Areopagitica By Milton Essays - Book Censorship, English Civil War

Areopagitica By Milton What is the meaning of virtue? Milton answers this question in his speech Areopagitica. Milton will dicuss his meaning of virtue and show his anger at Parliament in the speech. He knows by their actions that Parliament does not know the true meaning of virtue. To understand Areopagitica, you must first understand the reasoning behind the writing. Milton, being a Puritan, did not agree with the beliefs upheld by the Roman Catholics. Free will and free speech was the center of his soul, and to have them governed and censored by Parliament was an outrage. He knew that they did not truly understand what virtue was and did not want to hear any explanation. "In Areopagitica he definitely adopts the doctrine of free will and turns against the predestination of the Presbyterians" (Tillyard 136). Milton's beliefs at the time of his writing was that man is born with the seeds of good and evil and if the opportunity arises, some men will choose the evil way. He wants everyone to understand that man, no matter who the person is, has a choice in determining which road to take. Milton is realistic when he Henderson 2 writes because he knows he is fighting a battle that is weighted against him. He feels the power of the Parliament, but he knows the possibility for victory is evident. Even this possibility does not deter him from realizing that he is still dealing with man who has the choice to do good or evil. "But in Areopagitica beneath the excitement of hope there can be detected the whisper of doubt" (Tillyard 135). Milton tries to explain the meaning of virtue in his writing with the hopes that Parliament will heed what he is saying. Milton explains to them that good and evil walk hand in hand and that man has the choice of free will. This choice gives man the chance to say no to evil and choose to do good. He writes of how Adam had the choice to do good, but instead he chose to eat the fruit and evil was introduced. From this deed, man has to make the choice of his own free will. "He that can apprehend and consider vice with all her baits and seeming pleasures, and yet abstain, and yet distinguish, and yet prefer that which is truly better, he is the true warfaring Christian" (Milton 778). The free will of man means the ability to choose what to read, speak or do, and to censor these choices of life is not the true Christian way of life. Milton wanted Parliament and the Roman Catholics to understand this no matter what it cost him. Bibliography Milton, John. John Milton: Complete Poems and Major Prose. Ed. Merritt Y. Hughes. New York: Macmillan. 1957 778 Tillyard, E. M. W. Milton. New York: Barnes & Noble, Inc. 1967. 135-136

Cynognathus Facts and Figures

Cynognathus Facts and Figures Name: Cynognathus (Greek for dog jaw); pronounced sigh-NOG-nah-thus Habitat: Woodlands of South America, South Africa, and Antarctica Historical Period : Middle Triassic (245-230 million years ago) Size and Weight: About three feet long and 10-15 pounds Diet: Meat Distinguishing Characteristics: Dog-like appearance; possible hair and warm-blooded metabolism About Cynognathus One of the most fascinating of all prehistoric creatures, Cynognathus may have been the most mammalian of all the so-called mammal-like reptiles (technically known as therapsids) of the middle  Triassic period. Technically classified as a cynodont, or dog-toothed, therapsid, Cynognathus was a fast, fierce predator, much like a smaller, sleeker version of a modern wolf. Clearly it thrived in its evolutionary niche, since its remains have been discovered on no less than three continents, Africa, South America and Antarctica (which were all part of the giant landmass Pangea during the early Mesozoic Era). Given its wide distribution, you may be surprised to learn that the genus Cynognathus includes only one valid species, C. crateronotus, named by the English paleontologist Harry Seeley in 1895. However, in the century since its discovery, this therapsid has been known by no less than eight different genus names: besides Cynognathus, paleontologists have also referred to Cistecynodon, Cynidiognathus, Cynogomphius, Lycaenognathus, Lycochampsa, Nythosaurus and Karoomys! Further complicating matters (or simplifying them, depending on your perspective), Cynognathus is the only identified member of its taxonomic family, the cynognathidae. The most interesting thing about Cynognathus is that it possessed many features normally associated with the first prehistoric mammals (which evolved from therapsids tens of millions of years later, during the late Triassic period). Paleontologists believe Cynognathus sported a thick coat of hair and may have given birth to live young (rather than laying eggs, like most reptiles); we know for a fact that it possessed a very mammal-like diaphragm, which enabled it to breathe more efficiently. Most startlingly, evidence points to Cynognathus having a warm-blooded, mammalian metabolism, quite unlike most of the cold-blooded reptiles of its day.

International Marketing for Travel and Tourism The 32nd Atlanta Jazz Essay

International Marketing for Travel and Tourism The 32nd Atlanta Jazz Festival - Essay Example The three dominant forces affecting Atlanta's history and development have been transportation, race relations, and the "Atlanta spirit." At each stage in the city's development, these three elements have come into play. Transportation innovations and their connections to Atlanta helped establish the city as a state and regional center of commerce and finance. And the Atlanta spirit-part civic booster program, part vision, with a healthy dose of business interests and priorities-has provided the city with an ever-changing set of goals and definitions of what Atlanta is and what it can become. In the recent past, the city of Atlanta has gained familiarity and has transformed from a commercial city into a city with international influence and tourist attraction. In a very little span of 6 years i.e. from 2000 - 2006, the metropolitan area of the city of Atlanta increased by almost 20.5%. This has made Atlanta the fastest growing metropolitan city of the United States. Transportation has always been an important factor in the growth of the city of Atlanta and also its development, had a significant impact on the city in the 1960s and 1970s. Atlanta's connections to three interstate highways continued during this period to direct and facilitate suburban growth and anchored the regional trucking industry to the city. Air travel also became increasingly important as Atlanta Municipal Airport emerged as one of the busiest air hubs in the nation. Office buildings and retail establishments followed this population growth and movement to the suburbs, especially on the north side of the city. In the transportation sector airplanes and automobiles continued to have the biggest impact on the metropolitan region. Atlanta's dramatic population growth in the last few decades has been matched by equally impressive economic growth. The city is, by most measures, the business capital of the Southeast. Atlanta's ties to transportation include Hartsfield-Jackson Atlanta International Airport (one of the top two busiest airports in the world), three interstate highways that intersect in Atlanta, and a nexus of freight and passenger rail lines. All of these transportation connections bring commerce, products, and people to the Atlanta area and provide employment, either directly or indirectly, to many of the region's citizens. Since the 1970s the hospitality, tourism, and convention industry has been another key element of Atlanta's economy, spurring the construction of new hotels, convention spaces, and related industries. From 1965 to 1975, for example, the number of hotel rooms in the downtown area alone increased from 4,000 to 14,000 and by 1972 Atlanta ranked third among cities in terms of convention business. Jazz Festival - Introduction: Renowned as the largest free jazz festival in the country, the Atlanta Jazz Festival is traditionally a Memorial Day Weekend celebration of a true American art form - Jazz. This year marks the 28th anniversary of the Festival. The finale of the event will take place in Piedmont Park May 28th - 30th. The Atlanta Jazz Fe

Need a teaching paper for a diabetic patient (portion control) Assignment

Need a teaching paper for a diabetic patient (portion control) - Assignment Example Patient education Diabetes type  II is a metabolic disorder that is associated with high blood glucose and lack of insulin or simply insulin deficiency in blood (Ackley & Ladwig, 2013). When it comes to management of diabetes type II, control of blood sugar is usually the central subject matter. After all, when ones level of blood sugar is kept within the target range, it can help him or her to live a healthy life. The main aim of patient education was for M.E. to improve her knowledge, skills and self-assurance, enabling her to take enhanced control of her own condition as well as incorporate effective self-management aspects into her daily lives (Ackley & Ladwig, 2013). This is premised on the fact that high-quality patient education can actually have a profound impact on health outcomes of patients and can drastically enhance quality of life. In particular, this patient education aimed at teaching M.E. on how to keep a balance diet and portion control in away that will help her manage her condition-Diabetes type  II. In this context, my main goal was to promote the health of M.E. and to avert any further outcome associated with the disease. The information that M.E. will receive, will be of great importance in terms of enabling her to make changes in her feeding lifestyle and this will help in controlling her blood glucose within normal or target range. All other aspects associated with her conditions such as, if she had ever confided her condition into anyone, and if anyone has ever told her anything regarding her condition, were revisited before I brought about the topics to be discussed. She openly stated that she had shared a lot with her primary care doctor. In this case nonetheless, I assured her that my aim was simply to provide information that would her manage her condition well in terms of how to keep a balance diet and portion control. My primary teaching material in this case was a handout entailing illustrations and information about diabete s type II disease and the choice was based on the fact that illustrations serves to reinforce the point that has been taught and are easier to understand even for people who are not familiar with it. The first topic to be introduced was what diabetes was and its likely effects on ones body. I began by explaining to her that Diabetes Type II was a condition resulting from the failure of insulin to control to a minimum the level of glucose in blood (Ignatavicius & Workman, 2013). As a result, there is no absorption of glucose to be used by the body cells for the production of energy. Under the causes, I explained to her that the disease is caused by a mixture of genetic and lifestyle factors. Whilst some factors such as diet are under personal control or management, others, such as female gender, genetics and increasing age, are not. This, therefore, led into a discussion on the dangers associated with the disease: the danger of cardiovascular disease, including stroke and ischemic he art disease which are similarly life threatening. The next topic we discussed was what factors lead to Diabetes Type II, such as her Hispanic ethnicity, her old age, lack of physical activity, poor diet and family history of diabetes. Having informed her about all these, I then discussed with her about the things she could do in her daily life to manage her level of blood glucose. Specifically, I advised her to avoid diets that have high content of sugar. However, I emphasized that in as much as healthy eating is a foundation of any diabetes

The effect of endurance exercise on hypertension Essay

The effect of endurance exercise on hypertension - Essay Example Ehrman â€Å" it is believed that exercise training may decrease BP by improving renal function in patients with essential hypertension † So even a modest reduction of BP by endurance or resistance training decreases cardiovascular risk by 5-9%, stroke 8-14% and all cause mortality by 4 % (Vivian H.Heyward) BP is determined by cardiac output and total peripheral resistance; moreover it is elevated as result of one of the determinate or both. Therefore, non-pharmacological treatment for HT patients, needs to include theprovision for losing weight if overweight, limit alcohol intake to no more than 1 ounce of ethanol per day, reduce sodium intake to less than 100 mmol per day, maintain adequate dietary potassium, calcium, and magnesium intake, stop smoking and reduce dietary saturated fat and cholesterol intake for an overall cardiovascular health. Reducing fat intake also helps reducing caloric intake it is also important to control weight and non-insulin depended diabetes (Williams and Wilkins). Mode, frequency; duration and intensity of exercise are generally the same only in healthy population. Increasing exercise i ntensity to above 70% VO2 doesn’t have additional impact on BP. In addition, absolute sudden death during any particular episode of heavy exercise is low. Peripheral vascular disease includes vascular insufficiencies such as arteriosclerosis, arterial stenosis, Raynaud phenomena and Burger’s dieses. It’s usually correlated with hyperlipidemia and hypertension in older patients. Peripheral vascular disease manifests ischemia pain during physical activity and is due to mismatch between muscle supplies and demands. In treatment weight bearing exercise and medication is included. According to Roy J. Shephard, observing middle age and older post coronary patient over three years of vigorous and progressive endurance exercise. He established a decrease of resting provision at normal

Understanding and analysing self harm

Understanding and analysing self harm Self harm in all of its forms is one of the greatest dangers that face vulnerable adolescents, promoting unhealthy cycles, and increasing the risk of suicide and from the perspective of a school nurse, the problem is very evident. Whilst providing duties to young people with, or prone to, psychological, emotional or mental help problems it is clear that self harm is an ever increasing issue. There is evidence that would suggest that the rates of self harm within the UK are the highest in Europe (Mental Health Foundation, 2006, a) and as such, this act should be considered one of our nations significant health concerns. Self harm is a complicated and very challenging problem to face and as such a deep understanding of self harm is vital to combating it. In reviewing literature we must interpret a comprehensive volume of information relating to a given topic. In this instance the topic at hand is self-harm, and as such we are required to study and absorb as much of the available information in order to digest it into new insights and to provide evidence to inform our practical decisions. In this specific review the aim is to use the available literature to identify the most prominent and prevalent challenges that could face a school nurse in the treatment and management of youths that self harm. The act of self-harm has become all the more common amongst adolescents (Fortune and Hawton, 2005) (Laukkanen et al, 2009), wherein as many as one in 15 youths undertake self harm at one point or more in their lives (Mental Health Foundation, 2006, a). Self harm involves many types of personal injury, from poisoning to starving, though cutting is the predominant method of self injury (Lakkanen et al, 2009) and because of this, I have ensured to differentiate cutting, from other means of self harm within this review. The primary approach of this review is to attempt to identify the most prominent literature relative to this topic within the UK. Unfortunately there is only a small pool of literature governing the topic of self harm in youths; even foreign literature on the topic is just as underdeveloped and lacking, often using differing terminology, such as self-Mutilation (Derouin and Bravender, 2004). A further category of self harm that requires specific definition is the term Deliberate self harm, otherwise known as DSH. Whilst it is most frequently used in UK literature pertaining to the subject, it has been regarded as controversial, because of the mental connotations behind the disorder. (NICE, 2004). People who commit self harm, tend to not feel comfortable with the use of the word deliberate, as it disrupts the notion that the act is voluntary, which a lot of sufferers disbelieve (Royal College of Psychiatrists, 2007). In recognising different perspectives on the matter, the term deliberate should no longer be used in relation to self harm, to give an enlightened view of the topic within this literature review. When discussing young people or adolescent in this report, the terms will refer to any young person between 12 and 18 years of age. The average age of onset for self harm is 12 years (mental health foundation, 2006, a), however children as young as five years old have been reported to self harm (Bywaters and Rolfe, 2002). The cases of children that young performing self harm is very uncommon, and the rate tends to increase rapidly with age throughout adolescence (Hawton et al, 2003). Methodology. Gathering literary sources was done by utilising a search of CINAHL (Cumulative Index to Nursing and Allied Health Literature), a database for nurising based literature reviews. It is particularly suiting as it relaties specifically to nursing and allied health literature (Aveyard, 2010). In order to get the most comprehensive list of resources, several terms were used within the search; Cut* self-harm self-mutilation, Adolescent and School nurse in order to provide a wide range of literature related to the topic. Recent papers, such as those published within the last five to ten years were used. In order to gather enough information, the limit was extended to ten years, as there was simply not enough sources within a five year bracket. When performign these searches, the search terms were often linked in order to provide the best set of results. Other databases were used, using a similar method as this to good results. They included The British Nursing Inde, and PsychINFO. It is often emphasised how important it is to combine search strategies (Greenhalgh and Peacock, 2005), within literature reviews. Despite the advantage electronic searches provide, it is still possible to miss key sources of literature. (Montori et al, 2004). Every step to ensure the best quality of literature is provided should be taken, and as such within this review, any appropriate cited references have been thoroughly checked and sourced. In following various searches, the extracts from the articles were read for relevance to the review. They were also regarded to see if they met the inclusion/exclusion criteria and for general relevance and importance. The critical apraisal skills programme was used to great effect in ascertaining the quality of certain articles (Aveyard, 2010). Further articles that did not meet criteria at this stage were disregarded from the study. As could be expected, all literature that had been collated showed similarities in their findings and themes. These have been used to link the findings in a systematic manner for the purpose of this review (Pope et al, 2007). Prevelance, rates, reasons to harm, the factors behind harming, suicidal intentions and intervention are all themes which need to be studied and examined for the problems and considerations faced by a medical professional when encountering them. Prevelance One thought that is unanimous within studies concerning self-harm is that the act itself is much more than simply attention seeking behaviour. (Mental Health Foundation, 2006, a). This is supported by the instances in which youths attempt to hide their attempts behind long sleeved tops, or by cutting in areas of the body that are hidden from view, such as the inner thigh or the axilla (Freeman, 2002). Because of this, many acts of self-harm do not come to the attention of the healthcare services, so it is almost impossible to discern the true scale of the matter. However in one study 13 .2% of adolescents reported to have purposefully harmed themselves within their lives (Hawthorn and Rodam, 2006). There have been many studies on the matter, but it is difficult to compare results due to varying age groups and conditions. Two facts seem t o be agreed upon however, and they are that cutting is the most prevalent type of self-harm (Laukkanen et al, 2009) and that in all likelihood the true scale of the problem goes unrecorded. The latter could be due to several reasons; between youths hiding the fact they perform self-harm and that parents who have no fears in regards to their children, are less likely to give consent to permit these studies recording data. (Hintikka et al, 2009). With all reports agreeing that the situation as a whole reflects merely the tip of an iceberg, and that findings do not cover the majority of acts that go unnoticed by the medical services, health professionals require a greater understanding of the topic, in order to tackle the problem when they do encounter it. As School Nurses are often the first to contact youths who self harm (McDougal, 2003), it is even more vital to provide an understanding and means to address this problem. Whilst establishing a professional where pupils feel comfortable in disclosing their behaviour , it is also vital to promote awareness in the school and community at large of the dangers of this self-harming behaviour (Hackney, 2009). However the root of the problem lies in identifying those who are prone to cutting and other acts of self harm, and understanding why they choose to take this step. Why Adolescents Self-Harm There appear to be many reasons offered as to why adolescents choose to harm themselves including to feel more alive, to distract from the reality of their situation, and to even gain relief from the pressures that surround them (Mental Health Foundation, 2006, a). It can be used as a means of dealing with emotional extremes of anger, sadness or depression (Mental Health Foundation, 2006, a), or even as a means of expressing negative emotions such as self-loathing or loneliness. Whatever the cause, the reason behind it is often that the adolescents mind finds it easier to deal with physical pain and trauma than the emotional pain that is the root of the problem (Medical Health Foundation, 2006, a). Physically, there are endorphins released during the act of cutting which serve as to calm the person down (Starr, 2004). In doing this, the anxiety is reduced and not only is the adolescent satisfied emotionally, but also potentially addicted physically. Adolescents often feel that betwee n studies and their family, they have no control over their own life; and as such cutting can be a means of exerting control over themselves physically. (Derouin and Bravender, 2004). However in certain circumstances, it can be used to exert control of those around the youth, such as friends, family, and other loved ones. (Freeman, 2002). With this in mind, it is understandable why youths take to self harm as a means of resolving their emotional issues, as it has been recorded that most youths who have undertaken the act, hold it in a positive light (Griesbach, 2008). However it is only a temporary solution and an often dangerous one at that. Any gratification gained from the act itself does nothing to relive the underlying problem (Mental Health Foundation, 2006), and as such cannot be expected to resolve itself. Those who choose to self harm, tend to do so because of a complex combination of reasons and experiences, rather than a single, governing event (Fox and Hawton, 2004). As such, it can often be difficult for a Nurse to address these issues as a collective when dealing with those who self-harm. Factors associated to Self Harm Girls are more prone to internalise their problems than boys and as such, certain pieces of literature believe that girls are far more likely than boys to resort to self harm (Hawton et al, 2002). In contradiction to this, certain texts would state that in a study of admissions to an accident and emergency department, almost as many boys were admitted as girls, for the act of self harm (Lilley et al, 2008). As such, it is important to acknowledge that the differences between genders, may not reflect the likelihood of cutting as any greater than the other. There a re also emotional factors tied to self harm, tha t include feelings of loneliness, isolation, depression, frustration and worthlessness (Griesbach, 2008). These feelings in and of themselves often a re enough to cause concern that a youth could self harm, however combined with other factors such as separation from loved ones (through arguments or neglect), bullying or even abuse could amplify the risk of self-harm (Griesbach, 2008). It is just as important when considering these factors, that not everybody who has suffered neglect or abuse will self-harm, and that those that have will often handle things in a less destructive manner (Turp, 2002). Other behavioural factors have been linked to those who self-harm, which include aggressive tendencies, poor educational performance, substance abuse, and most commonly depressive moods (Laukkanen et al, 2009). There are also those who suffer from stress, or who feel as if they have little control over their life. (Griesbach, 2008) Family and Relationships Whilst behavioural problems can be tied to the reasons behind self-harm, often it is those closest to the adolescent that promote these issues, knowingly or otherwise, such as a parental figure providing either overprotection, or a lack of care (Marchetto, 2006). There are many psychosocial issues that may impart negative emotions, stress, or pressures upon a youth, with serious family and relationship problems being the more common (Laukkanen et al, 2009). With this to consider, a school nurse must realise that even the most superficial act of self harm could be linked to a very deep and complex series of psychosocial problems. Young people often feel uncomfortable opening up about such backgrounds, regardless of family circumstance (Griesbach, 2008) and consequently it can be difficult for a school nurse to uncover the true cause of self-harm with a patient. This difficulty in opening up must be considered when assessing a youth suspected of self harm in order to best establish a r elationship with the patient and thus a level of trust (Griesbach, 2008). Mental concerns. A high proportion of children can be diagnosed with mental disorders. With mental health problems such as anxiety, depression and even eating disorders being strongly linked to those who self-harm (Hintikka et al, 2009), these high proportions become all the more concerning. According to The Mental Health Foundation (2006, b) One in ten children have a mental health disorder, coupled with the strong links between self harm and these disorders gives cause for concern as to how much goes unrecorded. Depression has even been recognised as a major factor behind self harm (Derouin and Bravender, 2004), which is becoming even more common with girls who choose to cut. (Hintikka et al, 2009). However there is often a stigma attached to mental health issues that a school nurse will have to overcome when addressing these problems. Often establishing a heightened awareness of these disorders within the community will remove some of the stigma related to these disorders, and in turn will encoura ge youths to be more open and healthy with their thoughts (Hackney, 2009). Some adolescents however, have been discovered to have self-harmed for years by successfully hiding their injuries, and have shown no signs of a mental disorder (Derouin and Bravender, 2004) that stimulates the necessity to cut. Even if mental problems are not to blame however, the act of self harm is a sign that something is wrong within the youths life; self harm often being the outward response to unfavourable circumstances (Griesbach, 2008). Social Circumstances Peer pressure is an all too common part of adolescence. In regards to self-harm, this combined with curiosity and risk taking behaviour will often act as encouragement to try it (Derouin and Bravender, 2004). It is important for a school nurse to understand the presence of peer pressure, and be mindful of it when assisting those who have to overcome self-mutilation. Indeed it is necessary to be mindful of all outside social developmental issues when a school nurse attempts to break the cycle of cutting with a patient. (Derouin and Bravender, 2004). Suicide. Whilst those who choose to self cut or self mutilate often are not intending to attempt suicide, there can often be a risk. Often they are simply attempting to release extreme anxiety or inner pain, (Derouin and Bravender, 2004). However, there are difficulties when addressing this problem as a school nurse. Those who choose to cut are often less likely to be at risk of suicide than those who harm in a different manner; often their only aim is to release tension, and they are more in control of the damage they are inflicting than other methods. (Griesbach, 2008). However, evidence supports the notion that those who self-harm, will repeatedly self-harm, and in turn this increases their risk of suicide, intended or not (Cleaver, 2007). It is important to remember that in general young people will see suicide, and self-harm as two very separate things. Unfortunately for a school nurse, the characteristics of those who self-harm and those who intend to commit suicide are often shared (Hawton and James, 2005). Thus it can be a very challenging experience for a School Nurse to identify pupils who self harm who are at risk of suicide in a medium or a short term. It is vital for School Nurses to recognise the differences between the two, and intervene at the earliest possible opportunity, for every case of self-harm. Whilst Suicide is a rare event (NICE, 2004), it is still the third most common cause of death in the adolescent age group. As such any discovery of self-harming should be fully assessed for needs, emotional, psychological and social factors that are specific to the individual case (NICE, 2004) so as to better assess the problem at hand. Interventions There is some debate as to the best method to stop repeated self-harm, and unfortunately there is a lack of good evidence to support one method over another (NICE, 2004). Randomise Control Trials (RCT) are often the premier choice of researching and comparing differing interventions (Harner and Collinson, 2005). There had been positive results found within the realm of group therapy. Wood (2001) found promising results from a study into developmental group psychotherapy, recording a clinically significant difference to favour group therapy above other forms of aftercare and upon this evidence a first line of treatment should be prescribed as group therapy. Unfortunately in contrast to this a recent repetition of the study failed to yield any positive results to suggest that group therapy was a superior treatment (Hazell et al, 2009). As we can see there is a great difficulty in assessing the value of any research into treatment, and the importance of repeating the tests for grounded evidence. Young people say that they wish to be helped in a way that feels comfortable for them. This is understandable, as they are often discussing a private matter. Private support groups, one on one sessions and drop in services are viewed as particularly helpful (Griesbach, 2008). One of the most important factors is overcoming the negative attitude associated with the disorder; something that is even possessed by the nurses who treat it (Cleaver, 2007). As such it is important to treat the patient with respect and to listen to their problems, even if their roots do not stem from self-harm, but from daily, or emotional issues. Many who have self harmed state that had this service been available to them in the first place, they would not have started their disorder (Mental Health Foundation, 2006, a) Preventative measures must be taken to address self-harm in all of its forms. A school nurse is positioned at the forefront of these preventative measures, and often can find themselves in the best possible position to assist the youth. However; self harm is a very large, and very complex problem for a school nurse to address, with evidence suggesting nurses to feel overwhelmed and under supported when tackling the issue (Cook and James, 2009). With this in mind, the further education of school nurses to equip them to deal with these issues cannot be disregarded (NICE, 2004). When preventative measures fail it is good practise to advise people who repeatedly self injure with management techniques such as, how best to deal with scarring, alternative coping strategies, and harm minimalisation techniques (NICE, 2004). This concept is well established in health promotion and has been applied in recent years successfully to both sexual health education and in a reduction of teenage pregnancies (Lesley, 2008). Adolescence is a time for striving for independence, experimenting and taking risks (Lesley, 2008) and this approach of minimising self harm can often be the best approach to tackling those who have already self harmed. Evidence to suggest an effective treatment is not abundant (NICE, 2004) but to focus on minimising the damage is a pessimistic approach. Certain voluntary organizations advocate the thought If you feel the need to self harm, focus on staying within the safe limits (Mind, 2010). Young people want a range of options for self help best suited to them, even if it is something as simple as something to distract themselves from self harm for just a short period of time (Mental Health Foundation, 2006, a). Successful distraction techniques have been known to include using ice instead of cutting, or even marking with a red pen; other means involve simply venting pent up frustration such as by punching a punch bag (Mental Health Foundation, 2006, a) not all reliefs have to be physical, however, and often creative pursuits such as writing, drawing and painting can have a very positive effect (Griesbech, 2008). Often, it is much more constructive to engage in creative rather than destructive be haviour and is even more likely to change behavioural response to self harm (Norman and Ryrie, 2004). If unavoidable, it is advocated that those who cut use clean, sharp instruments and avoid areas that include veins and arteries (Pengelly, 2008). When advocating this a nurse must consider both the legal and ethical arguments of endorsing any form of self harm (Pengally, 2008). Many do not feel comfortable discussing these minimalisation techniques over the concern that this could be construed as encouragement and leave the nurse vulnerable to backlash (Pengally, 2008). That said, often self harm may be the only control that a young person feels that they have over their lives (Derouin and Bravender, 2004) it is essential for a nurse, when supporting adolescents, to make effective clinical decisions. Ethical dilemmas and diverse situations often arise in this field of medicine and must be balanced with the needs of the patient and community (Bennet, 2008). Ultimately, when undertaking these decisions, practitioners must consult with the rest of the clinical team and maintain in depth records. Similarly, the decision whether or not to inform the parents raises another ethical question. Inititally, it can damage trust between the nurse and patient in future consultations, however, should a youth be considered mature enough they should be treated as adults and thus given the same level of confidentiality (Hendrick, 2010). Limitations. The majority of sources of information within this review is qualitative research which is related to the desire to obtain the opinions of individuals alongside their experiences (Watson et al, 2008). The benefits of qualitative methods are that often a greater wealth of information is obtained, in terms of social and personal experiences and insights than would otherwise be available (Hall, 2006). Unfortunately, there are many criticisms that beset qualitative studies. For instance, many disregard the findings as they are not ecologically valid due to the small sample size (Parahoo, 2006) as such, findings of many studies often only reflect the characteristics of that particular sample as opposed to the diverse population that engage in the act of self harm. Furthermore, it is difficult to justify evidencing qualitative research as often its results are interpretative (Aveyard, 2010) of course, findings can also be affected by the differing assessment methods used to collate the inf ormation, such as whether the assessment was done autonomously or if it relied on parental consent. Recommendations. Harm minimalisation techniques need to be widely available to adolescents who self harm with recognization of the ethical dilemmas, in order to support school nurses within this field of practise. Future literature on the subject also needs to choose its terminology carefully and focus upon one form of self harm rather than generalising. This is the only manner in which a specific treatment can be formulated to address each individual form of self harm allowing nursing to develop appropriate preventative interventions. School nurses should also refer all youths who harm to CAMHS. The presumption that young people that cut are not suicidal or that they do not have mental illness is too high a risk to consider and even though the majority hold neither of these disorders, they can not be overlooked due to the minority that do possess them. Conclusion. The true extent of self harm or self cutting is very difficult to determine due to the inconsistencies and definition and underreporting that often it goes unnoticed. What can be agreed upon, is that self cutting is an increasing and serious problem among adolescents. School nurses hold a vital role in the management of this disorder and are often at the forefront of any prevention, treatment and education. An understanding of why adolescents self harm and all linked factors are vital for undertaking treatment of a patient. However, this challenge is complex and requires a large amount of training and support; it is very important to avoid any stigma attached to self harming when treating youth, they are often not attention seeking and frequently posess a lot of problems in their lives. Self harm masks underlying emotional, psychological and social trauma and can simply be a youths only outlet to relieve stress and emotional tension. It is undeniable that self harm is a rapidly expan ding area of research, however upon reviewing this literature many questions are still left unanswered. There is still the underlying moral and ethical difficulties that a school nurse must consider when supporting those who self harm

Symbols and Symbolism in The Catcher in the Rye :: Catcher Rye Essays

Symbolism in The Catcher in the Rye Throughout the novel, the reader is presented with various symbols. The symbols are clearly made evident by Holden’s constant repetition of their importance. The symbols are so important and their symbolism is directly related to the major themes of the novel.   Ã‚  Ã‚   Allie, Holden’s young brother who died several years earlier, was a key symbol throughout the story. When Holden remembers incidents from his past involving Allie, his attitude changes, such as when he writes the composition about Allie’s baseball glove or when Holden broke his hand after punching all of the windows after Allie died. He feels that Allie was one of the few people who were not phony in a world full of phonies. More importantly, Allie represents the innocence and childhood that Holden strives to find throughout his multi-day journey. In Holden’s opinion, Allie represents the purity that Holden looks for in the world. Holden admits that he admires Allie more than he admires Jesus, and even prays to Allie at one point, rather than Jesus. Allie is Holden’s role model, whom he judges the rest of the world according to. When Allie dies, it creates turbulence in Holden’s life.   Ã‚  Ã‚   At various points during the course of the novel, Holden inquires as to what happens to the ducks who are normally on a pond in Central Park, when winter comes and the water freezes. As he inquires, the answers he receives range from as farfetched answers as the idea that the ducks still remain there under the ice, just as the fish do, to uncaring answers such as a simple "What a stupid question!" remark. Despite the answer he gets, Holden is never satisfied with the reply. Holden doesn’t consciously realize that the ducks relate to him. Whether he will admit it or not, Holden is scared. He has been kicked out of numerous schools, he can’t get good grades, his parents are angry with him, and he spends his days wandering through New York City. He doesn’t know where he is going to go, reflecting his question about the ducks. Perhaps if he knew where the ducks went, he could follow their example.   Ã‚  Ã‚   While walking through New York City, Holden arrives at the Museum of Natural History. He remarks about the museum that he likes the glass cases that the museum officials place all of their exhibits in.

Dr. Doctor

Dear Doctor, Yesterday, during lunch, my best friend and I were discussing sexually transmitted diseases and we got into quite a brawl about some of the myths and facts of them. It seemed like the only statement we both agreed on was that the topic about sexually transmitted diseases (and how each are transmitted and statistics) should be taught in school, just how biological information and abstinence are being educated. With that being said, I have quite a few questions to ask you. Is it still possible to get a sexually transmitted disease if you are abstinent?If a person is infected with a sexually transmitted disease, can you tell by their appearance? Is there a higher chance that you will be infected by a sexually transmitted disease if you’re in your teen years? Can STDS only spread through semen and blood? If a woman is on birth control, does that prevent her from obtaining an STD as well? Can you, in fact, catch an STD from a toilet seat? And lastly, once you have a se xually transmitted disease, there’s no chance of becoming infected again, right?These were a bunch of questions that seemed to be left unanswered yesterday and I was wondering if you might be able to clarify them for me as well as every other reader out there. Thank you Doctor. Sincerely, Confused reader. Dear â€Å"Confused reader†, I do appreciate taking time to write to me about your questions and I also agree with you that the educational system should do more to inform the youth about sexually transmitted diseases before it may be too late. Also, as for your questions.. Yes, there is still a chance that one might become infected with a sexually transmitted disease while remaining abstinent. Abstinence does not preventAIDS, hepatitis B, and hepatitis C infections that come from nonsexual activities like using contaminated needles for doing drugs, unsterilized tattooing, or even taking steroids. You have no way of knowing if a person has a sexually transmitted disea se just by looking at their appearance and observing how ‘clean’ they are. Even doctors often can’t tell by looking if people have STDs; that’s why tests involving a patient’s blood work were made. Most STDs have very few signs or no signs at all. Only in really extreme cases of certain STDs could a person detect signs of an STD in the groin area; but don’t rely on it.It’s even possible to carry and spread the virus without ever having an outbreak. The truth is, about one in four sexually experienced teens become infected with an STD. Unfortunately, you are correct on this one. Statistics show that two-thirds of sexually transmitted diseases occur in people who are under twenty- five and one in four girls between the ages of fourteen and nineteen were determined to have at least one of four sexually transmitted diseases (Human Papillomavirus [HPV], Chlamydia, Herpes Simplex Virus, and Trichomoniasis. ).Young people (ages from 15- 24) h ave five times the reported rate of Chlamydia of the total population, four times the reported rate of Gonorrhea, and three times the rate of Syphilis. While semen and blood can spread some sexually transmitted diseases, some STDs like herpes and syphilis can be spread by skin on skin contact. For example, when herpes flares up, an active sore appears on the person’s body and if this sore comes into contact with another person’s skin (or moist areas like the mouth, throat, and also areas with cuts and/ or rashes), it can spread.However, it can also spread before the blisters actually form. I’ve actually heard these two myths before and never understood how they came about. The birth control pill has the potential to prevent one thing, the prevention of pregnancy from occurring. It holds no protection against sexually transmitted diseases. As for the myth about being able to get a sexually transmitted disease from a toilet seat, organisms cannot survive outside o f the human body for a long period of time. Some STDs are yours for life, like herpes and HIV.Others, like Chlamydia and Gonorrhea, can be treated; but you more likely to get infected again, since you are now vulnerable to the disease if you have sexual contact with someone who has them. In young girls, the second time you have Chlamydia, there’s more damage to your reproductive tract, which may cause permanent infertility. I expect that you read everything that I have written and have more of an understanding on sexually transmitted diseases. Remember: No sex is always better than safe sex. Sincerely always, The Doctor.

Free Essays on Reporting Violence In Newspapers

Abortion A woman owns her body and should have the right if she wants to have an Abortion. Legal abortions can save a woman’s life if there is complications with the unborn fetus. Abortions help over several complications that can be a result from childbirth. Also legal abortions can prevent women from getting back-ally abortions that can result in diseases, mutilations and death (9 Reasons). Others will say that if abortion becomes illegalized then this is a result of discrimination towards women. It is discriminating towards low- income women because not all women can afford to travel when its is necessary to received a legal and safe abortion(9 Reasons). Over the years women have had complications with childbirth. Women with heart diseases, Kidney disease and other illnesses can result in not only the fetus dying but also the mother that has complication with the birth. Abortion prevents women from having complications. If abortions was not illegal women and children deaths would have increases from these complications. No matter what, if a woman wants to have an abortions she will find every way to receive one. Legal abortion is the safest way. Not only does the mother have the medical needs received from a doctor but the abortion is safer, diseases free and the mother is less likely to die from the procedure. It is one of the many ways to prevent back-ally abortions that have been the cause of several deaths among pregnant women. Sever people agree that if abortion was illegalized then that would be discriminating against low-income women that can’t afford to travel to other countries to receive a safe and legal abortion. Again they are forced to a back-ally abortion that can result in death. Also others might say that a unborn child is not a human being so the result of abortion is not murdering a human(Sykes, Margaret & Ward, Dr. Roy Bowen). In any way a woman is more then a holder for a unborn baby, ... Free Essays on Reporting Violence In Newspapers Free Essays on Reporting Violence In Newspapers Abortion A woman owns her body and should have the right if she wants to have an Abortion. Legal abortions can save a woman’s life if there is complications with the unborn fetus. Abortions help over several complications that can be a result from childbirth. Also legal abortions can prevent women from getting back-ally abortions that can result in diseases, mutilations and death (9 Reasons). Others will say that if abortion becomes illegalized then this is a result of discrimination towards women. It is discriminating towards low- income women because not all women can afford to travel when its is necessary to received a legal and safe abortion(9 Reasons). Over the years women have had complications with childbirth. Women with heart diseases, Kidney disease and other illnesses can result in not only the fetus dying but also the mother that has complication with the birth. Abortion prevents women from having complications. If abortions was not illegal women and children deaths would have increases from these complications. No matter what, if a woman wants to have an abortions she will find every way to receive one. Legal abortion is the safest way. Not only does the mother have the medical needs received from a doctor but the abortion is safer, diseases free and the mother is less likely to die from the procedure. It is one of the many ways to prevent back-ally abortions that have been the cause of several deaths among pregnant women. Sever people agree that if abortion was illegalized then that would be discriminating against low-income women that can’t afford to travel to other countries to receive a safe and legal abortion. Again they are forced to a back-ally abortion that can result in death. Also others might say that a unborn child is not a human being so the result of abortion is not murdering a human(Sykes, Margaret & Ward, Dr. Roy Bowen). In any way a woman is more then a holder for a unborn baby, ...

Hemingway essays

Hemingway essays On the date of July 21, 1899 Ernest Hemingway, a now known brilliant writer, was born. Hemingway was conceivably the only writer to achieve the combination of international celebrity and literary stature in the twentieth century. Hemingway was brought up in the village of Oak Park, Illinois, close to the prairies and woods west of Chicago. Both here and in Michigan, he could explore, camp, fish and hunt with his father, Dr. Clarence Hemingway. In Chicago he would attend concerts, operas and visit art museums with his mother, a musician and an artist. Hemingway attended Oak Park and River Forest High School, where he was an active writer. He wrote articles, poems and stories for the schools publications largely based on his own experiences. The year Hemingway graduated he quickly secured a job with the Kansas City Star. There he received a writing style sheet that instructed: Use short sentences. Use short first paragraphs. Use vigorous English. (Parshall 1). These were rules he never forgot to incorporate into his works to get to the heart of a story. The following year he entered World War I as a volunteer with American Red Cross ambulance unit as a driver. There he was wounded near the Italian/Austrian front. Hospitalized, he fell in love with his nurse, who later called off their relationship. After World War I, Hemingway returned to northern Michigan to read, write, fish, and later to work for the Toronto Star in Canada. In 1921 married his first wife and moved to Paris. In Paris he continued to write for the Toronto Star as a foreign During his stay in Europe through the 1920s, Ernest was influenced by eccentric writers like Gertrude Stein and Ezra Pound their literary compression. Hemingways use of these methods in short stories and novels that captured the attention of critics and the In the 1930s, he turned to writing for cause...

Introduction to Leadership Essay Example | Topics and Well Written Essays - 500 words

Introduction to Leadership - Essay Example I realize much of this course, as well as the text book ( Northouse 2014) suggest that leadership is a phenomenon that resides in the context of the interactions between leaders and followers and makes leadership available to everyone (Northouse , 2014 p.8), but from my personal experiences, especially in a work context, trait theory appears to be the biggest contributor. Despite this it is obvious that one can only be a leader if there are those to be led, those who will interact with him and who share common aims, whether this is something as simple as making a profit , or , on a much grander scale, to improve the living standards of a whole population by acting as its government, or even to have some more negative aim such as the eradication of another people group as happened in Germany in the mid 20th century.   So leadership happens in many different areas of life – in business , in politics, in health care, in families   and in military life , to give just some of m any possible examples. A good leader must, by definition, be able to communicate his ideas to others, but there should also be two way communication , in that he listens to others , gets feedback for instance as to how a project is proceeding, or takes account of suggestions. My goal for my immediate future is not actually to become a leader, but more to understand the concept of leadership and how it can be done at its most effective. I have worked with those I considered to be good and successful leaders, as well as incompetent and ineffective ones.

Science and policy Essay Example | Topics and Well Written Essays - 1500 words

Science and policy - Essay Example Selecting an appropriate ambassador may also bring forward some form of challenge as this selected individual is the one to carry the face of the firm that carries out the activities of a knowledge broker. The selection should be flawless as any form of undue process in selection may pose a challenge to the firms. Some other challenges that can come in the way of the knowledge brokers include such challenges as managing interactions with stakeholders within acceptable limits. Some stakeholders may be difficult in a way to handle and hence this may be a major challenge that other brokers may crumble as they tend to check a way forward in dealing with such cases (â€Å"Knowledge Exchange†). The knowledge brokers may be working on a flat plan without settling down to lay the objectives. This may also pose a threat in achievement of desired results if they are not fully planned for and hence this too may end up countering the development agenda that these knowledge brokers have in mind (Hargadon 48). The knowledge brokers and their firms should also have a plan on a systematic way of availing results and outcomes through acceptable networks that are practitioner oriented. Doing anything else to this effect may have to backfire and end up being a challenge that will bring the firms down. The firms should also lay the strategies that will work towards distilling results and their strategies for maintaining long lasting legacies. However most of these firms lack the expertise to carry out such distilling processes and that means that a challenge will be witnessed as soon as the legacy flops (Brown 486). So some of the solutions that can be facilitated to curb such challenges can involve such remedies as: as for the challenge of trying to keep up with the stakeholders by trying to encourage them to invest ideally in the broker’s firm through time, resources and effort. The solution to this challenge is to try as much as possible to involve the stakeholder s and to give them the need to place their trust for you. If the relationship at the beginning is a good one, then the engagement should be fair throughout the period of the project. This approach needs much attention and hence the firm should conduct a good sense to determine the road taken by the research. After establishing that, then many more stakeholders will show interest and hence feel free to work with you. – SUE Researchers (Tsui L et al) For the challenge that comes from finding it hard to engage the stakeholders in the definition of various important aspects of the research. It should not still be debatable whether to involve the stakeholders, as the firms should go ahead and incorporate them in decision making on the kinds of design the research should have. The stakeholders should be allowed to assist in determining whether an approach is feasible or not. Serious members of the stakeholders’ board should be able to tell what befits the firm and what doesn ’t. With this approach, the problem of having to determine the level of indulgence of the stakeholders would be fully answered (Hargadon 50). One other challenge that is faced by the knowledge brokers may be that of that their research findings reach the desired audience and that the said findings are found to be