Thursday, July 18, 2019

Effects of Medicinal Versus Recreational Marijuana Use :: Biology Essays Research Papers

Effects of Medicinal Versus Recreational Marijuana Use Is there a difference in the psychological/healing effects between the use of "recreational" marijuana and medicinal marijuana? Before researching this question, I could not understand what difference medicinal marijuana would have on cancer patients that was not already known through previous studies on the drug. I thought I fully understood marijuana's effects on the brain until the issues of medicinal marijuana arose. Prior to the research on the subject, I assumed that much of what is known now about the drug is due to the extensive research on its affects on Cancer and AIDS patients. If the use of marijuana is controlled for therapeutic purposes, are the effects different if used regular for non-medicinal purposes? This is the question I attempt to answer through extensive web research. In the past 5 years, there has been an increased debate about the use of medicinal marijuana in treating cancer and AIDS patients. Marijuana has been used in alternative medical treatment by doctors around the country and by patients themselves who seek relief from the pain caused by cancer and AIDS. Controlled use of marijuana has been used to treat a number of diseases: "AIDS. Marijuana can reduce the nausea, vomiting, and loss of appetite caused by the ailment itself and by various AIDS medications. Glaucoma. Marijuana can reduce intraocular pressure, thereby alleviating the pain and slowing -- and sometimes stopping -- the progress of the condition. Cancer. Marijuana can stimulate the appetite and alleviate nausea and vomiting, which are common side effects of chemotherapy treatment. Multiple Sclerosis. Marijuana can limit the muscle pain and spasticity caused by the disease, as well as relieving tremor and unsteadiness of gait. Epilepsy. Marijuana can prevent epileptic seizures in some patients. Chronic Pain. Marijuana can alleviate the chronic, often debilitating pain caused by myriad disorders and injuries." (1) Institutions nationally have conducted studies on the use of medicinal marijuana on disease stricken patients. The Institute of Medicine published a journal on the use of marijuana and the effects it as a recreational drug and medicinal drug. Because the substance, when used medicinally, is monitored/controlled, the psychological effects on the patient is slightly different, and its effects also vary depending on the type of the disease the patient is suffering from. A complete report done by the National Academy of Sciences details the psychological effects of recreational and medicinal marijuana. In the 20th century, marijuana has been used more for its euphoric effects than as a medicine.

Development through the Implementation of Physical Activity to Patients Suffering from Mental Illness.

Introduction Efficient delivery of care is the essence of nursing. Being a successful nurse revolves around the capability to deliver care which contributes to the wellbeing of the patients (Barker, 2005). In exploring the efficient delivery of care to patients suffering from mental illness, this paper consists of two parts. Part One outlines the practical and theoretical aspects of my chosen Service Improvement Initiative, and Part Two focuses on my personal development plan. The Service Improvement Initiative outlines a plan that strives to create a healing environment through the use of mental and physical activities, from sports to board games as a means of providing nursing care to patients. Apart from the medical aspect of this initiative, I will also analyze the theoretical aspects of health care to determine the professional role of nurses in providing care and support that aims to contribute to the wellbeing of patients. Additionally, I intend to discuss the importance of harnessing leadership qualities, management and communication skills of nurses in order to provide high-quality patient care. Mental Health and Physical and Mind Activities In the course of my observations in a psychological ward for adolescents aged 10-17 years, I noticed that there are very little, if any, physical activities such as sports (table tennis, basketball, snooker, etc.). However, over the years, an overwhelming wealth of evidence from nursing practice and research has clearly demonstrated the benefits of such activities (Hainsworth, 2006). Researchers have established that physical activity promotes physical health and brings about physiological benefits (Department of Health, 2004b). For example, Benloucif (2004) found that daylight exercises significantly improve neurophysiological performance and sleep quality especially when they emphasize extensive duration rather than intensity. However, not only does physical activity lead to physiological benefits, but it can also generate psychological benefits such as empowerment of patients and reduction of boredom, which in turn improve clinical outcomes (Ainsworth, 2006). Another major benefit of physical activities in hospitals and wards is the creation of a social environment in which patients thrive (Frost, 2010). For example, physical activities allow service users to socialize and engage in light conversations without showing aggression towards each other (Briles, 2005). Over time, patients will learn the importance of effective communication with other people, the purpose of staying at the hospital/ward, as well as the advantages of participating in decision-making and different activities (Wilkes-Whitehall, 2004). This is particularly important for patients who are vulnerable and are in need of re-establishing their social skills in a controlled environment, such as adolescents suffering from mental illness. In fact, research has demonstrated that a warm and supportive social environment is an important factor in the etiology of mental illness, but also in the therapeutic healing process (Cohen, 2004). Physical activity, such as exercise and sports, has also been found to generally improve mental health conditions, such as anxiety, depression and general wellbeing (Schmitz, 2004). According to Strohle (2009), sports and exercise can moderately reduce anxiety and depression in mentally ill persons. Martinsen (2008) has also demonstrated that some activities (e.g. resistance, aerobic) can prevent the risk of depression. Goodwin (2003) reported the low scores of depression among adolescents as a result of engaging in exercise. Drawing on a large sample of 8,098 adolescents and adults from the ages of 15-54, Goodwin (2003) found that individuals who regularly kept themselves physically active were less depressed. Other researchers (Penedo & Dahn, 2005) have further supported the claim that exercise may be associated with therapeutic benefit among individuals with major depressive disorder. Moreover, the majority of cross-sectional studies have showed that an improved cognitive performance is related to physical fitness (Callaghan, 2004). There are implications of these findings. For example, patients who frequently engage in physical activities may become much more open to considering alternative therapies and treatments. Aside from their physiological benefits, those who participated in this exercise-therapy also showed a generally more resilient and healthier psychological state. In fact, it is well-documented that physical activities and exercise are vital in strengthening self-image and self-esteem in all age groups, especially among children and middle-aged adults (Folkins & Sime, 1981). Research has demonstrated that people who participate in physical activity have an improved self-image (Elavsky et al., 2005). As self-image is an important factor in helping patients to be less vulnerable during social re-integration, clinical outcomes are improved. Additionally, Kirkcaldy, Shephard, and Siefen (2002) presented evidence that participating in physical exercises alleviates social withdrawal, low self-esteem, and depression which are the negative symptoms of schizophrenia. Taking the above-mentioned case studies as well as other relevant literature together, it is clear that there is considerable evidence showing that physical activity through exercise and sports is effective in improving the mental and physical conditions of mentally ill service users. These physical activities promote better life quality via boosting self-esteem, reducing anxiety, improving mood, sleep and resilience to stress (Ekeland et al, 2009). However, further research is still needed to identify the effective exercise regimes and feasible delivery modalities for patients with varying illnesses. It is advised that activities that are any way strenuous or too rigorous would not be suitable for mentally-ill patients with cardiovascular conditions. Also, in order to prevent any form of musculoskeletal injuries, the duration and intensity of exercises should be increased gradually. It is therefore clear that a full assessment of patients must be carefully done by the appropriate medical practitioner before such activities are implemented (Richardson, 2005). Prior to outlining the Service Improvement Initiative, I will first outline the theoretical aspects that need to be considered when implementing a new initiative, and how these can be applied in practical terms. Theoretical Aspects In order to implement a service improvement initiative and effectively manage the changes that ensue, a clear understanding of theoretical aspects must take place. In this paper, the theoretical aspects will be drawn from John Kotter’s model and Pender’s Theory of Health Promotion (1996). In the former model, Kotter’s eight distinct phases will be organized into three broad phases: 1) creating a climate for change; 2) engaging and enabling the whole organization; and 3) implementing and sustaining change (Campbell, 2008). In the latter model, an action can directly motivate the behaviour of others through an extensive and rigorous plan of commitment from which the expected benefits will result (Pender, 1996). This author will examine theoretical aspects such as change management; accountability and responsibility, leadership and management skills, and professional/inter-professional collaboration. The first phase will focus on the importance of urgency, the building of guiding teams and getting the vision right. In fact, it is particularly important that a multi-disciplinary team has a sense of urgency in achieving the programme’s aims. The team must possess four main skills as highlighted by Campbell (2008): up-to-date knowledge about the necessary changes, an ability to justify and add credibility to the changes, awareness of any relevant knowledge on the changes and a sense of leadership in carrying out the changes. Moreover, the vision of the team must be summarised into a short-statement that encapsulates the goals of the initiative. Thus, in the case of the service improvement initiative, it is pivotal that the team of nurses and other staff has exposure to the benefits of physical and mental activities. This can be achieved through a day of seminars given by external scholars and practitioners, as well as take-away booklets and handouts that emphasise the need fo r integrating physical activity into healthcare. The second phase involves communicating the proposed changes that will enable action to take place. On the communication of the proposed changes, it is vital that all individuals involved in the initiative are completely knowledgeable about the changes that are being proposed. There must be a constant dialogue among the people involved to ensure that all parties are kept in the loop (Campbell, 2008). In fact, a clear communication strategy is also important for raising sufficient funds for a server improvement initiative. In order to garner both emotional and financial support, it is imperative that the short-term and long-term benefits of a service improvement initiative are communicated. For example, in the case of the service-user initiative for improving physical activity, the importance of improving the patient experience and the overall clinical outcome needs to be emphasised. Finally, the third phase highlights the importance of keeping a momentum when implementing change By creating a drive and motivation amongst employees, it becomes necessary to ensure that change does not become institutionalized but is a forward-looking process (Campbell, 2008). According to Kotter, â€Å"culture change comes last.† In other words, when change has been successfully implemented for a certain period of time, that is when attitudes and opinions change. In light of this, one would expect that it would take a certain amount of time for the service user initiative to become rooted in the culture of the health-care community. Other important theoretical aspects that also need to be discussed include accountability and responsibility. It is important that each member of the multidisciplinary team, in particular the nursing staff, are vigilant in maintaining both accountability and responsibility. In this case, responsibility is equivalent to the duty of care in law. This applies to all nursing tasks, from simple things such as bathing a patient to complex ones such as surgery. There is a certain degree of risk in any nursing task. When practitioners accept responsibility to perform a task, they must ensure that they accomplish it with competence and at least to the accepted standard (Scrivener, 2011). Accountability is commonly defined as â€Å"an inherent confidence as a professional that allows a nurse to take pride in being transparent about the way he or she has carried out their practice† (Caulfield, 2005, p.24). This reflects the positive aspect of accountability and puts focus on the development and demonstration of competence in practice (Scrivener, 2011). The Nursing and Midwifery Council (NMC, 2008) states that all nurses are accountable for their own actions in practice. As the last few years have seen a rise in litigation for nurses (Diamond, 1995), accountability can be a source of anxiety for nurses. It is therefore imperative that nurses follow strict protocols and guidelines, verifying when unsure and being constantly alert to new situations and information. In relation to responsibility and accountability, according to the NMC, nurses must always ensure that they take complete responsibility for their actions, and always act in according to what is agreed with their patients, their families and carers, and in line with the laws of professional health bodies (Scrivener, 2011). Given these guidelines, in my service improvement initiative, I will ensure that the appropriate responsibility is handed to managers and nurses. Whilst the manager will be ultimately accountable and oversee and be the primary point of contact regarding the actions of the nurses and other staff, there will also be others responsible such as administrative staff. It is therefore essential that there are good management and leadership practices in place so that nurses should have to achieve the proper provision of health care. Another important theoretical aspect to consider is the importance of managing in order to achieve the goals of an organization. Thomas and Worley (2009) describe management as a process of coordinating actions and allocating resources to achieve organizational goals. Similarly, Hersey and colleagues (2001) explained that management is a way of working with and through individuals and groups to accomplish organizational goals. The researchers identified management as a special kind of leadership that concentrates on the achievement of organization goals. Koontz and Weihrich (2008) stated that management is the process of organizing and maintaining an environment in which individual working together in groups efficiently accomplishes selected goal or aims. In application to nursing profession, Sullivan and Decker (2011) define management as the abilities to plan, manage, organize and deliver care. It includes the process of discovering a good way of caring for patients. The goals of the service improvement initiative must therefore be clearly structured and outlined to ensure that both individuals and groups can work towards the initiative’s aims which are to improve the quality of patient care. Leadership may be defined as the ability to direct and influence the task or activities of the members of a group in its efforts to achieve certain objectives (Huczynski & Buchanan 2007). These authors further define leadership as the process of influencing the activities of an organized group in its efforts towards creating an environment focused on goal achievement. Mullins (2007) stated that leadership is a relationship through which one person influences the behavior or action of other people. According to Gopee and Galloway (2009), the key elements of leadership are leader’s personal characteristics, interpersonal relationships, team working and being a role model. They also identified four styles of leadership which include autocratic, democratic, laissez-faire and bureaucratic. In the context of nursing, Sullivan and Garland (2010) list many leadership and managerial skills required from a nurse. These skills range from the initiation and implementation of change, criti cal thinking, problem-solving, effective communication, time-management, appropriate delegation, budgeting and allocating resources and understanding power and politics. In the service improvement initiative, it is therefore important for nurses to acquire both leadership and management skills to be able to function effectively (Marquis and Huston, 2009). In fact, Barr and Dowding (2008) explained that management and leadership skills should be integrated in order to provide high-quality care to the patients. Finally, another critical element for a successful implementation of the service improvement initiative is a culture of â€Å"inter-professional collaboration†. The World Health Organization defines inter-professional collaboration as a process in which â€Å"multiple health workers from different professional backgrounds work together with patients, families, carers, and communities to deliver the highest quality of care.† An expert panel of Inter-professional Education Collaborative (2011) defines inter-professional competencies in health care as â€Å"integrated enactment of knowledge, skills, and values/attitudes that define working together across the professions, with other health care workers, and with patients, along with families and communities, as appropriate to improve health outcomes in specific care contexts†. In the context of the service improvement initiative, a panel of inter-professionals will be involved from the first day to actual implementa tion to ensure that the highest quality of care is given to patients. The Service Improvement Initiative To improve the nursing services in the ward, I plan to execute a six-month program involving 10 adolescent patients from the ages of 10-17, from the psychological ward. Patients will be invited to partake in a range of physical activities, such as exercise and sports, as well as mind games. The overall aim of this initiative is to establish whether such activities have any effect on the behavior or wellbeing of patients. A secondary aim of the initiative is to explore various aspects of the delivery of care, taking into consideration the different theoretical aspects of the nursing practice. The budget will be need to be closely decided in liaison with the manager to ensure that there is sufficient funding for purchasing the sport equipment and the personnel for facilitating and monitoring physical activities. Although the programme is to be conducted in a normal hospital setting, funding will also need to be allocated for the services of the experts and all the administrative and logistical aspects of the initiative. Whilst as a nurse, I can initiate the set of activities for patients, I will need to draw on the assistance and expertise of other medical practitioners for the intervention to be successful. It will also be necessary to set up a multidisciplinary team that will aid in the implementation and completion of the initiative. Team members will be psychiatrists, physical therapists, mental health practitioners, and other experts. It is particularly important to draw on the expertise of a Physical Therapist as it is essential to determine the capabilities of mentally ill individuals when it comes to engaging in physical activities. Psychiatrists also play an important role in assessing the clinical outcomes of patients within a certain time-frame. Given previous research on the risks of physical activity for mentally ill patients (Richardson, 2005), careful considerations shall also be made to ensure that the types of physical activity will depend on the psychological condition of the patient and all physical activities will be limited to light exercise and light sports, such as table tennis. The assessment of the clinical outcomes of the service improvement initiative for adolescent patients will take place on a weekly basis. The assessment criteria will be decided by consulting experts and mental health practitioners. The amount of exercise given in the following week will then depend on the clinical results of the patients at the end of the week. This allows a continuous assessment of patient improvement. It is important to note that the proposed initiative may face a number of challenges. These challenges include the specific culture of a workplace in which some staff may oppose the change, funding costs, fear of increase in work load amongst nurses and a subsequent increase in staff anxiety level (Paton and McCalman, 200; Sharma, 2008). Professional Development Plan Introduction In this section, I will focus on one of the aspects of my personal development which I intend to concentrate on within the first six months of registration. In my personal development plan I will explore my strengths, weaknesses, opportunities and threats (SWOT) and write an action plan that is specific, measurable, achievable, realistic and timely (SMART). Using the reflective tools and SWOT analysis (Appendix B), I have identified my strengths, weaknesses, opportunities and threats, One of the main areas of expertise where I see the weakness and where I would like to see improvements in my knowledge and abilities in the management of medications. Being a nurse does not only require clinical skills but also good leadership, management and communication skills that are learned from practice. Action Plan Administration of medicines is a key element of nursing care. Drug administration is one of the major parts of the nurse’s clinical role. Although doctors traditionally take control of prescribing medicines, a registered nurse does have primary responsibility in administering the correct dosage of medicines. Nurses are responsible regarding the preparation of medicine, verifying and checking appropriate medication, monitoring the effectiveness of treatment and in certain cases, reporting any adverse drug reactions. Given research findings that patients do not always receive the correct medication at their drug rounds, nurses must be vigilant in ensuring appropriate medicine management (Andalo, 2006). However, there has been evidence that medicine management has not been given considerable priority by health care services, and that it is commonly excluded from pre-registration training or in practice (Snowden, 2011). The development of competency in medicine management requires an explicit academic component is present. This is particularly important given recent failures such as those highlighted in Francis Report (Wright, 2013). In this report, Robert Francis revealed the failure among nurses and healthcare assistants to feed patients and give them the basic elements of care such as dignity and respect. Initiatives to combat such behaviour in the future included holding nurses personally and criminally accountable, as well as holding hospital boards responsible should they fail to ensure that all patients are receiving high quality care (Wright, 2013). As I am a student who is in the transition period to a staff nurse, I am aware of the changing responsibilities and accountabil ity that are inherent to being a nurse. Personal Development Plan Nagelkerk (2005) highlights the importance of setting and identifying goals that are intrinsic to your personal development, as it allows you to reflect on your practice and also highlight your strengths and weaknesses, which gives you the opportunity to initiate and implement change. With this in mind, I plan to draw on Snowden’s â€Å"clusters on essential skills for medicine management†. This is relevant to the current service improvement initiative as it highlights the need for newly registered nurses to be completely briefed on patient history and able to responsible administer medicines (Snowden, 2011). Moreover, I will draw on the SMART (Specific, Measurable, Achievable, Realistic and Time) bound framework to set a time scale for my action plan. I will also draw on Snowden’s clusters on essential skills for medicine management as it is a parsimonious model that allows me to evaluate educational needs and professional development. During the first month of the programme, I will ensure that I am completely knowledgeable of the commonly administered medicines that the patients are taking, their actions and side effects. I will do this by liaising with doctors and psychiatrists, and also attending weekly ward rounds. Within the second month, I intend to increase my confidence when it comes to managing my medication round effectively using the eight rights checklist: â€Å"right medication†, â€Å"right patient†, â€Å"right dose†, â€Å"right time†, â€Å"right date†, â€Å"right route†, â€Å"right preparation† and â€Å"right documentation† (Morgan, 2000). I will also develop my knowledge of pharmacology such as the interaction of medicines with different systems of the body. In the third and fourth months of training, I will build up my knowledge on the necessary techniques for administering medicine. I will attend a series of sessions on medicine management as well as observe trained professionals. This is in line with research that nurses must constantly build their body of knowledge and develop their professional skills (Burton & Ormrod, 2011). The fifth and sixth months will focus on the application of the knowledge I acquired. This is where safety management, administration and monitoring of drugs come in. I will practice my skills in ordering medication, their storage and disposal of used medication. I intend to keep a reflective diary about all that I learnt from my own experience and experience of colleagues. The support and assistance of an experienced professional is very important and vital for a newly qualified nurse to gain confidence and practice effectively (NMC, 2008). With the right support and guidance from experienced colleagues, I should be able to manage medications safely and effectively. This will greatly enhance my professional confidence. Having clearly identified my goals and assigned a time limit to achieve them will help me to monitor my progress. I will work hard to make sure that my goals are achievable within the clinical setting. Conclusion Over the course of this paper, it has become clear that the responsibilities of a newly registered nurse are vast. The transition from a student to a nurse is not without its challenges and requires continuous training, support and guidance. To ensure that I am progressing in my knowledge of nursing, I will constantly engage in evaluations and assessment of my learning. For example, I will verify my learning in accordance with the standards of the Nursing and Midwifery Council. APPENDIX A Service Improvement Activity Notification Proforma Details of service improvement project/activity: The main aim of the Service Improvement Initiative is to provide physical activity to mentally ill adolescents aged 10-17 years. The initiative will assess the clinical outcomes following the physical activity intervention, as well as the development of nursing skills needed for the efficient and effective delivery of care. Reason for development: Based on my observations in a psychological ward for adolescents aged 10-17 years, there are no opportunities to be involved in activities such as sports (darts, snooker, etc.). These activities are proven to provide multiple benefits to the service users, both in terms of physical fitness and mental health. Time spent on the project/activity: The program will take place over a span of six months. Resources used: There are a number of resources needed for this initiative. Resources include sufficient funding for paying for the services of team members and experts, as well as a range of sporting equipment, such as table tennis tables. Who was involved: A multidisciplinary team consisting of a group of nurses a physical therapist, psychiatrists, mental health practitioners, and other experts will be set up. Future plans: The initiative will be implemented in six (6) months. It is hoped that the program will become successful and beneficial for the service users and the multidisciplinary team. APPENDIX B Strengths  ·Good communication skills,  ·Good team player  ·Positive attitude  ·Good interpersonal skills  ·Motivated and enthusiastic  ·Responsible Weaknesses  ·Assertiveness  ·Medicine management skills  ·Professional boundary issues Opportunities  ·Access to training  ·Learning from other members of inter-professional team.  ·Education, development and research  ·Effective supervision  ·Effective feedbackThreats  ·Lack of time  ·Staff attitude on ward  ·Staff shortage  ·My inexperience APPENDIX C Objective 1. Improve my knowledge of medication management. Where I am now Insufficient knowledge about medication. Goal To become competent in medication management. Action plan Read British National Formulary Check NICE guidelines on medication Work with colleagues on the ward. Administering medication regularly with supervisionTime 2 weeks 1- week 1- week continuouslyEvaluation Self-evaluation and evaluation by experienced professionals 2. Develop good knowledge of NICE guidelines on medication and current government policies on medication.Insufficient knowledge of NICE on medication management.Competency and ability to practice independently.Read through NICE guidelines on medication (internet, Nursing publications) Administering medication regularly with supervision. 2-month.Self- evaluation and evaluation by experienced professionals 3. Attend training on medication. Insufficient knowledge of certain medicinesGood knowledge about drugs, their use, dosages and side effectsAttend training and seminars on medication 4-monthReflects on the experience gained, discuss with mentor 4. Develop confidence in ordering medication, organising its storage and disposal. Inadequate knowledgeAbility to practice with confidenceActively participate in the daily running of the ward 6-monthEvaluation by mentor and reflecting on practice REFERENCES Andalo, D. (2006). Medicines management in English care homes: a grim and chaotic picture. The Pharmaceutical Journal. 276, 198-199. Barker, P., (2005). The tidal model: A guide for mental health professionals. London: Routledge. Barr, J. & Dowding, L. (2008). Leadership and Healthcare. London: SAGE Publications Limited. Beebe, L. H., Tian, L., Morris, N., Goodwin, A., Allen, S. S., & Kuldau J. ( 2005) Effects of exercise on mental and physical health parameters of persons with schizophrenia. Ment Health Nurs, 26, 661-676. Benloucif, S. (2004). Morning or Evening Activity improves neuropsychological performance and subjective sleep quality in older adults. Sleep, 27(8), 1542-1550. Briles, J. (2005). Zapping Conflict Builds Better Teams. Nursing Times, 35(11), 32. Burton, R., & Ormrod, G. (2011) Nursing Times: Transition to Professional Practice. London: Oxford University Press. Callaghan, P. (2004). Exercise: A neglected intervention in mental healthJournal of Psychiatric and Mental Health Nursing, 11(4), 476-483. Campbell, R. J. (2008). Change Management in Health Care. The Health Care Manager, 27(1), 23–39. Caulfield H. (2005). Accountability. Blackwell Publishing, Oxford, 3. Cohen, S. (2004) Social Relationships and Health. American Psychologist, 59(8), 676–684. Daley, A. (2002). Exercise therapy and mental health in clinical populations: Is exercise therapy a worthwhile interventionAdvances in Psychiatric Treatment, 8, 262–270. doi:10.1192/apt.8.4.262 Department of Health (2004). Choosing Health: Making Healthy Choices. Diamond, B. (1995). Legal Aspects of Nursing. Hemel Hempstead: Prentice Hall. Ekeland, E. (2009). Exercise to improve self-esteem in children and young people. Cochrane Database Syst Rev, 1. Elavsky S. et al., (2005). Physical Activity enhances long-term quality of Life in Older adults: Efficacy, Esteem, and Affective Influences. Annals of Behavioral Medicine, 30(2), 138–145. Folkins, C. H, Sime, W E. (1981). Physical fitness training and mental health. American Journal of Psychology, 36, 373-389. Frost, S. (2010). What are the benefits of activities in nursing homesLivestrong Publications. Accessed March 21 2013 from: http://www.livestrong.com/article/151544-what-are-the-benefits-of-activities-in-nursing-homes/ Goodwin, R, D. (2003). Association between physical activity and mental disorders among adults in the United States. Preventive Medicine, 36(6), 698-703. Hainsowrth, T. (2006), The benefits of increasing levels of physical activity. Nursing Times, 102(20), 21. Hersey, P., Blanchard, K. & Johnson, D. (2001). Management of Organisational Behaviour: Utilising Human Resources. 8th ed. Upper Saddle River, NJ: Prentice-Hall. Gopee, N., & Galloway, J., Eds. (2009) Leadership and Management in Healthcare. London: SAGE Publications Limited. Huczynski, A., & Buchanan, D. A. (2010). Organisational behaviour. 7th Ed. Harlow: Prentice Hall. Inter-professional Education Collaborative Expert Panel (2011). Core competencies for inter-professional collaborative practice: Report of an expert panel. 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(2009). ‘Physical activity, exercise, depression and anxiety disorders’, Journal of Neural Transmission, 116, 777–784. Sullivan, E.J. & Decker, P.J. (2011) Effective leadership and management in nursing. Upper Saddle River, N.J.: Pearson Prentice Hall. Sullivan, E. J. & Garland, G. (2010) Practical Leadership and Management in Nursing. Harlow: Pearson Education Limited. Taylor, A.H. & Faulkner, G. (2008). A new academic journal with a specific focus on the relationship between physical activity and mental health. Mental Health and Physical Activity 1(1), 1-8. Tappen, R., Weiss, S., & Whitehead, D. (2004) Essentials of Nursing Leadership and Management. 3rd Ed. Philadelphia: FA Davis Company. Thomas, G., & Worley, C. (2009). Organisation Development and Change. Canada; South-Western. Wilkes-Whitehall, D. (2004). Archives of Women’s Mental Health – Interpersonal psychotherapy for depressed adolescents, 7(4), 251-25.Elizah

Wednesday, July 17, 2019

Lord of the Flies Coursework

The master(prenominal) characters in the entitle of the flies are ex channeliseable to mankind attractions that have control by means of history. I agree that the main characters from gentle of the flies are similar to the world leaders that have ruled through and through history. There are quad main characters in the film Lord of the Flies and they are shit, Simon, neanderthal and Ralph. all(a) these characters have an individual point of find and they all have diametric personalities. knave is very comparable to the world leader called Adolf Hitler. Adolf Hitler was absolute evil, powerful, mad, and hated by others, bright, late religious and stubborn.Adolf Hitler was a leader because he was able to convince pile and buzz off them do what he wants them to do. manual laborer cherished to be a leader as well and after the votes when he wasnt picked to guide the kids he persuaded Ralph that he would dish up him out. Jack thought he was all-powerful because everyon e followed what he said. Half way through the movie Jack was getting throwaway(prenominal) because people found him too ascendent so he used hes skills to convince people that he is the best leader and that he is a good deal better than the leader that they picked which was Ralph.I think Jack wasnt so bright just now he knew how to convince people to recall him and this made him very stubborn and tough. He was very sure of him self and he was a very confident person. When the kids joined his group because they had a choice of connexion Jack or Ralph they picked Jack and he turned really aggressive and killed cardinal members of the opposite group. Jack took his anger on animals and other members from the plane crash. gluttonous reminds me of Martin Luther ability as he wanted to change the whole of America to make peace. shote wanted to change the people that argued and he was very supportive towards the leader Ralph.When Jack was a very leader Ralph wasnt sure what to do to stop him and Piggy helped him and seemed to be very supportive and friendly. He was also very gullible and he thought he could trust Ralph by telling him a secret that people used to call him Piggy and he never liked him. He asked Ralph non to tell anyone but Ralph told everyone about it. Piggy carried on being very squeamish towards Ralph. Piggy was very smart and tolerate just like Martin Luther King and he spoke his mind and came up with different ideas. By Natalia Jozwiak 10EA

Tuesday, July 16, 2019

Bruno Bettleheim’s “The Use of Enchantment”

Bruno Bettleheim’s “The Use of Enchantment”

Since it exists an individual can not deny collective guilt on survivors portion.Together with classics, there are great classic story books with the adventures of licensed characters, irony, and new story books with every possible topic.These many books entertain children and teach them at the oral same time. Some books include brief history and political science lessons. Other features of these books include dinosaurs and other animals.Maybe a whole range of these know Yiddish.A book like â€Å"The Three Little Pigs† new teaches hildren how they can live in brick old houses in order to protect themselves from enemies. It helps children develop defensive mechanisms against harmful animals logical and other things. Other books like â€Å"Goldilocks† teach children how that there is nothing, which is ever right. It educates children on the relative importance of acknowledging mistakes and correct them.

Obviously, for whatever there what has to be some recognition that theres a organic matter and sadly not everybody seems convinced.Bettelheim used the theory as the daily basis to explain the significance of symbolic and emotional messages to children.The present author believed that when children read conventional little fairy tales, they develop and mature emotionally. For those who tend to avoid the economic theory of Freudian, â€Å"The Uses of Enactment† is suitable for the translation of old stories. Some of the stories may instill fear in childrens summary developing minds.Thats merely a fairy tale if people say! Stories should explain how our existence.He compares and contrasts differences in various other stories with their symbols. On the other hand, those who do not concur with Freudian theory will how find several unanswered questions from â€Å"The Uses of Enactment. Generally, analyses by Bettelheim Bruno is essential in examining the importance of good fa iry tales to childrens owtn These books expose other kids to ditterent contexts, cultures, and themes. They consider also expose children to different character traits.

The short story appears to be straightforward and simple to follow, how ever a interpretation is simple.Old stories can be a late little more detailed and a little longer.The parents can logical not meet with your children demands logical and can not afford to feed the children.They are forget not as prepared to accept the concept that they can famous teach only by example, while they are all different set to teach their kids discipline logical and understand that they are the ones to do so.

After seven or six, once the kid begins to lose their baby teeth, he or shes ready for more drama.Bear in mind, its not vital to have a story every moment.Because the whole course needs writing there will not be a midterm or final.When applying for a position to last get a milieu therapist, your work experience is taken into consideration.

Monday, July 15, 2019

Age of the Universe Essay

The get on of the globe is verbalise to be n primordialwhat 13.75 cardinal historic period senile. The rule utilize in envision this ripen would be attempting to take c atomic number 18 the historic period of chemical substance elements, old(a)est virtuoso clusters, as substanti each(prenominal)(prenominal)y as discolour eclipse understanding datums. Scientists the kindreds ofwise settle to rule the man of discourses set kayoed of enlargement, and demeanour of orbicular clusters, which argon b every(prenominal)-shaped assembly of stars. In locate to prevail this, scientists squeeze tabu physical exertion hot de organization to specialise how old a precondition diverseness of atoms is in c atomic number 18en experiments. In assign to find the enume grade of expansion of the exis tennerce, The Hubble dislodgeless quantity was the raw genuine cosmologic simulation leechlike on minginess and composition of the worldly concern. virtu all(prenominal)y regulations use by The Hubble perpetual is that the dry atomic number 18na is pl deadly of uncomplicated motion and the eld of the universe is 2/3(Ho) with Ho be The Hubble constant (1). puff up-nigh distinguishable figula is that the gentlemanss is give voice to attract real minute social function and the jump on of the universe is 1/ Ho, which is immediately considered to be to a greater extent completed (1).The succession of the terra firma is approximately 4.54 meg season old, virtually 9.21 mature aft(prenominal)wards the universe was organise. The primary(prenominal) supposition of how the flat coat was exploited is the s tumefyed kick Theory, or a star explosion. nigh likewise environ is a supernova. This happens in the universe when the wreckage from an explosion crashed into a cloud of gas, legal transfer in the ingre pass awaynts for our solar intrustment. The validation of our solaascent came inaugural from the bankrupt of a solar nebula. after(prenominal) to the highest degree ten to 20 unmatched thousand thousand old age after this collapse, miscellanyula consequently agglome locate to grains, to lumps, to boulders, to major planetesimas. soon it became chunks of tremble volumed luxuriant to check their suffer gravitative field. So, rough plantesimals became the embryologic form of planets in our solar system today. As more than than angulates and enlighten planets collided with planet do master(prenominal), cheekiness began to dis summersaultionate and pissing began to form and collect on the rear.References eon of the globe . (2007, July 9). USGS. Retrieved January 16, 2013, from http//pubs.usgs.gov/gip/geo start out across/age.html mature of the raiseation . (2012, celestial latitude 27). The historic period of the Elements . Retrieved January 16, 2013, from http//www.astro.ucla.edu/wright/age.htmlHow did the acres form? The satellites and our solar System. (2013, January 1). UK2Planets The Planets in our solar System. Retrieved January 16, 2013, from http//www.uk2planets.org.uk/how-did-the- worldly concern-form/How old is the conception?. (2012, declination 21). organismness ci . Retrieved January 16, 2013, from http//map.gsfc.nasa.gov/universe/uni_ag smell- clock meters gunstocks archaeozoic country was non a memorialise up for perfection bread and exactlyter be mystify it was a lighting and hell-like milieu. So oft so, that scientists nonwithstanding called it Hadean eon, which is an antique classical invent for bring under. It was a place with more vol thunder mugoes and near scientists take down hypothecate at that place were Continental cheekinesss and oceans. dismantle though it was exceedingly hot, scientists s rap make up that any(prenominal)(a) bacterium could pull round these fundamental conditions. gibe to Watson, by apply zircon crystals, they c ould as legitimate that proto(prenominal) body politic had a clear unshak seted temp seasonture. The zephyr consisted of light speed dioxide, water, and volcanic gases. Today, not as umteen volcanoes exist. No unrivaled rightfully k directlys when flavor was bloodated. Asteroids whitethorn seduce hit from time to time, having an upshot on hold offs gentle wind by causation complete molecules to synthesize. ribonucleic acid and desoxyribonucleic acid be the contract fit stuff for all animateness, and they are make up of grand handcuffs of nucleotides. Nucleotides are make up of deoxycytidine monophosphate, hydrogen, nitrogen, type O, and morning star atoms. An authoritative footmark in the origin of liveliness is the index of all liveliness things to reproduce. offset with ribonucleic acid beingness satisfactory to self-replicate itself, we whence take into being able to pass ancestral material onto offspring, and so infixed selection. miller and Urey build an setup fill with water, methane, ammonia, hydrogen, further no atomic number 8. They hypothesized that this was the mixed bag of the melodic phrase of premature primer and change state and condensed the water to keep it circulating. miller and Urey unplowed this going away for a hebdomad and utilise idea chromatography to be able to show that many a(prenominal) aminic acids and some primaevalish(a) total fertiliser molecules were straightaway in the flask. galore(postnominal) opposite scientists beget tested this taste and form that amino group acids, protein molecules, adenine, and former(a) nucleic acid bases were present. almost theories mention an electrical spark could realize servicinged get hold of these amino acids and sugars in the automatic teller machine, early(a)s allude the front origins of liveness could scram met on body. black lovage graham Cairns- metalworker says clay could help the organic compounds beg in punishing and comp pack into patterns alike to genes today. close to scientists theorized that liveness was brought from someplace else in infinite kinda than graduation on populace, which is alike know as panspermia. In reality, no wiz is sure of how feel began be safari no unrivalled was round to know, but these theories take helped us view a sense of spell and cognition of how support was broachd.References7 Theories on the decline of vitality Live acquaintance . (n.d.). acquirement tidings acquirement Articles and catamenia Events Live perception . Retrieved January 14, 2013, from http//www.livescience.com/13363-7-theories-origin-life.html untimely public non So Hellish, new-sprung(prenominal) lead Suggests LiveScience . (n.d.). Science word of honor Science Articles and true Events LiveScience . Retrieved January 14, 2013, from http//www.livescience.com/241-early- reason-hellish-study- insinuates.htmlHow did life originate?. (n.d.). dis position Evolution. Retrieved January 14, 2013, from http//evolution.berkeley.edu/evolibrary/ term/origsoflife_04milling machine and Ureys prove and Molecules of life. (n.d.). anthropological convey of Workers, occupational Health, public Health, framework Workers. Retrieved January 14, 2013, from http//anthropologicalstudy.blogspot.com/2011/03/miller-and-ureys-experiment-and.htmlThe declension of bread and butter. (n.d.). RCN D.C. metro fast Internet, digital logical argument TV & telephony gain Provider. Retrieved January 14, 2013, from http//users.rcn.com/jkimball.ma.ultranet/BiologyPages/A/AbioticSynthesis.htmlancient LifeRadiometric go come out is use to date materials ground on coincidence in the midst of the observe copiousness of a of course occurring hot isotope and its corrupt rate (1). slightly diametrical types are carbon 14 geological dating, h wizy oil-argon dating, and atomic number 92-lead dating. They offer up all- significant(prenominal) randomness rough dodo ages and the rate of evolutionary changes. radiocarbon dating is apply to consider the rest of materials with carbon as of 58000 to 62000 geezerhood agone (2). Potassium-argon dating is use to tone the crossing of radioactive rot of an isotope of potassium into argon. This system whole kit for collusive the age of samples a little over a a couple of(prenominal) potassium old age. Uranium-lead dating on the separate hand, can cast the age snip of a sample from roughly 1 million to 4.5 cardinal historic period ago (3). This mode has 2 separate decomposition reaction chains, uranium serial publication, and atomic number 89 series, occurring by a series of of import decays. It is important to make up different types of radiometric dating because the farming has been around for kind of some time and a lot of changes has happened in each era, epoch, and eons.thither was not as overmuch group O dep give the sackency in macrocosms e arly nimbus as on that point is today. The guide of type O bearing is chiefly because of volcanic military action as head as oxygen producing organisms like cyanobacteria, in the oceans of early undercoat. bluish green algae as well as blue-green algae produced their nada an oxidativeally, psychotherapeutic oxygen and taking in carbon dioxide, and evacuant oxygen. oxygen gained a indissoluble forepart in earths atmosphere 2.45 one thousand million days ago for the aerobic organisms that inhabited.When the dental p latishs of earths crust shift, along with their suave layers below, this is called plate tectonics. This sequels in how our uncorrupted and land bunch appears passim time. Kenorland, one of the outset supercontinents of early earth stone-skint up to the highest degree 2.6 billion long time ago. other supercontinent called capital of southerly Carolina thence form or so 1.8 years ago, and after that Rodinia form from capital of South Carolinas remains, that stone-broke 550 million years ago. The gaolbreak of these supercontinents caused the earth to go through freeze temperatures. Oceans broke out and then Pangea make and let out into twain supercontinents called Laurasia and Gondwana. Laurasia consists of what is now northerly America, Asia, Europe, and Gondwana of South America, Africa, India, Antarctica, and Australia. These continents in time bedspread and broke to form what we piddle got today. throng experimental quenchings are when a species has drop dead wiped out. at that place befuddle been or so atomic number 23 atomic reactor defunctnesss that go for occurred so far. The counterbalance that occurred was during the Paleozoic era which was the prohibit of the Ordovician. Scientist pitch that 60% of world-wide and naval lives had disappeared out of nowhere. The conterminous smokestack quenching was the late Devonian. The environment no durable provided replete for the survival o f the fittest of these organisms. The leash aggregate extermination was the end of the Permian during the Mesozoic era, where scientist prime that 85.5% of all maritime species became nonexistent. The Triassic extinction is the one-quarter one that happened in the Mesozoic era. oceanic thornlesss people fall by 50%. The at long last agglomerate extinction caused the dinosaurs, as well as plants and other tropic oceanic life to die out during the Cenozoic era. globose temperature and oceans caused flooding for 40% of all continents. unitary opening is that because of the wide awake change of carbon dioxide in the atmosphere, plentitude extinction occurred. plot of ground carbonic acid gas in the atmosphere changed, surface layers in the orphic oceans began to sink. CO2 change magnitude to a fault promptly for creatures to adapt in time. just about theories suggest an angulate caused some slew extinction, striking the earth. The asteroid cogency have out of use(p) the sunlights rays or cause the earths temperature to rise likewise high. Periods of terrific speciation happens because of mutations. Mutations come from ionizing radioactivity and other factors. Species that do survive, change and cause this speciation. slightly researchers say that humans is hitting the one- ordinal potty extinction because many species are endanger and fall population. Researchers also found that major mammals have make more and more rarified that they could be extinct in about 30 years. These endanger species, researchers found, whitethorn be the result of human activities like home ground death and hunting. So, we are fundamentally in a sixth pickle extinction, because human act upon the main cause.ReferencesBiello, D. (2009, August). The Origin of atomic number 8 in acress Atmosphere. scientific American. Retrieved from http//www.scientificamerican.com/article.cfm?id=origin-of-oxygen-in-atmospherePlastino, W. Kaihola, L. Bartolom ei, P. Bella, F. (2001). cosmic flat coat step-down In The radiocarbon beat By shimmer spectrographic analysis At The subsurface research lab Of granny Sasso. radiocarbon 43 (2A) 157161.Parrish, Randall R. Noble, Stephen R., 2003. zirconium silicate U-Th-Pb Geochronology by Isotope Dilution caloric ionisation business deal spectroscopic analysis (ID-TIMS). In zircon (eds. J. Hanchar and P. Hoskin). Reviews in Mineralogy and Geochemistry, Mineralogical monastic order of America. 183-213.Wilkins, A. (2011, January). A autobiography of Supercontinents on Planet Earth. io9. Retrieved from http//io9.com/5744636/a-geological-history-of-supercontinents-on-planet-earth

Sunday, July 14, 2019

Explication Essay of a&P by John Updike

sample 1-Explication onrush of A&P by joke Updike We return on the whole had that upshot of c scaness when we realize, no lengthy children, our stopping points seat out restly bear on the cut by of our succeeding(a). A&P give prickles an sixth sense into the briny faces ack promptlyledge custodyt of how he perceives his carriage, the spicys of those slightly him, and how with star automatic stopping point he everlastingly reassignd the itinerary of his life. Sammy, the teller of A&P, is a 19 social class anile son whose boldness of a nonher(prenominal)s, scorn of unanimity, and his flush finis fashioning be teend disc o really, that our actions wallop our future.Sammys speculation of others is youthful and serves whole as a mismanagement from his self-distain. He describes, in great detail, the three female childs who record the A&P, in their c endure suits. He under pass ons with their physiologic descriptions, which use up him to acquire their spirit summarizations. He goes so farthest as to give them nicknames. in that respect was the squatty maven, a towering maven, with scurrilous whisker that hadnt preferably frizzed skilful, and and past the troika one, She was the queen. 385. Queenie and tartan and spoiled in height(predicate) Goony-Goony. 388. firearm Sammy is reverberance up the deal in his verification slot, he visualizes Queenie as this rich, advanced misfire.He fantasizes close to what her family is akin and how dream their parties must(prenominal) be. He consequently depicts his family as sw pass on class, as if this was well-nigh issue to be disgraced of, and that he was in a higher place that. Her buzz take a manner and the other men were tolerateing close to in ice-cream coats and crouch up ties and the women were in sandals pick out up herring snacks on toothpicks morose a titanic glass plate. When my pargonnts fill psyche over they collar lemonade and if its a fat engagement Schlitz in tall glasses. 387. His assumptions and mean solar twenty-four hour perioddreams allow him to escapism his reality, temporarily.This is a deal technique, a way for him to generate finished with(predicate) the twenty-four hours to day, at a hypothecate his shuns, and a life he locations as below him. During Sammys descriptive assumptions of these girls, he alike illustrates his view of the confederacy about him and his detest of concord. Sammy describes the modus operandi shoppers and in doing so he depicts his despise of conformity. He depicts them as sheep with the unfitness to disgorge from their plane phone numbers. The sheep get-up-and-go their carts gobble up the aisles-, I interest you could effectuate finish detonate in the A&P and the mess would by and soundy gr experience hold back hit and checking burgoo off their lists. 386. He views individually day as foreseeable with zippo to ol o ccurrenceion previous to. That is why when these girls entered the pedigree it was a stack to behold. It was the rude change in the day by day conformity that Sammy so urgently requireed. The barge ins jolly empty, it cosmos a atomic number 90 afternoon, so there was nought to do ask out lean on the read and gestate for the girls to picture up again. 387. He changed that day, from a teen male child with vernal daydreams closely girls, to an big. It was because of the acuteness he visualised from these girls. When the manager, Lengel, embarrasses the girls for their pretermit of clothing, it upsets Sammy.He then chooses to quit. He reasons it is the justly survival of the fittest, cerebrate it is the mature thing to do. To rise for what is even off, and to vowelise his deviation with Lengel at his attempt in wound the girls. - however recollect how he declargon that sanely girl discolour makes me so scrunch inner(a) I biff the No cut-rate sale oral contraceptive pill and the utensil whirls pee-pul and the drawer splats out. 388. He c formerlydes that the conformity of these pot and the day to day routine is unacceptable, in particular when it makes you hump superior, that you make the right to injure others.While he demonstrates his dislike for conformity, he now has make a efflorescence conclusiveness that has consequences he had non considered. Sammy demo typic teenage behavior, by reservation a intoxicating decision, in quitting his caper in advance rationalizing it. afterward witnessing Lengel verbally take to task the girls for wearable their bikinis into the retentiveness, Sammy decides, in hast, to quit. He believes this lead portray him as a battler in the girls eyes. He very rapidly discovers they exited the pedigree with not so untold of a shine back in his direction.Now, he has to live with his ad libitum adult decision and the consequences of his choice in quitting his job. sulle nly it seems to me that once you begin a motion its pitch-black not to go through with it 388. He considers the point that he allow tribulation this decision later on on and that he impart scotch his mom and dad, as Lengel pointed out. Sammy, you get intot want to do this to your mum and Dad. He tells me. Its true, I fall apartt 388. He cursorily dismisses these thoughts and makes fixing that initially he whitethorn be rueful of his brainish decision, that realizes this is what he require to do.After he exits the store he optimistically pictures for the girls and realizes they are gone. I look around for my girls, theyre gone, of course. 389. He has to take in the fact that he is alone, having to stand on his own twain feet, and know that the course forrad with be difficult. -I matte up how hard the solid ground was expiration to be to me hereafter. 389. sure as shooting to be full of trials, Sammy takes his offshoot bright travel into adulthood. His r oseola decisions may have not been quick-scented only if they were call for in his epiphany, which forever changed him.Although Sammy make some distressing choices, they were requirement in his go into adulthood. Everyone makes deplorable decisions, but it is how we be active later that make us who we are. The future is coat with mistakes of the past. We are to learn from them to manipulate we do not ring them. bum Updikes A&P depicts the unavoidable decisions of a unseasoned man, through his thoughts and actions, and the ensuant consequences of those decisions that allowed him to mature. flora Cited Barnet, Cain, & Burto. literary works for Composition. 9th Edition. Longman. Updike, John. A&P. pg. 385-389.

Saturday, July 13, 2019

14 Coursework Example | Topics and Well Written Essays - 250 words - 1

14 - Coursework grammatical casePiccinini has on some(prenominal) do leave out luminousness on the gentle- animate macrocosm hybridizing coordinate of identity element with his animal the likes of sculptors that check human traits.thither be 2 mechanisms of describing identities of hatful, locations and subjects. These accommodate some(prenominal) visualize and schoolbookual matter edition translations. In as some(prenominal) as both mechanisms parcel out the practise that cosy economic aid is to be remunerative to the expert flesh out of the soul or place, they dissent in the smell out that text description requires that either the quintuple sentiences be install into implement (Bridwell et.al 192). On the other(a) hand, visualize requires the procedure of the sense of sight, a component part that makes it easier for a person, place or thing be easy fill outd. Amidst these differences however, it is of commodious meaning to recognize the fact that text descriptions ar challenge because they put up hopeful descriptions of pack or places. This helps non hardly in depiction the pictures of the people being described, but their feelings as