guidance I have learned molecular techniques used for the investigation of bacteria. It is due to his patient and undying support that pushed this study through. A good and encouraging attitude and his excitement about this work encouraged me to explore deeper into learning as much as possible in the process. I wish to also thank Ms. YYYY who also made this research a success through teaching me about the most fundamental and traditional microbiology techniques. Mr. QQQQ introduced the isotope ratio mass spectrometer to me. He was also very encouraging and it was through his words of wisdom that the concept behind stable isotope geochemistry became one that I can handle well, and with ease. This research owes its completion to WWWW who collected the sediment samples from XXX Estuary. All the other members of the microbiology laboratory were very helpful throughout my visits to the lab. It was their long, well-informed discussions that made the research a success, and I will forever cherish such

Identify key features of widely used business application programs Research Paper

Identify key features of widely used business application programs - Research Paper Example Word processors have now become one of the basic requisites of businesses. Using a word processor, one can make a document, save it in an electronically conducive format in a disk or drive, display it on monitor, make amendments to it by inserting commands and various typescripts from keyboard and eventually print it (Dibbern, 2004). It has various advantages, which makes it highly popular among literate individuals. Above all, it is convenient then a typewriter in which you have to retype the whole document in case of any error. However, in Word Processor, editing words, paragraphs and formatting is very easy. Word processing applications provide you with â€Å"file management systems, font specifications, referencing systems, graphics, layouts, grammar and spelling checkers, WYSIWYG  (what you see is what you get) etc† (Dibbern, 2004). Some of the popular word processing applications include â€Å"Microsoft Word, Notepad, Google Docs, Lotus Manuscript, WordPad† (Dib bern, 2004), and many more. Presentation software is another category of application program that creates a continuity of words and pictures to present an idea or story. Business presentation applications are user friendly, compatible, and transferable as well. They enable the user to include images, audio, as well as video developed with other tools. Its advantages are many but primarily it helps in appearance of documents, providing snapshot of ideas, sound effects and much more. Some popular presentation software include â€Å"Microsoft PowerPoint, Lotus’s Freelance Graphics, and Corel Presentations, etc† (Dibbern, 2004). These softwares enable a user to have animations attached to their work and improve appearance of data to maximize value. Spreadsheet is one of the most powerful programs used for bookkeeping, scheduling, and data storing purposes. It contains arrangement of cells in the form of table of rows and columns. Each cell has a value and each value may have a

CRJ-105 questions Essay Example | Topics and Well Written Essays - 250 words

CRJ-105 questions - Essay Example However, given the drug courts currently in operation and the success with which they have operated to date it is clear that they are the future for drug related crime. According to the National Institute of Justice, â€Å"As of June 2010, there were over 2500 drug courts operating throughout the U.S. More than half of these target adult offenders; others address juvenile, child welfare and different court case types.† (National Institute of Justice, 2011) Anything that can reduce crime while at the same time reducing the potential for recidivism of criminals and benefit the community at the same time is a positive approach within the modern criminal justice system. By integrating treatment programs into the sentencing of the individuals for the drug related crimes committed society will see a vast difference over time as well as the levels currently seen in the prison system will be reduced. According to one report, â€Å"A number of randomized and controlled experimental studies published in peer-reviewed journals have found that drug court graduates have significantly lower re-arrest rates†¦Ã¢â‚¬ (National Institute of Justice,

Culture of Excellence in the Classroom Essay Example | Topics and Well Written Essays - 750 words

Culture of Excellence in the Classroom - Essay Example The key ingredients for success in creating the best culture of excellence in the classroom are the teacher’s experiences, responsibilities, and goals. Certainly many teachers teach the way they were taught.  A teacher’s experience and philosophy are important aspects for successfully providing a culture of excellence in the classroom. For example, if the teacher believes in individualism using Mill’s philosophy, he will encourage students to focus only on themselves, which in turn could result in the development of selfish attitudes.  This will lead to developing a generation which has less effective involvement in their society. On the other hand, if the teacher believes in Bentham’s philosophy, which espouses the approach of the greatest good for the largest number of people, he will encourage students to share what they have learned with their peers.  Ã‚  This enhances the possibility of developing a generation of mutual respect for all peoples.  It is because of these factors, that educators must carefully consider their philosophy of education before they ever enter the classroom. They want to make sure that they foster a learning environment that not only fits their personality, but also is flexible enough to effectively reach all of the students in their classroom. Teacher experience is a vital component in developing a culture of excellence in the classroom because it is through these experiences that students can gain insight and knowledge in a fresh and relevant way. Likewise, there is no doubt that the participation of all stakeholders is important for creating and developing a culture of excellence.  Nevertheless, there is still a tremendous amount of responsibility thrust upon the teacher. For instance, he is charged with the task of implementing institutional rules that society expects its citizenry to uphold. Also, he is responsible to the students because the instructional techniques used in the

Business Intelligence - BI, mining, analytics, and data warehousing Research Paper

Business Intelligence - BI, mining, analytics, and data warehousing - Research Paper Example Moreover, the management of Caesars Entertainment is dedicated to environmental energy and sustainability protection and it recognizes the significance of being responsible steward of the environment (Caesars License Company, LLC.; EDGAR). Since the business of Caesars Entertainment is always expanding, its management has decided to implement a new technology based structure in an attempt to manage business operations successfully and effectively. For this purpose, Caesars Entertainment will make use of latest tools and technologies such as BI (Business Intelligence), mining, analytics, and data warehousing to better manage and control business operations. This report presents a detailed analysis of some of the important aspects and areas of Caesars Entertainment business where BI solutions can be implemented. At the present, almost all the organizations make use of latest tools and technologies to leverage and augment their business capabilities. For instance, many business organizations use Teradata and IBM Cognos solutions to improve their marketing strategies and customer satisfaction level by means of a closed-loop technology based systems. In the same way, with modern technology based solution such as Teradata, Harrah Entertainment enlarged its usage of IBM Cognos business intelligence software to extract and drill additional and deeper customers’ data. Moreover, by making use of these innovative technologies business is able to effectively extract and segment customers’ data into many profiles as well as utilize this extracted and filtered customer segmentation data to extend targeted campaigns to extract preferred customers’ behavior. For instance, it can help Harrah Entertainment know about clients who have not visited for over 6 months and implement strategi es to bring those customers back. As well, business uses business intelligence and data warehousing to promote innovative games by determining

Labour Market in the United Kingdom Essay Example | Topics and Well Written Essays - 1500 words

Labour Market in the United Kingdom - Essay Example The employment pattern in Britain is however different today. With over 70 per cent of the population in United Kingdom classified as being in work, there has been a notable trend of movement towards part-time employment from full-time employment (Mabey, Salaman, & Storey 1998). Worth noting is the fact that the number of women in employment in steadily increasing. For instance, women accounted for just over half all part-time employment in 1998 (Mabey, Salaman, & Storey 1998). Moreover, it was estimated that in the same year 45 per cent of women in United Kingdom were in part time employment as compared to 8 per cent of men. Additionally, the flexibility of the labour market in United Kingdom allows people to have more than one job. For example, nearly 1.3 million people had two or more jobs by 1998 (Mabey, Salaman, & Storey 1998) Although changes in the labour market in the United Kingdom have been towards a more open and non-discriminatory system, there has been criticism that the market employs a "voluntaristic" tradition (Mabey, Salaman, & Storey 1998). However, some economists view the labour market as a form of free market. In such a setting, there is freedom for employers to implement meaningful utilization of labour while avoiding impracticable and induced level of labour costs (Mabey, Salaman, & Storey 1998). Furthermore, the free labour market attracts inward investment in United Kingdom (Mabey, Salaman, & Storey 1998). In contradistinction, it is noteworthy that a very flexible labour market may compromise work relations or undermine worker output. As Mabey, Salaman, and Storey (1998) noted, employers in the free about market may seek low-cost strategies to access labour. Such a move would result in underinvestement in training, poor skills at work, low pay for the workers and fierce competition at the lower level of the labour market [Streeck 1992, cited in Mabey, Salaman, and Storey (1998)]. From the aforementioned perspectives, it is worth noting that the effects of transformation in the labour market in United Kingdom in the past decade are amenable to discussion. While some changes have brought plausible benefits, some have caused compromise in the workplace employee relations (Blyton & Turnbull 2004). As noted above, a flexible labour market encourages employer-independence in making decisions. Nevertheless, since the market is subject to competition, employers may use strategies such as pay adjustments to win employees. As such, employers may pay their employees based on performance (Blyton & Turnbull 2004). Effects of flexible labour market Although the free labour market allows employers freedom to employ without constraint, employers have to comply with the minimum wage directive that was introduced in 1997 (Howell 2005). Moreover, the flexibility in the labour market has caused a significant drop in the number of members joining trade unions. For example, while 49 over cent of the workforce in the United Kingdom were registered with labour unions, the figure dropped to 26.8 per cent in 2000 (Howell 2005). This may imply that employees enjoy better work relations currently than in 1980 hence the decline in

Social implications of the Internet Essay Example | Topics and Well Written Essays - 1000 words

Social implications of the Internet - Essay Example These innovations facilitated a tremendous flow of information, in the technical, business, cultural, political and entertainment fields. They also created a mass society, hungry for new products, better services, entertainment and general awareness, which resulted in an explosive growth in the advertisement - production - consumption cycle. Though the telephone, and to a certain extent the telegraph, had a limited scope for a two way interaction between ordinary citizens, the other media like radio and television presented only a one way flow of information. These media were still not truly interactive. The combination of all the above technologies, and also the innovations in electronics, led to the development of computers and private local networks. They allowed, for the first time, a two way exchange of written as well as graphic information between the networked computers. Since the use of these networks was initially limited to research and defence, they were more or less under the control of the government. Surprisingly, this very fact was instrumental in the further development of computing and networking technology. ... s were made by a few individuals for the people, the Internet was a development which became 'of the people, by the people and for the people', with a much larger portion of the mass society participating in the development process. The integration of the concept of World Wide Web with the internet, and also the advancement in Satellite Communication has practically connected each individual to every other, across the globe. The social impact of this phenomenon is unprecedented. With the refinement in the computer languages, the common man, with minimal or no expertise, has also been made part of this fully interactive medium, and can now explore, process and share any type of information, whether written or graphic, with any other person, in any part of the world, without taking a step out of his house. Right from children in schools, to senior citizens in retirement, the complete society has been integrated. The concept of Small office-Home office ( SOHO) is gaining popularity, reducing the necessity of commuting to the work place. Outsourcing of work is another development, which has made a considerable social impact, because of the internet. The society has also greatly benefited from the improvements in the service industry such as Banking, Insurance, Medical services, tourism etc., all due to the Internet. Like any other technology, the Internet is not without its set of problems. The major problem is uncontrolled uploading and downloading of information. Pornographic and other unsuitable content is already corrupting young minds. It is extremely difficult to invoke legal provisions in business transactions, due to the global reach of the Internet, and due to the absence of strong, mature and enforceable Cyber laws. Innocent people often fall prey to smart

Accounting Principles and Health Care Essay Example for Free

Accounting Principles and Health Care Essay There are no formal accounting principles that apply to health care. However, there are five generally accepted guiding principles used in the management of the financial aspects of health care management (Cleverly, Song Cleverly, 2011). Understanding the five guiding principles are important in understanding financial information and managerial accounting and how the principles relate to health care (Cleverly et. al. ). The five principles include, accounting entity, money measurement, duality, cost valuation, and stable monetary unit. Each principle and how it relates to health care is discussed in the following (Cleverly et. al. ). Accounting Entity An accounting entity is the business or corporation that performs clear economic activities, separate from any personal economic endeavors (Accounting Tools, 2010). An accounting entity requires financial records that define financial activities (Cleverly et. al. ). In health care, accounting entities can be hospitals, clinics, or other entities that are part of a larger corporation. See more: Social process essay Accounting is geared to measure and report the financial activities of the entities under consideration. Money Measurement Money Measurement is very simply, a way to keep count and records of the incoming and outgoing revenue of the accounting entity. This is not an easy task and involves consideration of various issues (Cleverly et. al. ). Resources and liabilities have to be considered and calculated to determine accurate money measurement. Resources are also referred to as assets. Scarce resources are things, supplies, money, and other things or resources that are needed by the company in order to generate money. These resources are limited and necessary to the entities operation (Cleverly et. al. ). This may include nursing staff for heath care organizations. Other scarce resources for health care organizations may include buildings, many different kinds of medical supplies, medications, and other supplies to care for patients and maintain the organization. Assets are the resources that the organization has and the money generated. Liabilities are resources that are owed for services, supplies and other things that the organization has acquired. The ideal goal of any business is for the assets to be greater than the liabilities (Cleverly et. al. ). Duality Duality is a simple mathematical equation or rather, it seems simple. The equation states, â€Å"The value of assets must always equal the combined value of liabilities and residual interest, which we have called net assets. † (Cleverly et. al. pg. 185 para. 1) This requires balancing reports about changes in either side of the equation. In health care, for instance, changes such as buying supplies, receiving payment for services, or paying the electric bill are all transactions that require balancing the books, so to speak, so that the equation is still equal. Cost Valuation Cost Valuation can be defined as choosing the right price for services, supplies and other things of value (Hutton, 2005). Choosing the right price may be based on the history of what the entity has paid that is reflected by money measurement or may be based on other measures of what a cost should be (Cleverly et. al. . Market value is a way to assess a cost value. This seems to be favorite way with many organizations. This method is not considered objective, however and can provide different opinions on what an item is worth, making costing difficult (Cleverly et. al. ). Replacement value is another way of choosing the right price. This gives the cost of how much money it would take to replace an item or service (Cleverly et. al. ). In health care for instance, when costing an expensive piece of medical equipment, replacement value makes more sense than market value. The organization may receive different quotes on market value but replacement value should be more consistent and reliable. Stable Monetary Unit The stable money unit is our country is the dollar. The dollar is used in money measurement and other principles that have money values attached. The dollar is always the dollar but the value can change based on the economy and inflation (Cleverly et. al. ). An example of how this might impact health care is, suppose the organization, based on replacement value, has allotted a certain amount of money to purchase an expensive medical devise. Before the purchase has been made, the dollar decreases in value or is unavailable and has to be imported. The value of the dollar has changed; the country from which the item is imported from may have experienced a decrease in the value of the United States Dollar. The dollar is still a stable monetary unit though there may be fluctuations due to inflation or other events. Conclusion There are no specific hard rules that govern accounting; the five guiding principles of accounting are used to help organizations keep track of the entity’s assets and liabilities.  The principles are not perfect but serve as a guide to costing and money measurement. The stable money unit in our country is the dollar. The dollar may experience fluctuations in value but is still considered stable and how the United States measure and pay for any expenses. The five principles seem simple and as one looks into each principle further, it is noted that there are complexities and problems that must remain in the forefront of the accountant’s mind when keeping up with the financial end of any organization.

One-pot Synthesis of Porous Coordination Polymers

One-pot Synthesis of Porous Coordination Polymers Generally, the properties of crystals are strongly determined not only by their chemical composition, but also by their morphology, size and surface structure.1-3 Over the past decade, crystals with specific crystal facets have attracted great research interest because the exposed facets on the crystals finely affect the chemical and physical properties of the functional materials.4-6 For example, noble-metallic nanocrystals having high-index facets generally show much higher plasmonic and catalytic activity than that of nanocrystals with low-energy facets.7-9 Therefore, the design and synthesis of crystals with specific crystal facets is desired, but is still a challenge. Porous coordination polymers (PCPs) or metal-organic frameworks (MOFs), which are considered as a unique class of inorganic–organic hybrid materials with metal centers and organic linkers,10 have received growing attention in recent years because of their tailored pore structure, high surface area and many exceptional properties such as gas adsorption and storage,11,12 drug release,13,14 sensing,15,16 membranes,17,18 and catalysis.19,20 To date, many research efforts have been focused on the design, synthesis and applications of bulk MOFs materials; however, nanosized MOFs (NMOFs) materials have become increasingly interesting in the last decade because their microstructure, morphology and size also determine the properties and applications of NMOFs materials.21-22 Likewise, aspect ratio and exposed crystal facets of NMOFs crystals play an important role on the properties of materials such as sorption properties, and oriented film formation as well.23-25 Therefore, controllabl e synthesis of well-defined NMOF crystals with specific exposed crystal facets in the nano/micrometer range is highly desirable. However, it is still difficult to design a universal synthetic method to achieve above target due to the variety in MOFs structures and various experimental parameters affecting the crystal shape and size. To date, several synthetic strategies have been employed by research groups for the synthesis of NMOFs such as room-temperature precipitation,26-27 hydro/solvothermal techniques,22,28 microwave-assisted synthesis,29,30 sonochemical synthesis31,32 and electrochemical synthesis method.33 Among them, room-temperature precipitation, in which the solutions of metal salts and organic linkers are mixed, is the simplest system to produce NMOFs. Compared with other methods, solution-based precipitation syntheses at room temperature possess some advantages, such as safe reaction process, easily controllable reaction conditions, low energy consumption, and short reaction time. On the other hand, the use of various additives is an important synthesis approach for the fabrication of NMOFs materials with tunable morphology and size because the additives usually suppress nucleation and crystal growth during the reaction process. Monocarboxylic acids and their salts have been widely used as the addi tives or capping agents for the preparation of NMOFs which can alter the coordination equilibrium at the crystal surface during the nucleation and growth process.29,30,34 Kitagawa and coworkers have used the combination of the coordination-modulation method and microwave synthesis to control the size and morphology of HKUST-1 in which dodecanoic acid was employed as the coordiantion modulator.29,30 Huber and Fischer have yielded stable and size-selected MOF-5 colloids by adding p-perfluoroethylbenzoic acid as capping reagent.34 Besides, N-heterocycles and alkylamines also are used as additives in the synthesis of MOFs and ZIFs. Oh et al. reported that pyridine was added in the solvothermal synthesis of In-MIL-53 to manipulate the morphology of the microsized crystals.35 Huber and Wiebcke reported a rapid room-temperature production of ZIF-8 crystals with different sizes by employing an excess of auxiliary ligands such as 1-methylimidazole and n-Butylamine.36 Another kind of additive s including surfactants and polymers also has been used to control morphology and size of NMOFs which could suppress the growth of specific crystal facets. Our previously reported HKUST-1 nanocrystals with controllable size and morphology from nanocube to microoctahedron have been readily synthesized at room temperature by adjusting the concentration of CTAB (CTAB = cetyltrimethylammonium bromide).26 Zeng and Eddaoudi reported highly monodisperse M(III)-soc-MOFs with a morphological evolution from simple cubes to complex octadecahedra have been achieved using a series of surfactants and structure-directing agents.37 Porous coordination polymer [Cu2(PZDC)2(PYZ)] crystals (PZDC = pyrazine-2,3-dicarboxylate, PYZ = pyrazine) with tunable size were prepared in a predictable manner via addition of organic polymer Poly(vinylsulfonic acid, sodium salt) by Kitagawas group.38 However, to the best of our knowledge, the study on other types of additives such as acids or bases allowing control t he morphology of NMOFs, especially inducing the crystal morphological evolution of polyhedron, has not been realized so far. Although the role of the pH of the reaction medium, which is to deprotonate the ligands, accelerate nucleation rate and consequently cause smaller size of particles has been studied systematically,39 the detailed studies on the morphological evolution of crystal induced by acid−base environment of the reaction medium are scarce. Herein in this work, we develop a simple and straightforward method for the one-pot synthesis of porous coordination polymers with controllable shape by using different bases (sodium acetate, aqueous ammonia, triethylamine and NaOH) as deprotonation reagents in the ethanol-water mixture at room temperature. We specifically selected porous coordination polymer MOF-14 ([Cu3(BTB)2], H3BTB = 4,4,4-benzene-1,3,5-triyl-tribenzoic acid) as candidate material for the investigations which possesses a dicopper paddle wheel secondary building unit that exhibits unsaturated metal centers upon activation and has received great attention due to its high porosity and large specific surface areas.40 Its benzenetribenzoate-based analogue HKUST-1 ([Cu3(BTC)2], H3BTC = 1,3,5-benzenetricarbocylic acid) also was studied. In this paper, a morphological evolution of MOF-14 from rhombic dodecahedron to truncated rhombic dodecahedron, cube with truncated edges and to cube was achieved by increasing the conce ntration of sodium acetate, likewise, a morphological transformation of HKUST-1 from octahedron to cuboctahedron and finally to cube was obtained in the similar process. We further investigated the proposed crystal formation mechanism and found that the higher-energy surface of crystals would appear when more amount of bases were added, indicating that the exposed surface facets of porous coordination polymers could be controlled by acid−base environment of the reaction medium. The gas adsorption properties of MOF-14 with different shapes were also studied and it reveal that properties of MOF-14 display a strong dependence on the facets exposed on the surface.

Endocrine Disruption :: The Endocrine System

The endocrine system is very dynamic and has ties to most, if not all of the other major systems of the body. It is responsible for production of hormones and the regulation of them as well. These hormones act as chemical messengers within the body. Through several differing mechanisms, they are able to trigger very specific responses in target cells or organs. This is what enables the endocrine system to guide growth, development, reproduction, and behavior, among many others as well. The hormones produced from the endocrine system come from a wide range of different places. Among those responsible for hormone production are the glands and a few organs as well. The glands that are involved are the pituitary, thyroid, thymus, parathyroid, and adrenal. The organs, which also play a vital part, are the pancreas, gonads, kidneys, heart, and parts of the digestive tract. All these different glands or organs work together in the production of certain hormones. Those produced in one location will almost always have an effect on many other areas of the body, not just the surrounding tissues. An analogy that fits very well with the study of the endocrine system is that of a message in a bottle. We can think of the body as a river, and a specific hormone may be a bottle containing a message. The organs or glands mentioned above would manufacture the â€Å"bottles'; (hormones) that would be released into the river (blood stream). If there were no receptor sites for the hormones in the body, then they would continue to flow along the river and probably not make their destination. However, there are systems of receptor sites that enable specific hormones to bind in specific places. Structure also plays a major role in determining which hormones are able to bind to which receptors. When these â€Å"messages in bottles'; reach their appointed destination, the binding into the receptor site causes a cascade of reactions to occur. It is these reactions that are vital in maintaining our homeostasis. Many times the binding of the receptor site causes a direct expression of a certain gene. This is where endocrine disrupters can exert major damage. In addition to gene expression, endocrine disrupters cause havoc in many other areas of the body. What exactly are endocrine disrupting chemicals? Endocrine disrupters are chemical agents that produce reversible or irreversible effects in individuals or populations by interfering with hormone function.

Solutions in Higher Education Essay -- Education, Training Faculty

Senge’s (1990) characterization of controlling versus learning organizations helps illustrate the challenge Medtech faces in making the shift to a learner-centered college with outcome-based classroom practices. When new and expansive patterns of thinking are nurtured, collective aspiration is set free (1990); however, Harris and Cullen (2008) state that the work environment at many colleges is quite to the contrary. So our questions are the same as stated by Boyer (1987) nearly three decades ago, â€Å"Is it possible for students to become independent, self-directed learners, as well as, how can faculty improve their teaching so as to encourage creativity and critique? For the purpose of this project, I will make the assumption that the answer to the first question is yes, and therefore, deal primarily with the second. â€Å"If we accept the premise that the learner-centered class is a microcosm of the learning organization, then it follows that the professional development of leadership should reflect professional development of teachers (Harris & Cullen, 2008). This can only be accomplished through concrete mechanisms for effecting change. The problem identified for this project stems from Dr. Terry O’Banion’s (2010) statement, â€Å"we cannot assume students are learning†. I identified that existing teaching and assessment often does not achieve the learning objectives required for the courses due to the hiring of faculty who are experts in their field; however, are not trained educators. In the past, tradition dictated that knowledge of the discipline was sufficient for the transmission of knowledge to students; however, this can no longer be taken for granted. The recommended solution is to implement a process for the shift from traditiona... ...the communication to the students will be through the updated syllabi and implementation of new practices in the classroom. Finally, the campus will host an open house on-site for all affiliate partners that include classroom demonstrations that will highlight the new practices. In addition, the presentation will include an explanation on how the new practices benefit the partners with externs and potential employees who have the critical thinking skills required for on the job success. Welsh (n.d.) reflected on a higher education that was static in the mid-twentieth century as he admits that is not so anymore. His charge is that change is necessary today for higher education to remain vibrant. The entire institution must become learner-centered and by initiating incremental steps, immediate rewards, and links to intrinsic motivation we will achieve that vision.

Disabled By Wilfred Owen Essay example -- English Literature

Disabled By Wilfred Owen In my essay,"Disabled" by Wilfred Owen. I am going to describe how successfully he uses poetic techniques to present the true effects of war in his poem. The main technique used in the poem is contrast, as well as other techniques. Which makes the fate of the young man more pitiful. The use of irony, word choice, and powerful images, all create the sense of atmosphere in each stanza. The contrast of mood and tone is used in the first and second stanza, which creates a change of mood. In the first stanza words like "ghastly" and phrases like, "saddening like a hymn", are used by Owen to create a dull and depressing mood. Which represents the mans present life in which he is stuck in. Then in the second stanza words like "gay" are used to create a mood that is very happy and joyful. Which represented the mans past life, before the injury. Contrast is also related to the irony in the poem. Firstly, before his injury all the girls loved him and were fighting to get their hands on him. One of the main reasons he went to war was to "please his...

Goodbye To All That Essay

In the autobiography, Robert Graves stated how his life has been influenced by the two sides of his family. He had a very strong drive to succeed and possessed great intelligence, which basing on his statement, were his father’s greatest influence in him. Good thing that Robert Graves have decided to write a novel of his account in France, because if he did not, there will be no compilation of stories that war-related story readers will be spending time with. On Arrival In France This chapter is a detailed anecdote about the intensity felt by the public during the First World War. He provided a clear depiction of what took place during the war, and gave a narrative visualization of the images prevalent in a war zone and the feelings that haunted the people – including the threats of explosions and the fear of death which were rampant during the period. As a poet, he worked hard to enable himself in providing a clear depiction of the war stories, however, his capacity is only limited to what he had seen and experienced. Being a journalist is an entirely different profession from a poet, however, Grave proved the mutual intention and passion of both profession. In this light, I would make a comparative analysis between the works of Robert Graves and Joseph Lee Galloway, an American newspaper columnist, who was the only civilian present in the Vietnam War. Both of the two writers had proven their courage as civilians living amidst the war. The life of Galloway, as depicted in the movie â€Å"We Were Soldiers† was a clear narration of the entire war scene, the feelings that were involved as he experienced violence in the middle of the war. On the other hand, Graves’ autobiography successfully touched his readers’ minds in his poetic way of stressing out the value of life, especially when under grave threats against life during the war era. His courage was most tested at times when he had to stick to his decision that he ought to pursue his passion and continue fulfilling his profession even if it meant risking his own life in the middle of the war. Though he wasn’t literally fighting, he acted as a soldier in such a way that he was fighting for his life just to enable himself in providing the people with the most dangerous pieces of information and valuable lessons that were taught during war experiences. Also in this chapter, he showed a distinct psychological capability of a poet in carefully observing the natural tendency of the soldiers to act calmly while their insides were rattling at the commencement of the war. He justifiably narrated the real feelings of the soldiers as they faced the dangers implicated during the war. â€Å"They never sang out of tune†¦ † was an emotional attack to a reader’s heart (Graves, Robert, Goodbye to All That). After Grave said that the soldiers were a bit frightened or nervous at the moment, they never sang out of tune. He asserted the justifiable manner at which the soldiers’ courage were supposed to be appreciated. He magnified the idea that though these soldiers were indeed afraid and trembling at the threat of dying, and the hollow future of their families at the pain of losing, still these soldiers didn’t back off at the brink of danger. Instead, they continued fighting notwithstanding the fears, pain and danger that were accustomed to their jobs. Guns in the Distance The battlefield was a mere case of â€Å"survival of the fittest†. All around, soldiers were ready for the battle and all of them kept hold of their only partners during the war – guns, ammunitions, bombs, grenades and other destructive weapons that were used by both sides. As the mere sound of explosions caused the soldiers to feel the danger and seek for refuge, they had learned all the tactics to preserve their lives. Consequently though, they were able to transform the fear into something that was fun, and something that calmed them down rather than causing even more threats and disturbance in them. The Trench Danger was everywhere and the trench was their only refuge. It served as their only shelter against all the atrocities and dangers from the enemies. However, the tranquility they felt in the place wasn’t enough to keep them from all the dangers of the war. Death was a presence though least welcomed, most prevalent in the war zone. And neither the shelter provided by trenches was enough to secure the soldiers from dying. The trench gives a soldier a chance to live longer, but he must suffer the consequences of being with it. He has to be strong enough to soak his feet to the wet and slippery trench. He has to be careful of the holes right and left, to the low and high wires of the field telephones and to the deep areas in the trench. He must be alert, cautious and apprehensive of all the bullets coming from anywhere, because bullets does not choose who to kill. It does not know who it wants to land on, to whose body or head or face. It just blows inside you and stops you from thinking, and feeling, and breathing. Moreover, the life in trench though provided a home for the soldier, was the least safe and comfortable amongst all the places disrupted by war. It would not keep them away from bullets, shells and other explosives that endangers human life. And though there were discomforts within the trench that had seemed to devoid the place of its tranquility, the trench was a place to hide – even though it danger itself is inculcated within its borders. Battalion Headquarters There lies a great difference between the battalion headquarters and the trench. Wherein trench did not provide them enough protection and shelter from bullets and explosions, coupled with the discomfort within the area; the battalion headquarter was a comfortable place wherein the menace of the war was less visible and felt. However, ordinary soldiers did not experience comfort and luxuries that the place could offer. Rather, high ranking military officials were the ones who enjoyed the luxury of such place. It was a clear irony. The soldiers who were fighting face to face against death lived with fear, exhaustion and restlessness. They lived through the war with a miserable condition – poor shelter, less time to feed themselves, and even lesser time to allow their bodies and minds to rest. And the foods they eat were not nicely cooked. Soldiers lived with all the discomfort, difficulties, inconvenience and troubles. While on the other hand, those high ranked military officials who are not facing the dangers of the open war enjoyed all the luxury and favors that they could avail of. They are not suffering the fear of dying because they were sheltered safe from all the atrocities of the war. The irony lies in the mere fact that those who are risking their lives and facing bullets and bombs most of the lives suffered from discomfort and danger; while there were those military officials who did not fight amidst the battle were the ones enjoying the favors that life could offer them. There is also an acquainted thought about how soldiers in the battle and the soldiers out in the battle behaves in front of the officers. When Graves narrated the time when they have passed through the group of men in the battalion headquarters, he is sure that the group were aware that they were officials, but they did not make any recognition. In the trenches, soldiers know how to honor them. They even call Graves â€Å"Sir†, and gives recognition to the officers. They are well-disciplined, and yet, they are those in the danger zone. Did the war zone discipline them? If it did, then maybe it is better to put this group of soldiers in the battle field to cultivate a disciplined attitude. How was that? The Only Survivors Only the survivors of the battle were the ones who gained honors and established good reputations for themselves because they had the capability of passing their stories onto other people. They were able to narrate how they have lived their lives during the onset of the war. However, people had forgotten those who heroically died during the battle. Commemoration of the soldiers who died in the battlefield had been less probable because during this time, only those who survived became the center of attention amongst the civilians. And the tasks of remembering the courageous acts of those who did not survive were only left amongst the families of the non survivors. The heroism of these people had become a mere representation of a distinct part of the history, rather than heroism remembered and commemorated. Then how to survive in the battle anyway? When in the trenches, it is cold, no good foods, no rest, no peace of mind†¦ how are they about to survive in that kind of living? Does the survival of the fittest also mean surviving from cold, bacterias and viruses? We all know soldiers do not mind how far they could be dirty or gross, because all they have in mind is to stop the enemy from fighting and to battle against them. It is not part of their mission to have a sensitive stomach when they joined the military. If they need to eat the soil, they will, in order to survive in the battle. Half of the soldiers were lost because of coldness. They suffer severe rheumatism, or being frost-bitten. But those sufferings will not be acknowledged when they died. Only those who survived will get the great reputations. Only the fittest has the right to be accustomed. Those who died will just be part of the history. How sad†¦ Our Timetable Two hours? Is that a sleep or just a nap?. In this chapter, Graves illustrated the dedication those soldiers had for the sake of their duties. Their lives at the middle of the battlefield was spent with rifles, grenades, bullets, bombs and other ammunitions; with little time left for eating, sleep and rest. They have to work all day and night, with only two hours of sleep. Yes, they still have two hours to rest their minds and bodies, but do we think they could really rest in that situation? No, because they should be always alert in anything to happen because their lives are always at the risk and danger. In addition, the scarce time left for them to rest was spent in more desolation and increased vigilance that rendered them the incapability of spending that scarce amount of time for the rest needed by their body. Thus, rest became an abstract concept for them. For resting shall render them complacency that might induce more danger for their lives and the cause that they were fighting for. They could not rest for once, for there is a tendency that they will never wake forever. A Soldier’s Death This chapter was highlighted by Graves’ anecdotes on the deaths of particular soldiers. The deaths by these soldiers were far worse than the deaths in the middle of the war. These deaths were more tragic. Soldiers decided to end their agony by suicide. The whole depiction of the battle was more engrossed in the mere fact that most of the soldiers faltered and lost their hopes. And it was more awful that these incidents were not properly documented and reported. Military officials didn’t have much of the courage to honestly admit that the emotional burdens caused by the war was far worse than the physical exhaustion that it imposed amongst the soldiers. Thus they made false accounts and fake letters and reports that were given to the families of the soldiers who committed suicide. How many soldiers have those kinds of stories? We do not know. We can not guess. Kill the Lice The life of the lice is like the life of the soldiers. Just as invaluable and ambiguous. Which was better to kill, the young ones or the old ones? Just like them, soldiers were killing soldiers of the enemy. But they did not care who they had killed, young or old. What only matters was that they were able to defend their cause. Killing has been their lives. Humans are like lice, living in the world, from birth to death. It matters not who shall die first, the same way that a longer life was only out of sheer luck. For normal people who does not understand the lifestyle of the soldiers, life is not compared with lice’s life. Being a human is far different from being lice. But for a soldier who lives like lice, there is a great similarity. Seems like there is nothing different between them. Live today, die tomorrow†¦ with any cause, nice or worst. In the life of a soldier, their life is ambiguous. Just like lice’s†¦ Gas, Sir, Gas! It was such a sudden false alarm. For the lower ranked soldiers, every sign of enemy’s attack meant danger, and they were supposed to do something about it. But on the part of the high-profiled officers, everything was just common scenario. The gas alarm was not a thing to apprehend the officers, because they knew how to analyze the situation. Their knowledge and experiences in every battle taught them how to react on such situations. For the common soldiers, it was panic; but for the officers who could sense the attack, there wasn’t any reason to get alarmed because they were ready for it. Thus, I would say that Robert Graves is a very intelligent writer. His writings really made sense and I do not doubt why he had become a legendary figure in the world of literary. â€Å"Goodbye To All That† was a great success in touching the lives of his readers and generating a dramatic empathy towards anyone’s emotions. He wrote all his war anecdotes because he wanted to forget and let go of all the disturbing experiences of the war. He discovered secrets, experienced many difficulties, he was a witness on many painful suffering and deaths. And as such, he wanted to forget these experiences, but he wanted to share everything that he was has learned through all these experiences.

Adventure Time Essay

Have you ever gazed upon one of Salvador Dali’s surreal paintings, and it left you in a bewildered state? You’ve pondered what he was trying to display, or perhaps you were left wondering, is there a story behind this? Well, I am here today to tell you of such a story. See, we live in a time where people tend to take things much too seriously, far too often. When the world seems to erase happiness from one’s life, there lays Adventure Time, shimmering in the horizon in all its pastel glory. It is a beacon of happiness, joy, abnormality, and an escape route for all those trapped in a calloused hand of disappointment. The show may appear to disguise itself as a children’s program, but I can tell you confidently, that it provides material for more than one target audience. There’s a reason why high school and college students enjoy watching Pixar films or shows from their youth, and Pendleton Ward, the show’s creator, really hits home with a cartoon that may well be the most creative, and entertaining TV program of it’s kind. This is a fine example of the phrase â€Å"do not judge a book by its cover†, because underneath Adventure Time’s amazing array of bright and colorful characters, lies a subtext that involves a very large portion of dark and rather bizarre moments. This world that you are diving into and sharing with these characters is not as â€Å"sugar coated† as it leads you to believe. Adventure Time is set in a post-apocalyptic Earth, where The Great Mushroom War wiped out it’s inhabitants, leaving one human child alive. Which brings us to our stories main protagonist, Finn the Human, who was raised by a family of elasticated, shape-shifting dogs. Jake the dog, Finn’s brother and best pal, joins Finn on his Adventures of saving princesses from the evil Ice King, exposing themselves to constant dangers while they protect the kingdom of living candy from horrifying terrors. Although it sometimes may be weird yet amusing, like when our heroes place themselves inside the stomach of a giant to prevent the bears that are partying within from being digested and melted by lava, Adventure Time can become serious when the characters portray real emotion. A cartoon needs more than just mind-blowing implications to entertain an older audience. In more recent episodes, it was shown that the main antagonist of the show, was once a human antiquarian (someone who studies ancient artifacts), who discovered a cursed crown sometime before the Nuclear fallout. When he placed it on to make his fiancee laugh, he blacked out and started experiencing horrifying visions. When he came to, something happened that drove his fiancee away. This later connects to why he steals princesses, to fill the gap in his heart from when his own princess left him. Also, our hero is in love with a princess made entirely out of bubblegum, but cannot be with her due to the fact that she is 18 and he is 13, causing him emotional stress. He later falls in love with a princess made out of flames, who is highly unstable when she is angry. Finn has a hard time being with her because she burns him whenever he tries to hold her. I’m sure some of you may connect with the feeling of wanting someone, but something prevents you from being with that person or simply, the person has no feelings for you. This show is stacked to the brim with moments like these. Not only is there an emotional intelligence to balance the show’s oddness, but there is a very artistic and poetic vibe behind the story. There are numerous musical numbers, and remember able quotes that make you think. A couple of my personal favorite quotes from the show are: â€Å"In the dark recesses of the mind, a disease known as FEAR feasts upon the souls of those who cannot overcome its power†¦ And so fear forces deep within the soul of a hero. Conquered†¦ at least, for now. † â€Å"I am the true coward. Hiding from sincere expressions like a vampire in the nude who hides from the light. Thank you brave hero. I was freed from bottle jail, but my new prison is shame. † Can we pull back the veil of static and reach in to the source of all being? Behind this curtain of patterns, this random pattern generator. So clever. Right here in every home, watching us from a one-sided mirror. † When a cartoon is able to be demented and touch the heart at the same time, I believe it is a show for everyone to enjoy. So grab your friends, and experience many different lands, with Jake the Dog and Finn the Human, a show where the fun never ends, it’s Adventure Time. Adventure Time Essay Adventure Time (originally titled Adventure Time with Finn & Jake[2]) is an American animated television series created by Pendleton Ward for Cartoon Network. The series follows the adventures of Finn (voiced by Jeremy Shada), a human boy, and his best friend and adoptive brother Jake (voiced by John DiMaggio), a dog with magical powers to change shape and grow and shrink at will. Finn and Jake live in the post-apocalyptic Land of Ooo. Along the way, they interact with the other main characters of the show: Princess Bubblegum (voiced by Hynden Walch), The Ice King (voiced by Tom Kenny), and Marceline the Vampire Queen (voiced by Olivia Olson). The series is based on a short produced for Frederator’s Nicktoons Network animation incubator series Random! Cartoons. After the short became a viral hit on the internet, Cartoon Network picked it up for a full-length series that previewed on March 11, 2010, and officially premiered on April 5, 2010. The series, which is heavily inspired by the fantasy role-playing game Dungeons & Dragons as well as video games, is produced via hand-drawn animation. Episodes are created through the process of storyboarding, and a single episode takes roughly nine months to complete. The Adventure Time cast records their lines together in group recordings as opposed to different recording sessions with each voice actor, and the series also regularly employs guest actors and actresses for minor and recurring characters. Each Adventure Time episode is about eleven minutes in length; pairs of episodes are often telecast in order to fill a half-hour program time slot. The series has completed four seasons of twenty-six episodes each, and is currently on its fifth, which debuted on November 12, 2012. Ever since its debut, Adventure Time has been a ratings success for Cartoon Network. As of March 2012, the show is viewed by approximately 2 to 3 million viewers per week. The show has received positive reviews from critics and has developed a cult following among teenagers and adults, many of whom are attracted due to the series’ animation, stories and characters. Adventure Time has also been nominated for five Annie Awards, three Primetime Emmy Awards, two Critics’ Choice Television Awards, and a Sundance Film Festival Award, among others. In 2013, the series won a Motion Picture Sound Editors Award for the episode â€Å"Card Wars†. In addition, the series has also produced various clothing and merchandise, video games, comic books, and DVD compilations.

Famine, Affluence, and Morality Essay

In Singer’s article Famine, Affluence, and Morality, his main goal is to get the point across that there are people in the developing world that are starving and have a lack of healthcare and the lack of shelters. He argues about how affluent countries react to the issues like Bengal and the way they look at the moral issue surrounding it. He also argues that the way of life is taken for granted by affluence people. The first counter- argument in the article is â€Å"the view that numbers do make a difference† (Singer, 1971). It refers to if every affluent person would give 5 dollars to the Bengal Relief Fund that money would add up. Therefore, there is no reason to have to give more money than anyone else in the same position. Singer argues that this is based off a hypothetical situation. He, however, says in the article that there is no way for that work since no one would give more than 5 dollars then there would not be enough money to provide food, shelter, and medical care. He says by giving more than 5 dollars he will be able to end more suffering. The second counter argument people do not judge the way Singer suggested they should. Many people tend to keep their judgments to themselves unless they go overboard, step out bounds, and break some type of moral code. The example that Singer uses is taking someone else’s property. Most people tend not to look bad on owning expensive items instead of giving to people less fortunate. Singer’s response to this argument is, â€Å"unless that principle is rejected, or the arguments are shown to be unsound, I think the conclusion must stand however strange it appears. It might, nevertheless, be interesting to consider why our society, and most other societies, do judge differently from the way I have suggested they should. † (Singer, 1972) At what point do people draw the line at what should be done and what is good but not mandatory. Singer brings up a point that, â€Å"In a society which held that no man should have more than enough while others have less than they need. † (Utilitarian Philosophers, NDG) Many people are influenced by the people around them. If people are giving less than people around them are likely to give less, but if people give more than people around him are likely to give more. The third counter argument is the difference between duty and charity. The argument is that in some utilitarian theory that everyone should work full time to increase happiness over misery. Meaning that, if people work more, are paid more money than people would not be as miserable, many people say money cannot buy happiness. Singer’s reaction to this counter- argument is that, â€Å"we ought to be preventing as much suffering as we can without sacrificing something else of comparable moral importance. † (Utilitarian Philosophers, NDG) Singer defines marginal utility as the level at which giving more would result in suffering in his dependents or himself. The meaning of this is that one would limit their material possessions to less than nothing. He further explains that he proposed a more moderate version of marginal utility, â€Å"that we should prevent bad occurrences unless, to do so, we had to sacrifice something morally significant, for one might hold that to reduce oneself and one’s family to this level is to cause something significantly bad to happen. (Singer, 1972) It relates to his arguments because he insists that we need to limit our material possessions to that of the Bengal refugees. Singer compares the distinction between duty and charity as not an easy line to draw. However Singer gives an example as this, â€Å"The charitable man may be praised, but the man who is not charitable is not condemned. When we buy new clothes not to keep ourselves, warm but to look â€Å"well-dressed† we are not providing for any important need. We would not be sacrificing anything significant if we were to continue to wear our old clothes, and give the money to famine relief. By doing so, we would be preventing another person from starving. † (Singer, 1972) In other words, instead of buying expensive worthless stuff for yourself giving the extra money would benefit more people and make it more charitable; however, you do not give the extra money to charity you are not looked at any differently. I do agree with some parts of his article, however, I disagree with most of it. First, I think that his article come off with a major attitude in my mind. He does however make some good points like the way he talks about how some people are influenced by the people around them. Another good point that he made is it should not matter how far the distance is wither they are in the same area as you are thousands of miles away. I do not agree with how he insinuates that the richer you are the more you should give. I believe that a person should give as much as he or she wants. I also believe that a person giving charity should not be held at a higher pedestal then someone that is not able to give to charity.

Dementia: Alzheimer’s Disease and Social Care Diploma

Unit DEM 301 Understand the process and experience of dementia This unit provides you with the knowledge on the neurology of dementia including the causes, difficulties and needs of the person with dementia. This will help to support your understanding of how people may experience dementia. With the development of improved health care and healthier lifestyles, people are living longer. With an increase in an ageing population come age-related conditions such as dementia. Age is not the only cause of dementia as you will discover within this unit. In this unit you will learn about: the neurology of dementia he impact of recognition and diagnosis of dementia how dementia care must be underpinned by a personcentred approach. 1 Level 3 Health & Social Care Diploma 1. Understand the neurology of dementia 1. 1 Causes of dementia The word ‘dementia’ is a term which describes a serious deterioration in mental functions, such as memory, language, orientation and judgement. How ever, the causes are still not yet fully understood. Research in this area is ongoing and to date a number of types of dementia and their causes have been identified. The brain is a complex organ and is divided up into different areas that control different functions within the ody. The brain contains around 100 billion cells. In dementia some of these cells stop working properly. The part of the brain that this occurs in will affect how that person thinks, remembers and communicates. Senile dementia is a term that refers to dementia in people aged over 65. It is not uncommon for people under the age of 65 to develop dementia. This is known as early onset dementia. Cerebral cortex Ventricles Healthy brain Hippocampus Cortical shrinkage Moderately enlarged ventricles Mild Alzheimer’s disease Dementia is a major health condition which affects over 820,000 people in the UK. Worldwide, more than 35 illion people are estimated to have dementia, with 4. 6 million new cases being di agnosed every year. Shrinking hippocampus Severe cortical shrinkage Severely enlarged ventricles Types and causes of dementia Alzheimer’s disease Many people ask if dementia and Alzheimer’s disease are the same thing. The short answer is no. Alzheimer’s disease is the most common cause of dementia. It is responsible for approximately two-thirds of dementia in older people. Dementia is a contentious topic, with many proponents wishing to enable rights and choices of individuals with dementia Alzheimer’s is caused by nerve cells dying in certain areas of the brain. In addition to this, the connections between affected nerve cells deteriorate. As he disease progresses, it spreads and affects cells in other parts of the brain. The cause of the brain cells dying and the deterioration of the connectors is not fully known. 2 Severe Alzheimer’s disease Severe shrinkage of hippocampus Brain affected by dementia and unaffected brain. Vascular dementia Vascul ar dementia is a form of dementia caused by damage to the brain through deprivation of oxygenated blood. Oxygenated blood is carried around your body and brain through arteries. Deoxygenated blood is carried through your body in veins. It is these arteries and veins that make up part of your vascular system.When an organ in your body is deprived of blood, that organ (or part of it) will die. This is what happens to the brain in vascular dementia. The conditions which can cause these problems are preventable and include high blood pressure, heart problems, diabetes and high cholesterol. When supporting people into leading a healthy lifestyle, it is important to bear this condition in mind, in the hopes of preventing the onset of vascular dementia. Understand dementia Rarer forms of dementia Creutzfeldt-Jakob disease (CJD) CJD is a form of dementia caused by prion disease. Prions are proteins which are found in mammals.When these proteins cluster together in the brain, they cause brai n cells to die. When these cells die they leave holes in the brain called spongiosis. Examining the brain under a microscope reveals the cells to appear spongelike. This damage to the brain causes neurological difficulties and dementia. There are four forms of CJD: †¢ †¢ †¢ †¢ sporadic familial iatrogenic variant. Although each of these conditions is very rare, their prognosis is extremely poor. The affected person’s life expectancy is radically reduced, with death occurring usually within 6 to 24 months from early diagnosis. The isease can take many years from the time it infects a person to it causing recognisable symptoms. The cause of Sporadic CJD is unknown and its onset is very fast. It affects people over the age of 50 and can cause death within a matter of months. Familial CJD is an inherited form of the disease. Its symptoms usually affect the person at an early age from 20 to 60 years. Death occurs between two and ten years of symptoms beginning. Iatrogenic CJD occurs as a result of contaminated blood or tissue entering the healthy person’s body. This can take place with corneal transplants, grafts or the use of growth hormones.To prevent the risk of contamination, transplants are no longer taken from people known to have the disease and growth hormones are now developed artificially. Because prions cannot be destroyed using normal sterilisation procedures, any surgical instruments used on people with CJD are not used on other patients. The last form of CJD is known as Variant CJD. This form affects people at a younger age with the average age of death being 29 years. The average time the person is affected by this disease is 14 months. Variant CJD is caused by bovine spongiform encephalopathy (BSE) – a form of prion disease which affects cattle.The person contracts this disease by eating infected beef products. Unit DEM 301 To reduce the risk greatly of infected beef products reaching the market, manufacturer s now remove the animal’s brain and spinal cord from general sale. Functional skills Maths: Recording data This information can be used to record data in a chart and shows the use of working out averages for statistical purposes. Biswanger’s disease This is a form of vascular dementia in which damage occurs to the blood vessels in the deep white matter of the brain. It affects people over the age of 60 and is often as a result of long-term hypertension or high lood pressure. Dementia and learning disabilities Some people with learning disabilities are at risk of developing dementia in adult life. People with Down’s syndrome are at risk of developing Alzheimer’s disease. The risk of Alzheimer’s increases as the person gets older. It is estimated that over half of the people with Down’s syndrome will develop Alzheimer’s disease when they are in their 60s. Fronto-temporal dementia Fronto-temporal dementia is a rare form of dementia. It t ends to affect younger people and is more common within men. The condition is caused by damage to the frontal lobe and/or the temporal parts of the brain.These areas are responsible for the person’s behaviour, emotional responses and language skills. The condition includes those known as Pick’s disease, Frontal Lobe Degeneration and dementia associated with motor neurone disease. Dementia with Lewy Bodies (DLB) Lewy Bodies are tiny protein deposits which are found inside the nerve cells of the brain. These deposits alter the way the brain functions and can be found in people with either dementia or Parkinson’s disease. Approximately four per cent of the older population who have dementia are affected by DLB. This form of dementia has characteristics of both Alzheimer’s andParkinson’s disease. 3 Level 3 Health & Social Care Diploma 1. 2 Types of memory impairment commonly experienced with dementia Within humans, the term ‘memory’ refers to information stored in the brain. Apart from storage, it also includes the retention or keeping and recalling of that information. A person’s brain is extremely complex and can store, retain and recall many, many pieces of information for many, many years. The ease with which the person can remember information will vary depending on the subject, the person and their state of mind. If the information is unusual or interesting, they ay remember this more so than information which is uninteresting or mundane. Memory loss can be defined in different ways depending on the situation it is being used for and the type of memory which is lost. Memory loss can be the inability to retrieve information from the long-term memory. This type of memory loss usually happens when the person is distracted or is not fully concentrating when the memory is formed. Another form of memory loss is when new memories are stored within the brain replacing older memories. Think of your brain as a fil ing cabinet; there is only so much information you can store n it at any one time. To make room for new information, you will need to take out or discard some old information. This type of memory loss is normal and is experienced by everyone. Memory loss can also be described as the fading away of memories. This sort of memory loss can occur with telephone numbers, facts or people’s names if you have not used them for a while. Think back to when you were at school. You would have known the names of many of the students and teachers. Can you recall all of the students’ and teachers’ names now? You may barely remember what their faces looked like and you may be truggling to remember everyone’s names. This could be because you have not had any reason to remember this information. It is not something you have had to use on a regular basis. Memory loss due to the ageing process can be defined as being the shrinking of the hippocampus, which is responsible for the storage of long-term memories. The hippocampus is usually the first part of the brain which suffers damage, leading to Alzheimer’s disease. Hippocampus Location of the hippocampus. Case study Recognising normal memory loss Christine is 43 years old and is concerned about her memory. She is a very busy lady with a stressful job.Christine is walking down the corridor at work heading to yet another meeting. She is going over in her mind what she needs to raise in the meeting and checking through her diary to see what time she needs to leave to get into town for her third meeting of the day. Carol, one of Christine’s colleagues, bumps into her and tells her that Mark has telephoned and would like to see Christine later today at 3. 15pm in the staff canteen. Christine says, ‘OK,’ and carries on to her meeting. 4 At 3. 30pm Christine is sat at her desk writing up the minutes from a meeting last week when the telephone rings.It is Mark; he is in the staff can teen waiting for Christine and he is not very happy. He asks if she had received his message. This jogs her memory and she realises she should be in the staff canteen. She apologises and tells him she is on her way. 1. Explain in detail why you think Christine forgot about meeting Mark. 2. Why is it that Christine is able to remember what was discussed in a meeting a week ago, yet cannot remember what she was told earlier that day? Understand dementia Functional skills English: Writing; Reading In this unit there are a number of examples of case studies. These studies have all been laid out using a uitable format and attention has been paid to ensure that spelling, punctuation and grammar are accurate. You will need to use these skills when writing case studies in your place of work. You will need to read and understand both straightforward and complex texts, and use the information in an appropriate way. Within psychology, memory loss is usually defined as the inability to retrieve declarative memories from the long-term memory. An example of this could be amnesia. The person experiencing amnesia may not be able to remember facts or declarative memories, but they retain their procedural memory which is responsible or remembering skills such as riding a bicycle, reading or talking. People with dementia may experience short-term memory loss. Their ability to store, retain and recall information may be affected due to the damage of the cells within their brain. Short-term memory loss Short-term memory can differ from one person to another. Research has been carried out on this by asking subjects to remember numbers. A list of numbers is read out at approximately one per second. The subject is then asked to recall these numbers and on average it has shown that a person can remember seven consecutive numbers.A person with dementia may have difficulties remembering things that happened only a short while ago. However, the same person may be able to remember things that happened many years ago. Other memory difficulties could include: †¢ †¢ †¢ †¢ †¢ †¢ a difficulty in recognising people or remembering their names the inability to find the right words for things or objects repeating conversations that they have already had asking the same question in a short space of time forgetting appointments or recent events misplacing items, forgetting where they have put things or where they are usually kept †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢Unit DEM 301 the inability to recall what they have had to eat or even forgetting they had eaten the loss of skills such as self-care, washing, dressing, putting clothes on in the wrong order, shopping and cooking the inability to judge time, thinking it is time to get up when it is the middle of the night forgetting where they live becoming unaware of their surroundings forgetting to take medication, possibly thinking they have already taken i t forgetting their disabilities such as getting up to walk even though they are not able, which results in their falling an inability to have empathy which could make the erson appear selfish personality changes – if previously extrovert, they could become introverted and vice versa the loss of social etiquette including making thoughtless comments, being rude or exhibiting sexual behaviours in public. Initially people experiencing these memory losses may feel frustrated or angry with themselves. They are angry because they know that they have forgotten, and frustrated because they are unable to remember as they used to. Activity 1 Memory impairments Think about the people you support. What types of memory difficulties do they experience and how do you know about this? Functional skillsEnglish: Speaking and listening Have a discussion with colleagues about the types of memory difficulties that people you are working with have. Ensure you take an active part in the discussion and that you show effective listening skills. It is important to keep in mind that no two people’s memories will be affected by dementia in the same way. The inappropriateness of their behaviours is caused by a physical change to the brain and therefore the person has no control over it. 5 Level 3 Health & Social Care Diploma 1. 3 How individuals process information with reference to the abilities and limitations of ndividuals with dementia The workings of the brain are very complex. As stated previously, the human brain is made up of around 100 billion cells. In the main these cells are called neurons. It may be easier to think of these neurons as switches which are either switched on or switched off. If the neuron is switched off it is resting; when it is switched on it fires electrical impulses along its body known as the axon. At the end of this axon there is a small part which releases a chemical. The chemical travels over a gap known as the synapse where it turns on ano ther neuron. These chemicals are known as eurotransmitters. There are 60 identified chemicals involved in the brain’s activity. The following are some important neurotransmitters relating to the process of memory and associated functions. Dopamine The chemical dopamine is critical for controlling your body’s movements. If you do not have enough dopamine, you will not be able to move or control your movements very well. Dopamine also controls the flow of information from other areas of the brain, especially memory, attention and problem-solving tasks. Serotonin The chemical serotonin is the neurotransmitter enhanced by many antidepressants, such as Prozac, nd has become known as the ‘feel-good’ neurotransmitter. It has a profound effect on mood, anxiety and aggression. Acetylcholine (ACh) ACh controls activity in the areas of the brain that are connected with attention, learning and memory. People with Alzheimer’s tend to have low levels of ACh in th eir brain. Glutamate Glutamate is vital for making the links between neurons that are the centre of learning and long-term memory. Reading about these chemicals and what they do can help towards explaining how the person with dementia, 6 who has damage to these neurons, has difficulty with their memory.Because the neurons are damaged or destroyed, they are not able to produce or transmit important chemicals which are required for the person to function fully. Nerve cell Synapse Axon Dendrite The amount of electricity the human brain produces when each of its neurons is firing is equivalent to a 60-watt light bulb. Left-sided and right-sided brain The collection of 100 billion cells or neurons in the brain is divided into two halves, known as hemispheres. The right side of the brain is responsible for putting information together – for example, information received from eyes. If you see a lady the information goes from our eyes to the right side of your brain, firing neurons, putting the information together so you are able to say, ‘I can see a lady. ’ The left side of the brain analyses information which is collected by the right side of the brain. It enables you to expand on what you see so you are able to say, ‘I know who that lady is, it’s my sister Michelle. ’ People with dementia who have damage to the neurons on the right side of the brain will have difficulty putting information together. They will be able to ‘see’ things, items or people, but will not be able to make the connection of what those things, items or people are.People who have damage to the neurons on the left side of the brain tend to be affected by depression. They will have more organisational problems and will have problems using language. Understand dementia 1. 4 How other factors can cause changes in an individual’s condition that may not be attributable to dementia Experiencing a loss or reduction in memory does not always i ndicate a form of dementia. There are other health conditions which could affect somebody’s level of memory. These are often referred to as reversible dementias. The part of the brain that has become damaged will determine how the person will be affected.Unit DEM 301 Drug and alcohol induced memory loss The effects of drug misuse including excess alcohol can cause damage to the neurons in the brain, resulting in neurological difficulties including memory disruptions. Myalgic Encephalomyelitis (ME) Conditions affecting memory ME, otherwise known as Chronic Fatigue Syndrome (CFS) or Post-Viral Fatigue Syndrome (PVFS) is a chronic, disabling neurological disorder. It is characterised by persistent fatigue and muscle pain. Symptoms can include cognitive problems such as loss of memory and concentration, recurrent sore throat and enlarged neck glands, disturbed sleep patterns and ersistent headaches. Brain injury Medication Injuries to the brain can be caused by external trauma su ch as a blow to the head, or internal factors such as a result of a stroke or aneurism. The level of brain injury can be anything from mild to severe. This can result in both short-term and long-term or permanent difficulties. Some prescription medications can have side effects which can affect somebody’s memory. Brain tumour A tumour of the brain can be benign (slow-growing, non-cancerous) or malignant (invasive, often growing rapidly and cancerous). sensation hearing movement speech, movement and sensory functions Parietal obe Frontal lobe Occipital lobe Temporal lobe Cerebellum hearing and vision Brain stem Parts of the brain and their primary functions. Diet Some foods can have an effect on a person’s memory. It is believed foods such as those containing vitamin C and sugars can have an effect on memory. Encephalitis Encephalitis is an inflammation of the brain, usually occurring as a result of viral infection. Huntington’s disease Huntington’s diseas e is a hereditary, neurodegenerative disorder of the central nervous system. It can cause emotional, intellectual and movement problems. The course of Huntington’s is characterised by involuntary ovement of the limbs, trunk and face, progressive loss of mental abilities, and the development of psychiatric problems. Huntington’s disease usually appears in middle age (30–50 years) but can develop in younger and older people. Hydrocephalus Hydrocephalus is usually associated with Spina Bifida and is caused by a build-up of cerebro-spinal fluid (CSF) in the brain. This condition can also be caused by infections such as meningitis, premature birth, head injury or stroke. Hydrocephalus can lead to problems with concentration, short-term memory, organisation and coordination. Lack of sleep/insomniaPeople who have difficulty sleeping may experience various health problems including memory difficulties. 7 Level 3 Health & Social Care Diploma Lyme disease Lyme disease is an infectious disease caused by the bacterium Borrelia Burgdorferi. The disease is transmitted to humans through the bite of an infected tick. If left untreated, Lyme disease may affect a person’s memory. Multiple sclerosis (MS) MS occurs as the result of damage to myelin – the protective sheath surrounding nerve fibres of the central nervous system. This damage interferes with messages between the brain and other parts of the body.Parkinson’s disease This is a progressive neurological condition, which can affect the person’s ability in talking, walking, swallowing, writing and memory. Stress Stress is the emotional and physical strain caused by your response to pressure from the outside world. Stress can affect your health in many ways, including memory difficulties. Stroke A stroke occurs because of a disruption to the blood supply to a particular area of the brain, causing damage to that area of the brain. 1. 5 Why the abilities and needs of an individ ual with dementia may fluctuate Each person may experience dementia in different ways.There is no definitive direction or path that the condition will follow and there are no exact timescales in which the condition may progress. You have examined how the person’s condition will deteriorate over time, but during that time it can also fluctuate or come and go. Fluctuation of needs and abilities It is not fully known why somebody with dementia can have ‘good days’ and ‘bad days’. Part of the answer for this could be because we all have good and bad days. This very much depends on how we are feeling, how much sleep we have had, what activity we are doing and how much we want to do that activity. 8When you are having a bad day, everything you do seems to go wrong. Could this be simply because you are feeling so negative? Can your attitude have an effect on the outcome? Think about this for a while. If you do not like doing something, it seems to take fore ver to get it over and done with. The time drags and your level of boredom or uninterest rises. On the other hand, when you are doing something you enjoy, the time rushes by so that before you know it the activity comes to an end. This theory could also relate to the person with dementia. If the person is doing something that is familiar to them, something that they have done many imes and have developed a routine for, the person may appear very confident and able to do it with ease. They may appear to show no signs of dementia. However, take the person out of their familiar surroundings and out of their routine, and their confusion will grow, causing their symptoms to be more obvious. Stress has been identified to have an effect on our memory. In the early stages of dementia, the person may be fully aware that they have forgotten where they have put things. This can cause their stress levels to rise, resulting in added memory difficulties, frustration and confusion.In these earlier stages it is important for you as a care worker to give the person emotional support. Do not be tempted to take over what they are having difficulty with. Help them to calm down and think about what they are doing. The more the person becomes agitated, the greater their difficulties will become. As the condition progresses, the more support the person will require. This will include support with day-to-day activities. You can give support through reminding the person what they need to do. Do not overload them as this will increase their stress and therefore their symptoms. If the person asks you a question and epeats it several times within a short space of time, answer it as though it is the first time you have heard the question. Do not show your frustrations as this will only cause them to become upset when they see how their behaviour is affecting you. In the later stages, the person will become emotionally and physically frail. Their reliance on care will increase to the point where they are no longer able to care for themselves. They may lose their ability to eat, walk or speak, with only the occasional word being shouted or crying out. Understand dementia Unit DEM 301 2. Understand the impact of recognition and diagnosis f dementia 2. 1 The impact of early diagnosis and follow-up to diagnosis For most people, receiving the diagnosis of dementia is very distressing. It is also very upsetting for their family. Many people today still think of dementia as being a condition which causes people to go ‘mad’. It is these negative images that can add unnecessary distress to both the person and their family. funeral through the drawing up of a will. They can be encouraged and supported to sort out any bills and arrange for future bills to be paid for by direct debit so that important bills are not overlooked. The person may ind comfort in keeping busy during the initial stages and they may feel reassured that their future has been planned to meet t heir needs. If you are supporting somebody who is exhibiting any signs or symptoms of forgetfulness, confusion or the inability to find the right words when communicating, it is important that they see their GP. Diagnosis can be difficult to make in the early stages as the symptoms of dementia can develop slowly. They can also be similar to symptoms of other health conditions. The GP or health professional will be able to monitor any pattern of symptoms and undertake tests over a period of time o measure any changes in the person’s mental ability. A brain scan can help with diagnosis; this could be a CT scan or MRI. If a diagnosis is made, the person may be referred to a specialist for further treatment. Early diagnosis The early diagnosis of dementia is essential in order to: †¢ †¢ †¢ rule out other conditions that may be treatable access advice, information and support allow the person with dementia and their family to plan and make arrangements for the futur e. Receiving an early diagnosis of dementia can help the person and their family to plan and prepare for the future. Although there is no cure at present, there are arious medications available which can help improve symptoms and, for some, slow down the progression of the disease. Early diagnosis can help the person to identify and access sources of advice and support for their condition. The early education of the person and their family can help them to develop a better understanding of what the future may hold. The person will have time to put their finances in order and to make wishes for their Discussing the future with the person can help with understanding and accepting. Following diagnosis, the person may want to live as independently as they can for as long as they can.They may not appreciate someone taking over their life in these early stages where they are still able to care for themselves. To enable the person to remain as independent as possible, it may be an idea to encourage them to contact social services, if they have not already done so, to find out what support they could be entitled to. In order to aid their memory the person could place a list of important telephone numbers by their phone. This way they will always know where a telephone number is if they need it. Labels could be placed on cupboard doors to remind them of the contents. Notes could be placed n doors as a reminder to lock them. Lists could be put on a noticeboard of things to do and days to do them on, such as putting the rubbish out for the refuse collectors. 9 Level 3 Health & Social Care Diploma The most important thing to support the person with is in continuing to enjoy their life. Support them to continue with their hobbies or interests. One good activity which will help them in the future is the development of a life history book. Encourage and support them to collect together photographs of people who are important to them, events which hold important memories such as the birth of their first randchild, their wedding day or family holidays. Encourage the person to label each photograph clearly in the book so that they can look back at it at any time and be reminded of good memories. Early diagnosis can enable the early introduction of specialist services. The services may include: †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ family GPs – referring the person for further tests, reviewing medication district nurses health visitors community psychiatric nurses consultants memory clinics neurologists geriatricians neuropsychiatrists physiotherapists dieticians clinical psychologists speech and language therapists.In the very early stages of dementia the person may have days or episodes of forgetfulness which could be put down to the person being off-colour or having an off day. These episodes may be masked by their ability to recall past events easily. They may be able to give a re ason as to why they cannot remember what you have just said to them. They may say that the television was too loud and they did not hear you. They may even be adamant that you had not told them anything, giving rise to you questioning your own memory. The person may have difficulty understanding or following new ideas or regimes. To cover these ifficulties they may say that they preferred the old way, as it is not as confusing. They could hide occurrences of misplacing items, making out that someone has moved the item or someone has taken it. All of these events, happenings and reasons could be very genuine and indeed the person themselves may believe in what they are saying to be true. If they were all true, the person would be a very unlucky person to be experiencing all of these negative events. The likelihood of them all occurring to the same person in a short space of time would be rather remote. Recording all of these occurrences would enable you nd the team to build up a pict ure of the person’s mental and physical health. Recording times that they In many cases, the earlier the diagnosis and follow-up, the sooner the person can start regaining their life again. This is not to say that they will receive a cure – at this moment in time the only option open to people is acceptance and treatment in slowing down the progress of the condition. 2. 2 Recording possible signs or symptoms of dementia in line with agreed ways of working The health and well-being of a person should be monitored on a regular basis to ensure any resulting needs can be actioned without delay.When monitoring somebody’s condition, it is important to record any findings in line with your organisation’s policies and procedures. 10 Misplacing items can be one of the first symptoms of dementia. Understand dementia needed reminding to do something or became confused or disorientated would enable you to look back and identify frequencies to ascertain if their memor y is deteriorating. Involving the family When supporting somebody with dementia, it may be of immense benefit to involve the family. Encourage and support the family to keep a diary of the person’s symptoms. As a care worker, you may not see the erson as much as their family do and therefore they can help to give you a better picture of the person and their needs. The diary that the family compiles could help them and you to identify changes in the person that may be otherwise missed. The diary could also aid in monitoring any current interventions and the resulting benefits to the person. Unit DEM 301 Suggested monitoring and recording The person’s GP or neurologist may benefit from the information recorded in altering any medications or treatment the person receives. The following areas are those which it is important to monitor and record in the erson, as these will show what changes have occurred and over what period: †¢ †¢ †¢ †¢ †¢ †¢ †¢ memory behaviour personality ability to cope with daily living skills care-giving strategies – have they worked? activities the person enjoys any medications they have taken that day (including prescriptions, over-the-counter and herbal remedies) with details of medication name, dosage, and when and how many taken daily. Case study Identifying dementia Geoffrey had been living in sheltered housing for a number of years following a stroke. His confidence in his own abilities since the stroke had been very low and he as often heard mumbling to himself. Geoffrey is visited every morning by the warden Leona to check that he is OK. Geoffrey always met Leona on his doorstep as he put out his empty milk bottle. One morning Geoffrey was not on his doorstep as usual, which concerned Leona. She rang his doorbell and waited. Geoffrey came to the door and greeted her with his usual smile. ‘Are you all right Geoff, you haven’t put out your empties? ’ she asked . Geoffrey nodded, scratched his head and replied, ‘I’m fine, I haven’t finished the bottle yet as I didn’t drink much yesterday. ’ ‘As long as you are all ight then,’ Leona replied, waving goodbye as she turned and walked away. The following day, once again Geoffrey was not on his doorstep. Leona rang the doorbell again and was greeted by Geoffrey still wearing the same clothes as he had on the previous day. ‘No milk bottles to put out again today? ’ she asked. Geoffrey agreed, saying he had decided to drink more water: ‘I’m cutting down on my cups of tea, getting a bit of a beer belly,’ he joked. Leona was a little concerned but then shrugged it off, believing Geoffrey was always getting his words mixed up, due to his age. As the weeks passed Geoffrey had days when he did ot put out any empty bottles, and then he would put out three or four at a time. Some days Geoffrey looked unwashed or unshaven, whi ch was unlike him. Leona was concerned but on talking to Geoffrey she felt she was worrying about nothing. Geoffrey’s behaviour had been up and down for over 12 months when Leona announced she was changing her job and a new male warden, Patrick, would be taking over. Geoffrey did not take this news very well and he became agitated, blaming Leona for the death of his wife. Leona was very shocked by this, especially as Geoffrey had never been married. She mentioned this to Patrick during her andover and explained she thought something was not quite right but she could not quite put her finger on it. Patrick asked how long had this been going on for and then said he would take care of it. 1. After visiting each resident in the sheltered housing, what actions should Leona have taken? 2. What concerns would you have had regarding Geoffrey? 3. How would records of Leona’s visits to Geoffrey have been of benefit? 4. What actions should Patrick take now, especially regarding G eoffrey? 11 Level 3 Health & Social Care Diploma The diagnosis of dementia does not generally occur following the first visit to the GP.Generally there is a process in which the person goes through in order to receive a definitive diagnosis. During this process it is vital that any potential signs of dementia are reported following your organisation’s policies and procedures, and in line with government guidelines. National Institute for Health and Clinical Excellence (NICE) NICE has devised detailed guidelines in supporting people with dementia. This also includes the early diagnosis of dementia. Within this guide it states that primary health care staff should consider referring people who display any signs of mild cognitive impairment (MCI) for ssessment. MCI is a relatively new term to describe those who show some difficulties with their memory but do not have dementia. Studies have shown that 50 per cent of people with MCI go on to develop dementia later in life. NICE al so includes in its guidelines information regarding the diagnosis and assessment of dementia. It states that diagnosis should only be made following assessment to include: †¢ †¢ †¢ †¢ the person’s history a cognitive and mental state examination a physical examination a review of all medication including over-the-counter remedies. As a care worker, your input in reporting possible signs f dementia would go towards the person’s history. Your input can help them receive the care that they need, when they need it. It is for this reason that you should ensure timely reporting of any observations you make or concerns you may have. To report a concern, you must follow your organisation’s guidelines. If you are unsure of what these guidelines state, you should speak with your line manager as soon as possible to ensure your actions follow best practice for the person. In general terms, most reports are given to a designated member of staff. This may be your line manager, supervisor or manager.Your verbal report should be factual and to the point. Try to avoid giving your own opinions. Although opinions can help to look 12 at and clarify various issues from differing viewpoints, they can also be unhelpful if used inappropriately. Once you have given a verbal report, you should back up what you have discussed with the appropriate person, by writing a written report. Again your written report should be factual and detail all of the actions you have taken. Some reports will have an increased impact if they are delivered in a certain way. For example, you may have been asked to monitor somebody over a set period of ime and report back your findings. Simply writing those findings down may not have the same effect as plotting your findings on a graph. A graph or chart will give a visual representation of your findings, which may give a better explanation as to the person’s mental state and any changes that have occurred. 10 Inc idence of wandering 2. 3 Reporting possible signs of dementia within agreed ways of working 8 6 4 2 0 Week Reporting occurrences such as wandering can have a greater impact if plotted on a graph. Activity 2 Process of reporting Speak with your manager or line supervisor to identify our organisation’s policy and procedures on the process of reporting information. Functional skills English: Speaking and listening This discussion can be either formal or informal and can give you the opportunity to practise taking part in a one-to-one discussion. Understand dementia Reflect Imagine you, or someone you love, had just been given the news that you or they had dementia. Being honest, what would be your initial thoughts or feelings? Do you feel it is OK to feel or think this way? Is there anything you feel that society can do to help with the acceptance or understanding of dementia?Unit DEM 301 2. 4 The possible impact of receiving a diagnosis of dementia on the individual and their f amily and friends Receiving news which you know will have a major impact on your future and those who are close to you can be very frightening and overwhelming. The person may feel very insecure at the time, despite possibly having family and friends around them. The impact on the person and their family and friends can vary; some may see it as a relief that the cause of their difficulties has been diagnosed, while others may be in disbelief, preferring not to acknowledge what they have been told.Many older people fear becoming a burden on their family more than they fear death. 13 Level 3 Health & Social Care Diploma Feelings NICE requirements The person may be shocked on first hearing the diagnosis; this can often turn to denial. One theory on loss or grief shows that the process usually goes through five stages including: NICE guidelines state that following a diagnosis of dementia, health and social care professionals should provide the person and their family with written infor mation regarding: 1. 2. 3. 4. 5. †¢ denial anger bargaining depression acceptance. It is felt that the person may not necessarily go through ach stage in this particular order, and indeed can go backwards and forwards, repeating various stages a number of times before reaching and remaining at acceptance. The person may experience fear or the concern that they will lose control over their lives and their future. They may also fear becoming a burden on their family and friends. Some may feel guilty, blaming themselves, thinking that they could have prevented their condition happening. Whatever feelings the diagnosis creates in the person, you should encourage and support them to talk about their feelings. Some may not feel comfortable voicing heir feelings to their family and friends, preferring to talk with someone they do not know. The person’s family and friends should not be upset by this decision and should respect the wishes of their loved one. Initially the person may simply want to curl up and lock out the world around them. Family and friends need to be supportive in these situations. Telling the person to ‘get a grip’ or that what they are doing is silly is not going to be of any benefit – in fact, it will often make things worse. 14 †¢ †¢ †¢ †¢ †¢ †¢ †¢ the signs and symptoms of dementia the course and prognosis of the condition treatments ocal care and support services support groups sources of financial and legal advice, and advocacy medico-legal issues, including driving local information sources, including libraries and voluntary organisations. Any advice and information given to the person and their family should be recorded in the person’s care notes. The confidentiality of the person should be respected if they decide they do not wish any information to be given to their family. Understand dementia Unit DEM 301 3. Understand how dementia care must be underpinned by a per son-centred approach 3. 1 Person-centred and nonperson-centred approaches to ementia care It is important to remember that people with dementia are individuals first, with their condition of dementia coming second. They may also be mothers, fathers, brothers, sisters, sons or daughters. They may have led a fulfilling life before the condition of dementia took hold of their memories and personality. How could the care of any person be anything other than individual, specific to their needs, involving and respecting their views on how they want their care to be delivered? Person-centred care is a way of providing care with the person at the centre of everything you do. Another way f describing it is individualised care – care that is given to the person according to their needs, wishes, beliefs and preferences. One would hope that gone are the days when everyone in a care home got up at the same time, ate their breakfast at the same time, got washed and dressed at the same time , even going to the toilet at the same time. These regimented routines of care homes were devised for the benefits of the staff, not the people being supported. The day revolved around tasks, duties that had to be met, more often than not putting the people’s specific needs at the end of the priority list.If you needed support, which type of care home would you choose? Earlier on in this unit we looked at how dementia can affect people and identified that no two people would necessarily follow the same process through the condition of dementia. This being the case should automatically exclude all people with dementia being treated in the same way. Studies have shown that a person-centred approach can help reduce agitation in the person with dementia. Agitation is often caused by the person’s frustration in not being able to express themselves. The expression could be one of sadness, pain, thirst, hunger or tiredness.Other studies on a person-centred approach have shown that the person often remains living in their own home for longer. A person-centred approach can also ensure that the person does not endure the degrading, discriminatory and abusive practices which could otherwise occur. People and all those involved in their care should feel safe, feeling that they are a part of what is going on, receive continuity of care, have purposeful goals which they are supported to progress towards and have a feeling that they do matter. How does a person-centred approach benefit the person? As a care worker, you should identify the specific needs f the person with dementia. These needs could arise from their gender, ethnicity, age, religion and personal care. Other needs could also arise from their physical health or physical disability, any sensory impairment, communication difficulties, problems resulting from poor nutrition, poor oral health or learning disabilities. The person’s needs should be identified with input from the person, their fami ly, friends and any other persons that may be important in that person’s life. Once the person’s care needs have been identified, plans should be made to draw up a support plan which will describe how those needs will be met.As with the assessing of needs, the person must be at the centre of the support planning process. Nothing should be planned for them without them. 15 Level 3 Health & Social Care Diploma Case study The importance of a person-centred approach It is approaching lunch time but Mrs Lancaster is not really hungry. She would like a drink and would prefer to remain in her room as she is comfortable and her favourite television programme is about to start. Mrs Lancaster is not able to voice these preferences verbally, as she finds it very difficult to verbalise and so has given up trying. Tracy, one of the senior care workers, entersMrs Lancaster’s room and makes her jump, as Mrs Lancaster did not hear Tracy entering. ‘Come on then love, your dinner’s ready,’ Tracy tells Mrs Lancaster. She then promptly holds Mrs Lancaster under the arm and says, ‘Up you come chum. ’ Mrs Lancaster reels back in pain and cries out. Tracy responds saying, ‘Don’t be silly, now come on, your dinner’s going to get cold,’ again pulling up under Mrs Lancaster’s arm. Mrs Lancaster pulls away, which makes Tracy annoyed. She bends down and puts her face close to Mrs Lancaster’s and says, ‘I’ll leave you here to starve if you carry on like that. ’ Mrs Lancaster cannot take any more bullying or hreats from Tracy so she brings her head back and then sharply forward, head-butting Tracy. ‘You nasty woman, you ought to be locked up doing things like that! What have I ever done to you to deserve treatment like that? ’ Tracy shouts, leaving the room with a bloodied nose. 3. 2 Different techniques to meet the fluctuating abilities and needs of the individua l with dementia people with dementia. Seize the challenge and look forward to the unexpected. As the saying goes, ‘variety is the spice of life’. 1. Explain six things in detail that could have possibly led to Mrs Lancaster head-butting Tracy. 2.What should Tracy have done to prevent this occurrence? 3. Describe a way Mrs Lancaster could be supported to communicate in future. 4. Describe how her care could be given using a person-centred approach. Knowing the person Many people with dementia are able to live in their own homes for most of their lives with care being given to them by their families. It is important that the person is supported to recognise that the condition that they have is not the fault of anyone, especially not their own. When supporting the fluctuating needs and abilities of the person, it is very important that you recognise that hey are not responsible for the things that they do. It is not the person who is spitting out their food; it is the cond ition’s effects on the person’s ability to communicate which is preventing them from saying, ‘I don’t like that. ’ It is not the person who is constantly wandering around the environment; it is the condition that has taken away their spatial awareness. As a support worker, you must focus on the skills and abilities that the person has, rather than those that they have lost. Ensure that you are fully aware of and respect the person’s background, their history, likes and dislikes.Be prepared for changes and adapt a flexible approach. No two days may be the same in supporting 16 By learning about each person’s history and background, you can design the care and support you provide around their specific needs. For example, the person may have been a sergeant major in the army, which could account for his shouting out his orders. The person may have experienced a traumatic event in their lives such as being trapped in a collapsed building, which could account for them becoming agitated and screaming when the lights are switched off in their bedroom at night. Without this background knowledge, nd more importantly understanding, the person who shouts his orders may be wrongly labelled as being noisy and dictatorial. The person who screams in the dark may be wrongly labelled as disruptive and attention-seeking. A person’s physical condition can be affected by their dementia. Their mobility may be reduced as may the person’s ability to maintain their own personal care or diet. Combining these factors can increase the person’s susceptibility to other illnesses such as chest infections or physical conditions such as pressure sores. Understand dementia Ensure the person’s support plan is kept as up to date s possible and shows alternative methods to use for various fluctuations in their support needs. Support other care workers by sharing proven practices. As a support worker, you may have identif ied triggers to somebody’s behaviour. Do not keep this information to yourself; inform other care staff and have it recorded in the person’s support plan. This would be the same for identifying any new method or way of supporting the person to meet their fluctuating needs. Provide a stable environment and suitable surroundings One of the main triggers resulting in somebody with dementia becoming agitated and confused is a change n their routine. Any changes to the person’s life or daily routine can cause them to become unsettled, which could lead to inappropriate behaviours. To ensure stability it is important to: †¢ †¢ †¢ †¢ have consistent, regular staff. Unfamiliar faces can cause the person great upset. Ensure they know the staff and ensure the same staff member provides care to the person in their own home maintain a familiar environment. It is an eventuality in everyone’s life that their surroundings will change at some point. Th is could simply be through redecoration or changes in furniture. Where possible, if decoration needs to be undertaken within the erson’s environment, try to make the new decor similar if not the same as it was previously. If relocation is required for the person, ensure this is minimised by confirming the suitability of the new location. This will save on the person needing to be relocated again due to the environment not being suitable for their needs ensure the person is in a non-stressful, constant and familiar environment establish a regular routine, regular physical activity and adequate exposure to light to improve any sleep disturbances. Specific strategic support People with dementia may behave in a way that is completely out of character.Some of these behaviours can be disturbing to onlookers and especially the person’s family, seeing their loved one behaving in a way they have never seen before. The following are examples of the types of behaviours people wit h dementia may display. Unit DEM 301 Wandering People with dementia may tend to walk or wander apparently aimlessly for a variety of reasons. This could be because they are bored or they feel they need to escape or get out of the environment they are in. The person may simply need to use the bathroom but cannot remember where it is. On occasions this wandering may take them out of the house or even own the street. This could lead them into becoming ‘lost’ if they are unable to find their way back home. For most people, wandering may only be a short phase that they go through. And, although little comfort at the time, people with dementia often retain a good degree of road sense and are seldom involved in traffic accidents. To reduce incidents of wandering, promote physical activities to reduce the person’s boredom and to help use some pent-up energy. What dangers could wandering have for somebody? Incontinence Loss of bowel or bladder control usually occurs as th e dementia progresses. Sometimes these accidents may appen because the person cannot remember where the bathroom is or cannot get there in time. If the person does become incontinent, you need to help them to maintain their dignity and respect by being understanding and reassuring. Incontinence pads, sheaths or catheters can be obtained to help keep the person free from unnecessary embarrassment and frustration. 17 Level 3 Health & Social Care Diploma Agitation Agitation can include behaviours such as sleeplessness, verbal or physical aggression and irritability. These types of behaviour often increase with the stages of dementia and can become quite severe.Agitation may be triggered by a variety of factors including environmental factors, fear and tiredness. Most often agitation is triggered when the person feels as if they are no longer in control of the situation. You can help reduce episodes of agitation by reducing the intake of caffeine, sugar and processed foods. The reductio n of noise or crowds can also help, as does the maintenance of the person’s routines. is a list for further reading which will help your knowledge and understanding further. Doing it well Meeting the needs of people with dementia †¢ Know the person well, including their history and background. Keep their support plan up to date. †¢ Provide a stable environment and suitable surroundings. †¢ Ensure specific strategic support. †¢ Improve your knowledge and understanding. Repetitive speech or actions It is a common occurrence with those who have dementia to repeat a word, statement, question or activity more than once in a short amount of time. This repetition can be frustrating and stressful to the care giver and their family. Repetition is often as a result of the person becoming anxious, bored, fearful or agitated. One way of reducing this is to provide them with reassurance. Alternative strategies could include isplaying reminders of activities around thei r home such as ‘Dinner is at 6:30pm’ or ‘Dave comes home at 5pm. ’ This may assist with reducing anxiety and uncertainty about anticipated events. Paranoia People with dementia may suddenly become suspicious, jealous or start accusing others of things. When this happens, the person will believe in what they are saying and therefore you should not try to argue or disagree with them. Stay calm and encourage the person to calm down. Ask them what is wrong and let them know that you are there to help them. Improve your knowledge and understanding Many organisations have helpful information on nderstanding and supporting people with dementia. Set yourself a goal to develop your practices through research, talking to people who are in the early stages of dementia or family and friends of those who have it. Learning about dementia from those who have firsthand experience is often more beneficial than reading a book, although books have the benefit of being portabl e and accessible at any time. At the end of this unit there 18 3. 3 How myths and stereotypes related to dementia may affect the individual and their carers Dealing with the difficulties that come with the diagnosis of dementia is not going to be made any asier with the myths and stereotypes that society has created. Within society, dementia is often seen as a condition that causes the person to require 24-hour care in a secure environment so they cannot get out and wander aimlessly. People who are newly diagnosed with the condition are sometimes disbelieved because they appear ‘normal’ and are dribbling or babbling. Some myths or falsehoods can create an unrealistic hope within the person or their family. Some of these untruths profess to offer cures or preventions. The following information can help you to identify fact from fiction. Q – Can using aluminium saucepans affect the risk of eveloping Alzheimer’s? A – No, there is no convincing evidence that cooking with aluminium saucepans increases the risk of developing Alzheimer’s. Q – Is it true that people who follow a healthy lifestyle reduce the risk of developing dementia? A – Yes. Research shows that people who enjoy a healthy lifestyle by eating a well-balanced diet, not smoking and taking regular exercise reduce their chances of developing dementia. Recent research has shown that being healthy in mid-life can help lower our risk of developing dementia as we age. Understand dementia Q – Can Ginkgo Biloba help people with dementia? A – No.Unfortunately, the latest evidence shows that Ginkgo Biloba has no benefit for people with dementia. Q – Does eating meat have any connection with developing Alzheimer’s? A – There is no convincing proof that eating meat is linked to developing Alzheimer’s. Q – Do people who have dementia become childlike? A – No; it is very important to remember that people wi th dementia are adults and should be treated with the dignity and respect other adults receive. Many people, quite wrongly, have stereotypes when it comes to dementia. It is these stereotypes that can become the fear of reality for people newly diagnosed ith dementia. Sometimes it is the person’s own stereotyping of dementia that they have to face. Facing and resolving this can only occur with education and acceptance. Unit DEM 301 3. 4 Ways in which individuals and carers can be supported to overcome their fears Research has shown that many people fear the thought of developing a form of dementia. The worry of losing one’s identity, independence and mind for some is a greater fear than the fear of death. Worrying about a condition that you may not develop seems futile. Worrying about a condition which you have developed will not do your health much good.Simply telling somebody who has received a diagnosis of dementia or their family not to worry is insufficient. Advis ing the person and their family to talk about their fears will help towards them overcoming any uncertainties. Ignoring the condition or pretending it is not happening is simply denial. To help all those involved to overcome worries for the future, the person and their family should be supported to learn the truth, what they can expect from the future. Activity 3 Understand the condition What’s in a name? The person and their family should be supported to develop a true understanding of the condition they are acing. Information can be obtained from GPs’ surgeries, health centres, libraries and the Internet. When obtaining information from books or the Internet, you need to ensure it is up to date and reliable. Internet sites run by organisations such as the Alzheimer’s Society or NHS Direct can be seen as reliable sites, as can educational sites such as those ending with . org. Some of the facts relating to dementia do not always make for easy reading; however, the person and family need to know what to expect. Skirting around these issues will not enable the preparation that may be required. This could lead to a bigger shock when it ctually happens, which would not do anybody any favours. Devise a simple questionnaire which you can either send out to colleagues or staff within your organisation, or give to your family and friends. Ask questions such as, ‘Give the first word that comes into your head when you hear the word â€Å"dementia†. ’ Include a few questions that relate to the myths around dementia to see if your colleagues or family know the truth or not. Compile the results from your questionnaire and discuss these with your assessor. People’s inappropriate views or opinions on dementia often arise from ignorance. For many, the only portrayal hey have of dementia is that which they see on television. Storylines shown in films are often of people in the advanced stages of dementia. If this is the only per spective you have, then there is no wonder why society looks at this condition in the way it does. If the individual newly diagnosed with dementia or their family has only ever known of dementia in this way, then their fears will understandably be heightened. Encourage future planning Once the person and their family are aware of how dementia may affect the future, they should be supported to think ahead and be ready for the changes that will follow.The person and their family will need to prepare things not just materially but emotionally as well. At some point the person may require support with toileting and other personal care needs. They may not want their family attending to this sort of personal care, 19 Level 3 Health & Social Care Diploma preferring to have a care worker attend to their needs at home. There may come a point where the person is unable to stay in their own home due to the advancement of their condition. The fear of this eventuality can create a lot of worry f or them. Supporting the person to plan for this can help allay those fears.They and their family could be supported to identify a care home which the person may move into in the future. Simply knowing that this step has been arranged can help them feel a little easier, knowing that they will not be placing a burden on their family. Making life easier The person may have received a diagnosis of dementia because of their current memory difficulties. The family may worry that the person will not be able to cope very well at home, forgetting to take their medication, forgetting to lock doors and windows when going out and so on. These sorts of worries for the family will not necessarily lessen.As each day passes they may worry. As each day passes the person’s condition may increase, making the family worry all the more until it becomes a vicious circle. To help reduce these fears, the person can be supported to remain as independent as possible at home with the use of notes, labe ls, lists – any memory joggers. The environment in which the person lives can be made safer – for example, installing grab rails or an emergency pull cord system. Making these minor changes to the person’s home may reduce the natural worries of the family with regards to their loved one’s safety. Dealing with the diagnosis of dementia is never going to e easy. Some people and their families may benefit from receiving counselling. This can often b