Exercise Intervention Anxiety Disorder Health And Social Care Essay

Background: The wellness benefits of exercising are good documented and these effects could assist people with anxiousness upset, affectional and temper upset, and substances abuse. Mental upsets are major public wellness significance. It has been claimed that vigorous physical activity has positive effects on mental wellness in both clinical and nonclinical populations. This paper reviews the grounds for this claim and provides recommendations for future surveies. Aims: To find the mental wellness effects of exercising for people with anxiousness upset, affectional and temper upset, and substances use upset. Search Scheme: Clinical tests on anxiousness upset, affectional and temper upset, and substances use upset ( August 2010 ) were searched based on Cochraine, MEDLINE, PsycINFO, PsycheArticles, Sport Discuss, and PubMed database. Mentions from relevant documents were besides inspected. Choice Standards: All randomized controlled tests comparing any intercession where physical activity or exercising was considered to be the chief or active ingredient with standard attention or other interventions for people with anxiousness upset, affectional and temper upset, and substances use upset. Data Collection & A ; Analysis: Citations and abstract were inspected and the quality is assessed, and the informations were extracted. Main consequence: Ten randomised clinical tests met the inclusion standards. Tests assessed the effects of exercising on physical and mental wellness for affective/mood and anxiousness upset, besides the ingestion alteration on illicit drugs and intoxicant. Overall figure go forthing the tests were & lt ; 50 % . Most tests use exercising as accessory intervention to standard attention and found important ( p & lt ; 0.05 ) consequence of exercising towards better mental province and habit-forming behaviour. Exercise were found to better physical fittingness ( VO2 max = 0.48 mlO2/min ) . There is no important consequence of exercising activity and strength in anxiousness upset but important for depression and substance usage upset ( DASS Cohen ‘s vitamin D = 0.82, Depression: d= 0.57, Anxiety d= 0.92, Stress d= 0.76 ; PDA & gt ; 60 % ) . Exercise consequence is higher than standard attention entirely or accessory intervention with speculation. Exercise dose differs for underlying fitness degree, p hysical well-being, and age. Green environment act as accelerator while smoking behavior block the fittingness result. Background There are about 450 million people suffered from mental and behavioural upsets worldwide. One individual in four will develop one or more of these upsets during their life-time [ 1 ] . Mental upsets contribute to about 11 % of 1996 disease load worldwide and it is predicted that it will increase up to 15 % in 2020 [ 2 ] . By looking at local context, about half of Australian population experience mental unwellness at some point of their life-time [ 3 ] , which contribute 13.3 % of the entire state load of disease and hurt in 2003 [ 4 ] . A good mental wellness enable single to manage daily events and obstructions, work on their ends, and map efficaciously in society. Minor perturbations in mental wellness could with detain early intercession will non merely a suffered to the person but besides a load to their households and society well. The economic and personal costs of mental unwellness are besides the major concerned in societal and public wellness. Exercise was believed to heighten person ‘s ability to get by with and pull off their mental upset apart from its good documented physical wellness benefit. Improved quality of life is peculiarly of import for persons with terrible and digesting mental wellness jobs as exercising may relieve depression, low self-pride and societal backdown. A Mental upset is normally determined through clinical diagnosings utilizing the ICD10 or DSM-IV standards. In Australia, anxiousness upset, affectional and temper upset and substances maltreatment are the chief mental upset in this state [ 3 ] therefore will be used in this reappraisal. Description of the status Anxiety Disorder Anxiety upsets are a group of unwellnesss characterized by relentless feelings of high anxiousness, utmost uncomfortableness and tenseness which will significantly interferes with their day-to-day life. Its frequently come out of the blue and presented with intense physical symptoms such as shortness of breath, palpitations, sudating, trembling, feelings of choking, sickness, abdominal hurt, giddiness, pins and acerate leafs, feelings of losing control and/or feelings of impending day of reckoning [ 4 ] . Anxiety upsets besides affect the manner a individual thinks, feels, and behaves. There is different figure of anxiousness upsets which include panic upset, agoraphobia, societal phobic disorder, generalized anxiousness upset, obsessive-compulsive upset, and post-traumatic emphasis upset, which most frequently begin in early maturity and common among adult females than work forces [ 5, 17 ] . It is reported that lifetime prevalence of entire anxiousness upset was 10.6 % – 16. 6 % [ 23 ] . Affectional Disorder Affectional upset characterized by dramatic alterations or extremes of temper which include frenzied or depressive episodes, and frequently combinations of the two. They may or may non hold psychotic symptoms such as psychotic beliefs, hallucinations, or other loss of contact with world [ 9 ] . This upset could be categorized into depression, dysthymic depression, passion, hypomania, and bipolar affectional upset [ 5 ] . For lifetime prevalence, the corresponding pooled incidence rates were 6.7 per 100, 3.6 per 100, and 0.9 per 100 for several major depressive upset ( MDD ) dysthymic depression upset and bipolar I disorder classs [ 16 ] . Substance usage upset Substance usage upset refers to mental and behavioural upset ensuing from psychotropic substance usage such as intoxicant, opoids, others stimulations, psychedelic drugs, baccy and volatile upsets [ 5 ] . The focal point of this paper will look at the survey on intoxicant and illicit drugs. In the short term, the person may comprehend these effects as rather desirable nevertheless, prolonged and heavy use may ensue in physical injury, dependence, and backdown jobs and long term psychological harm or societal injury. This will leads to poisoning, harmful usage, dependance, and psychotic upsets [ 5 ] . Harmful usage is diagnosed when harm has been caused to physical and mental wellness. Dependence syndrome involve strong desire to take substance and trouble in control the usage, physical backdown, tolerance, disregard of alternate pleasance and involvement, and relentless usage despite injury to self and others. Indicate prevalence of intoxicant usage upset has been estimated to be abo ut 1.7 % globally, which higher rate among work forces 2.8 % to adult females 0.5 % [ 18 ] . While, the load attributable to illicit drugs was estimated at 0.4 % of entire disease load, and economic cost of this harmful drugs dependants and usage in the United State has been estimated to be USD98 billion [ 22 ] . Exercise and mental wellness There is no individual mechanism has yet been found to adequately explicate the diverse scope of mental wellness effects possible through physical activity engagement. The plausible mechanisms for psychological alteration through physical activity and exercising autumn into one of three wide positions as explained by Mutrie ( 2003 ) where there is biochemical alterations such as increased degrees of neurotransmitters ; physiological alterations such as improved thermo-genesis, musculus and cardiovascular map and, suggested psychological alterations such as societal support, sense of liberty, improved perceptual experiences of competency, enhanced organic structure image, self-efficacy and distraction. Important of reappraisal There is a turning acknowledgment that physical activity can heighten mental wellness ( Faulkner 2005 ) . Regardless by this fact, there is still limited grounds to propose the effects of exercising on anxiousness upset, affectional and temper upset, and substances abuse reported in the population characterized by these mental unwellnesss. The intent of this reappraisal is to concentrate specifically on methodologically strict tests in updating current consensus refering the possible function of exercising in bettering the mental wellness of persons with anxiousness upset, affectional and temper upset, and substances use upset. Aim To find the mental wellness effects of exercising programmes for people with anxiousness upset, affectional and temper upset, and substances use upset, and factors that enhance the consequence. Method Types of participants Clinically diagnosed grownup ( aged 17 and supra ) with diagnosed anxiousness upset, affectional and temper upset, and substances abuse utilizing any standards, with any length of unwellness and in any intervention scene. Types of intercessions Physical activity or exercising will be the chief or active elements intercession studied in this reappraisal. As a consequence of most clinical topics is under intervention, intercession in concurrence with others will be considered every bit good. Only intercessions which address mental wellness result of exercising, its dose, and factors attribute to effectiveness will be included. Others exercise survey that potentially discussed the result of heightening physical exercising intercession on mental wellness position will besides will be included for prospective reappraisal. Types of result steps Results were groups harmonizing to appraisals of mental and physical wellness, and were grouped by different upsets, factors attribute to effectiveness, and dose exposure result. The primary result will be mental province mark. Search methods for designation of surveies Search is restricted to English literature will be used as more clip is needed for paper interlingual rendition. Electronic hunts The MEDLINE, PsychInfo, PsychArticles, PubMed, Cochrane, SportDiscuss, SAGE, Springerlink, and JSTOR articles and diary databases ( August 2010 ) were searched utilizing the phrase: [ ( physical* and ( therap* or intercession ) ) within the same field of rubric, abstract or index term Fieldss ) or ( ( fitness* or sport* or gym* or exercis* or * danc* ) in rubric, abstract and index Fieldss Reference ) or ( *exercise* or danc* or physical act* in intercessions field in Study ) ] and besides different phrases for upset studied is added in term, mention and survey field: anxiousness upset ( panic disorder*or agoraphobi*or societal phobi* or generalized anxiousness disorde* or obsessive-compulsive disorde*or post-traumatic emphasis disorde* ) , temper or affectional upset ( depressio*or dysthymi*or mani*or hypomani*or bipolar affectional disorde* ) , and substance usage upset ( alcoho*or cocain*or heroi*or ampletamin* or illicit dru* ) . Data aggregation and analysis In the choice procedure, abstracts of research documents were independently assessed by the hunts for relevancy. When abstract was ill-defined and dissensions occurred, the full study is required and the appraisal procedure repeated. With single-minded dissension, information is extracted from each survey and even from unpublished beginning for the intent of this reappraisal. Surveies are so independently assessed for its methodological quality base on sequence coevals ; allotment privacy ; blinding ; uncomplete result informations ; selective coverage of the consequences ; and any other prejudices identified. The criterion Risk Ratio and Odd ratios at 95 % assurance interval ( CI ) will be used as reading of intervention consequence. As a consequence of uninterrupted informations result in mental wellness tests are frequently non usually distributed, standards for inclusion is used where the standard divergences and agencies for the end point steps on evaluation graduated tables is obtained and the standard divergence ( SD ) , when multiplied by 2 had to be less than the average [ 19 ] . Even though some grade of loss to follow up informations must lose credibleness [ 19 ] , all test in the chief analysis will be included all. Merely survey with result of more than 50 % engagement will be interpreted. Consequence Consequences of the hunt There are about 264 electronics studies inspected and of these, 254 surveies were excluded on the footing of their abstracts. Ten randomized controlled tests ( Carta 2008 ; Jerome 2008 ; Oeland 2010 ; Doyne 1987 ; Kenzor 2008 ; Murphy 1986 ; Sinyor 1982 ; Merom 2007 ; Ng 2007 ; and Brown 2010 ) were included in this reappraisal. Extra 6 surveies ( Mackay 2009 ; Jokela 2010 ; van Hauvelen 2006 ; Perrino 2009 ; Brown 2005 ; and Tart 2010 ) were included for prospective position on exercising effectivity factors that could be used for execution of survey. Included surveies We included ten randomized controlled tests ( Carta 2008 ; Jerome 2008 ; Oeland 2010 ; Doyne 1987 ; Kenzor 2008 ; Murphy 1986 ; Sinyor 1982 ; Merom 2007 ; Ng 2007 ; and Brown 2010 ) . All surveies have been published since 1982 which illustrates turning attending to the function of exercising as a signifier of accessory therapy for the focussed mental unwellnesss. One survey ( Merom 2007 ) investigated the effects of an exercising programme on anxiousness upset where brisk walking exercising and others exercisings were implemented. The 8 -10 hebdomads plan lengths, with exercising dosage of & gt ; 30 proceedingss continuance, done five times per hebdomad have shown a singular lessening of anxiousness among patients in the intercession group. Compare with others mental illness surveies ; there are legion surveies on affectional and temper upset. Reviewed surveies shows that exercising does work to cut down depression and anxiousness in bipolar patients with merely one hr per hebdomad of simple group brisk walk exercising for 8 months lengths ( Carta 2008 ) ; and for major depression patient, the positive result were observed after 150 proceedingss per hebdomad group walking for 8 hebdomad length plan. Greater entire clip exposure will give better important result for bipolar patient ( Ng, 2007 ) and the badness of affective/mood psychiatric job does non act upon the exercising result ( Jerome, 2008 ) . Oeland et Al ( 2010 ) have demonstrate that, increased in physical activity will enormously leads towards better organic structure physiology alterations among these patient. Their depression degree were found to hold farther lessening with high degree strength exercising comparison to low denseness exercising at equality d osage ( 4 times per hebdomad with 60 proceedingss continuance ) of exposure ( Doyne 1987 ) . The chief result measured for Drugs and Alcohol usage upset is the per centum twenty-four hours abstention ( PDA ) . Structured group exercising were found leads towards better PDA result as accessory therapy for drugs nuts and alcoholic patients ( Murphy 1986 ; Sinyor 1982 ; Brown 2010 ) at the lower limit of 8 hebdomads intercession ( Murphy, 1986 ) to 12 months intercession ( Sinyor 1982 ) . The effectual dosage reported in these surveies is 20-70 proceedingss exercise modus operandi for the least one time a hebdomad. Unstructured exercising has demonstrated lower result in Kendzor ( 2008 ) and Sinyor ( 1982 ) surveies, verified by their several intercession group and control group result. 1. Methods: All tests were randomized. The continuance of the tests ranged between 8 hebdomads ( Murphy 1986 ) and 24 months ( Ng 2007 ) . 2. Participants: All tests included people diagnosed with anxiousness upsets, affectional or temper upsets, and intoxicant or drugs use upset utilizing DSM-IV standards ( Carta 2008 ; Jerome 2008 ; Oeland 2010 ; Doyne 1987 ; Kenzor 2008 ; Murphy 1986 ; Sinyor 1982 ; Merom 2007 ; Ng 2007 ; and Brown 2010 ) . Merely one survey does non utilize in- or outpatients ( Murphy 2007 ) . Participants ranged in age from 18 to 80 old ages. 3. Setting: Three surveies were conducted in community Centre ( Kendzor 2008 ; Murphy 1986 ; Sinyor 1982 ) , one offered in the university ( Doyne 1987 ) , and the remainder is offered in and outpatient services. 4. Study Size: The smallest sample size is 16 participants ( Brown 2010 ) and the largest figure of participants in sample is 620 people ( Kendzor 2008 ) . 5. Interventions: All survey utilizing exercising as their chief activity used to mensurate the result. The experimental conditions identified in each of the included surveies differed in exercising continuance and strength. The exercising activity strength are from a simple walking to high strength supervised structured aerophilic exercising. Most selected surveies implement consistent continuance of exercising 20-60 proceedingss five times per twenty-four hours for the least 8 hebdomads. Merely good structured supervised intercession implements increase strength ( Sinyor 1982 ; Brown 2010 ) . All exercising programmes were in add-on to participant ‘s usual attention except intercession in Murphy, Pagano and Marlat ( 1986 ) survey. 6. Control intercessions: Standard attention: Participants continued with their usual intervention in Carta 2008, and add-on with Group Cognitive behaviour therapy and merely instruction benefit of exercising for Merom 2007, Oeland 2010, Doyne 1987, Kendzor 2008, Sinyor 1982 and Brown 2010. There are two control groups in Murphy, Pagano & A ; Mariat ( 1986 ) survey which one group in speculation intercession while the others were non in either exercising or speculation. These participants were university pupil non with any intervention for inordinate intoxicant consumption. Merely Ng 2007 does non implement control in their intercession. 7. Results: Depression Anxiety Stress Scale ( DASS-21 ) is a 21 point self study questionnaire designed to mensurate the badness of a scope of symptoms common to both Depression and Anxiety. Each point is scored from 0 ( did non use to me at all over the last hebdomad ) to 3 ( applied to me really much or most of the clip over the past hebdomad ) . Merom 2007 and Ng 2007 used this graduated table. World Health Organization Quality of Life BREF Version ( WHOQOL-BREF ) is scale to measure physical wellness, psychological, societal dealingss and the environment on a five-point graduated table where 1 = hapless QofL and 5 = good QofL. Carta 2008 and Oeland 2010 usage this graduated table. The Clinical Global Impression – Badness graduated table ( CGI-S ) is a 7-point graduated table that requires the clinician to rate the badness of the patient ‘s unwellness at the clip of appraisal, comparative to the clinician ‘s past experience with patients who have the same diagnosing. Considering entire clinical experience, a patient is assessed on badness of mental unwellness at the clip of evaluation 1=normal, non at all ailment ; 2, boundary line mentally badly ; 3, mildly ill ; 4, reasonably sick ; 5, markedly ill ; 6, badly sick ; or 7, highly ill. Ng 2007 used this graduated table. The Clinical Global Impression – Improvement graduated table ( CGI-I ) is a 7 point graduated table that requires theA clinicianA to measure how much the patient ‘s unwellness has improved or worsened comparative to a baseline province at the beginning of the intercession. Rated as: 1, really much improved ; 2, much improved ; 3, minimally improved ; 4, no alteration ; 5, minimally worse ; 6, much worse ; or 7, really much worse. Ng 2007 used this graduated table. The Repeatable Battery for the Assessment of Neuropsychological Status ( RBANS ) is a screening battery designed to mensurate attending and treating velocity, expressive linguistic communication, visual-spatial and constructional abilities, and immediate and delayed memory.A Jerome 2008 used this measuring for to records schizophrenic patient activity. Symptoms Checklist-90 ( SCL-90 ) is used as a screening step of general psychiatric symptomatology. It includes dimensions mensurating somatization, obsessive-compulsive, depression, anxiousness, phobic anxiousness, ill will, interpersonal sensitiveness, paranoid ideation, and psychoticism. This was used by Jerome 2008 Center for Epidemiologic Studies depressive graduated table ( CES-D ) is a short self-report graduated table designed to mensurate depressive symptomatology in the general population. The points of the graduated table are symptoms associated with depression which have been used in antecedently validated longer scales.A It was found to hold really high internal consistence and equal test- retest repeatability. Cogency was established by forms of correlativities with other self-report steps, by correlativities with clinical evaluations of depression, and by relationships with other variables which support its concept cogency. This was used by Jerome 2008. Beck Depression InventoryA ( BDI ) is a 21-questionA multiple-choice self-report stock list, used for mensurating the badness ofA depression from a psychodynamicA position. In its questionnaire is designed for persons aged 13 and over and composed of points associating to symptoms of depression such as hopelessness and crossness, knowledges such as guilt or feelings of being punished, every bit good as physical symptoms such as weariness, A weight loss, and deficiency of involvement in sex. Used by Doyne 1987 and Kendzor 2008 Figure1: Methodological quality sum-up: reappraisal writers ‘ judgements about each methodological quality point for each included survey. Adequate Sequence Generation Allocation Concealment Blinding? Incomplete Outcome informations addressed Free of Selective Reporting Free of Others Bias Merom et Al 2007+++?+–Carta et Al 2008+++++–Ng et Al 2007+–+–Jerome et Al 2008+++–+–Oeland et Al 2010++++++Doyne et Al 1987+++++–Kendzor et Al 2008++––Murphy et Al 1986+++++–Sinyor et Al 1982+++–+–Brown et al 2010++?–+–Hazard of prejudice in included surveies Allotment: All survey reported as randomized. Blinding: None of the surveies were double-blinded. The reported consequences may overstate estimations of intervention consequence and None of the surveies reported any trial of blinding Incomplete result informations: Most of the surveies have withdrawal from the sample population as the highest reported were in Sinyor ( 1982 ) survey which about 60 % remains in the survey, which were due to self backdown from being participant after undergone first stage of intervention. Selective coverage: Most analyze describe the mean and standard divergence. Others beginning of prejudice: most of the survey have inclination of choice prejudice, measuring prejudice and mistake due to consequence of confusing particularly consequence of group therapy and regular undergone intervention. Discussion Ten surveies were included in this reappraisal. Overall, these surveies showed that exercising therapy can hold an impact on mental wellness results like mental province and general operation with no inauspicious effects. There are assorted surveies looking at the impact of exercising towards anxiousness in non-clinical samples utilizing DASS and SCL-90 inquiries tools, which were excluded for reappraisals apart from the ground of its non-clinical test survey design. Compare to usual intervention entirely and GCBT, prolonged and frequent exercising conducted in group for at least 8 hebdomads were significantly effectual in cut down anxiousness, depression and emphasis among patients diagnosed with generalised anxiousness upset, panic upset, and societal phobic disorder. Similar consequence was observed for bipolar upset and major depression in add-on to their usual intervention, irrespective of the psychiatric status badness and exercising strength ( Jerome 2008 ) . Clinical tests have shown high twenty-four hours abstention from drugs and intoxicant best occurs in good structured, high strength group exercising among alcoholic and drugs addict, in add-on to their usual intervention for the job. Kendzor 2008 survey has demonstrated there was no consequence of single low denseness physical activity towards cut downing the heavy imbibing wont. We could reason that, the minimal effectual dosage for exercising to mental position is 40-60 proceedingss session, repeated 3-5 times per hebdomad for uninterrupted 8 hebdomads continuance. This dose plants for low endurance brisk walking exercising with a proper warming up session. Increases in exercising strength will give better physical fittingness, and ideal weight direction. Type of exercising, its strength, and dosage is modified base on underlying fitness degree and age ( Jerome 2008 ; Jokela 2010 ; van Hauvelen 2006 ; Perrino 2009 ) . Others factors that could impact exercising effectivity is the exercising environment. Mackay & A ; Neill 2009 survey shows that there is important relationship between anxiousness alterations and green environment. Exercise strength works for depression ( Brown 2005 ; Jerome 2005 ) and substance usage upset ( Sinyor 1982 ; Brown 2010 ) but non for anxiousness ( Mackay & A ; Neill 2009 ) . It is found that smoking behaviour will detain exercising fittingness consequence ( Tart 2010 ) . AUTHOR ‘S Decision Deduction of pattern Peoples with mental unwellness The consequences of this reappraisal indicate that there are assorted benefits of exercising to persons with anxiousness upset, temper and affectional upset, and substance usage upset, which can better constituents of mental wellness by take parting in structured group exercising. Limited figure of surveies on proper strength and dosage of exercising towards the betterment of mental wellness for the different population group and underlying psychiatric jobs has cause troubles for medical practician to come out with clear counsel to the patient. Physician, physical therapist, professional physical trainers, and wellness pedagogue should be consulted for better support and advice towards implementing exercising as intervention intercession. It is clear from this survey that, exercising plants as accessory therapy for identified psychological jobs and high strength exercising work for substance maltreater and depression patient. The best consequence of exercising is that it conducted in group and being supervised. Patient with anxiousness does responds to high strength exercising but the consequence is non much different comparison to low strength exercising. Current guidelines for lifestyle activity and exercising appear do non truly work for the justified mental upsets. Therefore, roll uping 40-60 proceedingss of proper physical activity on most or all yearss of the hebdomad is a good guideline. This should be continued for lower limit of 8 hebdomads for a better mental position result. Cessation of smoke will further guarantee better wellness benefit. For physician, wellness pedagogue, physical therapist and professional physical trainers Regular exercising is known for its physical, mental, and societal benefits. It is a multidimensional attack that requires physician, wellness pedagogue, physical therapist and professional physical trainers to guarantee patients to go and remaining active for its physical and psychological benefit. Proper information guidelines to patients are indispensable in the long tally. Health practicians should besides be equipped with this latest information and every bit good stress on the safety of intercession to avoid negative consequence of exercising particularly muscle hurt if non decently done. Side consequence of medicine and structural barrier for intercession ( socio economic position, substructure ) every bit good as underlying medical status should besides be considered before recommend this intercession to the patients. In others word, exercising intercession is personalized to accommodate single state of affairs. For policy Structural barrier may restrict patient engagement into exercising intercession in mental upset intervention. It is shown from the surveies that patients with mental wellness have better opportunity to better their morbidity when adhere into exercising intercession as accessory intervention for their implicit in psychological jobs. Proper guidelines for wellness practicians and patients are required for better communicating to present the information for both. Multidisciplinary attack should be emphasized in this patterns which could profound positive impact on patients wellness and well-being. More clip is required to present and explicate this message to patient as the plan is personalized to suit single implicit in societal and physical well-being. Policymakers should see the execution of this multidisciplinary programmes approach within their several intervention installations. They should besides see to supply better exercising installations in the community therefore every bit good promotes green environment and the constitution of good structured community exercising group plan for a long term benefit. There is opportunities that uninterrupted exercising plan could be used as bar of acquired mental wellness jobs due to life-style alterations. More grounds on this is required and with such grounds support, cost benefit or cost effectual analysis of preventative exercising intercession in mental wellness could be established. In long-standing, this could be helpful in cut downing pharmaceutical cost for mental wellness in a state. Deduction for research General There are assorted established measuring used in describing mental wellness result therefore cause troubles to compare the survey consequences. It is recommended that in research pattern for mental wellness result, the measuring should be standardized. Specific It is of import in future for us to hold a clear define continuance, frequence and strength of exercising plan for each mental wellness upset ; sing the implicit in medical and physiological well-being of single. Survey on the alterations of fittingness degree due to the intercession is increasingly in patterns, and in any future research it should be reported in the record. Mental wellness is a complex subject where there is no clear cut point of disease and ever presented with a comorbid status of either other mental upset or chronic diseases. This should every bit good to be considered in future research particularly in intercession survey. It is besides a challenge in the research of this country to guarantee the determination is free from cofounding consequence of biological and societal diverseness in the complex planetary society. In the terminal, with the constitution of complete survey in mental wellness country could lend a better theoretical background to explicate the mec hanism of this variegation. This will assist every bit good towards low cost of intervention in mental wellness upset in the hereafter. Mentions 1. World Health Organization ( 2005 ) . Promoting Mental Health: Concepts, Emerging Evidence, Practice. Geneva: WHO Press. 2. Commonwealth Department of Health and Aged Care 2000, Promotion, Prevention and Early Intervention for Mental Health: A Monograph. Canberra: Mental Health and Special Programs Branch, Commonwealth Department of Health and Aged Care. 3. Australian Bureau of Statistics ( 2007 ) . National Survey of Mental Health and Wellbeing: Summary of Results. Canberra: ABS. 4. Australian Institute of Health and Welfare ( 2006 ) . Australia ‘s Health 2006. AIHW. Canberra: AIHW. 5. Australian Bureau of Statistic ( 2008 ) . National Survey of Mental Health and Wellbeing: Summary of Results. Canberra: ABS. 6. Jerome G.J, Young D.R, Dalcin A et.al ( 2009 ) . Physical Activity Levels of Persons with Mental Illness Attending Psychiatric Rehabilitation Programs. Schizophrenia Research. 2009 ; 108 ; 252-257 7. Tart C.D, Leyro T.M, Ritcher A, Zvolensky M.J, Rosenfield D, Smith J.A.J ( 2010 ) . Negative Affect as a Mediator of the Relationship between Vigorous-Intensity, Exercise and Smoking. Addictive Behaviors. 2010 ( 35 ) ; 580-585 8. Mackay G.J, Neill J.T ( 2010 ) . The Effect of â€Å" Green Exercise † On State Anxiety and The Role of Exercise Duration, Intensity, and Greenness: A Quasi-Experimental Study. Psychology of Sport and Exercise. 2010 ; 11 ; 238-245 9. Perrino T, Mason C.A, Brown S.C, Szapocznik J ( 2009 ) . The Relationship Between Depressive Symptoms And Walking Among Latino Older Adults: A Longitudinal, Cross-Lagged Panel Analysis. Aging & A ; Mental Health, 14: 2, 211 – 219 10. Doyne, E. J. , Ossip-Klein, D. J. , Bowman, E. D. , Osborn, K. M. , McDougall-Wilson, I. B. , & A ; Neimayer, R. A. ( 1987 ) . Runing Versus Weight Lifting In the Treatment of Depression. Journal of Consulting and Clinical Psychology, 55, 748-754. 11. France, C. , Lee, C. , & A ; Powers, J. ( 2004 ) . Correlates of Depressive Symptoms in A Representative Sample Of Young Australian Women. Australian Psychologist, 39, 228-237. 13. Bryan A, Hutchison K.E, Seals D.R, & A ; Allen D.L ( 2007 ) . A Transdisciplinary Model Integrating Genetic, Physiological, and Psychological Correlates of Voluntary Exercise. Health Psychology, 26, ( 1 ) , 30-39 14. Brown W.J, Ford J.H, Burton N.W, Marshall A.L, Dobson A.J ( 2005 ) . Prospective Study of Physical Activity and Depressive Symptoms in Middle-Aged Women. American Journal of Preventive Medicine, 2005 ; 29 ( 4 ) :265-272 15. Somers JM, Goldner EM, Waraich P, Hsu L ( 2006 ) Prevalence and Incidence Studies of Anxiety Disorders: A Systematic Review of the Literature. Can J Psychiatry, 51:100-113 16. Waraich P, A Goldner EM, A Somers JM, A Hsu L ( 2005 ) Prevalence and Incidence Studies of Mood Disorders: A Systematic Review Of The Literature. Can J Psychiatry. 50 ( 9 ) :569-70. 17. Mutrie N, Faulkner G. ( 2003 ) Physical Activity and Mental Health. In: Everett T, Donaghy M, Fever S editor ( s ) . Physiotherapy and Occupational Therapy in Mental Health: An Evidence Based Approach. London: Routledge,82-97. 18. Faulkner G, Taylor AH. Exercise, Health and Mental Health: Emerging Relationships between Physical Activity and Psychological Well-Being. 1st Edition. London: Routledge, 2005. 19. Altman DG, Bland JM. Detecting Lopsidedness from Drumhead Information. BMJ 1996 ; 313:1200. 20. Van Heuvelen MJ, Hochstenbach JB, Brouwer WH, de Greef MH, Scherder E ( 2006 ) Psychological and Physical Activity Training for Older Persons: Who Does Not Attend? Gerontology. 52, 6, 366-75 21. 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Oeland AM, Laessoe U, Olesen AV, Jorgensen P ( 2010 ) Impact Of Exercise On Patients With Depression And Anxiety. Nord J Psychiatry. 64:210-217. 26. Kendzor DE, Dubbert PM, Olivier J, Businelle MS, Grothe KB ( 2008 ) The Influence Of Physical Activity On Alcohol Consumption Among Heavy Drinkers Participating In An Alcohol Treatment Intervention. Addictive Behaviors. 33 ; 1337-1343 27. Sinyor D, Brown T, Rostant L, Seraganian P ( 1982 ) The Role of a Physical Fitness Program in the Treatment of Alcoholism. Journal of Studies on Alcohol. 43 ; 3. 28. Brown RA, Abrantes AM, Read JP, Marcus BH, Jakicic J, Strong DR, Oakley JR, Ramsey SE, Kahler CW, Stuart GL, Dubreuil ME, Gordon AA ( 2010 ) A Pilot Study Of Aerobic Exercise As An Adjunctive Treatment For Drug Dependence. Mental Health and Physical Activity. 3 ; 27-34 29. 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Sepsis and Barbara

This portfolio will provide evidence of my experience in an acute care setting. I will provide an appendix giving a brief summary of a patient I cared for whilst undertaking a placement in an acute setting. This portfolio of evidence will be based on a patient diagnosed with sepsis secondary to her chest infection. I will discuss extensively the aetiology, pathophysiology and clinical features of a patient presenting with sepsis treated in an acute care setting.I will explore the role of the different healthcare professionals that were involved in the care of the patient describing how they contributed to her holistic care. I will incorporate evidence base supporting the approach used by the doctors, nurses and microbiologists in the diagnosing and caring for the patient. I will equally evaluate practice using findings from contemporary research policy and practice on the care of the adult with acute care needs.I will also discuss the value of our practice in accordance with professi onal, ethical and legal frameworks that ensure the privacy of the patient’s interest and well-being. Finally, I will conclude by summarising this portfolio of evidence in relation to acute care practices and focus on identifying my future learning needs in developing myself personally and my professional practice. It is indicated by Latto (2011) that a meeting between The American College of Chest Physicians and the Society of Critical Care Medicine in 1991 brought about the use of systemic inflammatory response syndrome (SIRS) to define sepsis.SIRS being manifestation of two or more of certain medical signs including, a temperature of less than 36 degrees Celsius or greater than 38 degrees Celsius, a heart rate of over 90 beats per minute, respiratory rate of over 20 breaths per minute and white blood cells count of greater than 12000 or less than 4000. Further on to recognise sepsis, a patient has to have at least two signs of SIRS as well as a documented infection. Sepsis, as defined by Matot and Sprung, (2001) â€Å"is the systemic inflammatory response to infection. In addition to this definition, Herwald and Egesten (2011) indicate that sepsis could also be defined as the existence of bacteria or other micro-organisms in the blood, hypotension or shock. Rello, Diaz and Rodriguez (2009) emphasise that there is a difference between sepsis and systemic inflammatory response syndrome (SIRS) as sepsis is systemic inflammatory response to  infection  while systemic inflammatory response syndrome is a tool used to simplify the diagnosis of sepsis.Sepsis occurs as a result of the body fighting infection that has spread though the body via the blood stream as defined by Sepsis Alliance UK (2012). Barbara presented with low blood pressure, a high temperature, tachycardia and an increased respiratory rate. Patients who present with sepsis can progress to severe sepsis which is defined by Marini and Wheeler (2010) as â€Å"a syndrome caused by infection and defined by the presence of vital sign abnormalities and new organ system failure caused by the ensuing inflammation and coagulation. Associated with severe sepsis, there are three integrated responses as explained by Kleinpell, R. (2003) which are; activation of inflammation, activation of coagulation, and impairment of fibrinolysis. As the body detects infection, its natural response is inflammation. â€Å"Inflammation is a response of a tissue to injury, often injury caused by invading pathogens. It is characterized by increased blood flow to the tissue causing increased temperature, redness, swelling, and pain. † Kleinpell (2003).Ball (2011) in describing the process of inflammation in the body explains that inflammation occurs due to the white blood cells releasing pro-inflammatory mediators called cytokines these are proteins, peptides, or glycoproteins which include tumour necrosis factor alpha, interleukin-1 and interleukin-6, the white blood cells also releases a platelet-activating factor which is a lipid mediator that is well-known for its ability to cause platelet formation. The work of these mediators is to repair damages caused and prevent further damages from occurring.Normally, the body’s response in order to prevent damage by the release of these pro-inflammatory mediators is to release anti-inflammatory mediators which are interleukin-4 and interleukin-10 these are also cytokines which are a type of protein. In severe sepsis, there are excessive pro-inflammatory mediators which are not regulated by the anti-inflammatory mediators which results in overwhelming inflammatory reactions causing impaired tissue function and organ damage. Due to the pro-inflammatory mediators being released and unregulated by anti-inflammatory mediators, coagulation is promoted which is the clotting of blood.This happens in the capillaries which obstructs the flow of blood into the tissues causing hypoxia which then leads to the dysfunction of orga ns. Hypoxia is defined by Wiebe and Machulla (1999)  as â€Å"reduction of oxygen supply to tissue below physiological levels. † The activation of coagulation then causes fibrinolysis to be activated. Fibrinolysis is the process of breaking down of blood clots as defined by Leslie, Johnson, and, Goodwin (2011). This happens because the levels of plasminogen rapidly reduce.Plasminogen is a protein that when activated by enzymes transforms into plasmin which promotes dissolving of blood clots. Though the plasminogen levels fall rapidly, the antiplasmin levels remain normal which causes an end result of a decrement in the fibronolytic response. â€Å"The imbalance between inflammation, coagulation, and fibrinolysis that occurs in severe sepsis results in systemic inflammation, widespread coagulopathy, and microvascular thrombosis, conditions that can lead to multiple organ dysfunction†Ã‚  Kleinpell (2003)   Severe sepsis if not properly treated can then lead to septic shock.Septic shock is defined as sepsis with hypotension which is unresponsive to fluid resuscitation as well as abnormal perfusion that may include lactic acidosis, oliguria or alteration in mental status, Sepsis Alliance UK. (2012). In relation to the care that Barbara received whilst being treated for sepsis, there were different health care professionals involved throughout her stay in the hospital. An inter-professional team worked together to ensure that she was given holistic care taking into consideration the social aspect of her life, her spiritual values, her emotional and mental state of mind and full physical care.On recording Barbara’s clinical observations, we passed on our results to the doctors as Barbara was scoring a mews of seven. Guidelines on the Modified Early Warning Signs chart advices that if a patients’ scores a MEWS of four or more, the patient must be referred for urgent medical review, NHS Outer North East London Community Services (2011) The doctors immediately ordered for blood cultures to be taken. The blood cultures were used to investigate the reason why Barbara had an increased temperature as an increased temperature is a sign of infection as described by Hegner, Acello and Caldwell (2009).The blood tests and cultures taken were also to test for the serum lactate level, white blood cell count, tests to check how the liver and kidneys were functioning. The doctors then prescribed fluids to help in increasing Barbara's blood pressure. Working collaboratively to enhance the care that Barbara received, the microbiologists were involved in the diagnosis and care she received through the involvement by the doctors requesting for blood samples to be taken and investigating the reason why Barbara had an elevated temperature.By collecting a sputum sample from Barbara, the microbiologists were also involved in looking for the medication sensitive to the bacteria causing Barbara’s chest infection. The microbiologis ts also took blood for arterial blood gases test. They were very efficient in delivering the results of the blood tests showing that Barbara had an increased white blood cell count. Her serum lactate levels were 3. 4mmols/l. An increased white blood cell count along with an elevated temperature proved to the doctors that Barbara had an infection.The doctors commenced Barbara on the sepsis six bundle. The sepsis six bundle is a guideline within the Surviving Sepsis Campaign which gives information on what should be done in the first 6hrs that sepsis is diagnosed in a patient in order to aid safe recovery. The nurses ensured that from the moment Barbara was admitted, it was a duty to monitor her clinical observations. With the use of the Modified Early Warning Signs (MEWS) chart, we recorded her observations which enabled us to monitor changes in her blood pressure, respiratory rate, temperature, heart rate and oxygen saturation.This was also a way for us to assess her consciousness l evel checking to see if she was alert, responsive to voice alone, responsive to pain alone or unconscious. This enabled us to check for signs of improvement in her health or for deterioration. Our duty as nurses was to provide 24hr care to Barbara. With a blood pressure of 85/42 mmHg we ensured that Barbara got enough fluids as were prescribed by the doctors. These fluids were given intravenously to increase Barbara’s blood pressure.In a patient with sepsis, due to vasodilation as an inflammatory response to the infection, arterial circulation is ineffective therefore; intravenous fluids are required as advised by Institute for Healthcare Improvement (2011) Apart from receiving care from the nurses, we referred Barbara to the occupational therapist. The role of an occupational therapist as defined by Institute For Career Research, (2007) is to help in the development, recovery and maintaining of daily living and work skills of people with conditions that are disabling mentall y, physically, emotionally and developmentally.Institute For Career Research (2007). They ensured that on returning home, patients will have everything needed to make them comfortable. If need be, they will get their houses modified with a stair lift, a ramp or any additional equipment needed for them to make living at home easier. In relation to Barbara, the occupational therapist focused on her personal care, they assessed how easy or difficult it was for her to wash and dress herself and if she could manage cooking her food in the kitchen.This enhanced collaborative working as this enabled the nurses to be aware of what steps needed to be taken to provide optimum care to Barbara. We were informed by the occupational therapist that she would need all care in the area of her personal hygiene and assistance in most areas of her activities of daily living. With the information derived from the occupational therapist, we were able to refer Barbara to the social services to ensure that when she was fit for discharge, extra measures were taken to provide her with care in her own home.Barbara also received care from the physiotherapist. The role of the physiotherapist is to work as part of the multidisciplinary team to assess the patient and then provide treatment. Treatment would include exercise, movement, hydrotherapy, electrotherapy, massages and manipulation. A physiotherapist is also involved in providing health education this is elaborated by NHS Scotland (2002). In relation to Barbara, after we had referred her to the physiotherapy, they ensured that she received physiotherapy for her chest which was a series of claps on her chest, back and under her arms.This was very helpful to Barbara as due to her chest infection, she had a lot of mucus in her breathing passages and with treatment from the physiotherapist; she managed to cough it up. This positively enhanced the care that Barbara received as through collaborative working, the physiotherapist encouraged the loosening of mucus from her breathing passages which enabled us as nurses to acquire a sputum sample to send to the microbiologist to test for what antibiotics were suitable to treat Barbara’s chest infection.In addition to having lung cancer, Barbara also had liver and bone metastasis. With her consent, we involved the Macmillan nurses in her care. They focused on the social, emotional and practical impact cancer had on Barbara. They also gave her information on different support groups which were accessible to her and meetings where she could share her experience and listen to others experiences. Involved in the care of Barbara was the church priest.As Barbara was too ill to attend the hospital Sunday services as were her wishes, we invited a priest who could give her communion, emotional and spiritual support through her stay in the hospital. Barbara had a reduced appetite so we commenced her on a food diary in which we recorded everything that Barbara ate and how much of it she ate. After three days of commencing Barbara on the food diary, we showed it to the dietician. Barbara was quite ill and did not have the strength to take part in most of her activities of daily living including feeding herself.The dietician came to the ward to review Barbara and then prescribed ensure drinks and little cups of procal shots. These are nutrient supplements which provide protein, fat and carbohydrate in the body. All healthcare professionals worked together to enhance the quality of care that Barbara received although because Barbara had been diagnosed with sepsis, the decision of the dietician to provide Barbara with medication to boost her nutrition arguably caused deterioration in Barbara’s health.Studies show that when treating a patient with sepsis, permissive underfeeding is required to ensure that recovery is enhanced as encouraging a lot of dietary intake would cause lipogenesis which would result to excess production of carbon dioxide and res piratory overload, hyperglycaemia and over usage of energy which would lead to stress for the patient. Vincent, Carlet and Opal (2002).In supporting the doctors’ decision to prescribe intravenous fluids for fluid resuscitation on Barbara, Evidence has shown from the Surviving Sepsis Campaign (2011) under the sepsis resuscitation bundle that patients who are suspected of being in septic shock should be commenced on fluid resuscitation immediately. Guidelines on the Surviving Sepsis Campaign states that, â€Å"In the event of hypotension and/or lactate ;gt; 4mmols/L (36 mg/dL) deliver an initial minimum of 20 ml/kg of crystalloid (or colloid equivalent). † As explained by Winters and Glatter (2009), serum lactate levels are used to identify patients who have sepsis.They explain that an elevated serum lactate level is a method of forewarning of an increased mortality in patients with sepsis or septic shock. This proves that ordering for blood tests to check the serum lact ate level of Barbara was a positive step in treating Barbara by identifying the diagnosis of Barbara’s condition. Current evidence from the Surviving Sepsis Campaign (2011) indicates that analysing serum lactate levels in septic patients is not conclusive as â€Å"a number of studies have suggested that elevated lactate levels may result from cellular metabolic failure in sepsis rather than from global hypo perfusion.Elevated lactate levels can also result from decreased clearance by the liver. Although blood lactate concentration may lack precision as a measure of tissue metabolic status, elevated levels in sepsis support aggressive resuscitation. † This gives reason to why the doctors ordered for blood tests to be taken so as to measure Barbara’s serum lactate level. Through continuous input of intravenous fluids, Barbara’s blood pressure increased to 99/55 and remained stable and she was now scoring a MEWS of 3 as her respiratory rate was still elevate d at 24 breaths per minute and a heart rate of 105 beats per minute.Barbara’s temperature was still a little bit elevated at 37. 4? C but not scoring on the MEWS chart. The MEWS chart played a very important role in helping us evaluate Barbara’s health status. Although different studies show that there are pros and cons of using the MEWS system to evaluate patients’ health status. Studies show that the modified early warning scoring systems in the accident and emergency department or an acute care setting can help healthcare professionals identify patients that are at risk of deterioration.Though, concerns have been raised questioning the sensitivity of this system as a risk assessment tool in comparison with the early modified warning score (EWS). Griffiths and Kidney (2011), in their survey assessing the use of MEWS in the UK’s acute care departments found out that over 90% of respondents in the survey supported the use of the Early Warning Score in hel ping identify deterioration or improvement in patients who are admitted to the acute care departments to the use of the Modified Early Warning Score.This is evidence that supports the practice of nurses in monitoring Barbara’s condition through the use of modified early warning score. On the other hand, another study shows that many issues arose in implementing the MEWS chart in recording patients’ observation. The problems encountered with the MEWS chart include complaints of font size, size of the boxes provided to write in and due to this, some staff members have been reluctant to engage with the process making it difficult to monitor deterioration in acutely ill patients.NICE (2011) I think that the MEWS chart was very effective in helping us monitor Barbara’s condition because we were able to use the information recorded on it as a means of communication with other healthcare professionals involved in her care. In caring for Barbara, we ensured that her con fidentiality was optimised. This is a professional requirement for every nurse by the Nursing and Midwifery Council (2008). Through the use of a model called ‘Situation – Background – Assessment – Recommendation’ (SBAR), we ensured that communication between all health care professionals were detailed and solely on a need to know basis.This model did not only protect the confidentiality of Barbara, it also encouraged assessment skills helping to provide all information to health care professionals in a manner that makes it difficult to omit any information. In communication with other bodies involved in Barbara’s care, SBAR stood as a guideline in divulging information. Stating the situation Barbara was in, giving background information only in relation to her present condition, providing results of assessments carried that would relate to their function in the care of Barbara and finally getting the recommendation from the other body.This wa y, disclosure of information is kept to a minimum. Confidentiality is a key concept in protecting people that are vulnerable. Apart from being an ethical requirement, confidentiality also is a legal requirement. The legal principle of confidentiality lies within the Data Protection Act (1998), which simplified by Mind (2005) states that â€Å"Confidence is breached by the unauthorised use or disclosure of confidential information. † This act emphasises the principles that define confidentiality one of which includes sensitive personal data.This has to do with matters relating to a persons’ ethnicity, religious and political beliefs, physical and mental health, sexual orientation as well as criminal offences. In relation to Barbara, whenever we received a phone call from people claiming to be family members, in order to protect Barbara’s confidentiality, we never disclosed results of tests or doctors’ orders. We always gained consent from Barbara before gi ving information out to other parties involved in her care.Timing when caring for critically ill patients is a valuable commodity which makes it important to be able to identify when a patient is in need of urgent medical attention. In the course of looking after Barbara through her admission in the hospital, I realised that prioritising care was the main issue surrounding her treatment. Observing my mentor who was in charge of Barbara’s care as well as nine other patients, using the ABC technique she was able to prioritise the care that Barbara received.Ensuring that she had open Airways, Breathing with addition of oxygen therapy, Circulation through constant monitoring of her blood pressure. Prioritising of care is a skill that is essential in a care setting because if it was decided that all patients would be cared for in respect of their bed position on the ward, that would have had a negative impact on Barbara because she would not have received the urgent attention that she needed which could lead to a tragedy.Through prioritising care, my mentor was able to organise herself in caring for the other patients she was in charge of placing Barbara on the top of her list because she was in constant need of urgent care as when it was time for her intravenous fluids to be commenced because she had organised her time accurately she was able to meet up with demands placed by Barbara’s condition as well as demands of her duty to the other patients.In conclusion, this portfolio of evidence has defined the different stages of sepsis. It has explored the causes, pathophysiology and clinical manifestations. Fluid resuscitation was highlighted as the most important step to take in recognising a patient with sepsis. I described the different roles of the healthcare professionals in relation to the care that Barbara received.Using information from the surviving sepsis campaign, I explained the guidelines used in the treatment of sepsis and related it to the steps taken by the doctor to treat Barbara. I identified the key strength of my mentor in working under pressure by prioritising care. This is an area that I will need to develop myself in the course of attending placement in the future. I will research on techniques of prioritising patient care and research on the process of triage in relation to a care setting.

Nutrition Essay Example | Topics and Well Written Essays - 1250 words - 2

Nutrition - Essay Example For protein, the AMDR is 10 to 35% and the percent calories derived from my protein intake is found between the two limits. The AMDR for fat is 30 to 35% and the percent calories from my fat intake is again in between the two limits. Are there any nutrients from your diet that are above the recommended Tolerable Upper Limit (UL) – see front cover of the text for the table listing UL for various nutrients (please note that not all nutrients have an UL. Do you take a multivitamin? If so, after analyzing your diet, do you think you need to continue taking a multivitamin? If you do not take a multivitamin, do you think you need to take a multivitamin or do you think you can meet your needs by the foods you consume? According to the nutrition analysis that I have printed out, my intake of the following nutrients is 100% below the DRI: fiber (15.77%), calcium (41.76%), iron (81.3%), phosphorus (85.5%), ash (5.51%), vitamin A (74.87%), vitamin C (49.27%) and cholesterol (48.03%). Fiber is usually found in oats, seeds, beans, barley, peas, lentils, apples, citrus fruit, carrots, plums, and squash. Adding 3 apples, 2 potatoes with skin, 2 cups of lentil soup or 1 cup of bran in my diet would increase my intake of fiber. In order to address my calcium deficiency, I can add 2 cups of skim milk and 227 grams of yogurt in my daily diet. I should also add 10 cups of vegetables and two oranges a day in order to have more iron and vitamin C in my diet. With these additions to my diet, my lack of Vitamin A and cholesterol would also be addressed. The following nutrients, on the other hand, are above the 150% DRI: sodium (215.38%), thiamin (329.40%) and riboflavin (234.24%). Among these three, the quantity of sodium that I have consumed is the most alarming. For all three days, my consumption of sodium has gone over the tolerable upper limit of 2.3 grams per day. This excess can be a future cause of high blood pressure and kidney

Knowledge is nothing more than the systematic organisation of facts Essay - 1

Knowledge is nothing more than the systematic organisation of facts. Discuss this statement in relation to two areas of knowledge - Essay Example This was classical definition of knowledge which was ultimately endorsed but initially was described by Plato. Some grasp of knowledge’s relationship to information is required by an understanding of knowledge. The difference between knowledge and information has long been the practice in everyday language (Daniel, 2006, pp. 36).â€Å"Knowledge is nothing more than the systematic organization of facts† is the main theme of this essay. This essay will discuss this statement in relation to two areas of knowledge, i.e. history and ethics. Furthermore, it will investigate the ways of knowing and the two areas of knowledge. The potential knowledge issues, the sort of real life situations which can be drawn out and the challenges and difficulties will also be addressed by this essay. The labeling and division of the knowledge we posses are referred to as the areas of knowledge. Eight different areas of knowledge are identified by the TOK course. Ethics and History are the two areas of knowledge, which I will consider. The study of how to live our lives morally or the moral philosophy is referred to as ethics. Ethics is a branch of knowledge which is concerned with moral principles. The issue of moral issues is an example of a key area of discussion in ethics. Conduct is influenced or governed by these moral principles. The study of morals is referred to as ethics. Since ethics is based on the mind of an individual, therefore, knowledge may be refuted by the idea of ethics. Ethics may be based on beliefs or religion or may be raised through our own experience. In order to list things as facts, there may not be a written formula booklet of ethics. Since ethics is created and related to the time we live now, therefore, it is not highly related to the past. An area of knowledge that studies the recorded past is referred to as history. Understanding of human behavior can be deepened through study

Perspectives on Industrial and Corporate Change Case Study

Perspectives on Industrial and Corporate Change - Case Study Example Organizational structure and the leadership style as they realized that to improve the quality  of work they needed to improve the quality of work life of the employees as well.  To achieve this they began using a five-phase diagnostic model with two aims in mind. The first aim was whether this model of strategic human resource development could still be in use in five years and the second aim was to see what the changes were to achieve this goal. The diagnostic model of assessment required to see the strengths and weaknesses of the organization in question as well as every aspect within the organization itself (including employment, finances and leadership style and atmosphere). The model of SHRD (Strategic Human Relations Development) since it was delegated into phases took several years to be implemented. One of the most important benefits gained for the Tetra Pak project1 was the implementation of better communication systems in every area (especially that of employer-employe e relationship) and as a result of these several employees who have never been able to communicate effectively began to see this as an opportunity to voice out their opinions. The betterment of communication within the organization is very important  because effective communication allows for a better work environment and dissipates any resistance or discontent among the workforce. Proper understanding leads to a better quality of work as the supervisors and management are able to convey what they want to the workforce and the workforce has the ability ask what is required and needed and whether they will be able to do the task at hand.  Dosi, G., Teece, D. J., & Chytry, J. (Eds.). (1998). Technology, Organization, and Competitiveness: Perspectives on Industrial and Corporate Change. Oxford: Oxford University Press. Retrieved May 5, 2007,   L., Hailey, V. H., Stiles, P., & Truss, C. (1999). Strategic Human Resource Management Corporate Rhetoric and Human Reality. Oxford: Oxfor d University Press. Retrieved May 5, 2007 C., Cole, C., & Brunning, H. (1997). A Manual of Organizational Development: The Psychology of Change. London: Karnac Books. Retrieved May 5, 2007, from Questia database: http://www.questia.com/PM.qsta=o&d=55270794

Accident Victim Interview Report Essay Example | Topics and Well Written Essays - 500 words

Accident Victim Interview Report - Essay Example The victim was engrossed in his job and since he was wearing ear buds to protect him with too much noise he didn’t notice the chaos. He was unfortunately caught by the fireball after the explosion and sustained burn injuries. The quick action of his fellow co-workers and immediate first aid given to him saved his life. The Chemical Safety Board investigated the cause of accident and reported that a contractor had accidently switched a carbon steel pipe elbow with a low alloy steel pipe elbow during the maintainance work. This caused rupture in the pipe leading to leading to a failure mode called High- Temperature Hydrogen Attack (HTHA) causing fireball. The CBS found that it was not solely the mistake of the contractor, the company had not informed that the elbows were different and the maiintainance contractor had not used any method like tagging to re-install the elbows in their position. The victim was immediately rushed to the nearby hospital where he was immediately diagnosed and admitted for treatment. Doctors reported 20 percent first degree minor skin burns on covering his upper part of the body. He stayed in the hospital for about a week and missed work for another week before recovery. Some burn marks he still sustains on his body, however he is completely fit for work and thanks God for giving him a second life. The company took responsibility to bear the cost of his treatment and the labour union also demanded descent compensation for him till he recovered and joined work again. His company has witnessed two more accident cases prior to this one and they were fatal accidents leading to severe loss of capital and labour. This accident was followed by OSHA visit to issue safety guidelines and check the safety standards in the refinery. Following this accident the CBS recommended that industry should have its own committee to monitor the safety standards, hazard identification and

Personnel management Essay Example | Topics and Well Written Essays - 2000 words

Personnel management - Essay Example The main significance of diversity in any organization is that the employees can face many adversities and contingencies on a continuous basis. In a workplace where there is diversity, one can see that the employees have more empowerment and official rights. The main objective of an organization in attracting different employees is to enhance the team workability and talent pool. Moreover, the human resource department of an organization has more selection in recruiting employees if the workforce of the organization is supposed to be diverse and versatile. The workforce of an organization can be diverse in relation to many factors: gender, race, nationality, disability and education. Moreover, the organizations can reap more advantages and disadvantages from the employees if work diversity exists in a workplace. Practically, if we consider defining the concept of workplace diversity, it can be referred to as the inclusion of variety of people in an organization to receive full potentiality out of them. According to Edwards (2012), â€Å"When the workplace is diverse, it shows that your establishment is a true equal opportunity business that hires people with different backgrounds and races, instead of segregating, or discriminating against a certain individual†. The diversity in a workforce has a highlight of extracting potentiality from various human resources available throughout the world. This includes various types of people with different instincts who can contribute to the success and profitability of an organization. In America, the workforce diversity can be reflected in the employer’s option of hiring people aged from 25 to 64 in an attempt to get maximum potentiality and experience from the country’s manpower. In the same manner, it has been recently noticed that the recruitment of Hispanic/Latino employees has

Judaism , Christianity and Islam Essay Example | Topics and Well Written Essays - 1250 words

Judaism , Christianity and Islam - Essay Example Knowledge of God and certain religious practices have been handed down from one generation to another even before the age of written history. In the case of the three monotheistic religions, oral traditions have been documented in scriptures, and for which the claim to divine inspiration and revelation had become a common basis of faith and devotion. The Hebrew bible detailed the story of Israel in the light of the covenant between God and His people, and depicts a continuing saga of that relationship and of the saving acts of God. Christians, on the other hand refer to the Old Testament (sourced out from the same Jewish bible) as historical documentation of salvation and prophesies over the coming messiah. The fulfillment of such prophesies and salvation, however is contained in the New Testament which detailed the teachings of Christ, His death and resurrection, and ascension to heaven, including the spread of Christianity shortly after He went up to heaven. For Muslims, the very w ord of Allah, was revealed to the prophet Muhammad by the angel Gabriel. According to Muslim tradition, after this ecstatic experience Muhammad was able to recite exactly what he had been told. The term Qur’an, which means recitation,† occurs several times in the text itself; the term refers either to a fragment of the revelation or to the entire collection of revelations that are known as the Qur’an, the holy book of Islam (Microsoft Encarta) . All scriptures, each creed uses, tells us the story of the promise God made to Abraham, â€Å"I will shower blessings on you, I will make your descendants as many as the stars of heaven and the grains of sand on the seashore† (Genesis 22:17 - JB). There and then, the verse became the basis as to why the three religions are collectively referred to as â€Å"Abrahamic.† Both â€Å"Jews and Muslims, as well as Christians, trace

Consumerism Essay Example | Topics and Well Written Essays - 500 words

Consumerism - Essay Example Part of the problem is the â€Å"image† that we are expected to portray. Most people subscribe to the theory, â€Å"if everyone else is buying it, then I want that too.† If one of your friends went out and bought a new Ferrari, even though he already owned four cars, then you would inevitably feel envy towards him. Society would demand that you went and did exactly the same thing because you cannot look â€Å"out of place.† Broken down, consumerism basically is correlated with social standing. If you are of a certain social class, then specific lifestyle choices are expected of you. Take for instance our neighborhood friend who is making not much more than the minimum wage. She is a teenager so there are always expectations that she is cool enough for her peers. Peer pressure plays an enormous part in consumer spending. Our teenage neighbor makes only $8 per hour, which is barely enough to survive; yet she is spending hundreds of dollars on Gucci shoes and Prada bags. We must ask ourselves why she feels the need to be extravagant when she can’t afford it. The reason for this is twofold: (1) she has to uphold an acceptable image to her peers and (2) she is constantly being bombarded with advertising telling her that her life would be incomplete without a certain product. Advertisers generally use famous people to help promote their products because the regular consumer looks up to them as a role model. Our neighborhood friend is no different from the rest of us—she feels pressured to live a lifestyle that is perceived bring happiness in our lives. The problem with consumerism is that it increases the gap between the rich and the poor. According to the World Bank, the richest 10% of people on earth account for over half the total consumption. On the other hand, the poorest 10% only contribute less than 1% towards the global total. Consumerism is contributing to the breakdown of societies as

Network Design Consultation Essay Example | Topics and Well Written Essays - 2000 words

Network Design Consultation - Essay Example As for the server Windows server 2008 operating system would have to be installed, this is because the server would be used to manage the entire network. Because Windows Server 2008 is well designed to configure the networks as well as manage files and security settings it will be then recommended as compares to convectional operating systems because it has been optimized to manage a networked environment. To ensure the security of the network from outside intrusion a firewall would be most essential to handle cases of outside intrusion (Davis, 2004). In this case the option of using the inbuilt firewalls that come with the operating system may be used or alternatively a third party firewall maybe procured. For the network to operate a suitable network architecture has to be put into consideration (Hallberg, 2010). In this case a star topology will deployed due to the following reasons: first of all since the network would be managed centrally, cases on interruption upon a nodes’ failure would not disrupt the entire network. Secondly a star topology allows for easy expansion, for instance a technique called daisy chaining can be deployed whereby another switch can be connected to the main switch as another node and serve as a center of a second star topology (Sean Walberg, 2010). Since in this case one topology is deployed our network infrastructure will be illustrated as follows. The device wireless access point will have to be enabled so that the router can propagate wires signals. Secondly SSID (Service Set Identifier) will have to be set to default as well as allow for broadcast of SSID to associate in order to allow for wireless devices to detect the network when they come within range. Chanel settings allows one to select between the available channels offered by the router in our case 11 channels are available, this is

Ethics in Information Technology Essay Example for Free

Ethics in Information Technology Essay Chad White (2009) discussed that by the end of 2008, retailers have been sending a record breaking number of promotional emails. The main question is, is this increase worth the price of all the negative consequences of such campaign? Cassar (2009) said that people had less money to spend in 2008 and that they view the internet as a deal seeking venue but not actually purchase online. There are a lot of costs associated with even simple system messages like, â€Å"You have items left in your cart. † Doubling the sending of these emails over the holiday period can cause some serious irritation, too, as the company can easily be marked as spam because of these emails that are being sent at least twice daily by some. Before actually spending out the money for these promotional mails, it might be better if the companies spend the extra cost in promotion by helping the customers save more, for instance, they can offer a promotional coupon or free shipping. Noguchi (2008) said that email has become too time-consuming for people that instead of aiding to get things accomplished, email has become a distraction from work being done. In another article, Noguchi (2008) said that family can be reasons for email overload as some members of the family love sending pictures, videos and all other stuff they can think of to every email address they have on file. These things can get really distracting especially at work. Suggestions to resolve this dilemma: a person can always limit messages in his mailbox, do not open personal emails at work, mark emails requiring action, use spam blockers, be alert on the proper subject headings (Asiado 2010). The key is being organized (Asiado 2010). Schaper (2009) said that one way to avoid email overload is taking a break from emails even once a week. In fact, his research showed one Chicago based company is implementing this exact same rule. They understand that email is important and necessary to business but it can just be toxic, hence this policy. Glenn (2008) said that there is practically no privacy at work. Everything done by an employee on a work computer can easily be seen by his employer as everything is saved in the company’s hard drive. There is only one suggestion to resolve this: avoid using work computer to do incriminating acts against your own person or another. References: Asiado, T. (2010). Tips How to Reduce Email Overflow at Work. Suite101. Retrieved, 14 July 2010, from http://businessmanagement. suite101. com/article. cfm/tips-to-reduce-email-overflow-at-work Cassar, K. (2009). Little Holiday Cheer Ahead for Online Retail. neilsenwire. Retrieved, 14 July 2010, from http://blog. nielsen. com/nielsenwire/consumer/little-holiday-cheer-ahead-for-online-retail/ Glenn, H. (2008). E-mail at Work: Tips to Keep You out of Trouble. npr. org. Retrieved, 14 July 2010, from http://www. npr. org/templates/story/story. php? storyId=91604666 Noguchi, Y. (2008). Help! Family Spam is Crowding My Inbox! npr. org. Retrieved, 14 July 2010, from http://www. npr. org/templates/story/story. php? storyId=91402876 Noguchi, Y. (2008). Make it Stop! Crushed by Too Many E-Mails. npr. org. Retrieved, 14 July 2010, from http://www. npr. org/templates/story/story. php? storyId=91366853 Schaper, D. (2009). An E-Mail Vacation: Taking Fridays Off. npr. org. Retrieved, 14 July 2010, from http://www. npr. org/templates/story/story. php? storyId=91724075 White, C. (2009). Email Volume Sets New Records During Holidays. mediapost. com. Retrieved, 14 July 2010, from http://www. mediapost. com/publications/? fa=Articles. showArticleart_aid=98215

Dulce et Decorum est - Anthem for Doomed Youth Essay Example for Free

Dulce et Decorum est Anthem for Doomed Youth Essay Dulce et Decorum est and Anthem for Doomed Youth are two poems written by Wilfred Owen during the First World War. Owen, like most soldiers, joined up after being convinced that war was fun by propagandistic posters, poems and stories, and once he had realised that the truth was quite the opposite of this, he decided that it was his responsibility to oppose and protest against poets like Jessie Pope through poetry itself. People were not prepared for the sheer scale and manner of death and the mechanised nature of trench warfare, and had false expectations of the heroic endeavour, but little awareness of the realities. However, compared to Dulce, the anger portrayed is dramatically understated. Dulce is an outrageous protest, displaying the haunting and bitter effects of war, and after describing in great detail the horrific story of a soldier drowning and choking in gas, Owen reveals his passionate hatred for the false and misleading idealisms of heroism in war using particularly emphatic imagery in cancer and froth corrupted lungs. The fact that Anthem is a sonnet, is ironic in that they are usually about love, and because it is actually about grief, it somewhat lulls the reader into a false sense of security, therefore making the poem more effective. Both poems seem to talk about the vile and painful conditions in war, Dulce using onomatopoeia in trudge, giving the impression that war is truly appalling, immediately going against the common belief that it is a game from poems like Whos for the game?. Also, true to both poems is the idea of undignified and casual death, rather than the heroic, glorious death promised by governmental propaganda. For example, in Dulce, Owen talks about the way they flung [the dead soldier] in a wagon with such brutal nonchalance. Furthermore, Anthem introduces a typical Victorian funeral with singing choirs, and juxtaposes it with the shrill, demented choirs of wailing shells on the battlefield, and with the constant end-stopped lines, this conveys a sense of solemn grief rather than the vicious anger in Dulce, which tends to use enjambment more frequently. Also, Anthem discusses the lack of ceremony and dignity in which people are honoured after their death on the battlefield, and Owen reveals his anger for this using the powerful, hyperbolic alliteration in rifles rapid rattle. In addition, the fact that the sound of machine gun fire is reflected in the phrase rifles rapid rattle presents to the reader that the harsh realities of war are indeed more than just frightening. In addition, a sense of urgency and immediacy is portrayed in the second stanza of Dulce, when Owen uses direct speech and exclamations in Gas! Gas!, while the epizeuxis and use of the present continuous tense gives further emphasis to this desperate urgency .On the other hand, Anthem has a strong sense of sympathy and general tranquillity throughout the second stanza, which is juxtaposed by something quite the opposite in the first. As well as this, the light lexis used in words such as glimmers and tenderness in the second stanza, give the impression that it is a poem of mourning and respect rather than anger and hate. In general, Dulce uses fairly vulgar and crude language, conveying his disrespect for propagandistic poets, as well as his anger at the unawareness of the dangers of war of the British public: He plunges at me, guttering, choking, drowning. Owens use of the words guttering, choking [and] drowning, has numerous implications and effects. Firstly, a gutter represents the bottom of society, and therefore shows how soldiers dying is in fact not a respectable act, but rather an act that is hardly noticed by society. Also, the onomatopoeic sounds of guttering and choking, give an even more emphatic image of death on the battlefield, portraying Owens desire for the awareness of the harsh realities of war in youth culture as well as in everyday men. Finally, the fact that Owen uses three separate adjectives to describe the horrific scene, in addition to the tri-conic feel it gives, the phrase implies that Owen could not put what he was seeing into words, and therefore persuading the reader that war is simply a catastrophic, desperate excuse for a fight, sacrificing millions of men in the process. Unlike Dulce, Anthem brings out the mournful, respectful side of Wilfred Owen through the melancholy atmosphere he creates through the modulation of harsh imagery to a more resigned tone: The monstrous anger of the guns but in their eyes Shall shine the holy glimmers of goodbyes. This dramatic contrast between coarse and frightening imagery in monstrous anger of the guns and the solemn melancholy in the holy glimmers of goodbyes is a very moving one. This is not only because the phrase refers to tears in young mens eyes, which in itself is a saddening image, but also because it refers to goodbyes, forcing a more personal image of saying goodbye to close friends or relatives as they go to war upon the mind of the reader, again, creating a sombre mood. In addition, the end-stopped line following goodbyes is very effective in that it makes the goodbye seem all the more sudden, harsh, and hurtful. In conclusion, Dulce and Anthem, although they are both written in protest against the deceiving propaganda made by various people, they go about it in different ways. Dulce is an outright outrage at individuals, which we know from Owens draft that it was targeted at Jessie Pope, using coarse and harsh language to do so. Anthem on the other hand is a more solemn and moving poem, although it starts as if it were to be an outrage, before we learn that in fact, it is only grieving for the dead and their lack of ceremony, and it becomes literally, an anthem for doomed youth.

Philosophy Essays Daoism Confucianism

Philosophy Essays Daoism Confucianism Daoism Confucianism Daoism: An Introduction China has contributed immensely towards the culture of the world, some significant contributions include Tangculture which is Bhuddhist influence in art and the same is predominant in the field of sclupture and numerous other masterpieces which are well admired all round the world.One such masterpiece is Daoism, the term may sound complicated but in reality it is not as complicated as it sounds. This paper will discuss the evolution and the principles of Daoism. Daoism has a native connection like another term which is Confucianism, the spirit of the Chinese people is reflected by Daoism. It evolved from the ancient Chinese society and it portrays the beliefs and idealogy of the Han nationality. The souce of its origination is from the workship of gods and spirits. Daoism is regarded as philosophical tradition of China malong with Confucianism. Daoism encompasses thought and practice that sometimes are viewed as philosophical, as religious, or as a combination of both. While modern scholars, especially those in the West, have been preoccupied with classifying Daoist material as either philosophical or religious, historically Daoists themselves have been uninterested in such categories and dichotomies.(IEP.UTM 1, September 2008) Scholars across Europe have been working maticulously on how to classify Daoism, whether it constitutes to philosphy or religion. The confusion has prevailed for quite sometime now. During the time of the Han Dynasty, Daoism was not in existence but early texts like Daodejing and the Zhuangzi triggered off the beginning of Daoism. There is a common belief among the people that a teacher by the name Laozi founded the school and also wrote himself all the major works called as Daodejing, the same is also known as Laozi. Daoists were the people who followed Daoism; they firmly believed that immortality was not a gift from god. They also believed that this is a connection between the nature and their bodies. People who though like this were believed to be living in the mountains and considering the same they considered their bodies to be mountains and walked on the path of immortality. They involved themselves in interesting activities such as physical exercises, discovering new sexual p ostitions to make sure that the flow of energy is greater than what it wasin the earler position, they also tried their hands at Chemistry but many of them died becuause of over experimentation. Not only did they die but a few emporers who followed in their footsteps also met with the same fate as the Daiosts. Get help with your essay from our expert essay writers Daoism always wanted people to cultivate the quality of self-cultivation in them. The teachings that were later called Daoism were first known under the name of Huanglao Dao in the 3rd and 2nd cent. BCE. The thought world transmitted in this stream is what Sima Tan meant by Daojia. The Huanglao School was a center of Daoist practitioners in the state of Qi (modern Shandong). Huangdi was the name for the Yellow Emperor, from whom the rulers of Qi said they were descended. When Emperor Wu, the sixth sovereign of the Han dynasty (r. 140-87 BCE) elevated Confucianism to the status of the official state ideology and training in it became mandatory for all bureaucratic officials, the tension with Daoism became more evident. And yet, at court people still sought longevity. Wu continued to engage in many Daoist practices, including the use of alchemy, climbing sacred Taishan (Mt. Tai), and presenting petitions to heaven. (IEP.UTM 1, September 2008). Principles of natural order as first established in ancient Chinese philosophy To define the principles, a step by step approach towards learning a few new concepts is required. The most important term is Dao, translating the Chinese word into English is very difficult because no word in English exactly gives the Chinese meaning but the english word which comes closest is the way, the meaning is the right path, the word describes the nature of the world in the true sense. People believe that Dao keeps the universe balanced, it is a strange belief but the sentiments of the Chinese people are attached with it. Knowing the key terms is very important as it paves the way in understanding Daoism better. The term Dao should not be misunderstood, it is not treated as god or a guiding figure, it is merely the path which should be adopted by an individual. The term is also perceived as a road. By this it is understood that the Chinese believed in changes, where as resisting changes is human nature, so from this it can be made out that the Chinese were unlike other peopl e who had this feeling of resisting changes. The next important term is Wu Wei, this is the core of Daoism or in other words it will not be unfair to say that this forms the center of Daosim. If the literal meaning of this term is taken, it means without action or in other words doing a task effortlessly. The main goal of Wu Wei is to align with Tao, hence it can be made out that the two terms are realted in more ways than one. Wu wei should be the way of life, because the dao always benefits, it does not harm (ch. 81) The way of heaven (dao of tian) is always on the side of good (ch. 79) and virtue (de) comes forth from the dao alone (ch. 21). What causes this natural embedding of good and benefit in the dao is vague and elusive (ch. 35), not even the sages understand it (ch. 76). But the world is a reality that is filled with spiritual force, just as a sacred image used in religious ritual might be (ch. 29). (IEP.UTM 1, September 2008). The next term is Pu, the terms sound really strange because these are taken from Chinese language and any language which is not familiar creates a strange impact on people. The term means simplicity; it is all about passive reception. This is perception of people leaving prejudice out of the equation, which is very difficult in any circumstances. Prejudice plays a key role in anyones perception and leaving it out of the equation is a very very big ask for all the normal people. The term Pu is all about being content with what is available with a person. The fourth and the last principle is De, the concept is very very complex and obviously very difficult to understand. To simplify the concept and understand it better it is fair to say that De is nothing but the expression of personal integrity. So the four terms aim at developing four qualities in a person namely oneness, all are equal and no differentiation of any kind should be shown towards anybody, harmonial action aims at mainta ing harmony among the people, dynamic balance focusses upon bringing stability in the people and cyclic growth makes sure that the people grow as individuals which is imperative for any individual, everyone should always strive to grow, there should not be a standstill as far as growth is concerned. All the four principles have their aims and all are meant to instill some quality or the other in an individual. How the style of poetry conforms to the basic ideals of the Daoists The poems written by the Daoists were called the Ci-poetry; it followed strict rhymic notes and lines. It was also made sure that the words used in the poetry were precise and made good sense. The Daoists composed Ballads, a musical poem which tells a story. The Book of Laozis Conversion of the Barbarians also collects 18 pieces of Ci of the Venerable Sovereigns 16 Transformations. They belong to Daoist tales about deities transformation. Tales about deities transformation are a means of relating the transformation of deities. Daoist tales about deities transformation refer to the style of relating the transformation of Daoist deities. In order to be adapted to the need of reciting and singing, this genre always adopts the form of yunwen (i.e. literary composition in rhyme). For example, Ci of the Venerable Sovereigns 16 Transformations is a piece of yunwen. The author arranges the plots according to the changes in orientations, and the shifting in places is based on the positions of the Eight Trigrams 4 in nine palaces of change. The Eight Trigrams represent the eight directions, and two cycles of the Eight Trigrams produce 16 pieces of Ci of transformation. (Eng. Taoism, 1 September 2008). The concept of the poems generally focussed upon immortality, ways to become immortal and what it takes to be immortal. Poetry was very influencial in shaping up the people at that time. Conclusion Classifying the term Daoism as philosphical or relioginal causes an ambiguity, let the scholars decide that but the positives can be taken and applied in day to day life, results will surely be visible if people stick to the four principles of Daoism which focus upon oneness, harmony, growth and dynamic balance. References Daoist Philosphy. In Iep.Utm. Retrieved on 1 September 2008 from: http://www.iep.utm.edu/d/daoism.htm#H2 A General Introduction. In Taoist.Org. Retrieved on 1 September 2008 from: http://www.taoist.org.cn/English/daoism.htm Daoism in Brief. In His.com. Retrieved on 1 September 2008 from: http://www.his.com/~merkin/daoBrief.html Taoism. In ReligiousTolerence. Retrieved on 1 September 2008 from: http://www.religioustolerance.org/taoism.htm

Stress And How To Manage It Essays -- essays research papers

Stress and How To Manage It Everyone has stress, and we all have different stressors. Each person has their own way of coping with stress. some ignore their problems while others face them head on. There are four types of stressors and we all experience them at some point in our lives. One of these stressors is hassles. Hassles are a part of everyday life, but if they aren't coped with, they an cause major problems. One hassle in my life is me being constantly sick all of the time. Lately, I have had a lot of colds and flus's. Coughing, sneezing, and missing school can get really old. It is a hassle to blow my nose and take my pills all of the time. My being sick is a big hassle, but it is not really a high quality of stressor. Hassles can cause quite a bit of stress, but they are nothing compared to a catastrophe. Catastrophes are unpredictable events that can change your life permanently. The biggest catastrophe in my life was when my best friend, Dre, died. It was hard for me because I knew what was happening to him but there was nothing I could do about it. My parents didn't know about him so I couldn't turn to them. I couldn't turn to my boyfriend because he wouldn't understand or care. Dre was the one person I could always turn to, and when I lost him my life changed forever. The death of a loved one is usually considered a life change, but in my case it was much more drastic than that. My life change that has caused me a lot of stress would be my problems with my ...

Kenneth Baranagh?s ?Henry V? :: essays research papers

Kenneth Baranagh’s â€Å"Henry V† Kenneth Branagh’s â€Å"Henry V† was a confusing fast paced movie modeled after William Shakespeare’s â€Å"Henry V.† Shakespeare’s writings enveloped one’s senses captivating their attention urging them to read on. Branagh’s version dragged the viewer on to the next scene without having a complete understanding of what was occurring in the movie.   Ã‚  Ã‚  Ã‚  Ã‚  The movie centered on the war between the English and the French. The French believed they would have no problem dominating over the English. King Henry (Kenneth Branagh), the leader of the English, is mocked and not taken seriously due to his past. Even more so the king now has something to prove. Hal Hinson hit it right on the nose when he said, â€Å"Harry is straight-faced and devout and determined, a man with something to prove.† The movie does show the power of speech as Henry encourages his troops leading them to victory at the Battle of Agincourt, which I enjoyed very much.  Ã‚  Ã‚  Ã‚  Ã‚   Much of the spoken text was difficult to understand either because the actors were speaking to quickly, or because the music got in the way. I agree with Robert Ebert when he described the same problem I encountered as, â€Å"distractingly intrusive music, which only gets in the way of the words.† The narrator did however help a little with the confusion. The characters in this movie were easily confused due to the fact that so many of them look alike. With so many characters in this play one would hope they would be easily distinguished. The exception to this being King Henry played by Kenneth Branagh. 2 Branagh did a wonderful job representing King Henry V. Many of Henry’s monologues are expressed extremely well. The two best being the two most famous, the monologue that got his enemies to surrender as he painted such a horrific picture of war, and the monologue he spoke to his troops for inspiration on St. Crispian’s Day. I enjoyed the last scene of the movie where Henry is shown wooing the princess of France, Kate, and think it was a great ending. I believe it was a touching scene with a little humor added because of the language and culture barriers between the two.

How Useful Are the 4Ps to Marketing Managers Today ? Essay -- product,

Marketing managers use marketing mix as a business tool in marketing. Marketing mix synonymous with the 4Ps which were amended and listed by Eugene McCarthy as Product, Place , Price and Promotion. First of all, Product refers to the product should fit the task the target consumers want it for, it should work , and it should be what the consumers expected to get. For instance, its packaging, labeling and offering. Therefore, this always remind marketing managers need to do careful research on how long the life cycle of the product is likely to be and focus their attention on different challenges that they are facing when they are developing the product. Secondly, Place (distribution) means that the way in which the product meets customers’ needs, the product should be easy for the consumers to shop. This may be a high street shop, mail order through a catalogue or it may even be doorstep delivery. Various strategies such as intensive distribution, selective distribution, exclusive distribution and franchising can be used by the marketing managers to complement the other aspects of the 4Ps. Thirdly, Price refers to the product should always be seen as representing good value for money. However, this does not mean that it should be the cheapest available, one of the main tenets of the marketing concept is that customers are usually prepared to pay a little more for something that really works well for them. The price is very important as being determined , it may affect the demands, sales ,the company's profit and hence, survival. Adjusting the price has a profound impact on the marketing strategy. There are 3 basic pricing strategies : market skimming pricing, market penetration pricing and neutral pricing. The 'reference val... ...personnel who will be responsible for analysis, planning and implementation. "The enterprise set up marketing department or sales department to undertake the marketing functions ,sometimes it would hire some experts from outside to engage in certain activities, such as market analysts and advertising experts. As a result, people in other area in the enterprise would decoupling from the marketing area ,at the meantime, the marketing managers are not involved in product design, production, delivery, customer service,advice handling and other activities "(Christion Gronroos, 1994), thus leading to potential conflicts between each functional department. "If the company produces the appropriate products, set appropriate prices, use appropriate distribution channels, and supported by appropriate promotional activities, then the company will success "(Kotler, 2001).