Business Economics Essay

Cindy wants to invest in a new business that involves the installation of solar panels. In order to make an informed decision on this business venture, she will need to review potential profit/loss in the solar panel industry by considering future prospects for this type of business. Cindy also needs to decide whether she will invest her own funds or borrow the money to start the business. The imminent growth of the solar photovoltaic (PV) industry is almost certain. When observing the rising costs of coal and natural gas prices, the decrease of PV system costs, and the government support of solar technology, the PV market looks to have a significant increase in volume over the next few years. According to SolarBuzz, a website dedicated to Solar Power and Energy, The solar PV industry has reached a critical tipping point, with end-market demand hitting record levels almost every quarter. This growth is being driven by leading module suppliers and project developers that returned to profitability during 2013, and which have now established highly-effective global sales and marketing networks.† (NPD Group, Inc., 2013) The article also states that â€Å"demand in Q1’14 will also achieve record-breaking status, as the strongest first-quarter ever seen by the PV industry.† (NPD Group, Inc., 2013) The cost of production for solar panels has decreased significantly. â€Å"The average cost for tier 1 solar photovoltaic manufacturers is expected to fall 6% during 2014, continuing the downward trend set in place since 2008, bringing the overall cost to a record low of $0.20 per watt, according to the latest research from NPD. (NPD Group, Inc., 2013) Further consumer incentives include lower utility bills, increased tax credits and higher resale values. â€Å"Homes with solar-power system using photovoltaic (PV) panels sell for an average of $24,705 more than homes without PV systems, research finds.† (Tanaka, 2014) The government supports the concept of solar power and aims to make it a major energy source. â€Å"Solar power as cheap as coal†¦ that is the holy grail of the solar power industry† (R. Glenn Hubbard, 2012) Government support includes generous subsidies to the consumer and producers of the PV industry. â€Å"Government agencies, utilities and others offer a variety of tax credits, rebates and other incentives to support energy efficiency, encourage the use of renewable energy sources, and support efforts to conserve energy and lessen pollution.† (Energy, 2014) I see four main factors influencing the price elasticity of demand: †¢Availability of close substitutes. Are there many available close substitutes for solar panels? The demand will tend to be elastic if Cindy and her customer can switch among the various types of PV’s for the same desired feature. †¢Are PV’s a necessity or a luxury? Currently, PV’s would be considered an elastic form of energy because there are other forms of electricity (coal/power plants). We once considered personal computers a luxury and they are now a necessity. Perhaps PV’s will be viewed the same way in the future. †¢How much of my income will PV’s consume? A large portion of consumer’s income equals elasticity. What portion of income can your client devote to the cost of solar panels? If it is a large share (elastic), what tradeoffs will client need to consider to make it a worthwhile purchase? †¢What is the time horizon when making decisions on PV’s? PV systems have productive life cycles of 30-50 years. (Brownson, 2014) A longer time horizon is said to be elastic. Recommendations Upon review of various criteria such as elasticity of demand, cost of production, etc, I would encourage Cindy to pursue this business venture. This sector is set to grow exponentially in the future. The fall in solar PV prices as well as other incentives will cause higher demand for  installation. This will benefit Cindy’s new business venture by bringing more installation business and lower input costs. This can be seen in the demand supply figure: It also makes good economic sense for Cindy to borrow money for her solar panel business venture as the government provides various subsidies to businesses involved in clean energy. â€Å"In total, the federal energy tax subsidies will cost more than $16 billion in 2013, up from only $5 billion in 2005.† (Bastach, 2013) Cindy can benefit from a piece of the clean energy subsidy pie. Bibliography Bastach, M. (2013, March 13). Most energy tax subsidies go toward green energy, energy efficiency. Retrieved from The Daily Caller: http://dailycaller.com/2013/03/14/cbo-most-energy-tax-subsidies-go-toward-green-energy-energy-efficiency/ Brownson, J. (2014, May 25). Department of Energy and Mineral Engineering. Retrieved from Penn State University: https://www.e-education.psu.edu/eme810/node/593 Energy, U. D. (2014, may 25). Tax Credits, Rebates, and Savings. Retrieved from Energy.gov: http://energy.gov/savings NPD Group, Inc. (2013, December). Solarbuzz. Retrieved from Solarbuzz: http://www.solarbuzz.com/news/recent-findings/strong-growth-forecast-solar-pv-industry-2014-demand-reaching-49-gw R. Glenn Hubbard, A. P. (2012). Economics. VitalSouce bookshelf version. Tanaka, S. (2014, May 22). Payback Time for Solar-Power Energy Systems. Retrieved from The Wall Street Journal: http://online.wsj.com/news/articles/SB10001424052702304198504579571960667560156?mg=reno64-wsj&url=http%3A%2F%2F online.wsj.com%2Farticle%2FSB10001424052702304198504579571960667560156.html

History with Derek Mahon Essay

History is a subject which preoccupies Mahon in many of his most important poems. I would choose particular poems because of his view towards our history and the past. His poetry presents history in a very negative light. Mahon sees the past as ‘deep-delving, dark, deliberate you would say’. In the poem Rathlin Mahon recalls historical violence on an island that is now a ‘sanctuary’ of peace and ‘through with history’. However this island in the past has witnessed ‘unspeakable violence’ with the massacre of the Rathlin women. He speaks of the ‘unnatural silence’ on the island gradually becoming ‘natural’ over the years through the island not being inhabited. Come the end of the poem Mahon is unsure ‘whether the future lies before us or behind’. Whether the violence is now behind us or is violence a continuing part of our future? In Mahons Poem Kinsale there is a welcome and a long awaited moment of light and hope. The opening line of this poem was an optimistic thought from Mahon himself by saying, ‘the kind of rain we knew is a thing of the past’. The use of imagery in this poem is both vivid and warming. The image of ‘Yachts tinkling and dancing in the bay’ is a striking image as it is both beautiful and positively uplifting. The sun is a direct contrast to the rain. The sun is an image of hope and the ‘future forbidden to no-one’ while the rain is the constant reminder of a violence filled history. Although Mahon showed a slight sense of hope he is constantly overcome with those ‘who have come so far in darkness and in pain’. In the poem A Disused Shed in Co. Wexford he uses the metaphor of mushrooms neglected in a shed to represent the victims of history. Please note! This is not an example of text written by our writers! Essaypedia.com is a database of essays that were collected at open web resources. You can use them at you own risk following the citation rules below. But we recommend you to order a custom plagiarism-free essay written just for you from one of our writers. Place an order, add your paper details and enjoy the results! You can keep in touch with your writer, check the draft of your paper and send your order for revision for free. If you are hesitating to place an order – just ask for a quote! However the both extraordinary and unbelievable picture of mushrooms with feelings is not the only reason I would choose this poem. Mahon uses the image of mushrooms neglected and forgotten to portray the misery and despair of thousands of victims who have died or survived the torturous past. ‘They are begging us you see’ to not forget them or forget what they have been through. Even the most insignificant people in history still deserve the recognition for their struggle. Small heroes from the past ‘In their wordless way’ are saying ‘Let not our naà ¯ve labours have gone in vain’. Mahon also deals greatly with the theme of isolation in this poem. The mushrooms are completely cut off from the world and their only form of light ‘Is a keyhole rusting gently after rain’. The theme of isolation is also portrayed in the poem Grandfather. The ‘Grandfather’ in the poem has completely isolated himself from family and friends. ‘Discreetly up to no good’ he leaves the house in the morning and does not return until ‘After dark’. However nothing gets by this grandfather, ‘Nothing escapes him, he escapes us all’. ‘His shrewd eyes bolt the door’ to his life and he would rather not be bothered by anyone or anything. Another good choice of poem sticking with the theme of isolation would be After the Titanic. In this poem the persona of Bruce Ismay is overcome with guilt and as a result has completely isolated himself from the world. This poem is a favourite of mine also because Mahon writes in the persona of Ismay so brilliantly. ‘Include me in your lamentations’ was the final line of this poem and it sums up what Ismay was asking for. Like the mushrooms in A Disused shed in Co. Wexford he wanted to be remembered just like those who had died in the sinking of the titanic. He believed he ‘sank as far that night as any hero’ as his life and soul died that night. He watched the ship go ‘thundering down’ and with it went his ‘costly life’. He now ‘stays in bed’ and ‘will see no-one’. Mahon allows the reader to become Bruce Ismay if only for a minute. It is amazing reading this poem. The poem Antarctica is also a great example of Mahons ability of writing in a variety of personas. In this poem Mahon writes in the persona of captain Lawrence Oates an explorer who gave his life for the lives of his fellow men. ‘I am just going outside and may be some time’ are said to be his final words. Mahons deals greatly with the theme of people in this poem. He shows that there is good in man kind and ‘At the heart of the ridiculous, the sublime’. Mahon shows that even in the worst instances of isolation imaginable, trudging utterly alone, to his death Oates action may seem entirely ‘ridiculous’ but in this case it is somewhat heroic. People in life may make some pretty foolish decisions but there might always be a good outcome. The poetry of Derek Mahon is poetry that one could not live without. With this collection of marvellous pieces his poetry will continue through generations and linger in peoples minds for some time, ‘In fact forever’.

The Middle Passage

The Interesting Narrative of the Life of Olaudah Equiano, or Gustavus Vassa, the African, Written by Myself† Is a traumatic narrative of the horrors suffered by the Africans slaves of the 18th century, which has touched my heart. No human being should ever have to endure what the African slaves and their families endured during slavery and voyage through the â€Å"The Middle Passage†. The Middle Passage was called the route of the triangular trade through the AtlanticOcean in which millions of people from Africa were shipped to the New World as part of the Atlantic slave trade. The author starts by giving details of the terrible conditions that he encounters on board of a slave ship. An example of the terrible condition in which the slaves lived is narrated by Equiano (2013) as: â€Å"The stench of the hold while we were on the coast was so Intolerably loathsome, that it was dangerous to remain there for any time†¦ † (1388) â€Å"The closeness of the place, and the heat of the climate, added to the umber In the ship, which was so crowded that each had scarcely room to turn himself, almost suffocated us† (p. 388). The conditions the Africans slaves endured during the Middle Passage were horrific; no human being should be force to live in such deplorable conditions. The lack of freedom on the slave ships caused great distress to the enslaved Africans. They were treated as cargo, chained one with the other and had to perform their bodily functions while chained. They were also forced to sleep cramped together few of them barely escaped without their limbs atrophying. They rarely had enough to eat or drink, and would grow sick in drove, than many of them wanted to die instead of living a life full of cruelties.The slaves were so tired of the detrimental conditions In which they have been forced to live In slave ships, under the most abominable and hellish hyglenlc conditions that they preferred to die, as Olaudah Equiano (2013) write s, â€Å"two of my wearied countrymen who were chained together (l was near them at the time), preferring death to such a life of misery, somehow made through the ettings and Jumped into the sea; immediately another quite dejected fellow, who, on account of his illness, was suffered to be out of iron, also followed their example† (p. 388) Some slaves did everything in the power to end their life; some tried to throw themselves into the Atlantic Ocean, but many were prevented from doing so by the crew and then they were nearly beaten to death to serve as an example, to prevent other slaves from doing the same.Most of the slave encounter white men for the first time when they were brought to the ship, to them those white men with red faces and long loose hair where a strange creature speaking a language they could not understand. They were suddenly separated from their families and forced to live with strangers whose languages they could not understand. I cannot even imagine th e turmoil these families when through. For most of the Africans slaves the Middle Passage marked the beginning of their emise, a life of detrimental treatment, torture and horrible living conditions.For others the Journey thru the Atlantic Ocean marked the end of their lives. Those of them that survived, however, were faced with the agony of a long horrendous Journey to an unknown land where an unknown future awaited them. The Middle Passage The Interesting Narrative of the Life of Olaudah Equiano, or Gustavus Vassa, the African, Written by Myself† Is a traumatic narrative of the horrors suffered by the Africans slaves of the 18th century, which has touched my heart. No human being should ever have to endure what the African slaves and their families endured during slavery and voyage through the â€Å"The Middle Passage†. The Middle Passage was called the route of the triangular trade through the AtlanticOcean in which millions of people from Africa were shipped to the New World as part of the Atlantic slave trade. The author starts by giving details of the terrible conditions that he encounters on board of a slave ship. An example of the terrible condition in which the slaves lived is narrated by Equiano (2013) as: â€Å"The stench of the hold while we were on the coast was so Intolerably loathsome, that it was dangerous to remain there for any time†¦ † (1388) â€Å"The closeness of the place, and the heat of the climate, added to the umber In the ship, which was so crowded that each had scarcely room to turn himself, almost suffocated us† (p. 388). The conditions the Africans slaves endured during the Middle Passage were horrific; no human being should be force to live in such deplorable conditions. The lack of freedom on the slave ships caused great distress to the enslaved Africans. They were treated as cargo, chained one with the other and had to perform their bodily functions while chained. They were also forced to sleep cramped together few of them barely escaped without their limbs atrophying. They rarely had enough to eat or drink, and would grow sick in drove, than many of them wanted to die instead of living a life full of cruelties.The slaves were so tired of the detrimental conditions In which they have been forced to live In slave ships, under the most abominable and hellish hyglenlc conditions that they preferred to die, as Olaudah Equiano (2013) write s, â€Å"two of my wearied countrymen who were chained together (l was near them at the time), preferring death to such a life of misery, somehow made through the ettings and Jumped into the sea; immediately another quite dejected fellow, who, on account of his illness, was suffered to be out of iron, also followed their example† (p. 388) Some slaves did everything in the power to end their life; some tried to throw themselves into the Atlantic Ocean, but many were prevented from doing so by the crew and then they were nearly beaten to death to serve as an example, to prevent other slaves from doing the same.Most of the slave encounter white men for the first time when they were brought to the ship, to them those white men with red faces and long loose hair where a strange creature speaking a language they could not understand. They were suddenly separated from their families and forced to live with strangers whose languages they could not understand. I cannot even imagine th e turmoil these families when through. For most of the Africans slaves the Middle Passage marked the beginning of their emise, a life of detrimental treatment, torture and horrible living conditions.For others the Journey thru the Atlantic Ocean marked the end of their lives. Those of them that survived, however, were faced with the agony of a long horrendous Journey to an unknown land where an unknown future awaited them.

Auer waffeln an austrian company's tale of growth,globalization and Essay

Auer waffeln an austrian company's tale of growth,globalization and decline - Essay Example Business organizations rely on the effectiveness of their marketing strategies, which should always determine the potential of the market thereby informing the subsequent production process of the organization. An effective marketing process should inform the production thereby preventing the organization from incurring losses (Solomon et al, 2009). SWOT analysis The marketing process relies on a number of organizational analyses key among which is the SWOT analysis. This is a business tool used in analyzing the potential of the business organization in sustaining the market demands. The first two components of the analysis are the Strengths and weaknesses of the business organization while the last two are opportunities and threats of the business. The first two elements are therefore within the organization and the organization can manipulate them to ensure it sustains its profitability. The last two on the other hand exist externally; they are part of the market forces implying th at the business organization cannon manipulate them. They therefore determine the profitability of the business. ... The growth if the business portrays a number of management success resulting from bold management strategies. However, the business later stifled away following a number of management lapses and the inability to maintain its market share. The success of the business depends on the effectiveness of the business idea and the nature of the execution of the idea. Guenter Auer identified a potential need for the foodstuff in the Austrian market. The business later flourished following the effectiveness of the business idea. Apparently, the Austrian market had lacked such a business thereby creating a loud that the Waffeln business seamlessly filled. Market entry strategies After identifying an effective business idea, the nature of executing the idea becomes essential in safeguarding the success of the business. Auer identified a gap within the market and therefore decided to fill it thereby developing a market of its own. The idea was unique and therefore took the market by surprise. The business therefore developed a sizable market for itself. However, Auer knew the nature of the market and the amount of potential it had. He therefore began by operating his business in a small scale within the small local market. This did not only provide adequate profitability but also provided the organization with an effective market research opportunity (Ghauri & Cateora, 2010). Through the small local market, he determined that the business could grow to become a national and progressively an international business. He therefore realized the need for a more qualified manager for the business a factor which compelled him to send his son to some of the best schools from where he studied manage net among other operational courses related to production.

Human Growth and development assignment 8 Essay

Human Growth and development assignment 8 - Essay Example Thus, social bonding is of paramount significance for infants to develop trust. The interaction of the infant’s temperament with the experiences in the immediate environment influences the personality development. Hence, the quality of interaction between the infants and caregivers plays a critical role in influencing personality development during infancy. Fundamentally, infants are self-centered, and their primary concern is to satisfy their physical desires. For instance, hunger is a primary concern for infants. The preschool children have patterns of psychosocial, social, and moral development. Notably, the preschool children tend to assert their control, as well as, power over the world by directing social interactions. For instance, the children take charge of their play. Similarly, the successful children in the preschool years feel they have the capacity to lead the others. In contrast, the unsuccessful children display a sense of self-doubt, guilt, and lack of initiatives. Socially, the preschool children will create friends and depart from the side-to-side play with their caregivers. The relationship between the preschool children and immediate people influences the social development (Mahmud, 2013). For example, the children will drift towards particular children and form strong relationships with them. At this stage, the children learn to cooperate with friends while playing and sharing things such as toys. Morally, the children will display empathy (Shaffer & Kipp, 2013). The chil d transits from self-centeredness to embrace empathy. Hence, the child exhibits a sense of consideration. The preschoolers become aware of what is wrong and right. The infancy and preschool phases have similarities, as well as, differences. Notably, the parent-child relationship influences social development during infancy and preschool years. The

Ethical argument smoking Essay Example | Topics and Well Written Essays - 750 words

Ethical argument smoking - Essay Example Those who consider it justified ethically say that to smoke or not is individual’s decision and everybody has a right to decide for himself/herself. Smoking cigarettes is often considered to be a cause of other problems. There is need to find out how frequently smoking becomes the cause of more serious and condemnable habits like smoking heroin or marijuana. The optimal limit to which one can smoke plain cigarettes without causing substantial damage to one’s health should also be determined. I think that currently my topic is not narrow enough to write a detailed argument about it. I might need to narrow it down so that I collect facts and explore the topic from a particular aspect like the optimal level of plain smoking or smoking as a cause of heroin consumption etc. People who oppose my position would say that smoking is injurious to health, so it cannot be justified on any grounds. They would also say that smoking in private is also not acceptable since the activity does not yield a single positive result but does carry a lot of risks for the smoker. I can say that cigarettes are not the only thing that are injurious to health; there are many other activities that are injurious to health or environment but they are not taken as seriously e.g. alcohol consumption, drunk driving, and consumption of junk food. I can say that to smoke in private should be allowed because there is practically no way to stop an individual from smoking in private. Any amount of energy or resources invested in trying to stop people from smoking in private would go wasted. The readers would know that cigarettes are injurious to health and can be a cause of such conditions as lung cancer and mouth cancer. I would need to carry out some research to prove my readers that cigarettes are not as injurious to health as they are frequently assumed to be. I

Choose two anthropology questions in this six questions and answer Assignment

Choose two anthropology questions in this six questions and answer - Assignment Example As a rite of passage, hajj represents a change in faith as Muslims who attend this annual pilgrimage are considered to have attained great faith in their religious beliefs. Hajj is also a rite of passage because it is a ritual worship that members of the Islamic faith are expected to fulfill (Tagliacozzo 4). The concept of the â€Å"one-and-the-many† can be said to relate to the notions of whether Hinduism is a monotheistic or polytheistic religion. Based on this concept, one understands how the multiplicity of Gods is an issue of concern in the Hindu religion. Among the Hindus, there is a tendency to worship many Gods as opposed to worshiping a certain religious deity. The various deities in the Hindu religion are a representation of a single supreme being known as Brahman. Hindus do not worship many gods; rather, they have only one god and different deities (Morgan

MICROECONOMIC Essay Example | Topics and Well Written Essays - 1500 words

MICROECONOMIC - Essay Example For the person who smokes cigarettes, it is a good commodity. Hence, the Price Consumption curve would be downward sloping one as in the figure above. But the slope will be a flat one because although the price goes up, the consumption does not get reduced at the same rate. Answer 2 The difference between a young smoker and an adult smoker is that the former can reduce the level of smoking as it is not a habitual activity for him hence cigarettes will be treated as a normal good for him. So when the price of the cigarette increases the young consumer can reduce the consumption. Hence the demand curve would be an elastic one (Gottheil, 2013, p.101). On the other hand, for an adult smoker cigarette consumption would not vary with changes in the prices because it would be an addiction for him and hence even if the price is high he would not be able to reduce the consumption of cigarettes. The demand for cigarettes for an adult would be inelastic. In the above figure, the producers of ci garettes face a perfectly inelastic demand curve from the adult smokers but a relatively more elastic demand curve from the young smokers. Now if the price of Cigarette increases the adult smokers will continue to buy the amount Qa but the young ones would adjust their consumption as per the prices. Since the quantity demanded of cigarette decreases for the young smokers, the demand for other good increases. But this does not happen in case of the adult smokers. Whatever be the prices of the cigarettes, they will continue consumption of the same amount .Hence the demand for other goods will remain constant or increase marginally. The above graph applies for the young smokers whose demand fluctuates with the changes in the prices. The initial demand for cigarettes is Q1 and the price is P1. The initial demand curve for other goods was D1. Now due to increase in the prices, the new quantity demanded would be less amount i.e. Q2. Thus the demand for other goods increases to D2. This ch ange does not happen for an adult smoker. He does not change the quantity and is ready to pay the price differential. Thus the demand curve for other goods remains constant. Answer 3 Though tobacco as an addictive consumption cannot be explained by the general economics laws of demand and supply, it has to be kept in mind that there are social costs as well as time costs associated with the continuous use of tobacco. Economic Research has provided evidence of the fact that the demand for cigarettes does decrease with an increase in the prices of cigarettes (McGowan, 1995, p.113). The income levels of the individual smoker also have an effect on the demand for cigarettes. Studies across the world has shown that the demand due to an increase in the prices of cigarettes have fluctuated more in the underdeveloped countries than in the developed countries. This proves that the people of these countries are more price sensitive than their developed counterparts. But addiction of cigarette happens irrespective of the level of income hence an increase in the tax rate may appear to be regressive because it may affect the poorer segment of the population. The consumption habits of the past also influence the consumption habits of the future. Hence the people who have a record of consuming cigarettes more in the past tend to consume even more in the future. Thus if anti

Current event Analyses Essay Example | Topics and Well Written Essays - 1750 words

Current event Analyses - Essay Example He gave us several benchmarks by which to judge writing or speech. I shall use those devices to analyze the recent speech by President Obama after the Boston terror attacks. Terrorism is a problem of huge magnitude globally. With the killing of Osama bin Laden, the President had earlier on reassured the nation that terrorism will be a thing of the past. However, an attack of the most elementary kind happened and several people lost their lives. Therefore, it is important to see how the president, who is well known for his good oratory skills, used this attribute to reassure the nation again. Apart from analyzing the elements of oratory that the President employed, there shall also be a focus on the effectiveness of the speech. One of the most important parts of rhetoric that should never be ignored is the setting. Usually in rhetorical analysis, there is a focus on the text, choice of words and even delivery, however; minimal attention is given to the setting. The setting was very im portant in this case because of two main reasons. One of the reasons is that the President chose to deliver his speech on the attacks in the town where the attacks took place. This is important because he gets to connect emotionally with the people who are affected by the killings. He could have chosen to deliver the speech from the White House, an equally important place, but far removed from the tragedy at hand (â€Å"Boston Marathon Bombing: Mystery Remains over Motive†). Another notable aspect about the President’s chosen setting is that it was a church. This was a time when the nation’s faith in the ability of government to fully protect them against any harm had been shaken. That faith needed to be strengthened and the best place to do that was at the church. The atmosphere was also better attuned to the humility that Americans had been subjected to by this event. We all know Americans as people who have an overly optimistic sense of their own abilities. T he ability to stop criminal attacks was wounded by this attacks and humility was necessary to try and better come to terms with the fact that terrorism is advancing, just as government’s military capabilities improve (Crocker 34). There are three kinds of appeals that we have come to associate with rhetoric. These appeals are to the pathos, the logos and to ethos (Pass 56). All these are certainly detectable in the President’s speech and they shall form the basis of my analysis of this speech. The appeal to the pathetic is the appeal to the emotions. The appeal to the logic and ethics are as straightforward as they sound (Genung 45). The most outstanding device that the President uses in this speech is metaphor. This is a device that runs throughout the President’s speech. The President begins by invoking scripture readings. This was a church service after all, so in a way it was expected. However, he takes it a little further than normal. He says that scripture tells us to â€Å"run with endurance the race that is set before us.† This is a statement that connects with the tragedy at hand in more ways than one. First of all it is important to remember that the attacks that necessitated this speech were targeted at runners in one of the most famous races, the Boston Marathon. This is an annual race that attracts participants from across the world. Likening the marathon to our ‘race in life’ is a strong way of trying to assure the people that life must go on after this gruesome event. The President extends that metaphor on and on

No topic Essay Example | Topics and Well Written Essays - 1000 words - 1

No topic - Essay Example For America, the 1960s was a year of assassinations. Really the only time since the 19th century that political assassinations had been successful, these assassinations made a scar on the American psyche. Two of the most important of these assassinations occurred in the year 1968, very close to each other. The first was the assassination of Martin Luther King Jr., the bold civil rights leader who had inspired millions of black Americans and help end segregation and vicious Jim Crowe laws in the south, especially with the passing of civil rights legislation in 1964. Shortly following Mr. King’s assassination, Robert Kennedy, then presidential candidate, was also shot dead. These assassinations changed the way public figures had to interact with the public, and, along with president Kennedy’s assassination earlier in the decade, caused a shift in which much greater barriers were put up between public figures and the general population, out of necessity. These assassinatio ns were indicative of the social upheaval that climaxed in the year 1968. Many of the best known protest movements of the 1960s had major expressions in this year. For one thing, the year saw protest movements and civil disturbances at a number of universities, including â€Å"one of the largest† at Howard university, which built up to the eventual protest and massacre at Kent State two years later (Forner 884). These were based around a number of issues, but the biggest was the growing opposition to the Vietnam war. Vietnam War opposition may have peaked several years after 1968, but this was probably the year that shifted public perception to being almost entirely negative. Many factors caused this shift, including growing American casualties. Some of the most culturally important, however, may have been the massacres that occurred and became public knowledge over the course of 1968. The most famous of these may have been the My Lai massacre, in which American forces killed somewhere in the order of 500 civilian Vietnamese, while South Korean forces were also accused of massacres elsewhere in the country. These massacres were recorded and broadcast to America through photography at a rate unprecedented in former wars – photographs of these sorts would be essential at turning public opinion against wars in general, and against Vietnam in particular. Question 2: How did Vietnam and the Watergate Scandal effect trust in the government? Vietnam and the Watergate scandal were both devastating to public trust in government offices. Vietnam was a long and slow erosion whereas the Watergate scandal was something of an immediate drop in public perception of the government. Vietnam, over the long term, was probably the more damaging (from the government’s perspective) of the two. The fact is that the Vietnam war was seen as a debacle in nearly every front. It was expensive both monetarily in terms of lives lost, while providing almost no benefit. Worse, it made the United States seem like butchers and villains both on the international stage and to civilians back home – people saw the â€Å"realities of warfare† (991), which, especially with a conscripted force, involve things like massacres, rapes, and other brutalities that people were not able to handle. This war made Americans suspect of

Multiple-Part Short Answer Essay Example | Topics and Well Written Essays - 750 words

Multiple-Part Short Answer - Essay Example The L. Monocytogenes has a lower pathogenic potential than other food borne pathogens. Therefore, the number of pathogens ingested through foods is still low. It is however inconsistent with the relatively high 50% lethal dose (LD50) (Lee 98). Therefore, the minimum dose required for causing clinical infection in the humans is yet to be determined but the large numbers of the L. Monocytogenes bacteria detected in the foods responsible for sporadic and epidemic listeriosis cases suggests it is still high The vibrio cholera, the cholera agent, is a normal inhabitant of the aquatic environment. It survives under a wide range of salinity and pH. The effect of selected environmental parameters can be identified through chemically defined solutions. From such conditions, the growth and activity of the vibrio cholera are seen as being affected and influenced by the low pH. The low pH was responsible for the reduced effectiveness and growth of the vibrio cholera bacteria. This condition of the pH altered the internal process of the bacteria causing it to slow down and reproduce slowly. Low pH contained less Na+ that was relevant for the growth of the bacteria. Hence, the vibrio cholera bacteria were bound to be minimal in number. From a past study by (Vimont, 1-4), vibrio cholera can be cultured for a period of 4days using and estuarine salinity of 25%. Salinity of the bacteria’s niche influenced the activity as measured through the uptake of 14C –amino acids. From the study of selected ions, it was evident that the activity and growth of the cholera were affected by pH. The LD50 is the dose at which a drug becomes lethal for 50% of the target population. It is expressed as the mass of the bacteria administered per mass of the target. Different bacteria types impact on the host differently. The lethal dose for particular bacteria can change over time due to various factors. This can be affected by the toxicity and the amount of the bacteria cells. As the

Patient Safety in Rural Nursing Because of Nursing Shortage Essay Example for Free

Patient Safety in Rural Nursing Because of Nursing Shortage Essay The United States is in the midst of a nursing shortage that is being increasingly discussed in the context of declining healthcare facilities in the nation. Over 1 in 7 hospitals (15%) report a severe RN nursing shortage with more than 20% of their nursing positions vacant and 80%-85% of hospitals report that they have a nurse shortage This shortage is predicted to intensify over the next decade or two as nurses belonging to the generation of baby boomers retire. The Nursing Management Aging Workforce Survey released in July 2006 by the Bernard Hodes Group reveals that 55% of surveyed nurses and nurse managers reported their intention to retire between 2011 and 2020 (AACN, 2006). In April 2006, officials with the Health Resources and Services Administration (HRSA) released projections that the nations nursing shortage would grow to more than one million nurses by the year 2020 (HRSA, 2003). Nursing colleges and universities are struggling to expand enrollment levels. In the report titled â€Å"What is Behind HRSAs Projected Supply, Demand, and Shortage of Registered Nurses? † analysts show that all 50 states will experience a shortage of nurses to varying degrees by the year 2015 (AACN, 2006). Factors driving the growth in demand for nurses include: an 18 % increase in the population; a larger proportion of elderly persons requiring proportionally higher levels of medical care; advances in medical technology that heighten the need for nurses; an increase in the number of work settings for nurses and demographic changes in an increasing U.  S. population (HRSA, 2003). Factors that are causing a decrease in the supply of nurses are: the declining number of nursing school enrollees, graduates and faculty; the aging of the registered nurse workforce; work environment issues leading to job burnout and dissatisfaction; high nurse turnover and vacancy rates; and declines in relative earnings (HRSA, 2003). Due to this critical imbalance between the supply and demand of nurses, the United States is today facing a nursing shortage crisis. Nursing shortage in rural settings: Research shows that nursing shortage as defined by the federal government exists mainly in rural areas of the country that are far away from metropolitan areas. These areas suffer more from nursing shortage than urban areas due to lack of economic resources to compete with urban based employers, inadequate training for nurses to practice in rural settings and dependence on non-hospital care settings in the rural areas. According to a paper published by the National Clearinghouse for Frontier Communities, â€Å"Impacts and Innovations in Frontier America† (December 2004), nurse shortages in frontier and rural communities derive not only from the current national shortage of nurses but also a long-standing trend favoring rural-to-urban migration of the educated, skilled workforce. There is also the issue of money. When examined by rurality, LPNs in rural settings ($21,941) report an income 23% lower than that reported by LPNs in urban settings ($28,408) (NCSBN, 2006). A large number of rural communities are losing existing employment and education opportunities and the paper suggests that the community context of a nurse shortage can be addressed only through community-based development approaches as well as the crafting of healthy rural policies. The Robert Wood Johnson Foundation published a report titled The American Nursing Shortage with the help of its researchers Bobbi Kimball and Edward ONeil. According to this report, even when some people feel a calling for the professions such as nursing, they are deterred by certain dimensions of the lifestyle, such as low pay, compulsory mobility and the need for service in rural areas. Available data and literature suggest that the impact of the nursing shortage on rural and frontier communities varies greatly from community to community. IN some rural places, there is no difficulty in filling vacancies but there may be just a few good paying jobs. However, in most rural areas, recruiting for openings is estimated to take about 60 percent longer to fill than in urban areas (Long 2000). Nurse employers receive many applications but often find applicants do not meet desired qualifications and then, they often have to accept lower qualifications to fill positions. Differences in education between frontier and non-frontier nurses exist both in their basic nursing education and the highest degree earned (FEC, 2003). Fully half of frontier nurses had qualified as RNs through associate degree (ADN) programs, in comparison with 40% of the non-frontier nurses; in contrast, non-frontier nurses were more likely to have attended diploma or BSN programs. Differences remain when looking at highest degree received; 44% of frontier nurses’ highest degree is the ADN, in contrast with 34% of the non-frontier nurses. And, while the percentage of nurses who have earned a bachelors degree is slightly lower among frontier nurses (30% frontier, 33% non-frontier), the percentage who has earned masters degrees is also lower among frontier (7% frontier compared with 10% non-frontier) (FEC, 2003). At Prairie Vista Nursing Home in Holyoke, Colorado, a town of about 1,900 people about 130 miles northeast of Denver, administrators reportedly had to work double shifts to cover shifts after a nurse retired. Recruiting nurses to work in rural areas is difficult to begin with; and, when urban-trained nurses enter rural practice, they often find they are ill-prepared for the demands of the job, contributing to job dissatisfaction and turnover. Once there, they typically find it difficult to access continuing education opportunities that fit their needs. â€Å"When educators bring their knowledge to us, they often do not realize that we practice differently than urban centers do† (rural nurse, quoted in Molinari 2001). In the rural setting, nurses typically fill multiple roles. There is a need for a broad range of skills and cross training in multiple jobs. â€Å"Rural nursing requires a high level of generalist skills and critical thinking† (Fahs, Findholt et al. 2003). Another issue is that the ethnic composition of the rural nurse workforce does not correspond with the population it serves. The ANA Rural Nursing module identifies five factors that affect rural nursing practice: threats to anonymity and confidentiality; traditional gender roles; geographic isolation; professional isolation; and scarce resources (Bushy 2004). Patient safety for nursing shortage in rural settings: Surveys and studies published recently confirm that the shortage of registered nurses is impacting the delivery of health care in the U. S. and negatively affecting patient outcomes. Research now shows that how well patients are cared for by nurses affects their health, and sometimes can be a matter of life or death. These studies have found that (HRSA, 2003): †¢ A total of 53% of physicians and 65% of the public cited the shortage of nurses as a leading cause of medical errors (Harvard School of Public Health, 2002,); A higher proportion of nursing care and a greater number of hours of care by nurses per day are associated with better outcomes for hospitalized patients (Needleman et al. , 2002); †¢ Nursing actions, such as ongoing monitoring of patient’s health status, are directly related to better health outcomes (Kahn et al. , 1990) ; †¢ 126,000 nurses are needed immediately to fill vacancies at our Nations hospitals. Today, 75% of all hospital vacancies are for nurses (American Organization of Nurse Executives, 2002); Low nurse staffing levels have contributed to 24% of unanticipated events in hospitals that resulted in death, injury or permanent loss of function (Joint Commission of Accreditation of Healthcare Organizations, 2002); †¢ Patients who have common surgeries in hospitals with low nurse-to-patient ratios have an up to 31% increased chance of dying. Every additional patient in an average hospital nurses workload increased the risk of death in surgical patients by 7% (Aiken et. al. , 2002); Low nursing staff levels were a contributing factor in 24% of hospitals’ reports of patient deaths and injuries since 1996 (Joint Commission of Accreditation of Healthcare Organizations, 2002); †¢ Less nursing time provided to patients is associated with higher rates of infection, gastrointestinal bleeding, pneumonia, cardiac arrest, and death from these and other causes (Needleman et al. , 2002); and †¢ Nurse executives surveyed indicated that staffing shortages are contributing to emergency department overcrowding and the need to close beds (American Organization of Nurse Executives, 2002). The Joint Commission on Accreditation of Healthcare Organizations, 2002 has issued a warning that failure to address the problem of nursing shortage in rural areas will result in increased deaths, complications, lengths-of-stay and other undesirable patient outcomes. JCAHO examined 1,609 hospital reports of patient deaths and injuries since 1996 and found that low nursing staff levels were a contributing factor in 24% of the cases (Joint Commission on Accreditation of Healthcare Organizations, 2002). New research indicates that a shortage of registered nurses prepared at the baccalaureate and higher degree level is endangering patients. In an article in the September 24, 2003 issue of the Journal of the American Medical Association, Dr. Linda Aiken and her colleagues at the University of Pennsylvania found that patients experience significantly lower mortality and failure to rescue rates in hospitals where more baccalaureate-prepared nurses provide direct patient care. At least 1,700 preventable deaths could have been realized in Pennsylvania hospitals alone if baccalaureate-prepared nurses had comprised 60% of the nursing staff and the nurse-to-patient ratios had been set at 1 to 4. Unfortunately, only 11% of PA hospitals have more than 50% of the nursing staff prepared at the baccalaureate level ( Institute of Medicine, 2003). A survey titled â€Å"Views of Practicing Physicians and the Public on Medical Errors†, conducted by the Harvard School of Public Health and the Henry J. Kaiser Family Foundation reported in the December 12, 2002 issue of the New England Journal of Medicine found that 53% of physicians and 65% of the public cited the shortage of nurses as a leading cause of medical errors. Overall, 42% of the public and more than a third of U. S. octors reported that they or their family members have experienced medical errors in the course of receiving medical care (AACN, 2006). Nurse researchers at the University of Pennsylvania determined that patients who have common surgeries in hospitals with high nurse-to-patient ratios have an up to 31% increased chance of dying. Funded by the National Institute for Nursing Research, the study found that every additional patient in an average hospital nurses workload increased the risk of death in surgical patients by 7% (AACN, 2006). According to an extensive study by Dr.  Jack Needleman and Peter Buerhas, published in the New England Journal of Medicine in May 2002, a higher proportion of nursing care provided by RNs and a greater number of hours of care by RNs per day are associated with better outcomes for hospitalized patients (AACN, 2006). Conclusion: Available data and literature suggest that the issue of nurse shortage is a national one. Yet, the impact of nurse shortage is better seen in the rural areas where nurses are not well paid, existing nurses are not well qualified and patients are dependent on local medical facilities. Because most frontier and rural communities are distant from hospitals, residents may rely on non-hospital based care settings for a greater proportion of their care than their urban counterparts. Due to these reasons, nurse shortage in rural areas has endangered patient safety. Nurses are the primary source of care and support in the health care sector and hence, a sufficient supply of nurses is critical in providing the national and especially the rural population with quality health care. Nurses are expected to play an even larger role in the future.

English language student teachers pedagogical content knowledge

English language student teachers pedagogical content knowledge My study aims to analyze the relationship between English language student teachers pedagogical content knowledge learnt from the university coursework and their practice of teaching during the practicum in schools. By pedagogical content knowledge (PCK) here, I mean the knowledge to teach English as a second language at secondary level. The focus of my study is to find out what PCK student teachers learn during their English language teaching course at the university and how they apply that knowledge in the classroom during the practice teaching. In this literature review I discus the concept of teacher education programmes, the practicum, link between theory and the practicum, gaps between theory and the practicum, how to strengthen the link between theory and the practicum and brief review of research on practicum in teacher education and English language teacher education programmes. In the end I state the aim of my study and the potential research questions. The purpose of this literature review is to provide an introduction to and grounding for my study. 2. Teacher Education Programmes Teacher education programs are designed and organized to train prospective and in-service teachers. These programmes educate teachers to teach at various levels of education such as pre-primary, primary, elementary, secondary and higher secondary levels. Two common types of teacher education programmes are pre-service teacher education which is also called initial teacher education (ITE) and in-service education and training (INSET). Initial teacher education prepares the new trainee teachers to teach at different levels whereas in-service teacher education provides training to the already working teachers. (Although there is a conceptual difference between the concepts teacher education and teacher training, in this document I will be using both these concepts in the same meaning. Generally in this document, teacher education or teacher training means pre-service teacher education. If I talk about in-service education of teachers, it will be mentioned in the text). Aldrich (1990) says that teacher education programmes are important to prepare future teachers to develop their professional competencies. Laczko-Kerr and Berliner (2002) argue that university teacher preparation courses prepare better quality teachers. The objective of the teacher education programme is to equip student teachers with a set of competencies to teach in the school context (Banks et al. 2001), to cope with the complexity of challenges in their everyday teaching work (Cheng, 2010). The challenge is to help student teachers put their learning from the teacher education programme into practice. Most teacher education programmes include different components: general education; subject-matter studies; foundation of education studies; methods studies; and field experience (i.e. teaching practice) (Stuart Tatto 2000; Zeichner Gore 1990). The general education, foundation courses and methods studies comprise the theoretical component whereas field experiences focus on the practical component of teacher education programmes. Korthagen et al (2006) argue that teacher education finds itself in a difficult position in the 21st century. He presents three reasons for dissatisfaction with the teacher education programmes. First reason is the irrelevance of teacher preparation for the reality of everyday practice in schools. It has generated pressure on teacher educators to rethink about the structure and practices of teacher education. Secondly, research evidence during the final decade of 20th century shows that new teachers appear to face severe problems during their first period in the profession. Wideen, Mayer-Smith, Moon (1998) also supported this view and said that the transfer from theory (presented and learnt during teacher education courses) to practice in schools is often meager. Thirdly, new concepts of teaching and leaning have emerged and developed overtime. Constructivist (Williams Burden, 1997; Roberts, 1998; Arends, 2004; Osterman Kottkamp, 2004) and social constructivist views (Roberts, 199 8; Beck Kosnik, 2006) have dominated the theory and practice of teaching and learning. These views argue for learner-centered approaches to learning and teaching and challenge the traditional practices in teacher education. It poses challenges for teacher educators. Teacher educators have attempted to respond to this challenging phenomenon to fulfill the demand of producing effective teachers in the 21st century. Zeichner (2010) argues that the old paradigm of teacher education where academic knowledge is viewed as the authoritative source of knowledge about teaching needs to be changed to the one where there is interlink among academic, practitioner and community expertise. As knowledge is constructed and shared by learners in constructivism and social constructivism, he argues that this new epistemology of teacher education will create expanded learning opportunities for prospective teachers that will better prepare them to be successful in enacting complex teaching practices (Zeichner 2010, p. 89). Darling-Hammond, Hammerness, Grossman, Rust Shulman, 2005) concluded that research on effective teacher education programs shows that where field experiences are carefully linked with coursework and carefully mentored, teacher educators are better able to accomplish their goals in preparing teachers to successfully enact complex teaching practices. In view of the complexity of the teaching-learning process Korthagen, et al. argue that the most basic problem which is still not being addressed adequately in teacher education programmes is how to connect theory and practice in such a way that teachers would be able to handle the problems of everyday teaching through theory-guided action (Korthagen, et al. 2006, p. 1021). My research focuses on the issue of analyzing the link between theory and practice of English language teacher education in the context of Pakistan. This analysis will help to understand what student teachers learn during coursework at the university, how they learn it and how they put that learning into practice during thee practicum. In the next part I discus the concept of practicum. 3. The Practicum Practicum (also termed as teaching practice/internship/induction or field experiences) may be defines as learning by doing (Schà ¶n 1987), learning from action (Hutton 1989) or work-based learning (Foster and Stephenson 1998). Stanton Giles (1989, 180) define the practicum as field experiences that focus on professional practice and activities that are explicitly focused on pre-professional practice. The ultimate goal of the practicum is to let student teachers demonstrate specific competencies that they are expected to have mastered at different stages in their pre-service stage (Yan, 2010) Practicum placements in schools are considered to be a significant component of pre-service teachers education program (Touchon Gwyn-Paquette, 2003; Leishem 2008). Practicum plays a major role in student teachers learning. Much of what teachers need to learn must be learned in and from practice rather than in preparing for practice (Ball Cohen, 1999; Hammerness, Darling-Hammond, Bransford, 2005). Teaching practice provides opportunities for student teachers to develop a contextualized understanding of the complexities. It also provides opportunities to develop classroom management skills, lesson planning and the ability to interact with students (Richards Crookes, 1988; Farrell, 2001). According to Huling (1997), practicum experiences offer teacher candidates a place to observe and work with real students, teachers, and curriculum in natural settings (p.1). Student teachers are able to apply their theoretical knowledge in the real classroom setting. Darling-Hammond and McLaughlin (1996) note that professional development opportunities are criticized for being non-contextual and isolated from the world of practice. Practicum in teacher education programmes provides opportunities of practice in the context of school. Zeichner (2006 p. 333) says that extended teaching practice can give the student teachers exposure to practices of experienced teachers. Student teachers may observe experienced teachers and can learn from their practices. It can also develop interaction among student teachers and the other school teachers. It is clear form the above that practicum is an important component of teacher education programmes. It not only provides opportunities for applying the theoretical knowledge the strudent teachers have gained from the teacher education institutions but also develops a sense of professionalism in them. It introduces the teaching profession to the prospective teachers. They can also interact with experienced teachers and can learn from them. 3.1. Linking Theory and the Practicum (Korthagen Kessels, (1999) argue that in application of theory model of pre-service teacher education in the United States, prospective teachers are supposed to learn theories at the university and then go to schools to practice or apply what they learned on campus. (Darling_Hammond (2006, p. 307) observes that one of the perennial dilemmas of teacher education is how to integrate theoretically based knowledge that has traditionally been taught in university classrooms with the experience based knowledge that has traditionally been located in the practice of teachers and the realities of classrooms and schools. Zeichner (2010, p. 90) also supports the view that one of the most difficult tasks is to strengthen the connections between what our student teachers do in their school and community placements and the rest of their teacher education program. The inter-relationship of theoretical knowledge and practicum is further elaborated by Lewis (2007). He uses the terms conjunction and disjunction to refer to the presence or absence of the relationship between what is taught in teacher education and what is practiced in schools. By conjunction, he means that there is no clash between the knowledge gained in teacher education institutions and what is to be practiced by trainee teachers in schools. Lewis argues that disjunction or the difference between university advocated practice and what actually occurs in schools, presents the prospective teacher with a dilemma. He quotes a student teacher who in doing the practicum in school who says: the course at university emphasizes engagement and use of constructivist oriented activities however the majority of classes I am doing have teaching that is fairly teacher oriented and content focused (Lewis 2007, p. 6). This type of confusion may be common in a number of contexts. It may happen when teacher education institutions do not take into account the contextual factors in schools. Russell (1988) identifies three types of tensions in theory-practice relationship: firstly is between campus-based course work and school-based relevance; secondly, between child and teacher-centered approaches; and finally, between what a student teacher can be told and what that person does in the classroom. Such tensions can be addressed by carefully designing and implementing the teacher education courses keeping in view the context of real school teaching and student teachers previous experiences. 3.2. Gaps between Theory and the Practicum Lack of connection between campus-based teacher education courses and field experiences has been a perennial problem in teacher education programs (Bullough et al., 1997, 1999; Zeichner, 2007, 2010). Studies show that student teachers feel there is a lack of connection between the teacher education programme and the school-based teaching experiences (Hobson et al. 2008, 414). Different reasons may be attributed to the gap between theoretical and the practical component of teacher education programmes. Ashcroft Griffiths (1989) say that it is very hard to preserve the unity of theory and practice during a short teaching practice period in schools. It is very common that cooperating teachers in schools know very little about the methods courses the student teachers have completed on campus and the course teachers in the university know very little about the specific practices used in the classroom where student teachers are placed. (Zeichner, 2010). Lack of well planned supervision and guidance on the part of cooperating teachers may also lead to disconnect between what the students have learnt and what they actually practice. It is often assumed that good teaching practices are caught rather than taught (Darling-Hammond, 2009). Zeichner and Tabachnick (1981) found that many newly learnt teaching theories or conceptions developed during teacher education programmes are diluted by the initial confrontation during their teaching practice and it raises doubts whether insights from teacher education had actually been achieved (Cole Knowles, 1993). As a result of the falling short of the expected practice of the theoretical knowledge, the student teachers may adapt to the common habit of teachers to consider teacher education too theoretical and useless (Elliot, 1991). Sometimes, the courses taught at the university may not be context specific to prepare teachers. In Australian context, Commonwealth Department of Education, Science Training (2002, p. 104) reported that the theoretical components of teacher education programmes are distant, irrelevant and inaccessible. The disconnect may be in various types like the disconnect between university coursework and the teaching context, gap or lack of cooperation between the student teachers and the supervisors or/and cooperating teachers, conflict between student teachers perceived competencies and their actual performance in the practicum etc. The gaps need to be minimized if teacher educators want to produce effective teachers for complex teaching tasks. In the next part I discuss how to minimize the gaps and strengthen the link between theory and the practicum. 3.3. Strengthening the Link between Theory and the Practicum Darling-Hammond (2006) suggests that carefully constructed field experiences coordinated with campus courses are more influential and effective in supporting student teacher learning than the unguided and disconnected field experiences. Evidence shows that traditional and loosely planned and monitored model of field experiences may create obstacles in student teachers learning (Feiman-Nemser Buchmann, 1985; Zeichner, 1996). One way to prepare student teachers for actual classroom is simulative teaching in which simulations of classroom situation are enacted (Cohen, 1981). Simulative teaching sometimes proves to be a fallacy and student teachers may encounter with reality shock when teaching in actual classrooms (Korthagen et al. 2006, p. 1027). Zeichner (2010) suggests that some portion of the methods courses can be taught in partner schools to mediate the gaps between their campus courses and the students school experiences. The course tutors should deliver model lessons in the actual classroom in the partner schools where the student teachers are required to do the practice teaching. Ball Forzani (2009) also support the notion that clinical experiences should be the central focus of pre-service teacher education from which everything else in a program emanates. Cheng et al. (2010) examined theory-practice gap as perceived by student teachers in Hong Kong. On the basis of their findings, the researchers propose four strategies to close the gap and strengthen the link between theory and practice. They recommend: student teachers need to develop their own competencies and reflect on their pedagogical practice; promoting self leaning or independent learning; encouraging teacher educators to model lessons and; arranging study abroad programmes for non-native student teachers to some English speaking countries. Darling-Hammond (1994, 1999) Fullan et al. (1998) recommend more involvement of university faculty in the student teachers supervision so that they may get detailed feedback and guidance on the practicum experiences. Casey Howson (1993, 365) suggest a three-person teaching team who should meet to discuss goals and strategies and attempt to build a strong scaffolding for pre-service students. The team includes education professors, field supervisors, and cooperating teachers. Korthagen et al. (2006) argues for a close cooperation not only in the sense of school-university partnerships, but also in three-way cooperation among teachers in schools, teacher educators in universities, and those who are learning to teach. Goodlad (1990) also recommends including teacher candidates perspectives in the mentoring process. In the next part I review literature on how to improve the practicum in teacher education programmes. 4. Improving the Practicum Student teachers perceive the practicum to be the most valuable part of their teacher education for its strong influence on their views of the roles of teachers (Smith Snoek, 1996). Organizing and conducting well planned and effective practicum may better help teacher education institution to realize their objective of producing more effective teachers. There can be number of problems which reduce the effectiveness of the practicum. Yan and He (2010) identify six problems in the practicum as perceived by English language student teachers in Chinese EFL context. These are: tension between vision and reality, unreasonable schedule of the practicum, practicum schools distrust, lack of supervision, student teachers lack of motivation in preparing lessons plans and lack of sound assessment system. These problems are associated with organization of the practicum, role of supervisors, assessment system and level of motivation among student teachers to teach. As teacher educators, we will n eed to address such issues to make the practicum more effective. Some of the most significant factors which can contribute to improve the practicum in schools are school-university partnership, role of the faculty in preparing student teachers for the practicum and supervising their practice and support and cooperation of the cooperating teachers. I will discuss these separately. 4.1. School-University Partnership School-university partnership does not mean that schools are only the practice fields for student teachers. This view limits the collaboration and cooperation between schools and universities. (Korthagen et al. (2006) argues that common view of learning to teach includes the assumption that the university-based components of teacher preparation offer the theoretical underpinnings of teaching and that school teaching experience (practicum) offers a situation in which those previously learning principles of teaching are practiced. This view creates many difficulties, including the fact that the expertise of teaching practice is often assumed to reside largely in schools with teachers. Further Gorodetsky, Barak, and Hadari (2007) pointed out that even in the current wave of school-university partnerships in teacher education, colleges and universities continue to maintain hegemony over the construction and dissemination of knowledge, and schools remain in the position of practice fields where student teachers are to try out the practices provided by the university. This view implies that schools are always at the giving end. Why should the head teacher and the cooperating teachers spar enough time to mentor the student teachers and collaborate with the faculty supervisors if they are not involved in any other component of teacher education programmes? The exclusion of school teachers from designing and pedagogy of teacher education courses also limits the actual training needs of the student teachers and the scope of the practicum. The practicum in particular and teacher education programme in general can be strengthened if experienced school teachers are involved in the university programmes. Zeichner (2010) gives an example of the University of Wisconsin-Milwaukee where teachers with evidence of a high level of competence in the classroom spend 2 years working in all aspects of the pre-service teacher education program, including student recruitment, general education, professional education sequence, ongoing program evaluation and renewal ef forts, and in supporting graduates in their early years of teaching. University faculty may also join the partner schools to teach the actual classroom for some period of time to refresh their knowledge of school teaching. This sort of useful partnership may help improving the practicum. 4.2. Role of the University Faculty in the Practicum In addition to working as course developers, course tutors, examiners, evaluators, managers etc. teacher educators serve as role models for the actual practice of the professional (Korthagen, Loughran, Lunenberg, 2005). This role model may be intentional or not. Loughran (1997) is of the view that modelling behaviour by the educator gives the student teachers an opportunity to experience and understand some likely outcomes of teaching. Research shows that explicit modelling of teacher educators can facilitate the translation into the student teachers own practice (Lunenberg, Korthagen Swennen 2007). Modelling is an effective tool to prepare student teachers for actual classroom teaching. The teacher educator can also deliver model lessons in the partner schools instead of creating simulative classrooms in the university. Supporting the concept of modelling, Russell (1999, p. 220) goes on to say that Universities generally, and university-based teacher educators particularly, have no right to recommend to teachers any teaching practices that they have not themselves used successfully at the university. Korthagen et al. (2006) argues that if teacher educators advocate some innovative practices that they do not model and explain in their own teacher education classrooms, teacher education reform will continue to elude us. University faculty can use modelling as a powerful strategy to prepare student teachers for the practicum. There can be some implications of model lessons as it may not be possible for trainee teachers to adapt themselves to the model lesson after some period of t ime. Furthermore, there may be more than one method of teaching the same lesson; sometimes it can be ridiculous to confine the student teachers to the method/methods used by the faculty in his/her model lesson. 4.3. Cooperating Teachers and the Practicum Support from cooperating teachers may be useful for student teachers during the practicum. But sometimes, cooperating teachers are overburdened because they also need to do their routine teaching and other school assignments simultaneously. In such a case it is likely that they do not take the practicum seriously and may not assist student teachers as they should have or would have wanted to help them. Guyton McIntyre (1990) emphasise the role of the cooperating teacher, who is most available, in developing student teachers practice. Farrell (2001) argues for support from the practicum school and cooperating teachers. He further contends that student teachers should be placed with competent cooperating teachers. If the cooperating teachers are not competent enough, they are likely to be less effective in student teachers development. Randall (1992) says that the cooperating teacher may heavily influence student teachers teaching styles through direct contact. He can provide on the s pot guidance to the student teacher. It is very common that cooperating teachers in schools know very little about the methods courses in the universities (Zeichner, 2010). Cooperating teachers need to be involved in the university courses and also trained by the university faculty for mentoring of the student teachers. It can help them perform their role more effectively in helping student teachers. In the next part I review research on the practicum in teacher education and English language teacher education and also argue for my proposed study. 5. Research on Practicum in Teacher Education and English Language Teacher Education Darling-Hammond (2006) states that there has been much discussion about the structure of teacher education programmes but there has been less discussion on what actually goes on in the teacher education courses and the clinical experiences that student teachers encounter and how the programmes add up to the knowledge and skills of the student teachers to prepare them for classroom. Yan (2010) argues that research on the practicum is mainly limited to general higher education programmes from the Western world, and the English language teaching practicum has received scarce attention. Little is known about how learners conceptualize their initial teaching experiences, and about what impact these experiences have on their professional development as teachers (Johnson 1996, 30) and what actually occurs during the practicum (Richards Crookes 1988; Freeman 1989). Snoek (1996) claimed that student teachers perceived the practicum to be the most valuable part of their teacher education for its strong influence on their views of the roles of teachers. Hodge et al. (2002) reported that the practicum had a positive impact on the student teachers attitude towards their work. Yan, (2010) contends that most second-language teacher preparation programmes simply assume that once pre-service teachers have completed their required coursework, they will be able to transfer their knowledge into effective classroom practices. It is, therefore, well worth investigating complexities and problems arising from the practicum to enhance its effect on student teachers professional growth and teacher education programmes. Cheng et al. (2010) examined the theory-practice gap by reporting a study that researched the inconsistencies between student teachers best teaching strategies and their most commonly employed ones. They conducted this study in the context of Hong Kong. A questionnaire and in-depth interviews were used to generate data. Total 228 final year student teachers of 4 years B. Ed programme completed and returned the questionnaire. In addition to it, 31 Year 4 student teachers enrolled in these programmes participated in in-depth interviews. Findings revealed three main dimensions of consideration attributing to the inconsistencies in the conceptions of teaching: pre-training experiences of student teachers, teaching context of the partner school and student needs. These considerations lead to expansive or constraining impacts on the student teachers selections of teaching strategies. Nevertheless, teacher education programmes are expected to have an expansive impact on the student teachers conceptions of teaching as well as to help them overcome constraining impacts from other sources of influence. Koeppen (1998) observed that student teachers face multiple difficulties in classroom instruction as theory versus practice occurs. Her case study of a student teacher found that the student had problems in linking university courses and classroom context during the practicum. What the student had studied for example, planning instruction and modeling did not match the reality he found in school. This student teacher struggled to reconcile himself to the teacher-centered teaching he was doing which was totally against the theory of teacher-centered learning which he had learned in his course. In the context of Pakistan, no such study has been conducted on the link between theory and teaching practicum in English language teacher education. Keeping in view the above cited literature, the present study aims to analyze the link between English language student teachers pedagogical content knowledge learnt from the university coursework and their practice of teaching during the practicum in schools. By pedagogical content knowledge (PCK) here, I mean the knowledge to teach English as a second language at secondary level. The focus of my study is to find out what PCK student teachers learn during their English language teaching course at the university and how they apply that knowledge in the classroom during the practice teaching. I pose the following questions to achieve the aim of the study: What type of pedagogical content knowledge the student teachers learn during English language teaching course at a selected teacher education department in Pakistan? How and to what extent English language student teachers apply/practice their pedagogical content knowledge to teach during the practicum in schools? What is the relationship between student teachers pedagogical content knowledge and their practice of teaching English at secondary level in Pakistan?

Post Natal Depression Case Study

Post Natal Depression Case Study Table of Contents Case Study Care Plan Medical Point of view The Role of the nurse Building a therapeutic relationship Respect and Empathy Communication Tackling the problem The Reality Therapy and choice therapy. Working the therapy with Rachel Problems met during sessions. Conclusion Case Study. A 21 year old lady presented at Crisis Intervention Team (CIT) stating that she has these thoughts in her mind that she is going to harm her baby. She was experiencing an excessive fear of what she might do to her baby since these thoughts were telling her that she was going to knock the baby’s head against the wall. She was physically trembling with fear and anxiety. She had reduced her food intake and this had resulted in considerable weight loss. She was not sleeping at night leading to tiredness, lethargy which was hindering Rachel (imaginary name) from performing her daily chores. The pregnancy was unplanned but her boyfriend Robert (imaginary name) was very supportive during and after the pregnancy. He was very worried about Rachel since she had a complete change in character and from a happy go lucky person she had turned into an introvert always worried and depressed. Rachel explained that she had always thought that motherhood would be an enjoyable period in life. She had always dreamt of this period but she had never imagined that it would end up to be the worst experience of her life. She was so focused on her baby that she had forgotten how to live. She was all the time concentrating on her childhood, how much she had felt neglected by her mother at that time and her innermost fear was that she will end up behaving like her; that is why she had stopped working, going out and enjoying everyday life. Despite this, she was feeling guilty that she was not giving enough attention to her baby. CIT offers follow up sessions for 3 to 4 weeks, during which Rachel was asked to identify her problems and prioritise them. By identifying areas where she would like to improve, she would be lessening her suffering and make herself feel better; this was done together with the nurse. Care Plan Medical Point of view Rachel was seen by the CIT psychiatrist who prescribed antidepressants with the aim to try and alleviate Rachel’s mood. Glasser (2003) complained that it is a pity that nowadays psychiatrist and medical doctors prescribe psychiatric drugs prior giving counselling sessions first. The role of the nurse regarding her treatment was to educate the patient regarding the importance of concordance and informing Rachel about any side effects that might occur when starting treatment. The Role of the nurse The role of the nurse is to help the patient get better by offering the optimum level of care in order to empower her patient and help him/her improve his/her quality of life. Smith, Wolf and Turkel in 2012, explained that for the patient to be cured, s/he needs to be cared for as no curing can occur without caring (p.137). The nursing care plan should be planned together with the patient in order to identify the patient’s needs, plan and set goals to overcome the obstacles. Kelsey (2013) stated that NHS is emphasising on patient participation in the care plan as this will help the nurse to engage more with the patient while the patient will feel more empowered. This concept is firmly believed at CIT, and it was always stressed that all professionals collaborate for optimum care delivery together with patient. The patient also has the right to choose family members and/or friends whom he wished to be involved in his/her care. Building a therapeutic relationship In order to formulate a care plan with the patient, a therapeutic relationship must be built for a successful outcome. Caring is based on a relationship and for relationships to be effective both parties must be involved, (Govier, 1992). The fulcrum of nursing care is building a nurse-patient relationship by engaging with the patient and his carers. Building a therapeutic relationship helps the nurse to gain indispensible information about her/his patient whilst the patient learns how to trust the nurse (Lehman et al., 2004). Although according to nurses trust is vital for building a therapeutic relationship, this can be very difficult to establish with the patient. Literature states that trust has been a debatable topic in research; it does not concern only on the health care profession but includes also the institutions and other services providing the care, (Laugharne Priebe, 2006). In Malta there is still a good amount of stigma regarding Mental Health and Mental Hospital thus people are afraid to talk about their mental health problems. The stigma that surrounds the name of the mental health hospital in Malta still carries fear of the unknown and beliefs about mental illness hinder the patients from seeking help. This often results in severe deterioration leading to an involuntary admission (Farrugia, 2006). The same thing happened with Rachel at the beginning of our sessions when she was still terrified to discuss her innermost thoughts, believing that she would be judged and labelled as mentally ill thus providing grounds for an admission. Rachel needed to overcome her fears and start to confide in the nurse. In order to gain her trust, the nurse had to reassure Rachel that no harm will come to her and if she wishes CIT could offer her care in the community reassuring her fears regarding hospitalisation. This could only happen if Rachel agrees to work with the team members and keep to the plan which they had agreed on together. Rachel agreed with the proposal inviting her boyfriend to join the plan, which he accepted. Support and information was provided to both parties and they were satisfied with the plan. Respect and Empathy The nurse assured Rachel that both parties should respect each other. Papastavrou et al (2012) explains that to show respect towards a patient one should allow autonomy, show dignity towards the person, care for him/her holistically and ensure privacy and confidentiality. Assuring the patient that since she is seeking help, the team’s aim was to provide that help and not to judge her thoughts and actions. For the nurse to be able to understand the patient better she has to put him/herself in the patient’s shoes and this skill is called Empathy. Empathy was found helpful to humanize the care delivered to the patient (Barker, 2003). When the nurse shows that his/her intentions are genuine and is trying to understand the situation by offering help and keeping agreements, the patient will start to trust her/him. Communication Establishing trust, showing respect and empathy to the patient, needs good communication skills; Taylor, Lillis, Lemone, Lynn, and Smeltzer (1989), claimed that a therapeutic relationship can never be built if there is no good communication skills. It is imperative for the nurse to learn to listen attentively to verbal communication but also to learn to read the non-verbal communication that the patient is sending. Through the non-verbals, the nurse can extract information which the patient wishes to hide such as fear and anxiety through her body language (Stuart, 2009). Glasser (2003), emphasised on the importance to allow time for patient to narrate their problem, in order to be able to assess the patient in depth. Tackling the problem She does not like her life at the moment. She misses work and school (she was learning art, her hobby is drawing) She hates the thought of becoming like her mother She hates the thoughts that are obscuring her mind preventing her from enjoying life. The nurse went through the list of problems written by the patient and together with Rachel she tried to group them into categories. Keeping in mind that CIT service is provided over a limited amount of time, it is of utmost importance that the team tackle the urgent problems which have prevented the patient from functioning normally and reaching a Crisis. For secondary problems, Rachel will be referred to another team who can offer longer term care. The first two problems discussed were the fact that she is absent from work and not attending art school at the moment. This fact is making her feel useless and lonely. She is not doing these things because she thinks that if she starts to do things that she used to enjoy, she will neglect her child. This will make her worst fear that she will become like her mother come true. This made it easier for the nurse to narrow the amount of problems because in agreement with Rachel they decided to group all the three problems under one heading: fear of becoming like mum. Rachel admitted that if she could be sure that she would be nothing like her mother she would feel less stressed. The second problem was her bizarre thoughts which were persecuting her. During the first meeting they discussed at length the issue of harming her child and what chance there was that she would actually harm him. She took so much care of her child since his birth three months ago that it was highly unlikely that she would ever harm him. In reality she was caring fulltime for the child, taking care of him 24 hours a day and never leaving his side. Rachel’s boyfriend assured the nurse that she never left her child unattended. He explained that they were living with her mother who took care of the house chores and gave them moral support whilst Rachel took care of her child. After discussing all this with Rachel it was concluded that what she was feeling was unhappy, she lost her joy of living. It was important for Rachel to try to control her thoughts and worries and to try learning to sort them out. First she needs to work out if the worries are founded or not and when that answer is found she needs to choose whether to ignore or believe them. The nurse opted to work with Rachel on the steps of Reality/ Reality Theory by Glasser to help her overcome these fears. The Reality Therapy/Choice therapy. William Glasser developed Reality therapy way back in the sixties and it was based on identity theory, (Zastrow, 2010). The last two decades Glasser noted that his therapy focused more on human behaviour, how can it be altered and improved leading him to change the name of Reality Therapy to Choice Therapy, (Wubbolding, 2013). The choice theory explains how the life of the individual is determined by the choices he made. Every individual has his perceptions about his/her reality of life and according to Glasser the individual behaviour is in constant attempt to narrow between what we want and what we have (Zastrow, 2010 pg 491). The aim of the therapy is to help and teach individual to satisfy the internal motivation and or basic psychological needs. The Choice therapy focuses on the basic needs of the individual. Glasser (1996) explained that the therapy emphasised the four basic psychological needs which included belonging, power, freedom and survival (Jong-un, 2007). Belonging refers to family and friends. People; with whom a person can socialise, enjoy him/herself with, as well as feel loved. Power refers to the individual achievements in life such as achieving dreams and feeling worthwhile. Having your own space, acting independently, being autonomous and deciding for yourself covers the need of freedom. Whereas, survival needs are covered by nourishment, intimate relationships and shelter. Sunich (2007) in his article argued that Glasser wrote about five basic needs and the ones mentioned above and adding fun. Contrary to traditional theories, the Reality Therapy promotes the idea to focus on the ‘here and now’ and reduce concentrating on the past. The therapy is based on the patient’s willingness to change, make choices, take responsibility and sustain commitment. Its aim is to assess and identify the unmet needs of the patient exploring what behaviours they are displaying that either assist or interfere with them meeting their needs (Sunich, 2007 pg.3). Working the therapy with Rachel The nurse explained how choice therapy works and Rachel agreed that she would like to give it a try. The nurse explained that reality therapy is best summarized as WDEP which means: wanting, doing, evaluation and planning, (Cameron, 2013) In Rachel’s situation, it is important to focus on what she really Wants; she wished to get rid of her thoughts and fear. It was explained to her that she needs to start to learn to identify unrealistic thoughts and learn to control them. After the problem was ascertained the next step taken was to ask Rachel what she was Doing to try and get what she wished for. Rachel tried to explain what she had been doing but Evaluating the situation together Rachel admitted that the method she had chosen was not working. After that Rachel and the nurse agreed to try and formulate a new Plan which will help Rachel gain her joy in life back,(Cameron, 2013) . In the first session Rachel described herself as: â€Å"blocked in a black tunnel†, she was afraid to talk about her thoughts because the nurse might think that she was â€Å"going crazy†. but could feel that with the right support there is hope for her illness. The nurse had to explain to Rachel that she should stop labelling herself as depressed and concentrate on how she was feeling at that moment. Rachel admitted she was feeling unhappy, and this was caused because the patient had stopped doing the things, she liked to do so that she would be able to concentrate on her son 24 hours a day 7 days a week. Although she knew that she was still fearful of the thought that she might harm the baby. The nurse explained that feeling unhappy for a reason is not being â€Å"crazy†; the important thing is doing something about it to improve the situation (Glasser, 2003). The thought that she might harm the baby was explored at length. Rachel admitted that she never did anything to harm her baby, she loved him unconditionally, and she took care of his Adls. She never misses his appointment at the baby clinic where they confirm that the baby is very healthy and this was confirmed by Robert. The nurse documented everything they said on a page divided into two columns, labelled good care and neglect After Rachel finished, the nurse handed her the paper and explained to her what she had done. All the things Rachel had stated were listed under the good care column and the neglect column remained empty. Then the nurse asked Rachel â€Å"Seeing this paper how much are the chances that you are neglecting your son?† Rachel stared amazed at the paper as she answered â€Å"none†, thus this makes your thought unfounded. The nurse explained to Rachel needs to learn to do this exercise each time she has a thought so that she can identify if the though t is realistic or just an imaginary one. So they planned Rachel’s homework until her next session which focused mainly on identifying the thought and reasoning it out. After the first session she confessed that she felt better; the fear that she was going crazy subsided, she felt that she was not alone any more in her dark tunnel and hope was instilled. Sessions went by and Rachel started to learn how to control her thoughts better but choosing to ignore them. She was better but not good enough yet. Rachel had to start to stay away from her son a couple of hours so she has time for herself. It was the biggest step for her and as she described it as the most painful but with the help of Robert and their extended families she started to work a couple of hours a week. This made a drastic change in Rachel’s mood and she started to feel happy again. She started to make friends and felt that she belonged in society again and not isolated anymore. â€Å"Happiness or mental health is enjoying the life you are choosing to live, getting along well with the people near and dear to you, doing something with your life you believe is worthwhile, and not doing anything to deprive anyone else of the same chance for happiness you have† (Glasser, 2003 pg 7). Problems met during sessions. Seeing the story in writing might look as if it had been easy to empower Rachel enough to achieve goal. It included four weeks of intensive counselling with two planned sessions a week and several phone calls from Rachel asking for support and reassurance. This could be done by praising Rachel for her decisions and actions. There were times that the patient had to be confronted about her decision for example â€Å"you are thinking and assuming that your mum will not be capable to look after your baby. Did she show any signs of mistreating him or being unloving towards the baby? Are these just your thoughts tormenting you or there are facts which might lead you to think that she is incapable of looking after him?† There are many authors who criticise this method because of the above: they argue that it is a harshly confronted therapeutic approach towards the patient. Wubbolding and Brickell (2000), did not deny it but emphasised the fact that reality therapy is a gently confronted approach. Glasser (2002), explained clearly the consequences of seven deadly habits, which may arise during reality therapy session. These habits are criticising, blaming, complaining, nagging, threatening punishing and bribing or rewarding to control, but they cannot be allowed in any relationship because they will simp ly destroy it (Sommers-Flanagan Sommers-Flanagan, 2012). There was one episode at the beginning when Rachel entered the office unannounced shaking and sobbing. She was so desperate at that moment that she could not even talk. The nurse waited for Rachel to calm down but each time she did and the nurse asked her to talk Rachel ended up sobbing again. After more than half an hour, in a soft but stern voice the nurse had to tell Rachel that she had to speak up if she wanted help. The statement might have sounded insensible and blunt but it was all about the reality of the situation; Rachel understood that and reached for a paper and with great difficulty wrote what was troubling her. Sommers-Flanagan Sommers-Flanagan (2012) agreed with other above authors who believe that Reality therapy at times is too directive and might become almost offensive and unethical towards the patient. Conclusion Rachel started to look forward to her therapy session; she worked hard on her problems, kept with the plan and gradually she reached her goal. Basic knowledge about the therapy helped the nurse conduct the sessions but also made her aware of the need for more intensive training (Sommers-Flanagan Sommers-Flanagan, 2012). Post Natal Depression Case Study Post Natal Depression Case Study The Experience of Health Illness Level 2 Assessment Client Study Culture and the service user experience This essay details the experiences that I had in dealing with and observing a Mrs. N, a 28 yr old lady who safely delivered a baby girl in December of last year. Her major problem was the development of post natal depression, but there were a number of contributory factors which were relevant in her case, one of which was her culture and ethnic background which coloured both her expectations and her reactions to the various landmarks which punctuated her illness trajectory. 1. Identify a specific client/user and provide a vivid but non-judgemental description of his or her personality, family, cultural and social background (include employment, education, housing etc). Mrs. N is a Bangladeshi lady who has been married for seven years. It was an arranged marriage. She is 28 yrs old which means that she was married comparatively late for her culture. Her husband, (Mr. N) is a year older than her and has been living and working in the UK for 8 years as a London Transport bus driver. He has been working to set up a home in the UK and it was always the intention that Mrs. N would come to the UK when conditions were stable for them. Mrs. N has lived in her in-laws home in Bangladesh until last year when she was granted permission to enter the UK and live with her husband. The seven years that she spent with her husband’s family were very difficult for her. She had a great deal of difficulty in coping with her mother-in-law’s (Mrs S.) overbearing and dictatorial manner. Mrs S felt that it was her place to â€Å"mould and shape† her daughter-in-law’s life and manners to suit what she considered to be her place in society. Mrs. N had only a limited education and would be considered to be less well educated than her husband. This was a major issue for the husband’s family and there was the underlying feeling that he â€Å"could have done better† for himself. Mrs S appeared never to miss an opportunity to remind Mrs. N of this fact. (Tseng, W et al. 2001) An additional factor was that both Mr. Mrs. N were intensely aware of the cultural and family expectations on them to have children. Although Mr. N frequently visited his wife in Bangladesh, she had not conceived for 6 years, which led to anxiety between the couple and friction between Mrs. N and Mrs S. When Mrs. N eventually became pregnant, she came to the UK to live with her husband in a culture that she was unfamiliar with and could only speak rudimentary English. She felt very isolated and had difficulty in coping with the day to day problems of living. 2. Provide a brief outline (no more than 200 300 words) of the basis of their need for health care (i.e. pregnancy or other specific physiological condition) highlighting only those aspects that may have implications for their cultural and social health and well-being. Mrs. N had a relatively uneventful pregnancy and a normal delivery. Routine midwife post delivery checks were normal, but it was noticed buy the health visitor that Mrs. N was becoming progressively more withdrawn, tearful and unable to cope with the new baby at about the 3 month period. This was difficult to assess as Mrs. N had difficulty in expressing herself and also was reluctant to involve the healthcare professionals in what she saw as â€Å"her problem†. There was some debate amongst members of the primary healthcare team as to whether these changes were indicative of post natal depression or whether they were due to social isolation or perhaps a combination of both factors. Post natal depression and culture A number of studies have shown that post natal depression occurs with a similar incidence across virtually all cultures and civilisations. (viz. Marks, M. N. et al. 1992). It is known that perinatal psychoses are a leading cause of maternal morbidity and suicide related to such morbidity is the major cause of maternal mortality in both the UK and in Northern Europe. (CEMD 2001). There is no good quality published work detailing the prevalence of such mortality in Asian countries, but there is no evidence to suggest that it is in any way significantly different from the European figures. In any event, one can clearly deduce that post natal depression (and the other perinatal psychoses) are a major cause of debility. Post natal depression is also known to be associated with longer term consequences for maternal mental health, marital problems and also the psychological health of the marital partner. (Asten P et al. 2004). It is also known to be associated with a number of adverse effects on the social and cognitive development of the infant and other siblings in the family. (Murray, J et al. 2003) A brief overview of the literature on the subject however, shows that the great majority of the studies conducted into the subject of post natal depression has been undertaken in Western societies (viz. Kumar, R. 2004). The consequence of this observation is that such research generally does not take into account the range of psychosocial experiences that are associated with other cultures and civilisations where there are differing rates of lone motherhood, differing degrees of social support and family bonding, quite apart from the different emphasis placed on relationships within marriage, kinship and family. All of these factors will intuitively impact on the incidence and nature (and possibly the clinical presentation) of post natal depression. 3. Define how you are using the notion of culture for the purposes of the assignment. Try to make explicit answers to the following questions: What evidence and research did you use to describe and analyse the client’s/user’s cultural perspectives, needs and any other factors that might influence their understanding and interpretation of health, illness and treatments? How did you gather the evidence? Evidence here must include the client/users own narratives. What were your findings? For example, how did the user/client describe their experience and how did their story fit with what you observed in practice? How did it fit with theory you have read? Were they seen as difficult or good clients by practitioners if so on what grounds and how might this be explained? Culture is a complex concept. Most definitions refer to various patterns of human activity and the symbolic structures that give such activities significance and importance. Cultures can be understood as systems of symbols and meanings that even their creators contest, that lack fixed boundaries, that are constantly in flux, and that interact and compete with one another (Findley A et al. 2006) Mrs. N’s culture was a central consideration in this case. Unlike many of her countrywomen, she had not become in any way anglicised and was, to a large extent, completely unprepared for the enormous cultural changes that she experienced between her lifetime home in rural Bangladesh and her new home in suburban London. If one adds to this the inevitable stresses of her first pregnancy, the loss of support of her (albeit critical) family and the advent of post natal depression. Bangladeshi culture regards childbirth as a major life event, generally with a greater significance than in western civilisations. (Cox, J. L. 2006). It is specifically considered to be one of the major â€Å"rites of passage† of a woman, not only from childhood to adulthood, but also into social respectability. (Gautam, S et al. 1992). Bangladeshi society has a number of specific rituals, prohibitions and proscriptions which typically accompany the passage of the woman into motherhood which are generally not found in western societies. These rituals both aid and guide the new mother, as well as providing the social support networks, to help the new mother adapt to her newly acquired role. It has been suggested that these rituals may assist in protecting new mothers from becoming depressed. (Seel, R. M. 1996) In the case of Mrs. N however, it is clear that she had no back up of such rituals or social network support, as she found herself being suddenly removed from her familiar society and being suddenly transported (at a very critical and emotionally charged time in her life) into an alien an unknown culture where she could not easily communicate with the healthcare professionals who were trying to help her. In a landmark study of transcultural birthing practices in 1983, Stern Kruckman found â€Å"surprisingly little evidence of the phenomenon identified in Western diagnoses as postnatal depression and suggested that the lack of post-partum rituals in Western society might be a cause of postnatal depression.† (Stern, G et al. 1983). The authors support this finding with the comment that â€Å"The effectiveness of counselling in treating the condition may be through its re-creation of post-partum ‘structure’ and the provision of social support which might formerly have been provided by the extended family (in Asian societies) and public recognition of the new role.† An additional feature which was not immediately apparent, but only came to light later in the trajectory of the management of the illness, was the fact that Mrs. N felt ashamed that she had given birth to a baby girl. In Bangladeshi culture it is considered a sign of cultural status to have boys, particularly the first child. Shaheen R et al. 2006). The fact that Mrs. N had a girl reduced her own self esteem enormously. 4. You should develop a discussion of the assessment of the person’s actual and potential cultural needs, with reference to a specific theoretical perspective that has been introduced in the module e.g. social class and effects on health or the impact of illness on the family. As far as possible, use the evidence of the client/users own words to provide a more vivid insight of the client/users view and to give a robust basis for your own analysis and discussion. Studies which have considered the cultural implications of post natal depression point to a number of factors which can be considered â€Å"independent risk factors† for the development of post natal depression. (Kit, L. K et al. 1997). In specific regard to the case of Mrs. N , one can identify many of these as being relevant to her case. We shall consider each factor in turn. Many studies point to a number of factors that are a cause of happiness in pregnancy (which reduce the incidence of post natal depression) and these include discovery of pregnancy and the awareness of foetal movement. There is no doubt that Mrs. N was delighted to find that she was pregnant, not only because it pleased Mrs S, but also it meant that she would join her husband in the UK. This has to be contrasted with the negative factors including the initial difficulty in conception in Asian families as being a factor which increases the likelihood of post natal depression. (Mari, J et al. 1999) Further negative associations were physical illness and discomfort, nausea, tiredness and a lack of sleep, (OHara, M. W et al. 1996) all of which were relevant to Mrs. N as she had bad back pain from about 18 weeks onwards which limited both her mobility and her ability to sleep comfortably. This pain did not resolve quickly after delivery and the lack of sleep persisted as she tried to establish breast feeding and experienced great difficulty as the baby did not feed well and therefore would not sleep well. The role of healthcare professionals is often cited as a cause of postnatal unhappiness in studies that involve Asian women (viz. Pillsbury, B. L. K. (1998) Maternity staff who are unsympathetic, and little time to talk (or difficulty in talking) are the commonest negative associations. Mrs. N certainly experienced both of these factors with some of the hospital staff and found her hospital visits very difficult. Fortunately Mrs. N has a normal, relatively atraumatic delivery which therefore spared her another independent risk factor for post natal depression. 5. How were these cultural needs addressed? If they were not, or only partially met, say so and describe in what way you feel they might have been better achieved. Mrs. N’s cultural needs were not met in a number of ways. Clearly the family support that she would normally expect to count upon was limited to her husband. This comment has to be seen in the context that her husband was a man, although she had known him for several years she had never lived in close dependent proximity to him before she was pregnant. In the same way, Mr. N was also a comparative stranger to this situation and he did not have other members of his family group to advise and support him. In the context of this small nuclear family unit (which clearly is not the cultural â€Å"norm† in Bangladesh) it was not surprising that tempers were frayed and that Mr. N did not always support his wife. It is possible that he did not even recognise the signs of the pathophysiology of the post natal depression. The language difficulty persisted. The hospital services provided a translator, but this lady was not present at every occasion that Mrs. N attended the hospital and therefore she sometimes had to rely on other Bangladeshi women to translate and to help her. Clearly this was far from satisfactory. 6. Offer a conclusion with some indication of how your experience of this particular person’s needs have informed your practice and evaluate your own interactions and experience with the client/user/patient and their carers. For further details on submitting assessments, pass requirements and other information please refer to the separate assessment pack. I have considered the case of Mrs. N at great length and reflected on its implications for my personal practice. (Palmer 2005). It is with some sadness that I look back. It seems clear that Mrs. N had a number of circumstances relevant to her post natal depression which were largely beyond her control. The fact that her â€Å"world† was uprooted while she was in the early stages of pregnancy and she was transported to a culture that was alien to anything that she had previously known, clearly was a major de-stabilising factor for her. The factors which could have been changed would have to be the fact that an empathetic translator could have been present at every interaction with the healthcare professionals and this might have not only eased her problems but might have given the healthcare professionals a reciprocal insight into her predicament. With her past history, one might reasonably deduce that she had a number of major risk factors for post natal depression and therefore it should have been actively considered from the point of delivery. There is a considerable body of evidence which suggests that the earlier post natal depression is positively diagnosed and aggressively treated, the less severe its eventual trajectory becomes. (Dennis C L 2005). The language difficulties, inexperience of cultural difficulties and a reluctance on the part of Mrs. N to seek help all contributed to her post natal depression reaching quite a severe level before it was finally recognised. References Asten P, M. N. Marks, and M. R. Oates (2004) Aims, measures, study sites and participant samples of the Transcultural Study of Postnatal Depression. The British Journal of Psychiatry, February 1, 2004; 184 (46): s3 s9. CEMD (2001) Confidential Enquiries into Maternal Deaths Why Mothers Die 1997 – 1999. The Fifth Report of the UK Confidential Enquiries into Maternal Deaths. London: Royal College of Obstetricians and Gynaecologists. Cox, J. L. (2006) Perinatal mental disorders – a cultural approach. International Review of Psychiatry, 8, 9 -16. Dennis C L (2005) Psychosocial and psychological interventions for prevention of postnatal depression: systematic review. BMJ 2005; 331: 15 (2 July), Findley, Carther Vaughn and John Alexander Rothney (2006). Twentieth-century World. Sixth edition, p. 14. Gautam, S., Nijhawan, M. Gehlot, P. S. (1992) Post partum psychiatric syndromes: an analysis of 100 consecutive cases : Indian Journal of Psychiatry, 24, 383 386. Kit, L. K., Janet, G. Jegasothy, R. (1997) Incidence of postnatal depression in Malaysian women. Journal of Obstetric and Gynaecology Research, 23, 85 89. Kumar, R. (2004) Postnatal mental illness: a transcultural perspective. Social Psychiatry and Psychiatric Epidemiology, 29, 250 264 Mari, J., Sen, B. Cheng, T. A. (1999) Case definition and case identification in cross-cultural perspective. In The Scope of Epidemiological Psychiatry (eds P. Williams, G. Wilkinson K. Rawnsley). London : Routledge. 1999 Marks, M. N., Wieck, A., Checkly, S. A., et al (1992) Contribution of psychological and social factors to psychotic and non-psychotic relapse after childbirth in women with previous histories of affective disorder : Journal of Affective Disorders, 24, 253 263. Murray, J. Cooper, P. J. (2003) The impact of postpartum depression on child development. In Aetiological Mechanisms in Developmental Psychopathology (ed. I. Goodyer). Oxford: Oxford University Press. 2003 OHara, M. W. Swain, A. M. (1996) Rates and risk of postpartum depression – a meta-analysis : International Review of Psychiatry, 8, 37 54. Palmer (2005) in Learning about reflection from the student Bulpitt and Martin Active Learning in Higher Education. 2005 ; 6 : 207 217. Pillsbury, B. L. K. (1998) ‘Doing the month’: confinement and convalescence of Chinese women after childbirth. Social Science and Medicine, 12, 11 22. Seel, R. M. (1996) Birth rite. Health Visitor, 59, 11 22. Shaheen R, Andres de Francisco, Shams El Arifeen, Eva-Charlotte Ekstrà ¶m, and Lars Ã…ke Persson (2006) Effect of prenatal food supplementation on birth weight: an observational study from Bangladesh. Am. J. Clinical Nutrition, Jun 2006; 83: 1355 1361. Stern, G. Kruckman, L. (1983) Multidisciplinary perspectives on postpartum depression: an anthropological critique. Social Science and Medicine, 17, 1027 -1041. Tseng, W. Hus, J. (2001) Culture and Family: Problems and Therapy. New York: Haworth Press. ################################################################ 1.7.08 Word count 3,070 PDG