Introduction to Communication in Health and Social Care

SHC 21: Introduction to communication in health, social care or children’s and young people’s settings 1. Understand why communication is important in the work setting 1. 1 People communicate by many ways including non-verbal highlighting facial expression, eye contact, body language, physical gestures such as touch, dress and behavior, along with verbal including tone and pitch of voice. The age and knowledge of a person one is communicating with, also dictates somewhat the amount of vocabulary i. words and terms used too . People communicate to share ideas, information, educate, build relationships, express feelings and emotions, to be social, ask questions and expand their knowledge and share different experiences. 1. 2 Effective communication affects all aspects of work. Talking to a child, parent, work colleague, friend or boss, takes on a variety of different levels of communication. Maybe more smiles are given when talking to a child rather than to a boss figure. Also read: How and When to Seek Advice About Communication Introduction to Communication in Health and Social CareHaving a good understanding of effective communication in the work place, can help avoid misinterpretation and misunderstandings especially important in ensuing a safe work place. Talking and listening to work colleagues, children and parents builds professional and personal relationships, helping establish trust between all parties. 1. 3 Observing reactions when communicating with people are especially important to ensure understanding on both parties. Maybe you have acknowledged that they may not be feeling well, are feeling sad or are excited about something through their body language.Reading someone’s expression can tell you a lot about the mood the person is in. Avoiding eye contact, can also indicate that the person feels uneasy. If someone is angry, they may need time to calm down, acknowledging peoples actions and reactions can help lift or diffuse a situa tion. It is not advisable to continue to verbally talk to someone from a different country who does not understand you, maybe you can seek the help of a translator to help communicate or use picture cards. If someone has limited hearing and sight, nsure you’re not in a dimly lit room and use visual aids in bigger print to help the person understand what your communicating to them. Being able to recognize the ways in people communicate even without words is important to understand and be aware of. 2. Be able to meet the communication and language needs, wishes and preferences of the individuals 2. 1. To find out an individual’s communication and language needs, wishes and preferences there are many ways to find out this information, it could be from the individual themselves, from a parent, teacher, friend of the individual or their carer.There may be care notes, medical notes or documents from authorities which you can access to obtain this information if no rules of c onfidentiality are broken, so you can see how they’re being managed, ways of communicating that helps and any progresses that have been made. Some preferences may also be based on the individuals beliefs, values or culture. It is important not to judge people for they may resist communication for fear of being judged or reprimanded. Offer reassurance about confidentiality and explain what this means. Also make sure the setting is fit for purpose, privacy is important.The individual and care worker should not hold a personal and private discussion in a room full of people, whereby the conversation could be overheard. 2. 2 Demonstrate communication methods that meet the individuals needs wishes and preferences could include using a louder pitch in voice when talking to someone who has hard of hearing and ensuring there is no background distractive noise. If someone has difficulty reading, audio books can help. If an individual has dyslexia, then reading the information out loud to them, can help them better understand .A child having difficulty in remembering, may find a tape or video recorder a great assistive technology aid. A wheelchair user can talk to people at eye level if the unaided person sits down on a chair making both feel more comfortable when having a conversation and if a person cannot communicate properly via a disability, flash/need cards can be designed, allowing the person to choose which card they would like, ie TV, cup of tea, book, food or toilet. In the case of a foreign language being spoken, the help of a translator or interpretation service can assist. 2. You can show how and when to seek advice about communication if you feel unsure about something, maybe a physical incident may have taken place which worried you, maybe something was thrown at you. Sometimes complex cases need extra assistance and help can be sought by talking to your peers, line managers, the individuals carer. A line manager or supervisor can help advise on sp ecialist organisations who offer expert advice and services, as it is best not to think or second guess that you can manage the situation by yourself especially if you do not have the necessary skill set to deal with certain communication problems.Professional duty to ensure individuals receive the very best care and support is essential to provide the best service you can for them. 3. Be able to reduce barriers to communicate 3. 1 There are many barriers to communicate both visible and invisible. One of the most common starts with oneself. One must make sure that the language used is one that the individual can understand. It is no use talking to someone about abbreviations, slang or acronyms when shortcutting talk, is not commonly used by the person you’re speaking to, ie they’re not in the circle/workplace which those shortcuts/terms are commonly used.Individuals may not clearly understand what you are saying to them if those terms are used. If someone is hard of he aring then calling them on a telephone would not be recommended unless they had specialist equipment dedicated to improve the quality of the call so they could hear you properly. If someone comes from a different country, then language can present barriers too. Other barriers could include: emotional distress, health issues, cultural differences and environmental problems 3. 2 Demonstrate how to reduce barriers to communication in different ways.One of the most important factors would include making the other person feel at ease and comfortable with you. They should feel happy and safe in your company. Use friendly facial expressions, be encouraging and actively listen and acknowledge what they’re saying to you. Speak clearly and not too fast. Remove any distractions such as background noise and make sure any hearing aids an individual has, is working correctly. Use non-verbal methods to communicate interest, sympathy or understanding.Repeat things when necessary and make sur e the physical environment is ideally suited to the individual especially if they have a physical disability, where being confined to a wheelchair makes it impossible to meet you on the 1st floor if there is no lift in the building. 3. 3 The ways to check that communication has been understood could include a recap of the conversation so that the messages discussed are re-confirmed and agreed by both parties. If communication has not been understood then going over what was said is essential and maybe in a different way to ensure agreement and understanding is reached.Summaries , clarity and agreements between both parties should ensure effective communication has been understood. 3. 4 Identifying sources of information and support or services to enable more effective communication can be sourced from a variety of organisations and experts. For example someone who is blind or going blind, may benefit from learning about the national charity, RNIB Royal National Institute of Blind Pe ople. A telephone number can be offered to the individual so they can make contact with the charity. Someone who is experiencing hearing loss, could contact Action on Hearing Loss and learn lip leading.Elderly could make contact with Age UK. The internet is a great source of information along with local library, community centers and workplace. Condition specific organisations including Cystic Fibrosis, Cancer Research and the Stoke Association allow people to access their services for further information and understanding. Translator (changing written text into another language ) or interpretation services ( converting spoken language into another) can also assist along with advocacy services for people who find it difficult to speak up for themselves, including GOV.UK website, Action for Advocacy website,The Independent Complaints Advocacy Service (ICAS) and Diabetes UK advocacy service 4 Be able to apply principles and practices relating to confidentiality at work 4. 1 The term c onfidentiality means a set of rules or a promise that limits access to, or places restrictions upon, certain types of information. One cannot discuss a person’s private conversation, make comment about them to another person or pass over their documents to someone whom has no immediate need for this information. You cannot divulge their details to other people without their consent first. . 2 Confidentially can be demonstrated in day to day communication in line with agreed ways of working by the following: †¢ If a medical emergency takes place, the paramedics, doctors may need access to the patients medical history notes. †¢ If someone moves care homes, then the new home would need the individuals private papers from the previous home †¢ If someone was critically ill, information about their health would be passed to their next of kin †¢ Organisations have their own policies and procedures showing circumstances in which information can be disclosed.These can usually be located within the HR Dept. 4. 3 Information might need to be passed on in the following circumstances : †¢ Court hearing †¢ Hearing, learning about or seeing abuse of children or elderly adults †¢ Community protection and public health (Alerting the authorities if you’re aware and know about a potential outbreak of a virus/disease) †¢ Suicide attempt, by contacting a relevant body ie Police †¢ Risk to the individual or risk at others nearby the individual 4. One may need to seek advice about confidentiality and if it should be maintained, if one is uncertain about the next steps, has concerns or been informed of something by the individual including that they are fearful of a situation, by talking it through with the manager, they can offer advice and expert information in how to deal with certain circumstances. Also by referring to the companies policy and procedural guidelines, which would cover: data protection act, code of practice , freedom of information act, general right of access and whistle blowing.

Brand History Ysl

Brand History Founded by: Yves Saint Laurent and his partner Pierre Berge Chief Designer: 1. Yves Saint Laurent 1962-2002 The Day of Birth: August 1, 1936 The Day of death: June 1, 2008 Reputation: He is considered by many of the world's best- dressed people to be the inventor of modern fashion. Besides that, he is seen as the last of a generation of clothes designers that made the Rive Gauche (French for â€Å"Left Bank† of the Seine River in Paris) home to the most talented fashion designers in the world. These designers include Christian Dior, Coco Chanel, and Hubert de Givenchy — all people who helped make Paris the international capital of fashion. CAREER: 1. Saint Laurent got his big break when he was only 17 years old. The shy young designer began to work for fashion legend, Christian Dior. 2. By the time he was 21 years old, Saint Laurent was in charge of Dior's empire. He immediately started to develop a unique style that combined Dior's elegance and tradition with a more wearable, realistic style. . Saint Laurent struck out on his own in 1961, opening his own fashion house where he created haute couture for socialites and celebrities. MAIN ACHIEVEMENTS: 1. Saint Laurent's trendsetting clothes not only changed the look of high fashion but also the life of the average woman. 2. Aside from his haute couture clothing, he offered another clothing line for women available in department stores. The designs from this line often turned heads and changed the lives of the women wh o wore them. 3. In the 1960s and 1970s, when women were joining the workforce in millions for the first time, Saint Laurent designed more gender-neutral looks based on pants and jackets. No longer did women feel like they needed to wear only skirts and blouses. The change met with resistance, but women those who wearing Yves Saint Laurent’s pantsuits would simply take off their pants to dictate what they were allowed to wear on more than one occasion. 4. Another clothing item of his that became popular was a jacket called â€Å"le smoking,† which is a square-shouldered tuxedo for women. When the jacket first appeared in his 1966 fall-winter collection, it immediately became a groundbreaking landmark in fashion history because it blurred the lines between traditional male and female style. 5. Saint Laurent also changed fashion by using other types of pop culture in his clothes. For example, he created the Mondrian dress in 1965. These colorful dresses were patterned with the Dutch artist Piet Mondrian's abstract and geometric designs. 6. Saint Laurent also aided the women's liberation movement by challenging other socially accepted norms. . In 1971, Saint Laurent posed nude for his own perfume ads. This was shocking to many people. He did it to raise this question: Why is it more socially acceptable when a woman poses nude for an advertisement than when a man does? 8. He is credited with having introduced the tuxedo suit for women. 9. He became the first designer to use ethnic models in his runway shows, and referenced other non-European cultures in his work. 2. Albe r Elbaz 1998-1999 3. Tom Ford 1999-2004 4. Stefano Pilati 2004- Logo Designed by: A. M. Cassandre Brand Main History: During the 1960s and 1970s, the firm popularized fashion trends such as the beatnik look, safari jackets for men and women, tight pants and tall, thigh-high boots, including the creation of arguably the most famous classic tuxedo suit for women in 1966, Le Smoking suit. Some of his most memorable collections include the Pop Art, Ballet Russes, Picasso and Chinese ones. He also started mainstreaming the idea of wearing silhouettes from the 1920s, '30s and '40s. He was the first, in 1966, to popularize ready-to-wear in an attempt to democratize fashion, with Rive Gauche a |name. He was also the first designer to use black models in his catwalk shows. Among St. Laurent's muses were Loulou de La Falaise, the daughter of a French marquis and an Anglo-Irish fashion model, Betty Catroux, the half-Brazilian daughter of an American diplomat and wife of a French decorator, Talitha Pol-Getty, who died of drug overdose in 1971, and Catherine Deneuve, the iconic French actress. Ambassador to the couturier during the late 1970s and early 80s was London socialite millionairess Diane Boulting-Casserley Vandelli, making the brand ever more popular amongst the -European jet-set and upper classes. In 1993, the Saint-Laurent fashion house was sold to the pharmaceuticals company Sanofi for approximately $600,000,000. In the 1998-1999 seasons, Alber Elbaz, currently of Lanvin, designed 3 ready-to-wear collections. Pierre Berge appointed Hedi Slimane as Collections and art Director in 1997, and they relaunched YSL Rive Gauche Homme. Hedi Slimane decided to leave the house 2 years later. In 1999, Gucci bought the YSL brand and asked Tom Ford to design the ready-to-wear collection while Saint-Laurent would design the haute couture collection. In 2002, dogged by years of poor health, drug abuse, depression, alcoholism, criticisms of YSL designs, Saint-Laurent closed the illustrious couture house of YSL. While the house no longer exists, the brand still survives through its parent company Gucci Group. The pret-a-porter line is still being produced under the direction of Stefano Pilati after Tom Ford left in 2004. His style is decidedly more French than the overtly sexy image that Tom Ford perpetuated. Brand Communication For advertising his companions, the Yves Saint Laurent uses familiar faces from the general public. In the beginning, Scroll Elela great names in fashion as Katoucha Niane, Betty Catroux, Loulou de la Falaise, Talitha Pol-actress Getty or Catherine Deneuve. Then, Kate Moss, Claudia Schiffer. The former supermodel Naomi Campbell is used for the campaign of the Autumn-Winter 09 collection. For the men's fragrance â€Å"Night of the Man† is Vincent Cassel who embodies the new face of the brand. The house YSL applies to make his shows an event for which the jetset people jostling to sit in the front ranks. The venues are just as prestigious as the models occupying the podium. The women's collection Autumn-Winter 07-08 and was held at the Centre Pompidou in Paris on 1 March 2007, while the men's collection for the same season was held in the workshops Berthier. Campaign Spring-Summer 2008 women has, in turn, held on the premises of the Foundation Yves Saint Laurent-Pierre Berge. The Creative Director Stefano Pilati is then, photographers Ines Van Lamsweerde and Vinoodh Matadin and the model is none other than Kate Moss. The Fall-Winter 2009-2010 collection create the event: it is first opened on the website of the brand, before being presented on the catwalk. Since 2007, Stefano Pilati created the event each year to the streets with his â€Å"Manifesto†: a photo catalog of luxury brand Distibution to passersby on the street. In 2008 he was with the image of supermodel Naomi Campbell, photographed by the duo Inez van Lamsweerde and Vinoodh Matadin-distributed simultaneously in Paris, New York, London, Milan, Tokyo and Hong Kong. A cotton bag flanked YSL logo was also provided for the occasion. In 2009 he was with the image of Claudia Schiffer and accompanied by a bag with the initials of the brand, designed by Stefano Pilati himself, and a small USB key.

Comparative Study Of Styles And Patterns Of Code Switching

Code-switching is known as the switch from one codification ( linguistic communication ) to another within the same context. It is besides known as a state of affairs where a individual is able to jump between two or more linguistic communications in his or her discourse. In her book, Myers-Scotton ( 1993 ) said that code-switching is a conventional method of communicating in any bilingual or multilingual society. Hence, in a multilingual state like Malaysia, it is customary for us to see a merger of one or more linguistic communications, idioms and manners in spoken and besides written signifiers. The promotion of the epoch of multimedia and engineering agencies that code-switching is no longer restricted to talk signifier but it can be observed in written signifier excessively. With a more developed communicating system, code-switching can be observed in changing interaction such as chat rooms, forums, web logs and web sites like Myspace, Friendster and Facebook. ( Montes-Alcala , 2007 ) . Therefore, different forms and manners of code-switching are emerging and people code-switch more frequently in written signifier of linguistic communications and this includes one of the ill-famed medium, web log. Blood ( 2000 ) and Werbach ( 2001 ) stated that John Barger was the first individual who came about with the term â€Å" weblog † in his web site on 17th December 1997 where the term was used to mention to a web site where an single updates on a regular basis ( Branum, 2001 ) . With the tendency of having a web log traveling ballyhoo over the state in recent old ages, we can somehow notice in each web log, code-switching in different spheres takes topographic point. These switches in term of forms and manners differ from people of each age group.Problem StatementSometimes, it crosses our head to utilize merely English as our manner of communicating but under certain fortunes, we tend to code-switch accidentally. This state of affairs happens particularly in a multilingual society. There are times when we realize that merely the usage of certain codification in a peculiar sphere can do linguistic communication meaningful. Over the old ages, in our state, we frequently face the quandary of taking the ‘appropriate ‘ codification to do a linguistic communication meaningful in different spheres. The codification or linguistic communication choice is dependent on the communicator ‘s age group every bit good. Sometimes, it confuses us whether or non a individual of a peculiar age group web logs utilizing same or different manners and forms of code-switching in web logs every bit good as the critical parts that domains play in finding which codification to take to exchange to.Significance of StudyMontes-Alcala ( 2007 ) noted in the yesteryear, there have been a batch of researches done on code-switching in spoken signifier but merely a minority of research workers focus their findings in written signifier. Hence, she conducted a survey on code-switching in the web logs of English-Spanish bilinguals to happen out the frequence of code-switching within their web log entries. Similarly, in our state, a figure of surveies on code-switching have been done on spoken discourses but so far, merely a minority of researches has been carried out to analyze code-switching in web logs in Malaysia. Therefore, this survey is important because it provides a new comprehensiveness for code-switching in written discourse by integrating the usage of CS in web logs. The ground is because different manners of communicating on the cyberspace such as confabs, web logs and chirrups are quickly catching traditional signifiers of communicating for both professional and leisure activities ( Norizah & A ; Azirah, 2009 ) . Therefore, surveies on CS in written signifier should be taken into history.AimsThis survey aims to look into the ground why a individual code-switch from one chosen standardized linguistic communication, English, to another in his or her web log, taking into history bloggers of different age groups. At the same clip, it besides serves to find in which spheres do these bloggers tends to code-switch the most every bit good as their manners and forms of code-switch. Simultaneously, it besides focuses on the factors that initiate and act upon code-switching in their web logs every bit good as the grounds why they chose a specific linguistic communication to code-switch to from English, for illustration, from English to Mandarin or from English to Malay.Scopes of StudyThis survey focuses on code-switching which involves more than two linguistic communications in the most sought-after on-line diary, web log. It focuses on bloggers from two age groups and how the bloggers from this age group web log, taking into consideration the frequence of code-switching within selected entries. Furthermore, different forms and manners they use in different spheres while blogging are highlighted.Restriction of StudyThe country of survey for this research is restricted to those bloggers who use merely English as their chief medium of blogging over a declared period of clip. Merely five bloggers of two different age groups will be selected to take part in this rese arch. Group 1 – 20 to 30 old ages old Group 2 – 50 to 60 old ages old In add-on, merely bloggers from an English instruction background will take part in this research. However, the Numberss of bloggers selected to take part in this research do non stand for the whole.Theoretical ModelThis survey is guided by the old work from assorted research workers such as Montes-Alcala ( 2005 & A ; 2007 ) and Norizah and Azirah ( 2009 ) in their surveies of the code-switching in written discourses.Research QuestionsWhat are the spheres and grounds that influence the bloggers of different age groups to code-switch? What are the differences in the forms and manners of code-switching between bloggers of these two different age groups?Literature ReviewBlom and Gumperz are considered the innovator research workers in code-switching as they did an early survey in the twelvemonth 1972 on the linguistic communication used in a Norse fishing small town through observation and analysis of tape recordings of the society. Through that, they discovered the society used and code-switched in several different linguistic communications when they were pass oning to each other. As the affair of fact, it was dependent on who the talker was turn toing to every bit good as the sphere both addresser and addressee was in. On the other manus, Valdes-Fallis ( 1976 ) , Poplack ( 1981 ) , McClure ( 1981 ) and Gumperz ( 1982 ) in the article, â€Å" Blogging in two linguistic communications: Code-Switching in Bilingual Blogs, † introduced the categorizations of code-switching maps – direct citations, accent, elucidation or amplification, contextual switches, lexical demand switches, triggered switches and others in support of the grounds why people code-switch. Montes-Alcala ‘s ( 2000 ) research merely to happen out that that most of those maps typically manifested in the literature of unwritten code-switching were besides present in the written signifier. Hence, it explains why she did a survey on code-switching jumping between English and Spanish in web logs.Research DesignQualitative method is chosen as the design as it is able to supply factual informations needed to back up the theory that linguistic communication does transform. On the other manus, with qualitative method, a comparative survey on the manners and forms of code-switching in two different age groups in selected spheres can be reasoned with the presence of sufficient informations. Data will be obtained through analysis of web logs to find the spheres of code-switching in selected entries. In add-on to that, a set of questionnaire will be distributed to the selected bloggers to get information of their backgrounds and experiences in blogging. The ground is to acquire to cognize the grounds why they want to code-switch and besides if there is any cause that influences them to code-switch from English to another linguistic communication, be it Mandarin, Malay or others.SubjectsFor this survey a entire Numberss of five bloggers from each age group as stated below are selected to take part in it: Group 1 – 20 to 30 old ages old Group 2 – 50to 60 old ages old These bloggers have to be bi- or multilingual in order to be selected, maintaining in head that English must be their chief medium of blogging. Lone entries with existent code-switching for illustration, alternation of different linguistic communications within the same entry are considered entries without incorporation of other linguistic communications is non considered as code-switching. The ground of restricting the range of the survey is to put a criterion and besides to homogenise the findings so that the informations collected can be more precise to peculiar age groups being studied.Data CollectionThe continuance for informations aggregation of this survey runs from September 2009 to March 2010. Therefore, in the period of six months, the entries posted by these 10 bloggers will be selected indiscriminately and analyzed, foregrounding the differences in forms and manners of code-switching in different spheres. At the same clip, questionnaires with consent signifiers will be distributed to these bloggers in the hope of happening the grounds why they code-switch from English to other linguistic communications and besides to detect the frequence of code-switching among them.Datas AnalysisThe information in this survey is analysed by utilizing the work of Montes-Alcala ( 2000 ) as a guideline. The spheres of which code-switching takes topographic point are noted from the entries of web logs collected. Then, the frequence of code-switching will be tabulated before analysis of findings. On the other manus, the distributed questionnaires will help in happening out under what fortunes or spheres does the bloggers code-switch? Thereafter, these spheres will be categorized and account for code-switching in each sphere will be included. Finally, a comparing of differences in manners and forms of code-switching among these bloggers will be drawn and analyzed.

Nationalism and Sectionalism Essay Example | Topics and Well Written Essays - 2500 words

Nationalism and Sectionalism - Essay Example This was a mighty issue which would generate much debate and ultimately foster sectionalism, which was so fervent until the label of Federalist (those who supported a strong central government) and anti-federalist (opposed to the watering down of state sovereignty created substantial followings. James Madison and John Tyler served together in the Virginia General Assembly. They devised a plan for a state's convention to be held in Annapolis, Maryland in September 1786. At this convention, the two men proposed that macro commerce is controlled and regulated by the Continental Congress. James Madison and Alexander Hamilton issued a report on the Annapolis meeting. The meeting amplified the urgency to reverse the economic trends. In their report to Congress, including an appeal addressed to Congress, to have the states appoint delegates for a gathering in Philadelphia. Further, that the announcement of purpose to all delegates, was to be a revision of the Articles of Confederation. Thou gh some members of Congress viewed this move as a stepping on their Congressional â€Å"toes†, nonetheless, the delegates from each state were summarily notified by Congress. â€Å"Rhode Island viewed the gathering as an attempt to circumvent their strong state sovereignty. The men of the state had a strong attachment to paper currency; they had low taxes and a state government which was supportive. Many other Americans also had misgivings, which were aligned with the men of Rhode Island. Patrick Henry was rumored to have said.† I smell a rat†. ... strong central government) and anti-federalist (opposed to the watering down of state sovereignty created substantial followings. James Madison and John Tyler served together in the Virginia General Assembly. They devised a plan for a states convention to be held at Annapolis, Maryland in September 1786. At this convention the two men proposed that macro commerce be controlled and regulated by the continental Congress. James Madison and Alexander Hamilton issued a report on the Annapolis meeting. The meeting amplified the urgency to reverse the economic trends. In their report to Congress (Madison and Hamilton), included an appeal addressed to Congress, to have the states appoint delegates for a gathering in Philadelphia. Further, that the announcement of purpose to all delegates, was to be a revision in the Articles of Confederation. Though some members of Congress viewed this move as a stepping on their Congressional "toes", nonetheless, the delegates from each state were summarily notified by Congress. "Rhode Island viewed the gathering as an attempt to circumvent their strong state sovereignty. The men of the state had a strong attachment to paper currency; they had3 low taxes and a state government which was supportive. They sent no delegates to Philadelphia. Many other Americans also had misgivings, which were aligned with the men of Rhode Island. Patrick Henry was rumored to have said." I smell a rat". (Quinn) Patrick Henry articulated his belief in the "sanction of place". It was the precursor of the adage or

Third Cinema (address one of the following questions) Essay

Third Cinema (address one of the following questions) - Essay Example Cinema has been divided into three categories, first, second and third cinema. Theses terms had their birth at the Bandung Conference of 1955, the first conference of the Non-Aligned Movement. China propagated the theory of the three distinct worlds. The first world i.e. the advanced capitalist countries included Western Europe, North America and Australasia; the second world i.e. the previous socialist countries of Eastern Europe and Soviet Union. The remaining countries were thus the third world, to which China stated its commitment. (1) First Cinema refers the model identified as the Hollywood movie. Also known as commercial or popular cinema, it corresponds to an ideology which the particular relationship between film and spectator is superfluous, where cinema is conceived as pure entertainment. Aim of this cinema is to maximize profits. This kind of film is made for display in large theatres, with a standardized duration either feature-length or blockbuster. All types of films come under this category even scientific documentary is susceptible to the aspirations of big money. Second Cinema is also known as art or parallel cinema. Parallel cinema has its own structures, patterns of distribution and exhibition, and its own ideologies. Art has become a cinema made by and for the limited social groups. It expresses the aspirations of the middle layers, the petty bourgeoisie and consequently is often revolutionary but pessimist and sometimes mystical. Like first cinema all categories of films may be found in this category. There is a deliberate uncertainty in the term ‘Third Cinema’ which requires clarification. The term ‘Third Cinema’ is derived from the correspondence with the term ‘third world’, referring to the underdeveloped countries of Asia, Africa and Latin America. In the dependent countries, third cinema is a cinema of de-colonization, which expresses the will to national liberation,

Nuclear Assignment Example | Topics and Well Written Essays - 250 words

Nuclear - Assignment Example : One, it is more economical as it uses less fuel and produces more energy; two, nuclear energy lasts longer unlike fossil fuels which can be depleted; and three, well-maintained nuclear power plants do not emit substances that could harm the environment while coal and oil pollute the air when burned. (Nuclear Energy retrieved from library.thinkquest.org/3471/nuclear_energy.html) Though nuclear energy has its advantages, its disadvantages far outweigh them. Let us take the case of the Chernobyl Nuclear Plant which, in 1986, had a meltdown (Nuclear Energy retrieved from library.thinkquest.org/3471/nuclear_energy.html) meaning the fission reaction went out of control resulting to an explosion in the nuclear plant instantly killing 2 workers of the plant and contaminating hundreds or perhaps thousands more in its surroundings. Within a few months, 26 more died because of radiation contamination. It was found out later that the cause of the accident was a flaw in the design of the nuclear plant and an undertrained operator. In short, human error is to be blamed. As for the Fukushima Daiichi nuclear disaster last March 11, 2011, it was not caused by human error but by natural calamities. The tsunami that followed the strong earthquake on that day damaged the generators and coolants resulting to a meltdown in the Fukushima Daiichi nuclear plant. Though no deaths f rom contamination were reported, thousands were evacuated from their homes to escape radiation contamination. There was radiation leak into the sea and radiation contamination was noted in the land, the air and even the food of the people. Too much amount of radiation in the body, as we all know, causes sickness and even death to the one contaminated. Both the Chernobyl nuclear plant meltdown and the Fukushima Daiichi nuclear plant disaster showed mankind how disastrous and damaging the use of nuclear energy can be. With just a small error and the wrath of Mother Nature, lives are destroyed, structures and

Discussion 4 Assignment Example | Topics and Well Written Essays - 250 words - 1

Discussion 4 - Assignment Example This also involves identifying gender’s role whose mainstream consideration is attributed to sexuality factors. The human sexual behavior is composed of diverse motivations, ranging from sexually-generated interests to behavioral classifications. For instance, the gender factor involves sexual drives and preferences, and the unique cultural interventions have explored advances in cultural range, which hence create substantial amount of sexual orientations (Johnson, 2004). The school of thought fostered by Suzanne LaFont (2003) illustrates that variations among sexual classes have diversely created sub category for minority sexual groups. Lack of moral obligations and the sheer interest for defining sexual orientations that provide a different biological taste has been incorporated into the human sexuality potentials. The rate and range of sexual preference has changed with time and this focus provider a critical reflection of gender connectedness between changing behaviors and changing societal values. The US interpretation of gender provides a conclusive approach or reproach to emerging sexual categories which are then incorporated into new social process (Zhou et al., 1995). The critical variation of sexual and gender factors including gays, transgender and intersex have been viewed as the new constituents of gender and the interpretation hence outweighs the traditional perception of gender. However, other cultures outside the U.S. underline the traditional classification of

Pharrell Williams and Robin Thicke Versus Marvin Gayes Case Essay - 1

Pharrell Williams and Robin Thicke Versus Marvin Gayes Case - Essay Example Marvin’s children said that the money they demanded was what they believed their father would have been given had he signed his song with the label. Robin and Williams argued that the family only had a right to the sheet music and not the sound. In fact, earlier they had sued Marvin’s estates in order to stop them from going ahead with their copyright infringement case. However, they both did not claim to have written this song together but independently. They held on to their innocence and said they were not through with the case yet. An additional $8000 is also to be added to the amount given to Marvin Gaye’s estate. This case has brought down Williams reputation as a songwriter as he was ordered to pay $1.6 million while Robin $1.7 million (Grow). Copyright infringement occurs when anybody breaches the restricted rights of another person’s material whether words, sound or pictures. This rule is seen as theft as the violator uses a copyrighted material without the owner’s authorization (Campbell, Cotter & Center for International Legal Studies, 2). Even though the two songs do not have the same sound, the words in the two songs are similar and this constitutes a breach. The two musicians have violated Marvin Gaye’s song even though they argue that the sheet music is what Gaye copyrighted.

Using Nintendo Wii in Library Programming for Young Adults Essay

Using Nintendo Wii in Library Programming for Young Adults - Essay Example (MacKenty, 2006) One of the most controversial issues that are highly associated with playing video games is the common perception that that these games could promote a culture of violence among the American youths. (Lieberman, 1998) In line with this matter, many studies have shown that playing violent video games is considered as one major factor that could increase the number of massacres in different schools. (Gegax, Adler and Pedersen, 1998) Despite the negative impact of playing video games in the students’ aggressive behavior (Winkel, Novak and Hopson, 1987; Graybill et al., 1987), the researcher will discuss the benefits of using Nintendo Wii and other game consoles in each of the local school libraries. Eventually, the researcher will critically analyze the how these games could increase the students’ interest in learning the school subjects. Prior to the conclusion, the researcher will provide a recommendation on how game console could be beneficial to the learning experience of the students. Nintendo Wii is considered as one of the top three next generation of game console that many school librarians are considering aside from Microsoft’s Xbox 260 Elite and Sony’s PlayStation 3 (PS3). (Czarnecki, 2007) Wii enables the players to control the game using the motion of the hands, measuring the body movement and its velocity accurately. (MacKenty, 2007) Wii is capable of delivering outstanding graphics and high quality sound which could significantly adds up to the quality of the students’ gaming experience. Since Wii game console is designed using the standard USB port, Wii games can easily be played by several students through networking. Wii game console is also applicable to older TV models to allow more students to view the game. Microsoft’s Xbox 260 Elite or PlayStation 3 is capable of multiplayer games. These two game consoles can be more appropriate to enable

Chapter one Essay Example for Free

Chapter one Essay The balanced scorecard was developed by Kaplan and Norton in the 1990s, according to published reports approximately 50% of fortune 1000 corporations have implemented the BSC system of business management. This discourse will examine the balance scorecard (BSC) business module and its potential fit on Pepsi Saudi Arabia. It will critically analyze the core elements of BSC, and why it could serve as the primary operating business engine for Pepsi corp of Saudi Arabia. This paper will reference data from other companies that  have adopted the BSC to evaluate the potential financial and operational advantage that Pepsi Saudi would stand to gain by using BSC. Even though there are inherent shortcomings in the BSC system of management, the paper will seek confirmation by using empirical findings and reports from other organizations that have already embraced BSC, Pepsi Saudi ought to benefit immensely from the system when it is fully implemented. INTRODUCTION: The Balanced Scorecard (BSC) was developed by Kaplan and Norton in the 1990s, it  is a management system designed to measure the entire performance of a company by measuring all relevant angles of the company’s operations. BSC requires the company to retain its core financial measurement, but it goes further and expands the measurement to other important business areas. The BSC looks at the entire business from four perspectives, the customer perspective, financial perspective, the internal business process and the learning and growth perspective. It collects and analyzes data relevant to the company. And it helps managers to get clearer more meaningful picture of their company, which in turn enables them to plan, improve and execute operational goals. The objective of this paper is to advocate the adaptation of BSC by Pepsi Saudi. The strength and economic advantages of BSC and why it would be beneficial to Pepsi Saudi will be extensively discussed in this presentation. PEPSI SAUDI ARABIA: The Pepsi company of Saudi Arabia is comprised of two key divisions based on the western region of the country, one the Saudi International Project Company (SIPCO)  and the other is Saudi Fruit Juice and Beverage Industry (SFJBI). This paper will look at this merger and how it could use the BSC methodology to elevate its entire operation and increase its profit margin. BALANCE SCORECARD (BSC). Developed in the 1990s by Kaplan and Norton, balanced scorecard is a business management system that uses measurement to verify strategic plans. It tries to align business operations to the strategies of the business, by measuring the performance of the business in relations to its goals, usually for a given time period. It relies largely  on the premise that a business principle or a business function that could be measured could also be improved upon. â€Å"What gets measured gets done†. If a company can establish a measurement system to analyze its performance, then that company can find a way to improve on its performance based on the result of the measurement. Experts generally agree that the companies that take the time to measure their own performance usually does better than the companies who do no possess the tools of measurement. Based on the outcome of a business measurement BSC encourages  managers to prioritize their efforts. The BSC does not focus on financial measurements alone, because financial measurement alone can not reveal all the important data needed for long term performance. The balanced scorecard incorporates such business elements based on the customers needs, employees, technology, and other critical elements that could help the company emerge stronger in the future. Essentially BSC takes stock of the whole business. It uses the â€Å"feedback loop† to pinpoint all problematic areas and then it develops solutions  for them. Managers and employees can then learn from those points that had been identified by the loop. It looks at the company’s current position then initiates the necessary strategies for correction. It uses learning, technical innovations and appropriate behavioral shifts and cultural identities to accommodate essential actions for the benefit of the company. BSC also sets aside time to study the applications that have been implemented, and then analyzes the results for effectiveness of those mechanisms or lack of effectiveness.

Elderly Suicide Strategies with Nurse Based Intervention

Elderly Suicide Strategies with Nurse Based Intervention Investigation into nurse strategies to prevent or minimise attempted suicide in patients over 65 This dissertation considers the rationale for positive nurse-based intervention in consideration of issues relating to suicide in the elderly. The introduction sets the context, including the historical context, of the issues and discusses the negative effects of ageism on issues relating to suicide in the elderly. The literature review considers selected texts which have been chosen for their specific relevance to the issue and particularly those that espouse the view that ageism is counterproductive to a satisfactory quality of life outcome for the elderly person. Conclusions are drawn and discussed with specific emphasis on those measures that are of particular relevance to the nursing profession whether it is in a secondary care facility, a residential home setting or in the primary healthcare team and the community. Introduction We can observe, from a recent paper (O’Connell H et al. 2004), the comments that, although there is no doubt that the elderly present higher risk of completed suicide than any other age group, this fact receives comparatively little attention with factors such as media interest, medical research and public health measures being disproportionately focused on the younger age groups (Uncap her H et al.2000). Perhaps we should not be surprised at the fact that both suicidal feelings and thoughts of hopelessness have been considered part of the social context of growing old and becoming progressively less capable. This is not a phenomenon that is just confined to our society. We know that the Ancient Greeks tolerated these feelings in their society and actively condoned the option of assisted suicide if the person involved had come to the conclusion that they had no more useful role to play in society (Carrick P 2000). Society largely took the view that once an individual had reached old age they no longer had a purpose in life and would be better off dead. In a more modern context, we note the writings of Sigmund Freud who observed (while he was suffering from an incurable malignancy of the palate: It may be that the gods are merciful when they make our lives more unpleasant as we grow old. In the end, death seems less intolerable than the many burdens we have to bear. (cited in McClain et al. 2003) We would suggest that one of the explanations of this apparent phenomenon of comparative indifference to the plight of the elderly in this regard is due to the fact that the social burden of suicide is often referred to in purely economic terms, specifically relating tools of social contribution and loss of productivity. (Breeching A et al.2000). This purely economic assessment would have to observe that the young are much more likely to be in employment and less likely to be a burden on the economic status of the country whereas with the elderly exactly the converse is likely to be true. This results in economic prominence being given to the death of a younger person in many reviews. (Adcock P,2003). There is also the fact that, despite the fact that we have already highlighted the increase in relative frequency of suicide in the elderly, because of the demographic distributions of the population in the UK, the absolute numbers of both attempted suicides and actual suicides are greater in the younger age ranges and therefore more readily apparent and obvious. The elderly are a particularly vulnerable group from the risk of suicide. In the industrialised world males over the age of 75 represent the single largest demographic group in terms of suicide attempts. Interestingly (and for reasons that we shall shortly discuss) although there is a general trend of increasing suicide rate with age the excess rates associated with the elderly are slowly declining in the recent past (Castell 2000). We can quantify this statement by considering the statistics. If we consider the period 1983 to 1995 in the UK then we can show that: The suicide rates for men reduced by between 30% and 40% in the age groups 55–64, 65–74 and 75–84 The rates for the most elderly men (males over 85 years) remained fairly static, this group still having the highest rates of any group By way of contrast, the 25- to 34-year-old male group exhibited a 30%increase in suicide rate during the same period, this group are becoming the group with the second highest rate, while the 15- to24-year-old male group demonstrated a 55% increase in suicide rates.(WHO 2001) Female suicide rates have shown a similar overall decrease, reducing by between 45 and 60% in the 45–84 age group. Elderly women, however, retain the highest rates throughout the life span (Castell 2000) The ratio of male to female elderly suicide deaths remains approximately 3:1 (Fischer L R et al. 2003) We can suggest that these trends in reduction of suicide, particularly in the elderly are likely to be due, amongst other things, to: The improved detection of those at risk together with the advent of aggressive treatment policies relating to mental illness in the elderly. (Warn M et al. 2003) One of the main reasons, we would suggest, for this obviously changing pattern and the discrepancies in the suicide rates between the age ranges, is the fact that, in direct consideration of the context of our topic, the elderly are more likely to be both amenable to professional help and also, by virtue that a higher proportion are likely to be in direct contact with healthcare professionals either through failing health or nursing homes and hospitals, (Soutine K teal. 2003), have the warning signs of impending suicide recognised and acted upon more promptly than the younger, arguably more independent age group. In specific consideration of the elderly group we should also note that attempted suicide is more likely to be a failed suicide attempt rather than a Para suicide. (Rubenowitz E et al. 2001). There is considerable evidence that the incidence of depression is increased in the presence of a concurrent physical illness (Conwell Yet al. 2002) and clearly this is going to be more likely in the elderly age group. Some sources have cited association rates of between 60-70%of major depression with physical illness in the over 70yr olds.(Conwell Y et al. 2000). Another significant factor is that it is commonly accepted that an attempted suicide is a strong independent risk factor in the aetiology of further suicide attempts. (Conwell Y et al. 1996) This trend is much more marked in the elderly group with a ratio of about 4:1 which compares very badly with the ratios in the younger age groups of between 8:1 and 200:1 (depending on age range, definition and study).(Hippie J et al. 1997) Aims and objectives In this dissertation it is intended to gain evidence based knowledge of the scope and significance of the phenomenon of attempted suicide in the elderly. In addition it is intended to gain evidence based knowledge in the use of strategies to ameliorate attempted suicide in the elderly to highlight gaps in the literature available and to suggest recommendations for change in nursing practice It is hoped tube able to suggest areas for research into the phenomenon of attempted suicide in the elderly. Methodology The initial strategy was to undertake a library search at the local post graduate library and the local university library (Client: you might like to personalise this) on the key words â€Å"suicide, elderly, prevention strategies, industrialised societies†. This presented a great many papers. About 40 were selected and read to provide an overview of the literature in this area. During this phase, references were noted and followed up and key literary works were assimilated. The bulk of the papers accessed and read were published within the last decade, however a number of significant older references were also accessed if they had a specific bearing on a particular issue. The most significant references were accessed and digested. The dissertation was written referencing a selected sub-set of these works. Rationale for proposal To increase nurses knowledge and understanding of attempted suicide in the older age group and to highlight through the literature review, evidence based strategies that can be employed to ameliorate attempted suicide amongst the elderly. Literature review Before commencing the literature review, it is acknowledged that the literature on this subject is huge. The parameters of the initial search have been defined above. In addition it should be noted that there is a considerable literature on the subject of assisted suicide which has been specifically excluded from these considerations The literature base for suicide in the elderly is quite extensive and provides a good evidence base for understanding, appropriate action and treatment. (Berwick D 2005) One of the landmark papers in this area is by Hippie and Quinton(Hippie J et al. 1997) which provided a benchmark, not only on the aetiology of the subject, but also in the long term outcomes, which, in terms of potential nursing care input, is extremely important. The paper points to the fact that there is a good understanding of the absolute risk factors for suicide in the elderly but a comparative lack of good quality follow up studies in the area. It set out to identify100 cases of attempted suicide in the elderly and then follow them up over a period of years. The study was a retrospective examination of100 consecutive cases of attempted suicide that were referred to the psychiatric services over a four year period. The authors were able to make a detailed investigation (including an interview of many of the survivors), about four years later. Their findings have been widely quoted in the literature. Of particular relevance to our considerations here we note that they found that of the 100 cases identified, 42 were dead at the time of follow up. Of these, 12 were suspected suicides and five more had died as a result of complications of their initial attempt. There were 17further attempts at suicide in the remaining group. Significantly, the twelve women in the group all made non-lethal attempts whereas all five of the men made successful attempts. The authors were able to establish that the risk of further attempts at suicide (having made one attempt)was in excess of 5% per year and the â€Å"success† rate was 1.5% per year in this group. From this study we can also conclude that the risk of successful repeat attempted suicide is very much greater if the subjects male. The authors were also able to establish that, because of their initial attempt, those at risk of self-harm were likely to be in contact with the Psychiatric services and also suffering from persistent severe depression. We can examine the paper by Dennis (M et al. 2005) for a further insight into the risk factors that are identifiable in the at risk groups. This paper is not so detailed as the Hippie paper, but it differs in its construction as it is a control matched study which specifically considered the non-fatal self-harm scenario. The study compared two groups of age matched elderly people both groups had a history of depression but the active study group had, in addition, a history of self-harm. The significant differences highlighted by this study were that those in the self-harm group were characterised by poorly integrated social network and had a significantly more hopeless ideation. This clearly has implications for intervention as, in the context of a care home or warden assisted setting, there is scope for improving the social integration of the isolated elderly, and in the domestic setting community support can provide a number of options to remove factors that mitigate towards social isolation. This would appear to be a positive step towards reducing the risk of further self harm. The O’Connell paper (O’Connell et al. 2004) is effectively a tour divorce on the pertinent issues. It is a review paper that cherry-picks the important information from other, quite disparate, studies and combines them into a coherent whole. It is extremely well written, very detailed, quite long and extremely informative. While it is not appropriate to consider the paper in its entirety, there are a number of factors that are directly relevant to our considerations here and weshall restrict our comments to this aspect of the paper. In terms of the identification of the risk factors associated with attempted suicide in the elderly, it highlights psychiatric illnesses, most notably depression, and certain personality traits, together with physical factors which include neurological illnesses and malignancies. The social risk factors identified in the Dennis paper are expanded to include â€Å"social isolation, being divorced, widowed, or long term single†. The authors point to the fact that many of the papers referred to tend to treat the fact of suicide in reductionist terms, analysing it to its basic fundamentals. They suggest that the actual burden of suicide should also be considered in more human terms with consideration of the consequences for the family and community being understood and assessed. (Mason T et al. 2003) In terms of nursing intervention for suicide prevention, we note that the authors express the hypothesis that sociality exists along a continuum from suicidal ideation, through attempted suicide, to completed suicide. It follows from this that a nurse, picking up the possibility of suicidal ideation, should consider and act on this as significant warning sign of possible impending action on the part of the patient. The authors point to the fact that the estimation of the actual significance of the various prevalence’s of suicide varies depending on the study (and therefore the definition) (Kirby M et al. 1997). In this context we should note that the findings do not support the ageist assumptions expounded earlier, on the grounds that the prevalence of either hopelessness or suicidal ideation in the elderly is reported asap to 17% (Kirby M et al. 1997), and there was a universal association with psychiatric illness, especially depressive illness. If we consider the prevalence of suicidal feelings in those elderly people who have no evidence of mental disorder, then it is as low as4%. It therefore seems clear that hopelessness and sociality are not the natural and understandable consequences of the ageing process as Freud and others would have us believe. This has obvious repercussions as far as nursing (and other healthcare) professionals are concerned, as it appears to be clearly inappropriate to assume that sociality is, in most cases, anything other than one of many manifestations of mental illness. It also follows from this, and this again has distinct nursing implications, that suicidal ideation and intent is only the tip of the iceberg when one considers the weight of psychological, physical and social health problems for the older person. (Warn M et al. 2002) If one considers evidence from studies that involve psychological autopsies, there is further evidence that psychopathology is involved. Depressive disorders were found in 95% in one study. (Duberstein P R teal. 1994) Psychotic disorders and anxiety states were found to be poorly correlated with suicidal completion. Further evidence for this viewpoint comes from the only study to date which is a prospective cohort study in which completed suicide was the outcome measure. (Ross R K et al. 1990). This shows that the most reliable predictor of suicide was the self-rated severity of depressive symptoms. This particular study showed that those clients with the highest ratings were 23 times more likely to die as the result of suicide than those with the lowest ratings. It also noted that other independent risk factors (although not as strong), were drinking more than 3 units of alcohol per day and sleeping more than 9 hours a night. One further relevant point that comes from the O’Connell paper is the fact that expression of suicidal intent should never be taken lightly in the older age group. The authors cite evidence to show that this has a completely different pattern in the elderly when compared tithe younger age groups. (Beauties A L 2002). The figures quoted show that if an elderly person undertakes a suicide attempt they are very much more likely to be successful than a younger one. The ratio of Para suicides to completed suicides in the adolescent age range is 200:1, in the general population it is between 8:1 and33:1 and in the elderly it is about 4:1. (Warn M et al. 2003). It follows that suicidal behaviour in the elderly carries a much higher degree of intent. This finding correlates with other findings of preferential methods of suicide in the elderly that have a much higher degree of lethality such as firearms and the use of hanging. (Jorum A Feet al. 1995). The paper by Cornwell (Y et al. 2001) considers preventative measures that can be put in place and suggests that independent risk factors commonly associated with suicide in the elderly can be expanded to include psychiatric and physical illnesses, functional impairment, personality traits of neuroticism and low openness to experience, and social isolation. And of these, t is affective illness that has the strongest correlation with suicide attempts. We have discussed(elsewhere) the correlation between impending suicide and contact with the primary care providers. Cornwell cites the fact that 70% of elderly suicides have seen a member of the primary healthcare team within 30days of their death and therefore proposes that the primary healthcare setting is an important venue for screening and intervention. It is suggested that mood disorders are commonplace in primary healthcare practice but, because they are comparatively common, are underdiagnosed and often inadequately treated (ageism again). The authors suggest that this fact alone points to the fact that one of the suicide prevention strategies that can be adopted by the primary healthcare team. they suggest that clinicians, whether they are medically qualified or nursing qualified, should be trained to identify this group and mobilise appropriate intervention accordingly. Obviously the community nurses can help in this regard as they are ideally placed to maximise their contact with vulnerable and high risk groups. We have identified the role of a major depressive illness in the aetiology of suicide in the elderly. Bruce (M L et al. 2002) considered the role of both reactive and idiopathic major depression in the population of the elderly in a nursing home setting. This has particular relevance to our considerations as firstly, on an intuitive level, one can possibly empathise with the reactive depressive elements of the elderly person finding themselves without independence in a residential or nursing home and secondly, this is perhaps the prime setting where the nurse is optimally placed to monitor the mood another risk factors of the patient and continual close quarters. The salient facts that we can take from this study are that there was substantial burden of major depressive symptomatology in this study group (13.5%). The majority (84%) were experiencing their first major depressive episode and therefore were at greatest risk of suicide. The depression was associated with comorbidity in the majority of cases including â€Å"medical morbidity, instrumental activities of daily living disability, reported pain, and a past history of depression but not with cognitive function or socio demographic factors.† All of these positive associations which could have been recognised as significant risk factors of suicide in the elderly. Significantly, in this study, only 22% of all of the seriously depressed patients were receiving antidepressant therapy and none were receiving any sort of psychotherapy. In addition to this the authors point to the fact that 31% of the patients who were put on antidepressants were taking a sub therapeutic dose (18% because they were purposely not complying with the dosage instructions). The conclusions that the authors were able to draw from this study were that major depression in the elderly was twice as common in the residential setting as opposed to those elderly patients still in the community. The majority of these depressed patients were effectively left untreated and therefore at significant risk of suicide. There was the obvious conclusion that a great deal more could be done for this study population in terms of relieving their social isolation and depressive illnesses. And, by extrapolation, for their risk of suicide. Ethical considerations. In consideration of the issue of suicide in the elderly we note that there are a number of ethical considerations but these are primarily in the field of assisted suicide which we have specifically excluded from this study. (Pabst Batten, M 1996) Evidence for positive nursing interventions Having established the evidence base in the literature that defines the risk factors that are known to be particularly associated with suicide in the elderly, we take it as read that this will form part of the knowledge base for the nurse to be alert to, and to identify those patients who are at particular risk of suicide. It is equally important to be aware of those factors that appear to confer a degree of protection against suicide. This will clearly also help to inform strategies of intervention for the nurse. Studies such as that by Gunnel (D et al. 1994) point to the fact that religiosity and life satisfaction were independent protective factors against suicidal ideation, and this factor was particularly noted in another study involving the terminally ill elderly where the authors noted that higher degrees of spiritual well-being and life satisfaction scores both independently predicted lower suicidal feelings. (McClain et al. 2003). The presence of a spouse or significant friend is a major protective factor against suicide. Although clearly it may not be an appropriate intervention for nursing care to facilitate the presence of a spouse(!) it may well be appropriate, particularly in residential settings, to facilitate social interactions and the setting up of possible friendships within that setting (Bertolote J M et al. 2003) Conclusions and discussion This Dissertation has considered the rationale behind the evidence base for nursing intervention and strategies to prevent or minimise suicide attempts in the elderly age group. We have outlined the literature which is directed at identification of the greatest â€Å"at risk† groups and this highlights the importance of the detection and treatment ofboth psychiatric disorders (especially major depression), and physical disorders (especially Diabetes Mellitus and gastric ulceration).(Thomas A J et al. 2004) Although we have been at pains to point out the relatively high and disproportionate incidence of suicide in the elderly, we should not lose sight of the fact that it is not a common event. One should not take the comments and evidence presented in this dissertation as being of sufficient severity to merit screening the entire elderly population. (Erlangen A et al. 2003) The thrust of the findings in this dissertation are that the screening should be entirely opportunistic. The evidence base that we have defined should be utilised to identify those who are in high risk groups, for example, those with overt depressive illnesses, significant psychological and social factors, especially those who have a history of previous attempted suicide. The healthcare professional should not necessarily expect the elderly person to volunteer such information and if the person concerned is naturally withdrawn or reserved, minor degrees of depressive symptoms may not be immediately obvious. (Callahan C M teal. 1996). In terms of direct nursing intervention, this must translate into the need to be aware of such eventualities and the need to enquire directly about them. The nurse should also be aware that the presence of suicidal feelings in a patient with any degree of depression is associated with a lower response rate to treatment and also an increase in the need for augmentation strategies. The nurse should also be aware of the fact that these factors may indicate the need for secondary referral. (Gunnel D et al. 1994). If we accept the findings of Conwell (Y et al. 1991), then the estimated population at risk from significant mood disorder and therefore the possibility of attempted suicide in the elderly, is 74%.This can be extrapolated to suggest that if mood disorders were eliminated from the population then 74% of suicides would be prevented in the elderly age group. Clearly this is a theoretical viewpoint and has to be weighed against the facts that firstly â€Å"elimination† of mood disorders (even if it were possible), would only be achieved by treatment of all existing cases as well as prevention of new cases, and the secondary prevention of sub-clinical cases. We know, from other work, that the detection and treatment of depression in all age ranges is low, and even so only 52% of cases that reach medical attention make a significant response to treatment(Bertolote J M et al. 2003). These statistics reflect findings from the whole population and the detection rates and response rates are likelyto lower in the elderly. (Wei F et al. 2003). It follows that although treatment of depressive illness is still the mainstay of treatment intervention as far as suicide prevention is concerned, preventative measures and vigilance at an individual level are also essential. Nursing interventions can include measures aimed at improving physical and emotional health together with improved social integration. Sometimes modification of lifestyle can also promote successful ageing and lead to an overall decrease in the likelihood of suicidal feelings. (Fischer L R et al. 2003) On a population level, public health measures designed to promote social contact, support where necessary, and integration into the community are likely to help reduce the incidence of suicide in the elderly, particularly if we consider the study by Cornwell (Y et al.1991) which estimated the independent risk factor for low levels of social contact in the elderly population as being 27%. Some communities have provided telephone lines and this has been associated with significant reduction in the completed suicide in the elderly (Fischer R et al. 2003) To return to specific nursing interventions, one can also suggest measures aimed at reducing access to, or availability of the means for suicide such as restricting access to over the counter medicines.(Slog I et al. 1996), Some sources (Castell H 2000) point to the possibility of introducing opportunistic screening in the primary healthcare setting. The rationale behind this suggestion is the realisation that there is high level of contact between the suicidal elderly person and their primary healthcare team in the week before suicide (20-50%) and in the month before suicide (40-70% make contact). This is particularly appropriate to our considerations here because of the progressively increasing significance of the role of the nurse within the primary healthcare team particularly at the first point of contact. (Houston, Ret al. 2002) The evidence base for this point of view is strengthened by reference to the landmark Gotland study (Ruts W et al. 1989) which examined the effect of specific training in suicide awareness and prevention in the primary healthcare team by providing extensive suicide awareness training and measures to increase the facilitation of opportunistic screening of the population. Prior to the intervention, the authors noted that, when compared to young adults, the elderly were only 6% as likely to be asked about suicide and 20% as likely to be asked if they felt depressed and 25% as likely to be referred to mental health specialist. This balance was restored almost to normality after the intervention. Suicide in the elderly is a multifaceted and complex phenomenon. It appears to be the case that the elderly tend to be treated with different guidelines from the young suicidal patient insofar as the increased risk is not met with increased assistance. (Kouras L et al.2002). We have presented evidence that the factors included in this discrepancy may include the higher overall number of young suicides, the higher economic burden that society appears to carry for each young suicide together with ageist beliefs about the factors concerning suicide in the elderly. From the point of view of nursing intervention, both in a hospital and in a community setting, there should be greater emphasis placed on measures such as screening and prevention programmes targeted at the at-risk elderly. There is equally a need for aggressive intervention if depression or suicidal feelings are overtly expressed, particularly in the relevant subgroups where additional risk factors may be active, for example those with comorbid medical conditions or social isolation or recent bereavement. (Harwood D et al. 2001), Many of the elderly spend their last years in some form of sheltered accommodation, whether this is a nursing home, a hospital, warden assisted housing or being cared for by the family. (Haut B J et al.1999) In the vast majority of cases this is associated with a loss of independence, increasing frailty and an increasing predisposition to illness that comes with increasing age. (Juurlink D N et al. 2004).This loss of independence and increasing predisposition to illness is also associated with depressive illnesses of varying degrees. (Bruce ML et al. 2002). These patients are arguably, by a large, more likely to come into contact with the nurses in the community. (Munson M L 1999)The comments that we have made elsewhere relating to the nurse’s role in being aware of the implications for the depressed elderly patient are particularly appropriate in this demographic subgroup. As a general rule, it may be easier to keep a watchful eye on patients who are exhibiting early signs of depressive illness or mood disorder in this situation by making arrangements to visit on a regular basis or on â€Å"significant anniversaries† such as the death of a spouse or a wedding anniversary. (Nagatomo I et al. 1998) when the risk factors for suicide increase dramatically (Schonberg H C et al. 1998) The literature in this area is quite extensive and covers many of the aspects of suicide in the elderly. It is noticeable however, that there is a great deal of literature on the subject of risk factors and associations of suicide together with plenty of papers which quote statistics that relate the various trends and incidences. There are, by comparison, only a few papers which emphasise and reflect on the positive aspects of nursing care. The positive steps that can be taken by the nursing profession specifically to help to minimise the burden of suicidal morbidity. There is clearly scope for studies in areas such as the impact that a dedicated community nurse might have on the levels of depression in the community if regular visits were timetabled. It is fair to observe that the community mental health nurses fulfil this role to a degree, but are severely hampered in most cases by sheer weight of numbers in the caseload. (Mason T et al. 2003) Having made these observations, we must conclude that there appears tube an overwhelming case for opportunistic screening of the at risk elderly at any point of contact with a healthcare professional. It is part of the professional remit of any nurse to disseminate their specific professional learning with others. (Yuri H et al. 1998). This can either be done on an informal professional basis in terms of mentorship or, if appropr

From a Dream to Reality Essay -- Teaching Education Essays

From a Dream to Reality When I decided to go back to school my objective was not only to increase my knowledge and receive a degree, but I decided that the only profession for me to pursue would be to earn a degree in teaching. Not because a business or computer degree would be out of my grasp, I can learn anything necessary to do a job, but because by earning a degree in teaching I would be able to fulfill a dream of mine that I had held since my own days in school. I want to be able to help children reach for the dreams in their lives. That is the reason that I have begun this program of study, to fulfill my life ambitions of becoming a teacher so that I can help inspire children to reach for their dreams that they are holding. Even though I’m starting college with this plan of being a teacher later than my colleges, I will be able to help them and my future students by sharing my life experiences that have occurred so far. I have always had a way with children, they seem to be comfortable around me and I like taking the time to listen and talk to them so that they are able to express what is on their mind. I believe that by being an available positive role model to them in their elementary school years I can make a difference in their life. Children are very special and I believe that it takes someone that is more interested in helping the child than in their job or the paycheck, to help make a child to succeed. The time I have had in life to observe people it has become apparent to me that if a child is not succeeding in school, there is a very good chance that as an adult, they will not succeed either. Though if that child has a positive role model in their life this may increase that child’s success rate. When that ch... ...e best role model for them. By being from a low-income family of seven children and being male I did not receive the encouragement that I needed to go to college. I was more or less told to graduate from high school and get a job. But I never let my dream die because I needed more out of life than a job. With this background I can show my students that they can achieve their goals. Obtaining or completing a degree in teaching is more than going to college and getting a degree. It is a profession that has a purpose, and that purpose is to help other people, and for me those people are children, to help them become whatever it is that they dream. To make this happen I will not only have teach them, but also to learn from them and help them learn from the world. By doing this I will become one of many excellent teachers who have helped me reach for my dream.

Internet Essay -- essays research papers

How to use Internet as a management resource? Introduction: Internet is a global network, connecting thousands of host servers worldwide. The United States Department of Defense established it in the beginning of the 1960 ¡Ã‚ ¯s. Today, there are now 10 to 20 million people using an Internet comprised of more than 30,000 networks spread out over 78 nations all over the world. Now the Internet has become a great electronic gateway that provides instant access to global news and information. The databases, documents, files, and programs that are  ¡Ã‚ °sitting ¡Ã‚ ± on Internet computers contain a tremendous amount of information. You can search for and find up-to-the-minute stock market activity, weather reports, music, recipe; you can make free long distance call; you can purchase goods; you can chat and see your friends. It seems you can do any thing you want. In order to cope with increasing competition, the managers have always effort to gain a competitive advantage throughout the implementation of Internet. So the fundamental purpose of our report is to outline the effective ways associated with the implementation of Internet that can help managers to improve their performance. Our report would like to discuss the effective ways for managers to use Internet in three aspects. The first is how managers can compete in the business world through searching and monitoring external information by using Internet. The second aspect is how managers can approach specific kno...

Managing Exam Stress Essays -- Coping With Exam Stress

Define stress: Stress is the body’s natural response to a threatening situation, and stress causes the release of hormones such as adrenaline, that prepare the body for its instinctual response to a threat: flight, fight or freeze. The adrenaline causes processes in your body to change, for example, your breathing and heart rate quicken, your senses sharpen, muscles tighten and your blood pressure is raised. These changes allow your reaction time to increase, which could mean the difference between life and death. However, many people, including students, live in stressful situations every day, and this has a negative effect of their health. Factors causing exam-related stress: One of the main causes of exam-related stress is the pressure on students to excel in the exams academically. Pressure can be placed on the student by family or friends, as well as by the student themselves. Pressure placed on the student by family members is often the result of parents wanting their children to achieve better results than they did, causing unnecessary stress on the student. Fear of disappointing family members also causes high levels of stress for the student. Certain expectations are held of students by their parents, such as being accepted into a certain high-school or tertiary institution. These expectations can be unrealistic and not be based on the student’s strengths and weaknesses. These expectations can also create pressure on the student to meet his parents’ expectations, which creates feelings of inadequacy when they can’t be met. Pressure is also placed on a student by himself. The student believes that in order to be a good student, they have to do well at school all the time. If the student wants to achieve a certa... ...and-depression-in-children/493_4525/causes-of-exam-stress-in-children.html ï  ¾ http://brainconnection.positscience.com/tests-stress-problems-for-students/ ï  ¾ http://www.kidshelp.com.au/grownups/news-research/hot-topics/exam-stress.php ï  ¾ http://developingchild.harvard.edu/topics/science_of_early_childhood/toxic_stress_response/ ï  ¾ http://www.themaneater.com/stories/2009/5/8/final-exams-causes-students-have-stress-bad-habits/ ï  ¾ http://education.jhu.edu/PD/newhorizons/strategies/topics/Keeping%20Fit%20for%20Learning/stress.html ï  ¾ http://www.15minutes4me.com/article/stress-how-does-stress-tension-affects-teenagers/ ï  ¾ http://www.guidetostressmanagement.com/effects-of-stress/effects-of-stress-on-teens.html ï  ¾ http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/Coping-with-exam-stress.aspx ï  ¾ http://www.bbc.co.uk/radio1/advice/factfile_az/exams_stress

Money Does Not Bring Happiness

There’s an opinion which says that money brings happiness. Some people agree with it, others not. The discussion has lasted for a long time and still there are different points of view about it. Nowadays, we can divide our society into two groups of people: those whose life is centered around money and others who know that there are more important things than being rich. The latter are aware that wealthy people often aren’t able to have a real friend.People who surround the wealthy, are only expecting for themselves. Moreover, there are people who believe that money can be a medicine for everything. But they make a mistake, as no sum of cash can prevent us from old age, loneliness, diseases, accidents, death or stuff like this. And it’s useful to remember that money is a fragile thing, which we can lose at any time. In addition, wealth makes people less sensitive. They aren’t able to notice both poverty, which is around them, and needs of others.However, m oney is the basic means, which lets people make their dreams come true – the dreams, which have been unavailable since one’s childhood, like travelling all over the world or buying a villa, that’s all to compensate a misery of someone’s childhood. Thanks to having money it’s easier in our life to establish ourselves. Cash can be helpful in achieving many goals like finishing our education. What’s more, money lets us buy basic products which are essential to our daily existence.Human can’t live without eating. We have to be able to earn some money to dress up properly. To sum up the issue is far from solving but it seems that even though money is useful to life we can’t buy the most important things – love or friendship. I think that human has to use money in proper way, without harming others. However, I presume that words: â€Å"Money doesn’t bring happiness† can’t exist in present world, because ev erything circles around money.

AP European History

However, the Soviet union established a scalded unionism regime that did not adhere to the Ideologies In which communism was oral signally created, which was to serve the masses. This form of communism failed in countries such as P land, Czechoslovakia. And Hungary. The original intent of communism was meant to have a classless society. However, the e soviet communist parties did not actually achieve that. As Molotov Dismissal wrote In The New Class, â€Å"The exclusive, if unwritten, law that only party members can become policeman, officers, diplomats, and only they can exercise actual authority, creates a special privileged group of bureaucrat TTS. The unofficial class of bureaucrats defied the true meaning of communism. Communists rulers cream Ted an illusion that was named communism, but In its basis, was not communism whatsoever. Soviet communists used their privileges to create a class that pushed the everyday cit Zen further down and limited the progress an individual can ma ke. The everyday citizen was force deed to live a life where they wake up, work, go home, eat, and sleep. The citizens were stripped down t o their basic necessities that were sometimes even rejected.Croatian columnist, Slovenia Dreadful , wrote how, Every mother in Bulgaria can point to where communism failed, from the failure of t he planned economy. To the lack of apartments, child care facilities, clothes, disposable diapers, or toilet paper. † The communist did not provide all the necessities for people to live comfortably. Still, kept suppressing the lower class, while the bureaucrats lived comfortably. Communism m was never meant to have a society in which an individual is held back from their necessities. Yet , The soviet communists repressed many necessities and civil rights which included freedom of s beech and public expression.Vocal Have, president of Czechoslovakia, spoke in his New Year's Day Address of 199 how, â€Å"Our country is not flourishing. The great cr eative and spiritual potential of our nation is not being applied meaningfully. † Have perfectly understood that communism withheld a lot of their creativity by not allowing people to freely express themselves. He even mentioned how, â€Å"The state, which calls itself a state of workers, is humiliating and exploiting them instead. † Communist worked pee pole extremely hard for a low wage â€Å"producing things for there is no demand while we are in short o f things we need. †Soviet communists took advantage of the power they had over the citizens and used t hat power to enlarge the gap between leaders of the communist party and the people being ruled According to a Croatian columnist, Slovenia Dramatic, â€Å"the banality of everyday life is where it [communism] really failed, rather than on the level of ideology. † The communist party did not provide enough services for the people which caused the people be opposed to communism. Without the support of th e people, communism was bound to fail. People are what makes the sees once of government. Without people, there would be no government.The Soviet government did not make life or the everyday citizen to feel as though they were being heard or included into all the e decisions that were being made by the government every day. Without a classless society, honest rulers, or support from the ruled, communism in t he Soviet Union set itself up for failure. The citizens of the eastern European socialist states ha d no right to go through life under communist rule by the Soviets. Communism did not improve the e economy, or unify the states. Communism actually did the opposite; it impoverished the countries and s operated the states. AP European History However, the Soviet union established a scalded unionism regime that did not adhere to the Ideologies In which communism was oral signally created, which was to serve the masses. This form of communism failed in countries such as P land, Czechoslovakia. And Hungary. The original intent of communism was meant to have a classless society. However, the e soviet communist parties did not actually achieve that. As Molotov Dismissal wrote In The New Class, â€Å"The exclusive, if unwritten, law that only party members can become policeman, officers, diplomats, and only they can exercise actual authority, creates a special privileged group of bureaucrat TTS. The unofficial class of bureaucrats defied the true meaning of communism. Communists rulers cream Ted an illusion that was named communism, but In its basis, was not communism whatsoever. Soviet communists used their privileges to create a class that pushed the everyday cit Zen further down and limited the progress an individual can ma ke. The everyday citizen was force deed to live a life where they wake up, work, go home, eat, and sleep. The citizens were stripped down t o their basic necessities that were sometimes even rejected.Croatian columnist, Slovenia Dreadful , wrote how, Every mother in Bulgaria can point to where communism failed, from the failure of t he planned economy. To the lack of apartments, child care facilities, clothes, disposable diapers, or toilet paper. † The communist did not provide all the necessities for people to live comfortably. Still, kept suppressing the lower class, while the bureaucrats lived comfortably. Communism m was never meant to have a society in which an individual is held back from their necessities. Yet , The soviet communists repressed many necessities and civil rights which included freedom of s beech and public expression.Vocal Have, president of Czechoslovakia, spoke in his New Year's Day Address of 199 how, â€Å"Our country is not flourishing. The great cr eative and spiritual potential of our nation is not being applied meaningfully. † Have perfectly understood that communism withheld a lot of their creativity by not allowing people to freely express themselves. He even mentioned how, â€Å"The state, which calls itself a state of workers, is humiliating and exploiting them instead. † Communist worked pee pole extremely hard for a low wage â€Å"producing things for there is no demand while we are in short o f things we need. †Soviet communists took advantage of the power they had over the citizens and used t hat power to enlarge the gap between leaders of the communist party and the people being ruled According to a Croatian columnist, Slovenia Dramatic, â€Å"the banality of everyday life is where it [communism] really failed, rather than on the level of ideology. † The communist party did not provide enough services for the people which caused the people be opposed to communism. Without the support of th e people, communism was bound to fail. People are what makes the sees once of government. Without people, there would be no government.The Soviet government did not make life or the everyday citizen to feel as though they were being heard or included into all the e decisions that were being made by the government every day. Without a classless society, honest rulers, or support from the ruled, communism in t he Soviet Union set itself up for failure. The citizens of the eastern European socialist states ha d no right to go through life under communist rule by the Soviets. Communism did not improve the e economy, or unify the states. Communism actually did the opposite; it impoverished the countries and s operated the states.

Lewiss Next

The power of the internet has catapulted the information boom among different societies since its emancipation. Its capabilities and power has shifted the realm of information access and potentials not only to several professionals but also to ordinary individuals. With this, such power has been affecting different practices and ideas that are often emanate direct and/or indirect outcomes. As information becomes more and more open to the public, the The book of Lewiss entitled ‘Next’ seeks to cater the unexpected occurrences and events that the Internet boom has created in societies. Such idea can be associated and compared to the story of the â€Å"Emperor’s New Clothes†. With such book and Han’s Christian Anderson’s short story, several overlapping ideas can be observed and seen. One is that there are instances of the relevant and current situations that are taken advantage by people due to society’s tolerance to such actions. (Yourdon, p.1) argues that â€Å"Lewis is obviously aware of the collapse of the dot-com stock market, and the backlash caused by that collapse; indeed, he argues that many of us have become so jaded and cynical that we're missing the deeper and long-lasting impact of the Internet.† Such idea also applies in the other story wherein citizens know that the emperor is addicted to changing his clothes every time and tolerates such idea. Commenting on this overlapping situation, it can be argued that no good true idea or scene lasts forever. Every action or situation has their corresponding loopholes that will take its toll in the future. Yes, there are positive benefits of these ideas in the promotion of something important however; there will come a time that such actions and ideas will become weak or vulnerable to different attacks left and right. Such issues have been elaborated by Lewis in his book and at the same time the two scoundrels who took advantage of the emperor’s addiction to clothes.   There must be continuous improvements and changes so as to prevent such things from happening. On the other hand, there seems to be a difference between the two. Since the introduction of the internet, it has become a necessity among individuals. This continuously applies up to now, as societies become more and more connected. The possibility of changes in this area remains to be difficult due to societies continued tolerance and dependency on the internet. The quote of Lewiss clearly shows the how society and individuals are willing to sacrifice and tolerate the status quo for the sake of increased convenience since the introduction of the information boom – the internet. The examples of Lewiss clearly showcase the ‘termites’ he is referring to. The internet had served its purpose of providing sufficient and added information with relative convenience among users. However, the unexpected consequences and subculture it creates often create discrepancies within the core of why it was created after all. These unexpected outcomes, instead of being reprimanded and stopped are being tolerated by society itself on the justification of freedom. It may be the case that people especially the older generations have underestimated the power that the Internet shall create in the future. Yes, the intention and objectives were in-line to the positive aspects. However, the younger generations are using it as a tool to further their cause which most of the time connotes something extraordinary or ‘radical’ in such manner. The most probable solution to such dilemma is creating and digging deep into the very foundations of why it was created in the first place. Then propose solutions that can help the process without compromising convenience brought about by the Internet. To conclude, the Internet and information boom has created several unexpected outcomes that in a way society tolerates. There must a consensus among different groups and societies in combating this issue. The internet was meant to be used in such a way that it will create convenience among individuals. It might be good sticking to that objective and nothing else. Work Cited Yourdon, Ed. ‘Next: the Future Just Happened’ in yourdon.com/personal n.d. accessed February 1, 2008 from ;http://www.yourdon.com/personal/books/gentech/next.html;

The Twilight Saga 2: New Moon Chapter 7 REPETITION

I WASN'T SURE WHAT THE HELL I WAS DOING HERE Was I trying to push myself back into the zombie stupor? Had I turned masochisticdeveloped a taste for torture? I should have gone straight down to La Push I felt much, much healthier around Jacob This was not a healthy thing to do. But I continued to drive slowly down the overgrown lane, twisting through the trees that arched over me like a green, living tunnel My hands were shaking, so I tightened my grip on the steering wheel. I knew that part of the reason I did this was the nightmare, now that I was really awake, the nothingness of the dream gnawed on my nerves, a dog worrying a bone. There was something to search for. Unattainable and impossible, uncaring and distracted but he was out there, somewhere. I had to believe that. The other part was the strange sense of repetition I'd felt at school today, the coincidence of the date. The feeling that I was starting overperhaps the way my first day would have gone if I'd really been the most unusual person in the cafeteria that afternoon. The words ran through my head, tonelessly, like I was reading them rather than hearing them spoken: It will be as if I'd never existed. I was lying to myself by splitting my reason for coming here into just two parts. I didn't want to admit the strongest motivation. Because it was mentally unsound. The truth was that I wanted to hear his voice again, like I had in the strange delusion Friday night. For that brief moment, when his voice came from some other part of me than my conscious memory, when his voice was perfect and honey smooth rather than the pale echo my memories usually produced, I was able to remember without pain. It hadn't lasted; the pain had caught up with me, as I was sure it would for this fool's errand. But those precious moments when I could hear him again were an irresistible lure. I had to find some way to repeat the experience or maybe the better word was episode. I was hoping that dj vu was the key. So I was going to his home, a place I hadn't been since my ill-fated birthday party, so many months ago. The thick, almost jungle-like growth crawled slowly past my windows. The drive wound on and on. I started to go faster, getting edgy. How long had I been driving? Shouldn't I have reached the house yet? The lane was so overgrown that it did not look familiar. What if I couldn't find it? I shivered. What if there was no tangible proof at all? Then there was the break in the trees that I was looking for, only it was not so pronounced as before. The flora here did not wait long to reclaim any land that was left unguarded. The tall ferns had infiltrated the meadow around the house, crowding against the trunks of the cedars, even the wide porch. It was like the lawn had been floodedwaist-highwith green, feathery waves. And the house was there, but it was not the same. Though nothing had changed on the outside, the emptiness screamed from the blank windows. It was creepy. For the first time since I'd seen the beautiful house, it looked like a fitting haunt for vampires. I hit the brakes, looking away. I was afraid to go farther. But nothing happened. No voice in my head. So I left the engine running and jumped out into the fern sea. Maybe, like Friday night, if I walked forward I approached the barren, vacant face slowly, my truck rumbling out a comforting roar behind me. I stopped when I got to the porch stairs, because there was nothing here. No lingering sense of their presence of his presence. The house was solidly here, but it meant little. Its concrete reality would not counteract the nothingness of the nightmares. I didn't go any closer. I didn't want to look in the windows. I wasn't sure which would be harder to see. If the rooms were bare, echoing empty from floor to ceiling, that would certainly hurt. Like my grandmother's funeral, when my mother had insisted that I stay outside during the viewing. She had said that I didn't need to see Gran that way, to remember her that way, rather than alive. But wouldn't it be worse if there were no change? If the couches sat just as I'd last seen them, the paintings on the wallsworse still, the piano on its low platform? It would be second only to the house disappearing all together, to see that there was no physical possession that tied them in anyway. That everything remained, untouched and forgotten, behind them. Just like me. I turned my back on the gaping emptiness and hurried to my truck. I nearly ran. I was anxious to be gone, to get back to the human world. I felt hideously empty, and I wanted to see Jacob. Maybe I was developing a new kind of sickness, another addiction, like the numbness before. I didn't care. I pushed my truck as fast as it would go as I barreled toward my fix. Jacob was waiting for me. My chest seemed to relax as soon as I saw him, making it easier to breathe. â€Å"Hey, Bella,† he called. I smiled in relief. â€Å"Hey, Jacob,† I waved at Billy, who was looking out the window. â€Å"Let's get to work,† Jacob said in a low but eager voice. I was somehow able to laugh. â€Å"You seriously aren't sick of me yet?† I wondered. He must be starting to ask himself how desperate I was for company. Jacob led the way around the house to his garage. â€Å"Nope. Not yet.† â€Å"Please let me know when I start getting on your nerves. I don't want to be a pain.† â€Å"Okay.† He laughed, a throaty sound. â€Å"I wouldn't hold your breath for that, though.† When I walked into the garage, I was shocked to see the red bike standing up, looking like a motorcycle rather than a pile of jagged metal. â€Å"Jake, you're amazing,† I breathed. He laughed again. â€Å"I get obsessive when I have a project.† He shrugged. â€Å"If I had any brains I'd drag it out a little bit.† â€Å"Why?† He looked down, pausing for so long that I wondered if he hadn't heard my question. Finally, he asked me, â€Å"Bella, if I told you that I couldn't fix these bikes, what would you say?† I didn't answer right away, either, and he glanced up to check my expression. â€Å"I would say that's too bad, but I'll bet we could figure out something else to do. If we got really desperate, we could even do homework.† Jacob smiled, and his shoulders relaxed. He sat down next to the bike and picked up a wrench. â€Å"So you think you'll still come over when I'm done, then?† â€Å"Is that what you meant?† I shook my head. â€Å"I guess I am taking advantage of your very underpriced mechanical skills. But as long as you let me come over, I'll be here.† â€Å"Hoping to see Quil again?† he teased. â€Å"You caught me.† He chuckled. â€Å"You really like spending time with me?† he asked, marveling. â€Å"Very, very much. And I'll prove it. I have to work tomorrow, but Wednesday we'll do something nonmechanical.† â€Å"Like what?† â€Å"I have no idea. We can go to my place so you won't be tempted to be obsessive. You could bring your schoolworkyou have to be getting behind, because I know I am.† â€Å"Homework might be a good idea.† He made a face, and I wondered how much he was leaving undone to be with me. â€Å"Yes,† I agreed. â€Å"We'll have to start being responsible occasionally, or Billy and Charlie aren't going to be so easygoing about this.† I made a gesture indicating the two of us as a single entity. He liked thathe beamed. â€Å"Homework once a week?† he proposed. â€Å"Maybe we'd better go with twice,† I suggested, thinking of the pile I'd just been assigned today. He sighed a heavy sigh. Then he reached over his toolbox to a paper grocery sack. He pulled out two cans of soda, cracking one open and handing it to me. He opened the second, and held it up ceremoniously. â€Å"Here's to responsibility,† he toasted. â€Å"Twice a week.† â€Å"And recklessness every day in between,† I emphasized. He grinned and touched his can to mine. I got home later than I'd planned and found Charlie had ordered a pizza rather than wait for me. He wouldn't let me apologize. â€Å"I don't mind,† he assured me. â€Å"You deserve a break from all the cooking, anyway.† I knew he was just relieved that I was still acting like a normal person, and he was not about to rock the boat. I checked my e-mail before I started on my homework, and there was a long one from Renee. She gushed over every detail I'd provided her with, so I sent back another exhaustive description of my day. Everything but the motorcycles. Even happy-go-lucky Renee was likely to be alarmed by that. School Tuesday had its ups and downs. Angela and Mike seemed ready to welcome me back with open armsto kindly overlook my few months of aberrant behavior. Jess was more resistant. I wondered if she needed a formal written apology for the Port Angeles incident. Mike was animated and chatty at work. It was like he'd stored up the semester's worth of talk, and it was all spilling out now. I found that I was able to smile and laugh with him, though it wasn't as effortless as it was with Jacob. It seemed harmless enough, until quitting time. Mike put the closed sign in the window while I folded my vest and shoved it under the counter. â€Å"This was fun tonight,† Mike said happily. â€Å"Yeah,† I agreed, though I'd much rather have spent the afternoon in the garage. â€Å"It's too bad that you had to leave the movie early last week.† I was a little confused by his train of thought. I shrugged. â€Å"I'm just a wimp, I guess.† â€Å"What I mean is, you should go to a better movie, something you'd enjoy,† he explained. â€Å"Oh,† I muttered, still confused. â€Å"Like maybe this Friday. With me. We could go see something that isn't scary at all.† I bit my lip. I didn't want to screw things up with Mike, not when he was one of the only people ready to forgive me for being crazy. But this, again, felt far too familiar. Like the last year had never happened. I wished I had Jess as an excuse this time. â€Å"Like a date?† I asked. Honesty was probably the best policy at this point. Get it over with. He processed the tone of my voice â€Å"If you want. But it doesn't have to be like that.† â€Å"I don't date,† I said slowly, realizing how true that was. That whole world seemed impossibly distant. â€Å"Just as friends?† he suggested. His clear blue eyes were not as eager now. I hoped he really meant that we could be friends anyway. â€Å"That would be fun. But I actually have plans already this Friday, so maybe next week?† â€Å"What are you doing?† he asked, less casually than I think he wanted to sound. â€Å"Homework. I have a study session planned with a friend.† â€Å"Oh. Okay. Maybe next week.† He walked me to my car, less exuberant than before. It reminded me so clearly of my first months in Forks. I'd come full circle, and now everything felt like an echoan empty echo, devoid of the interest it used to have. The next night, Charlie didn't seem the smallest bit surprised to find Jacob and me sprawled across the living room floor with our books scattered around us, so I guessed that he and Billy were talking behind our backs. â€Å"Hey, kids,† he said, his eyes straying to the kitchen. The smell of the lasagna I'd spent the afternoon makingwhile Jacob watched and occasionally sampledwafted down the hall; I was being good, trying to atone for all the pizza. Jacob stayed for dinner, and took a plate home for Billy. He grudgingly added another year to my negotiable age for being a good cook. Friday was the garage, and Saturday, after my shift at Newton's, was homework again. Charlie felt secure enough in my sanity to spend the day fishing with Harry. When he got back, we were all donefeeling very sensible and mature about it, tooand watching Monster Garage on the Discovery Channel. â€Å"I probably ought to go.† Jacob sighed. â€Å"It's later than I thought.† â€Å"Okay, fine,† I grumbled. â€Å"I'll take you home.† He laughed at my unwilling expressionit seemed to please him. â€Å"Tomorrow, back to work,† I said as soon as we were safe in the truck. â€Å"What time do you want me to come up?† There was an unexplained excitement in his answering smile. â€Å"I'll call you first, okay?† â€Å"Sure.† I frowned to myself, wondering what was up. His smile widened. I cleaned the house the next morningwaiting for Jacob to call and trying to shake off the Litest nightmare. The scenery had changed. Last night I'd wandered in a wide sea of ferns interspersed with huge hemlock trees. There was nothing else there, and I was lost, wandering aimless and alone, searching for nothing. I wanted to kick myself for the stupid field trip last week. I shoved the dream out of my conscious mind, hoping it would stay locked up somewhere and not escape again. Charlie was outside washing the cruiser, so when the phone rang, I dropped the toilet brush and ran downstairs to answer it. â€Å"Hello?† I asked breathlessly. â€Å"Bella,† Jacob said, a strange, formal tone to his voice. â€Å"Hey, Jake.† â€Å"I believe that we have a date† he said, his tone thick with implications. It took me a second before I got it. â€Å"They're done? I can't believe it!† What perfect timing. I needed something to distract me from nightmares and nothingness. â€Å"Yeah, they run and everything.† â€Å"Jacob, you are absolutely, without a doubt, the most talented and wonderful person I know. You get ten years for this one.† â€Å"Cool! I'm middle-aged now.† I laughed. â€Å"I'm on my way up!† I threw the cleaning supplies under the bathroom counter and grabbed my jacket. â€Å"Headed to see Jake,† Charlie said when I ran past him. It wasn't really a question. â€Å"Yep,† I replied as I jumped in my truck. â€Å"I'll be at the station later,† Charlie called after me. â€Å"Okay,† I yelled back, turning the key. Charlie said something else, but I couldn't hear him clearly over the roar of the engine. It sounded sort of like, â€Å"Where's the fire?† I parked my truck off to the side of the Blacks' house, close to the trees, to make it easier for us to sneak the bikes out. When I got out, a splash of color caught my eyetwo shiny motorcycles, one red, one black, were hidden under a spruce, invisible from the house. Jacob was prepared. There was a piece of blue ribbon tied in a small bow around each of the handlebars. I was laughing at that when Jacob ran out of the house. â€Å"Ready?† he asked in a low voice, his eyes sparkling. I glanced over his shoulder, and there was no sign of Billy. â€Å"Yeah,† I said, but I didn't feel quite as excited as before; I was trying to imagine myself actually on the motorcycle. Jacob loaded the bikes into the bed of the truck with ease, laying them carefully on their sides so they didn't show. â€Å"Let's go,† he said, his voice higher than usual with excitement. â€Å"I know the perfect spotno one will catch us there.† We drove south out of town. The dirt road wove in and out of the forestsometimes there was nothing but trees, and then there would suddenly be a breathtaking glimpse of the Pacific Ocean, reaching to the horizon, dark gray under the clouds. We were above the shore, on top of the cliffs that bordered the beach here and the view seemed to stretch on forever. I was driving slowly, so that I could safely stare out across the ocean now and then, as the road wound closer to the sea cliffs. Jacob was talking about finishing the bikes, but his descriptions were getting technical, so I wasn't paying close attention. That was when I noticed four figures standing on a rocky ledge, much too close to the precipice. I couldn't tell from the distance how old they were, but I assumed they were men. Despite the chill in the air today, they seemed to be wearing only shorts. As I watched, the tallest person stepped closer to the brink. I slowed automatically, my foot hesitating over the brake pedal. And then he threw himself off the edge. â€Å"No!† I shouted, stomping down on the brake. â€Å"What's wrong?† Jacob shouted back, alarmed. â€Å"That guyhe just jumped off the cliff! Why didn't they stop him? We've got to call an ambulance!† I threw open my door and started to get out, which made no sense at all. The fastest way to a phone was to drive back to Billy's. But I couldn't believe what I'd just seen. Maybe, subconsciously, I hoped I would see something different without the glass of the windshield in the way. Jacob laughed, and I spun to stare at him wildly. How could he be so calloused, so cold-blooded? â€Å"They're just cliff diving, Bella. Recreation. La Push doesn't have a mall, you know.† He was teasing, but there was a strange note of irritation in his voice. â€Å"Cliff diving?† I repeated, dazed. I stared in disbelief as a second figure stepped to the edge, paused, and then very gracefully leaped into space. He fell for what seemed like an eternity to me, finally cutting smoothly into the dark gray waves below. â€Å"Wow. It's so high.† I slid back into my seat, still staring wide-eyed at the two remaining divers. â€Å"It must be a hundred feet.† â€Å"Well, yeah, most of us jump from lower down, that rock that juts out from the cliff about halfway.† He pointed out his window. The place he indicated did seem much more reasonable. â€Å"Those guys are insane. Probably showing off how tough they are. I mean, really, it's freezing today. That water can't feel good.† He made a disgruntled face, as if the stunt personally offended him. It surprised me a little. I would have thought Jacob was nearly impossible to upset. â€Å"You jump off the cliff?† I hadn't missed the â€Å"us.† â€Å"Sure, sure.† He shrugged and grinned. â€Å"It's fun. A little scary, kind of a rush.† I looked back at the cliffs, where the third figure was pacing the edge. I'd never witnessed anything so reckless in all my life. My eyes widened, and I smiled. â€Å"Jake, you have to take me cliff diving.† He frowned back at me, his face disapproving. â€Å"Bella, you just wanted to call an ambulance for Sam,† he reminded me. I was surprised that he could tell who it was from this distance. â€Å"I want to try,† I insisted, start ing to get out of the car again. Jacob grabbed my wrist. â€Å"Not today, all right? Can we at least wait for a warmer day?† â€Å"Okay, fine,† I agreed. With the door open, the glacial breeze was raising goose bumps on my arm. â€Å"But I want to go soon.† â€Å"Soon.† He rolled his eyes. â€Å"Sometimes you're a little strange, Bella. Do you know that?† I sighed. â€Å"Yes.† â€Å"And we're not jumping off the top.† I watched, fascinated, as the third boy made a running start and flung himself farther into the empty air than the other two. He twisted and cartwheeled through space as he fell, like he was skydiving. He looked absolutely freeunthinking and utterly irresponsible. â€Å"Fine,† I agreed. â€Å"Not the first time, anyway.† Now Jacob sighed. â€Å"Are we going to try out the bikes or not?† he demanded. â€Å"Okay, okay,† I said, tearing my eyes away from the last person waiting on the cliff. I put my seat belt back on and closed the door. The engine was still running, roaring as it idled. We started down the road again. â€Å"So who were those guysthe crazy ones?† I wondered. He made a disgusted sound in the back of his throat. â€Å"The La Push gang.† â€Å"You have a gang?† I asked. I realized that I sounded impressed. He laughed once at my reaction. â€Å"Not like that. I swear, they're like hall monitors gone bad. They don't start fights, they keep the peace.† He snorted. â€Å"There was this guy from up somewhere by the Makah rez, big guy too, scary-looking. Well, word got around that he was selling meth to kids, and Sam Uley and his disciples ran him off our land. They're all about our land, and tribe pride it's getting ridiculous. The worst part is that the council takes them seriously. Embry said that the council actually meets with Sam.† He shook his head, face full of resentment. â€Å"Embry also heard from Leah Clearwater that they call themselves ‘protectors' or something like that.† Jacob's hands were clenched into fists, as if he'd like to hit something. I'd never seen this side of him. I was surprised to hear Sam Uley's name. I didn't want it to bring back the images from my nightmare, so I made a quick observation to distract myself. â€Å"You don't like them very much.† â€Å"Does it show?† he asked sarcastically. â€Å"Well It doesn't sound like they're doing anything bad.† I tried to soothe him, to make him cheerful again. â€Å"Just sort of annoyingly goody-two-shoes for a gang.† â€Å"Yeah. Annoying is a good word. They're always showing offlike the cliff thing. They act like like, I don't know. Like tough guys. I was hanging out at the store with Embry and Quil once, last semester, and Sam came by with his followers, Jared and Paul. Quil said something, you know how he's got a big mouth, and it pissed Paul off. His eyes got all dark, and he sort of smiledno, he showed his teeth but he didn't smileand it was like he was so mad he was shaking or something. But Sam put his hand against Paul's chest and shook his head. Paul looked at him for a minute and calmed down. Honestly, it was like Sam was holding him backlike Paul was going to tear us up if Sam didn't stop him.† He groaned. â€Å"Like a bad western. You know, Sam's a pretty big guy, he's twenty. But Paul's just sixteen, too, shorter than me and not as beefy as Quil. I think any one of us could take him.† â€Å"Tough guys,† I agreed. I could see it in my head as he described it, and it reminded me of something a trio of tall, dark men standing very still and close together in my father's living room. The picture was sideways, because my head was lying against the couch while Dr. Gerandy and Charlie leaned over me Had that been Sam's gang? I spoke quickly again to divert myself from the bleak memories. â€Å"Isn't Sam a little too old for this kind of thing?† â€Å"Yeah. He was supposed to go to college, but he stayed. And no one gave him any crap about it, either. The whole council pitched a fit when my sister turned down a partial scholarship and got married. But, oh no, Sam Uley can do no wrong.† His face was set in unfamiliar lines of outrageoutrage and something else I didn't recognize at first. â€Å"It all sounds really annoying and strange. But I don't get why you're taking it so personally.† I peeked over at his face, hoping I hadn't offended him. He was suddenly calm, staring out the side window. â€Å"You just missed the turn,† he said in an even voice. I executed a very wide U-turn, nearly hitting a tree as my circle ran the truck halfway off the road. â€Å"Thanks for the heads-up,† I muttered as I started up the side road. â€Å"Sorry, I wasn't paying attention.† It was quiet for a brief minute. â€Å"You can stop anywhere along here,† he said softly. I pulled over and cut the engine. My ears rang in the silence that followed. We both got out, and Jacob headed around to the back to get the bikes. I tried to read his expression. Something more was bothering him. I'd hit a nerve. He smiled halfheartedly as he pushed the red bike to my side. â€Å"Happy late birthday. Are you ready for this?† â€Å"I think so.† The bike suddenly looked intimidating, frightening, as I realized I would soon be astride it. â€Å"We'll take it slow,† he promised. I gingerly leaned the motorcycle against the truck's fender while he went to get his. â€Å"Jake†I hesitated as he came back around the truck. â€Å"Yeah?† â€Å"What's really bothering you? About the Sam thing, I mean? Is there something else?† I watched his face. He grimaced, but he didn't seem angry. He looked at the dirt and kicked his shoe against the front tire of his bike again and again, like he was keeping time. He sighed. â€Å"It's just the way they treat me. It creeps me out.† The words started to rush out now. â€Å"You know, the council is supposed to be made up of equals, but if there was a leader, it would be my dad. I've never been able to figure out why people treat him the way they do. Why his opinion counts the most. It's got something to do with his father and his father's father. My great-grandpa, Ephraim Black, was sort of the last chief we had, and they still listen to Billy, maybe because of that. â€Å"But I'm just like everyone else. Nobody treats me special until now.† That caught me off guard. â€Å"Sam treats you special?† â€Å"Yeah,† he agreed, looking up at me with troubled eyes. â€Å"He looks at me like he's waiting for something like I'm going to join his stupid gang someday. He pays more attention to me than any of the other guys. I hate it.† â€Å"You don't have to join anything.† My voice was angry. This was really upsetting Jacob, and that infuriated me. Who did these â€Å"protectors† think they were? â€Å"Yeah.† His foot kept up its rhythm against the tire. â€Å"What?† I could tell there was more. He frowned, his eyebrows pulling up in a way that looked sad and worried rather than angry. â€Å"It's Embry. He's been avoiding me lately.† The thoughts didn't seem connected, but I wondered if I was to blame for the problems with his friend. â€Å"You've been hanging out with me a lot,† I reminded him, feeling selfish. I'd been monopolizing him. â€Å"No, that's not it. It's not just meit's Quil, too, and everyone. Embry missed a week of school, but he was never home when we tried to see him. And when he came back, he looked he looked freaked out. Terrified. Quil and I both tried to get him to tell us what was wrong, but he wouldn't talk to either one of us.† I stared at Jacob, biting my lip anxiouslyhe was really frightened. But he didn't look at me. He watched his own foot kicking the rubber as if it belonged to someone else. The tempo increased. â€Å"Then this week, out of nowhere, Embry's hanging out with Sam and the rest of them. He was out on the cliffs today.† His voice was low and tense. He finally looked at me. â€Å"Bella, they bugged him even more than they bother me. He didn't want anything to do with them. And now Embry's following Sam around like he's joined a cult. â€Å"And that's the way it was with Paul. Just exactly the same. He wasn't friends with Sam at all. Then he stopped coming to school for a few weeks, and, when he came back, suddenly Sam owned him. I don't know what it means. I can't figure it out, and I feel like I have to, because Embry's my friend and Sam's looking at me funny . . and† He trailed off. â€Å"Have you talked to Billy about this?† I asked. His horror was spreading to me. I had chills running on the back of my neck. Now there was anger on his face. â€Å"Yes,† he snorted. â€Å"That was helpful.† â€Å"What did he say?† Jacob's expression was sarcastic, and when he spoke, his voice mocked the deep tones of his father's voice. â€Å"It's nothing you need to worry about now, Jacob. In a few years, if you don't well, I'll explain later.† And then his voice was his own. â€Å"What am I supposed to get from that? Is he trying to say it's some stupid puberty, coming-of-age thing? This is something else. Something wrong.† He was biting his lower lip and clenching his hands. He looked like he was about to cry. I threw my arms around him instinctively, wrapping them around his waist and pressing my face against his chest. He was so big, I felt like I was a child hugging a grown-up. â€Å"Oh, Jake, it'll be okay!† I promised. â€Å"If it gets worse you can come live with me and Charlie. Don't be scared, we'll think of something!† He was frozen for a second, and then his long arms wrapped hesitantly around me. â€Å"Thanks, Bella.† His voice was huskier than usual. We stood like that for a moment, and it didn't upset me; in fact, I felt comforted by the contact. This didn't feel anything like the last time someone had embraced me this way. This was friendship. And Jacob was very warm. It was strange for me, being this closeemotionally rather than physically, though the physical was strange for me, tooto another human being. It wasn't my usual style. I didn't normally relate to people so easily, on such a basic level. Not human beings. â€Å"If this is how you're going to react, I'll freak out more often.† Jacob's voice was light, normal again, and his laughter rumbled against my ear. His fingers touched my hair, soft and tentative. Well, it was friendship for me. I pulled away quickly, laughing with him, but determined to put things back in perspective at once. â€Å"It's hard to believe I'm two years older than you,† I said, emphasizing the word older. â€Å"You make me feel like a dwarf.† Standing this close to him, I really had to crane my neck to see his face. â€Å"You're forgetting I'm in my forties, of course.† â€Å"Oh, that's right.† He patted my head. â€Å"You're like a little doll,† he teased. â€Å"A porcelain doll.† I rolled my eyes, taking another step away. â€Å"Let's not start with the albino cracks.† â€Å"Seriously, Bella, are you sure you're not?† He stretched his russet arm out next to mine. The difference wasn't flattering. â€Å"I've never seen anyone paler than you well, except for† He broke off, and I looked away, trying to not understand what he had been about to say. â€Å"So are we going to ride or what?† â€Å"Let's do it,† I agreed, more enthusiastic than I would have been half a minute ago. His unfinished sentence reminded me of why I was here.