Criminology Theory Research Paper Example | Topics and Well Written Essays - 2500 words

Criminology Theory - Research Paper Example Theories allow scholars to make hypotheses, which are tested through empirical research in order to come up with assumptions that make us understand the world better. Theories, which depict the causation of crime, are complex but studies from the past and present helps the researcher in understanding the behaviors among criminals. These theories are used to determine the best causes of action that can be used in order to ensure that crime is prevented from happening in our society. Traditionally, punishment was very harsh and the police used brutality when recording statements from suspects without having to understand why certain people committed certain crimes. In addition, the punishments meted out on convicts were harsh and as a result, scholars begun to study criminology in order to ensure that punishments were fair (DeMelo, 2001). Classical School Before 1789, the law system, punishment, and access to justice were barbaric. The classical school’s interest was not the stu dy criminals but it focused on understanding the legal processes and law making. According to this school of thought, criminals knew the consequences of their actions and they even weighed the options before they engaged in any criminal activity. In addition, punishment was designed for the purposes of deterring crime and it was painful than the pleasure one got from engaging in any criminal activity. ... The human behavior is motivated by attainment of pleasure and the ability to avoid pain. Natural law reveals actions that people should not be engaged in, but the punishments that criminals received were not deterrent in nature, but brutal. No forms of punishments that criminals receive should be used to take way a person’s happiness while in the society. This is because according to Beccaria, a person is ready to relieve a minute amount of happiness in order to live in a secure and humble environment. Men do not want to be under scrutiny at all times and they feel more independent when the scrutiny is at the minimum (Beccaria 2009). Pleasures in human beings can be described as that of skill, wealth, sense, amity, piety, and benevolence. In addition, a good name, malevolence, memory, power, relief, and expectation constitute to feelings of pleasure in a person. Pleasures can be complex or simple. People will do everything to ensure that they have pleasure as opposed to pain. Pleasures and pains are caused by certain actions, however, the amount of the pleasure or pain felt is not proportional to the causing effect. Since majority in the society look for pleasure at all times, Bentham notes that people should be given a free will to enjoy their lives as long as they do not inflict pain on others (DeMelo, 2001). On the other hand, Bentham focused on utilitarianism because he believed greatest happiness for the majority. This could not be achieved without changing the justice system because the leadership of that time was corrupt and barbaric. The people, according to Bentham measure the probabilities between future and present pleasures against future

The Effectiveness of Ability Grouping Kindergarten Students In Reading Research Proposal

The Effectiveness of Ability Grouping Kindergarten Students In Reading Groups On Improving Reading Scores - Research Proposal Example study, these researchers drew on the ECLS-K database, from where they included only the first-time kindergarten students, who learnt in the same school the whole year. They also excluded students with learning disabilities, and those with limited proficiency in the English language. A multilevel analysis was then used to assess the influence of within-class grouping and other school and instructional factors on the reading achievement of kindergarteners. Nonetheless, the results from this study showed that when teachers use within-class grouping more frequently, this had a positive influence on the mean school gain in reading. This study therefore, suggests that the use of ability groupings in kindergartens might lead to an improvement in the early literacy and reading (O’Connell & Levitt, 2006). In another study, Tach and Farkas (2005) used the ECLS-K data to explore the influence of within-class reading on kindergarten and first grade students. These hypothesized that the ef fectiveness of within-class ability grouping is influenced by the incoming level of reading of the students, their proficiency in mathematics, as well as their preschool behavior problems, which are more common among boys and those students from families of low socioeconomic status. The researchers used hierarchical linear modeling (HLM) on the ECLS-K data, and included only those students and classrooms that had complete data, beginning from kindergarten, end of kindergarten, and first grade. Nonetheless, results of this study showed that prior reading test scores of students and the judgment of teachers on the learning ability of students influenced the effectiveness of within-class ability groupings in kindergartens. Overall, the ability groupings in kindergartens, according to this study,... This study exhibits considerable limitations. First, there will be bias in the selection process of participants. The selection criterion involved requires that only students who have never changed schools between fall and spring of their kindergarten year be included in the study sample. For this reason therefore, the results might not reflect the effect of ability grouping among all kindergarten students. In addition, the use of self-report questionnaires to establish the frequency of using ability groupings among teachers cannot generate the accuracy of teachers' self-ratings. Moreover, this data cannot determine the quality of instruction in the ability groupings and cannot establish whether the teacher modified the instruction to suit student’s needs. More so, the timing of the study might lead to misplaced levels of reading proficiency, thus leading to wrong results of the measure of academic process testing. This paper makes a conclusion that the role and effectiveness of ability groupings has not been given the attention it deserves. Therefore, as most kindergarten teachers attempt to improve the reading scores of their students, some have paid lee attention to ability groupings strategy. This study therefore, seeks to investigate the effectiveness of ability groupings on the reading scores of kindergarteners in Russell Primary School. Depending on the results of the study, ability groupings might or might not be recommended to kindergarten teachers.

Impact Of Immigration On Australian In Socioeconomic Context Economics Essay

Impact Of Immigration On Australian In Socioeconomic Context Economics Essay This essay will explain the economic, environmental and social impact of immigration on Australia and its role in the future prospects of the country. Studying the country for the group report and presentation we came across how important are the skilled immigrants as an addition to the labour force of Australia. Immigration is an interesting issue as it touches many areas of public life: economics, demographics and even religion. According to OECD around 3% of the people in the globe are migrants. Each country and even regions in a specific country experience migration differently. Therefore this essay with the use of PESTLE analysis to scan the political-legal, economic and environmental impact and Hofstede Cultural dimensions to explain social attributes, will be a focused research on immigration and its effect on the people and the country. The first part gives an inside of the history of migration and the early policies adopted by the country. Part 2 goes on to illustrate the trends over time concerning the migration policies and laws. Part 3 and 4 deal with the environmental and economic impact of immigration respectively. Finally, the social attitude and how are immigrants treated in todays society will be considered. Background Australia being a British colony and closely connected with the Empire, concentrated its early migration policies before World War II in keeping the country white accepting into the country only British and Europeans. However, after World War II migration was high in the agenda of politicians with policies being set in accordance with the needs of the country: allow more non-European skilled immigrants to cover the shortage of labour and expand the manufacturing industry. Their slogan was populate or perish and a large wave of immigrants was accepted in the country. The White Australia Policy was abolished in 1973 and regardless of origin; anyone could become a citizen of Australia being a permanent resident for three years or more. The years to follow will see the policies and laws towards migrants becoming more structured and focused. Significant changes took place aided by globalisation and the easier movement of people. Indeed globalisation and the fact that national events have international effects is one of the drivers of migration. Immigration policies We will analyse the Political and Legal parts (political support and initiative, legislation changes) of PESTLE to evaluate the immigration policies adopted by the governments. The permanent entry and conditions are established by the Australian Government whereas the Department of Immigration and Citizenship is responsible to issue visas under various programs. The size of permanent migration program increased substantially and this is mainly the aftermath of the growing focus on skilled workers. The Skill Stream accounts for 64% of the total Migration Program followed by the Family Stream which accounts for 35.7% and finally the Special Eligibility with 0.3%. In 2008 it was announced by the government that the skilled migration will be more demand driven and therefore more responsive to changes in the demand for labour and the needs of the economy. This was to assist industries facing skill shortages mostly in health and engineering sector. As with demand-driven operating models and especially pull models that support the use of resources as soon as the need arises, the Migration Program adapts policies to respond to the countrys needs. Australia had a brain drain problem for many years with highly skilled workers and professional leaving the country. It can be argued that that is one of the reasons why the Migration Program is so keen in accepting in the country skilled labour. Actually, legislation changes are made to accommodate the new immigrants, for example the removal of fees for English courses. However, concentrating more on the skilled immigrants might be seen as unfair by other categories of migrants as the recent riots have showed at Villawood a detention camp in Sydney. Detainees complained of lengthy waits to have their asylum claims heard. It is argued that those of a genuine need of government protection are not treated as it should. As a matter of fact, Immigration Minister Chris Bowen proposed a new law where any asylum seeker found guilty of an offence would fail to receive a permanent visa. In terms of return to the country, though, and especially the economy, skilled labour contributes more. The number of refugees arriving by boat increased substantially and even though the government tries to accommodate them all this is impossible. Impact of immigration on the environment Moving on to the Environment from PESTLE we will consider the level of pollution and attitudes from the government. Most of Australias geographical area is uninhabited with people concentrated in a small number of specific parts of the country and cities. Australia has one of the lowest population densities of all countries with only 2.92 people per square kilometre. Even though it may seem that Australia land area of 7.7 million square kilometres could support a larger population, this is impossible due to the fact that deserts occupy almost 38% of the country mainly in the centre and western part. The situation worsened with the recent severe floods in the many states. In Queensland alone 200,000 were affected and a mass evacuation took place. Therefore it is obvious that population increases are important to Australia since 75% of the population lives in urban areas with cities like the Australian Capital Territory having the highest population density at 152.5 people per square kilometre. A research of the Australian Bureau of Statistics (2010) showed that 54% of the population increase is due to immigrants. The Optimum Population Trust argues that to sustain the current standard of leaving the optimum population of Australia is 10 million people and 21 million at the lowest possible living standard. The current figure of population 22.5 million people and the projected figure of 36 million in 2050 are high above the optimum set by the organisation. However, it can be argued that natural resources like oil could sustain population pressures if the people, the government and major companies invest in substitutes and new technologies. As far as global warming and greenhouse gas emission are concern Australia is one of the largest polluter of the world with the CO2 emission reaching the outstanding figure of per capita. This and other environmental externalities like congestion may have a deteriorating effect on the living standards of Australians. Environmental deterioration due to increased migration must be weighed against economic impacts when considering the future of the country. Impact of immigration on the economy The Economy from PESTLE analysis seems to be the strongest card of the country. The economic performance of Australia has been remarkable since the economic crisis. This part will concentrate particularly on the impact the skilled immigrants have on the economy of Australia. Overall, larger population means more labour translating in higher gross domestic product and income. However, how this increase is spread across the population and the impact on living standards are not clear given the aggregate measures of GDP and GNI. If we consider GDP and GNI per capita then these are affected by the productivity of the workers and the participation rate. Skilled immigrants affect the supply composition of labour. It is projected in the Commission paper of 2006 that by 2024-2025 and with a modelled 50% increase in the skilled migrants working age share will fall by 0.17% and participation rates will increase by 0.73% due to the cumulative effect of migration. The unemployment rate will increase with the years of residency with the cumulative effect of decreasing unemployment rates of new arrivals early in the period begins to outweigh the higher unemployment rates of new arrivals late in the period, and overall the unemployment rate decreases by 0.03% and hours per worker will rise by 0.05 per week. As expected real gross domestic product was projected to be around 4 per cent higher than otherwise. The annual average income per capita was projected to be $383 higher but not equally distributed. Migrants are expected to benefit more from the increase in average income since the incumbent populations average real wages declined by $334, but income from other sources raised, especially from government transfers due to higher indirect tax revenue, $103 per annum respectively. A higher income per capita means that people will spend more leading to increased tax revenue for the government. The impact of increased skilled labour must by also be considered in the context of different industries and regions. For example in the Western Australia the most important sectors are mining and agriculture which are capital intensive affected mostly by changes in capital stocks rather than labour composition. The immigration increases can address the costs and time associated with the training of domestic labour. However, it may substitute domestic income and discourage the human capital investment of the country. The answer is to make the skilled migrants a compliment to domestic labour rather than a substitute. Peoples attitude towards immigration In order to analyse the social attributes towards immigration the Hofstede Cultural Dimensions will be used in this section. Overall, globalisation made people of Australia today more acceptable of foreigners settling in their country and they are open to the idea of a multicultural society. However, it is evident from the early migration policies discussed on previous section that the government had a discriminating approach towards non-British migrants especially those settlers coming from Asia, in an attempt to perceive the national identity. Many have argued that this attitude was a product of fear that as the British had colonised and decimated the aborigines so will a stronger nation do to them. With globalisation, people began to realise that foreigners settling in their country will be a reality for their everyday life. Ethnic communities were formed and foreigners took part in elections as government officials and academics. In the year 2010 the foreign-born population in Australia was 26.4% of the total population compared to the 3.1% of the world average. In a recent survey carried out by the University of Western Sidney 86.6% of the people asked agreed that It is a good thing for a society to be made up of people from different cultures. Nevertheless 80.1% answer for themselves that they are no prejudiced against other cultures but in the question Is there a racial prejudice in Australia 84.4% agreed. According to Hofstedes Cultural Dimensions Australia has the second highest level of individuality of 90 coming behind the United States ranking of 91. Individualism describes the relationships of people and the way the live together. People therefore are expected to take care of only themselves and immediate family maybe that is why Australians may still be suspicious of foreigners. In addition earnings are very important therefore they might feel a threat from the skilled migrants. Critical reflection This essay tried to tackle a very complex and significant issue of Australia. Maybe the analysis would have been more concise if it was concentrated in fewer areas that are affected by immigration. Most of the sources used are from the governments websites but in some parts critics were also evaluated. In addition the presence of International Business Models is not sufficient and more examples of models could have been used. Difficulties were faced in the research when trying to find the most recent statistical data. More independent sources could have been use and more coherent arguments. The results are inconclusive and a more detailed research must be carried out to better assess the question of what is the impact of immigration on Australia. The issue of migration must be set in a wider context taking under consideration a greater number of factors and drivers for example consider also the role of emigration.

pulp fiction :: essays research papers

Pulp Fiction is like boot camp for the Marines. You come into it from your civilized life, they subject you to violent language until you're numb, they abuse you verbally and physically until all of your normal feelings and values are reduced to dust. Leaving you aware that you have changed, and able to describe the change, you find yourself questioning the person you were previously. First thing you know you're saluting. This story is a cleverly disorienting journey through a landscape of danger, shock, hilarity, and vibrant local color. Nothing is predictable or familiar within this irresistibly bizarre world. You do not merely enter a theater to see Pulp Fiction: you go down a rabbit hole. Theater is an actor moving through time and space, telling a story. In Quentin Terintenio ¹s, Pulp Fiction, the actors portray savvy modern-day gangsters and the story is three stories told in backwards order. To say the least this not your average story. The theme of the story is redemption, and the journey to achieve that redemption. The characters are colorfully multidimensional and most importantly they are believable. The language of the story is street-smart and confident, like the characters. There is no main plot, only mirror plots that are reflections of each other. The theme of redemption is portrayed by two of the main characters of the story. These characters seek redemption and a new way of life, they each desire a more virtuous life. Butch (Bruce Willis) wants to pull off one last scam and then run away with the woman he loves. He seeks forgiveness and redemption through the future birth of his child. He wants his child to have a healthy childhood so that he will have the opportunity to hand down his precious gold watch, which was handed down to him. Jules (Samuel Jackson) has a near death experience and sees it as divine intervention that he is alive. Now he simply wants to leave his criminal lifestyle to  ³walk the earth ², and find his true self. Our story starts with the journey of the characters. The characters in this story are not simply black and white, from the moment you meet them you are drawn in and want to know more about them. The story ¹s intrigue, that element that makes the viewer curious, draws the audience in. And the story ¹s credibility, the consistency of the characters, holds the audience there, inside the movie.

Pericles Funeral Oration Essay

I do not think that everything Pericles said in his funeral Oration was true. Pericles goes on and on about how great the Athens city-state had become a strong democratic government. â€Å"He also talks about how they accept everyone into their city-state and give them the same rights as the Athens people regardless if they are foreigners†. â€Å"Pericles even compares his city-state to that of the Spartans; while using slanderous and defaming words to describe their culture†. Pericles believes from reading his Oration that the Athens are better people because of their equally of all in their city state and the freedom they have given their people. Pericles fails to see the contradiction in the culture and in the oration of the Speech he gives about the Athens way of life and this is because he is biased towards the men. Obviously everyone being equal is not true because woman is not equal to men and is certainly not treated as equals. â€Å"Pericles states himself that it is better for woman to never be spoken of whether it is glory or criticism†. He states that a woman’s place is in her home, the only jobs that are available to women are to bare children and to maintain the household, other than that everything else only a man should and could do. The fact that women are treated differently proves that the Athens were not a democratic state their laws to provide fairness to all the people were only catered to the males not the females. The Athens had a negative attitude towards woman and how they should be treated, Pericles seemed almost disgusted to even have to address woman in his speech and when he did he had nothing positive to say about them. Pericles exaggerates in his oration. He depicts a perfect picture of what the Athens society is thought to be, as if the people and the law have no imperfections that need to be spoken of. He illustrates a great city-state with no flaws but then continues to describe and speak of women as if they were not human and discrimination against them was normal. Pericles was in mourning and wanted to give the dead soldiers and their families and all the people of the city-state the honor and confidence they needed to continue on with the war so he exaggerated, he did not want to dishonor the soldier with his words so he chose to speak of their culture and everything they stood for. Coming from a leader’s perspective I think the ideology may be slightly off but much of it was true from the Athens culture and society.

The Return: Shadow Souls Chapter 24

Dear Diary, It's the night before the night of our first party – or rather gala. But I don't feel very gala. I miss Stefan too much. I've been brooding about Matt, too. How he walked away, so angry at me, not even looking back. He didn't understand how I could†¦care for†¦Damon, and yet still love Stefan so much that it felt as if my heart was breaking. Elena put down the pen and stared at her diary dully. The heartbreak manifested itself in actual physical pains in her chest that would have frightened her if she hadn't been sure of what it really was. She missed Stefan so desperately that she could hardly eat, could barely sleep. He was like a part of her mind that was constantly on fire, like a phantom limb that would never go away. Not even writing in her diary would help tonight. All she could write about were painfully tantalizing memories of the good times she and Stefan had shared together. How good it had been when she could just turn her head and know that she would see him – what a privilege that had been! And now it was gone, and in its place was racking confusion, guilt, and anxiety. What was happening to him, right now, when she no longer had the privilege of turning her head and seeing him? Were they†¦hurting him? Oh, God, if only†¦ If only I had made him lock all the windows to his room at the boardinghouse†¦ If only I had been more suspicious of Damon†¦ If only I had guessed he had something on his mind that last night†¦ If only†¦if only†¦ It became a pounding refrain in time to her heart. She found herself breathing in sobs, her eyes tightly shut, clutching the rhythm to her and clenching her fists. If I keep feeling this way – if I let it crush me enough – I'll become an infinitesimal point in space. I'll be crushed into nothingness – and even that will be better than needing him so much. Elena lifted up her head†¦and stared down at her head, resting on her diary. She gasped. Once more her first reaction was to imagine death. And then, slowly, because she was stupefied by so many tears, she realized that she'd done it again. She was out of her body. This time she wasn't even aware of a conscious decision about where to go. She was flying, so fast that she couldn't tell which way she was going. It was as if she were being pulled, as if she were the tail of a comet that was rapidly shooting downward. At one point she realized with familiar horror that she was passing through things, and then she was veering as if she were the end of the whip in a game of Crack the Whip and then she was catapulted into Stefan's cell. She was still sobbing as she landed in the cell, unsure of whether she had solid form or gravity, and uncaring for the moment. The only thing she had time to see was Stefan, very thin but smiling in his sleep and then she was dumped onto him, into him, and still crying as she bounced, as lightly as a feather, and Stefan woke. â€Å"Oh, can't you let me sleep for a few minutes in peace?† Stefan snapped, and added a couple of Italian words that Elena had never had reason to hear before. Elena had an immediate fit of the Bonnies, sobbing so hard that she couldn't listen to – couldn't even hear – any comfort that was on offer. They were doing horrible things to him, and they were using her image, Elena's, to do them. It was all too awful. They were conditioning Stefan to hate her. She hated herself. Everyone in the whole world hated her – â€Å"Elena! Elena, don't cry, love!† Dully, Elena lifted herself up, getting a brief anatomical view of Stefan's chest before she was sobbing again, trying to wipe her nose on Stefan's prison uniform, which looked as if it could only be improved by anything she might do to it. She couldn't, of course; just as she couldn't feel the arm that was trying to encircle her gently. She hadn't brought her body with her. But she had, somehow, brought her tears, and a cold, cable-wire-tough voice inside herself said, Don't waste them, idiot! Use those tears. If you're going to sob, sob over his face or his hands. And, by the way, everyone hates you. Even Matt hates you, and Matt likes everybody, the tiny cruel, productive voice went on and Elena gave way to a fresh gale of sobbing, absently noting the effect of each teardrop. Each drop turned the white skin under it pink and the color spread in ripples outward, as if Stefan were a pool, and she was resting on him, water on water. Except that her tears were falling so fast that it looked like a rainstorm on Wickery Pond. And that only made her think about the time that Matt had fallen into the pond, trying to rescue a little girl who had fallen through the ice, and how Matt hated her now. â€Å"Don't, oh don't; don't, lovely love,† Stefan begged, so sincerely that anyone would have believed he meant it. But how could he? Elena knew what she must look like, face swollen and blotched by tears: no â€Å"lovely love† here! And he'd have to be mad to want her to stop crying: the teardrops were giving him new life wherever they touched his skin – and perhaps the storm inside him had done best, because his telepathic voice was strong and sure. Elena, forgive me – oh, God, just give me one moment with her! Just a single moment! I can bear anything then, even the true death. Just one moment to touch her! And perhaps God did look down for a moment in pity. Elena's lips were hovering over, quivering over, Stefan's, as if she could somehow steal a kiss like this as she used to when he was still asleep. But for just an instant it seemed to Elena that she felt warm flesh below hers and the flick of Stefan's lashes against her eyelids as his eyes flew open in surprise. Instantly they both froze, eyes wide open, neither of them foolish enough to move in the slightest. But Elena couldn't help herself, as the flush of warmth from Stefan's lips sent a flush of warmth through her entire body. She melted into the kiss, and, while keeping her body carefully in the same position, felt her gaze go unfocused and her eyelids close. As her lashes swept against something with substance, the moment swept quietly to an end. Elena had two choices: she could shriek and rail telepathically at Il Signore for only giving them what Stefan had asked for, or she could gather her courage and smile and maybe comfort Stefan. Her better nature won out and when Stefan opened his eyes, she was leaning over him, pretending to be resting on her elbows and his chest, and smiling at him as she tried to straighten out her hair. Relieved, Stefan smiled back at her. It was as if he could bear anything, as long as she was unhurt. â€Å"Now, Damon would have been practical,† she teased him. â€Å"He would have kept me crying, because in the end, his health would be the most important thing. And he'd have prayed for†¦Ã¢â‚¬  She paused and finally began laughing, which made Stefan smile. â€Å"I have no idea,† Elena said finally. â€Å"I don't think Damon prays.† â€Å"Probably not,† Stefan said. â€Å"When we were young – and human – the town priest walked with a cane that he seemed to enjoy using on young delinquent boys more than as a source of support.† Elena thought of the delicate child chained to the huge and heavy boulder of secrets. Was religion one of the things locked away, put behind doors closed one after another in secret there, like a chambered nautilus until almost everything he cared about was inside? She didn't ask that of Stefan. Instead, she said, lowering her â€Å"voice† to the tiniest telepathic whisper, the barest disturbance of neurons in Stefan's receptive brain: What other practical things can you think of that Damon might have thought of? Things relating to a jailbreak? â€Å"Well†¦for a jailbreak? The first thing I can think of is for you to know your way around the city. I was brought here blindfolded but since they don't have the power to take the curse off vampires and make them human, I still had all my senses. I'd say it's a city about the size of New York and Los Angeles combined.† â€Å"Big city,† Elena noted, taking notes in her head. â€Å"But fortunately the only bits that would interest us are in the southwestern section. The city's supposed to be ruled by the Guardians – but they're from the Other Side and the demons and vampires here long ago realized that people were more afraid of them than the Guardians. It's set up now with about twelve to fifteen feudal castles or estates, and each of those estates has control of a considerable amount of land outside the city. They grow their own unique products and sell them in deals made here. For instance, it's the vampires who cultivate Clarion Loess Black Magic.† â€Å"I see,† said Elena, who had no idea what he was talking about, except the Black Magic wine. â€Å"But all we really need to know is how to get to the Shi no Shi – your prison.† â€Å"That's true. Well, the easiest way would be to find the kitsune sector. The Shi no Shi is a cluster of buildings, with the largest one – the one without a top, although it's curved, and you may not be able to tell from the ground – â€Å" â€Å"The one that looks like a coliseum?† Elena interrupted eagerly. â€Å"I get a sort of bird's-eye view of the city whenever I come here.† â€Å"Well, the thing that looks like a coliseum is a coliseum.† Stefan smiled. He really smiled; he's feeling well enough to smile, now, Elena rejoiced, but silently. â€Å"So to get you in and out, we just head from below the coliseum to the gate back to our world,† Elena said. â€Å"But to get you free there are – some things we need to collect – and those are probably going to be in different parts of the city.† She tried to remember if she had ever described the twin fox key to Stefan or not. It was probably better not to do it if she hadn't already done it. â€Å"Then I'd hire a native guide,† Stefan said immediately. â€Å"I don't really know anything about the city, except what the guards tell me – and I'm not sure if I would trust them. But the little people – the ordinary ones – will probably know the things you want to know.† â€Å"That's a good idea,† Elena said. She drew invisible designs with a transparent finger on his chest. â€Å"I think Damon really plans to do everything he can to help us.† â€Å"I honor him for coming,† Stefan said, as if he were thinking things out. â€Å"He's keeping his promise, isn't he?† Elena nodded. Deep, deep in her consciousness floated the thoughts: His word to me that he would take care of you. His word to you that he would take care of me. Damon always keeps his word. â€Å"Stefan,† she said, again in the innermost recesses of his mind, where she could share information – she hoped – in secret, â€Å"you should have seen him, really. When I did Wings of Redemption and every bad thing that had hardened him or made him cruel came undone. And when I did Wings of Purification and all the stone covering his soul came away in chunks†¦. I don't think you could imagine how he was. He was so perfect – and so new. And later when he cried†¦Ã¢â‚¬  Elena could feel inside Stefan three layers of emotion succeed one another almost instantaneously. Disbelief that Damon could cry, despite all that Elena had been telling him. Then, belief and astonishment as he absorbed her pictures and her memories. And finally, the need to console her as she stared at a Damon forever trapped in penitence. A Damon that would never exist again. â€Å"He saved you,† whispered Elena, â€Å"but he wouldn't save himself. He wouldn't even bargain with Shinichi and Misao. He just let them take all his memories of that time.† â€Å"Maybe it hurt too much.† â€Å"Yes,† said Elena, deliberately lowering her barriers so that Stefan could feel the hurt that the new and perfect creature she'd created had felt upon learning that he had committed acts of cruelty and treachery that – well, that would make the strongest soul flinch. â€Å"Stefan? I think he must feel very lonely.† â€Å"Yes, angel. I think you're right.† This time Elena thought a good deal longer before venturing, â€Å"Stefan? I'm not sure he understands what it's like to be loved.† And while he thought out his response, she was on tenterhooks. Then he said very softly, very slowly again, â€Å"Yes, angel. I think you're right.† Oh, she did love him. He always understood. And he was always most brave and gallant and trusting just when she needed him to be. â€Å"Stefan? Can I stay again tonight?† â€Å"Is it nighttime, lovely love? You can stay – unless They come to take me somewhere.† All at once Stefan was very solemn, holding her gaze. â€Å"But if They come – you'll promise me to leave then, won't you?† Elena looked straight into his green eyes and said, â€Å"If that's what you want, I'll promise.† â€Å"Elena? Do you†¦do you keep your promises or not?† Suddenly, he sounded very sleepy, but the right kind of sleepy, not worn out, but someone who has been refreshed and is being lulled into a perfect slumber. â€Å"I keep them close to me,† Elena whispered. But I keep you closer, she thought. If someone came to hurt him, they would find out what a bodiless opponent could do. For instance, what if she just reached inside their bodies and managed to make contact for an instant? Long enough to squeeze a heart between her pretty white fingers? That would be something. â€Å"I love you, Elena. I'm so glad†¦we kissed†¦Ã¢â‚¬  â€Å"It's not the last time! You'll see! I swear it!† She dropped new healing tears down on him. Stefan just smiled gently. And then he was asleep. In the morning Elena woke up in her grand bedroom in Lady Ulma's house, alone. But she had another memory, like a pressed rose, to put away in its own special place inside her. And somewhere, deep in her heart, she knew that these memories might be all she had of Stefan someday. She could imagine that these sweet-scented, fragile mementoes would be something to hold on to and cherish – if Stefan never came home.

Influential High School Novels Essays

Influential High School Novels Essays Influential High School Novels Essay Influential High School Novels Essay Essay Topic: 7th Grade 9th Grade High School The Giver When I was in 7th grade, I read a book that completely changed my perspective on todays society. The same thing happened to me when I was in 9th grade. Two completely different books, the Giver and To Kill a Mockingbird both showed me different sides of life, one set in the far future, and one set in the far past. To Kill a Mockingbird by Harper Lee teaches us many lessons that are still relevant today and will be for all of the time. The Giver, by Lois Lowry, does the same but in a different way. Something very common that both books share is the fact that they both are banned from numerous schools due to language, violence, religious viewpoints, or just being unsuited to the assigned age group. To Kill a Mockingbird is so important for our children, and their children, and many more future generations, simply because of the lessons taught from the story. The writing isn’t the best, and the story certainly isn’t anything to behold, but the things that Jem, Scout, and Atticus teach us will always be very insightful, and show us concepts we may miss out on today. Jem teaches us how growing up is quite awful, and he does this by losing all sense of his innocence during tom Robinson’s trial. Jem seeing an innocent man convicted really hurts him, and forces him to grow up in a way no child really should. Scout still has a bit by the end of the novel, and she shows us how that is something we need to cherish and not take for granted, ever. Atticus teaches us about standing up for what’s right and how our beliefs, no matter how small, are so important. These three influential characters have showed me how I’ve been shaped by what I stand by. My c hildhood innocence, in a way, still remains, though alarge portion of it is gone. We lose our innocence through experience, and the best teacher for that lesson is Jem Finch. He shows us how we may think we know a lot about people and things, but we really don’t until we’ve experien

Migration essays

Migration essays Every year hundreds of birds, mammals, and insects par take in a roundtrip journey to find a warmer climate, a better reproductive environment, and more food. Three species in particular that make this migration every year are the golden cheeked warbler, the whooping crane, and the monarch butterfly. Also, scientists believe they have figured out why these animals never wander off course or get lost. Scientists have carefully tracked several species to try to fully understand their migration behavior. The golden cheeked warbler is a bird that migrates twice a year. From mid March to late July these birds can be found in central Texas. They call the Ashe Juniper trees home, and these trees are also their breeding sites. When July finally comes around the baby warblers have grown enough to make the migration and it commences. All of the warblers head south to find more food. From late July to mid March the warblers are somewhere in Mexico and South America. According to the National Wildlife Federation their winter home is not specifically denoted (4). However, wherever they call home in our winter they find ample food to make it back to Texas again in March. Another bird that makes a migration trip is the whooping crane. However, these birds have four parts to their journey. From late April until mid September the cranes spend their mating season with one life long mate in Canada. The pair of cranes will return to the same spot every year to raise their offspring, and in September the family heads south to Texas. During this trip between mid - September and mid November the cranes fly during the day and stop at night to rest and eat. The first groups of cranes to get to Texas are the cranes that either did not mate, or whos young died on the way to Texas. Then the families will finally arrive. The third part of the migration is from mid November to l ...

7 Reasons to Enroll a Child in an Online Elementary School

7 Reasons to Enroll a Child in an Online Elementary School Every year, hundreds of parents pull their kids out of traditional schools and enroll them in virtual programs. How do online elementary schools benefit children and their families? Why are parents so eager to remove their kids from the system that has worked for decades? Here are some of the most common reasons: 1. An online school gives kids the freedom to work on developing their passions. Two decades ago, primary school children were given little no homework. Now, students often return from school with hours of worksheets, drills, and assignments to complete. Many parents complain that students aren’t given the opportunity to focus on their own talents: learning an instrument, experimenting with science, or mastering a sport. Parents of online students often find that students are able to complete their assignments faster when they don’t have the distraction of peers to hold them back. Many online students are able to finish their coursework in the early afternoon, leaving many hours for kids to develop their own passions.​ 2. Online schools allow kids to get away from bad situations. Difficult situations with bullying, bad teaching, or a questionable curriculum may make school a struggle. Parents certainly don’t want to teach their kids to run away from a bad situation. However, some parents find that enrolling their child in an online school can be good for both their learning and their emotional health. 3. Families are able to spend more time together after enrolling their kids in online school. Hours of class, after-school tutoring, and extracurricular activities are leaving many families with no time to spend together (aside from homework tantrums). Online schooling lets kids complete their studies and still spend quality time with their loved ones. 4. Many online schools help kids work at their own pace. One of the drawbacks of traditional classrooms is that teachers must design their instruction to meet the needs of the students in the center. If your child is struggling to understand a concept, he may be left behind. Likewise, if your child is unchallenged, he may have to sit bored and uninspired for hours while the rest of the class catches up. Not all online schools let students work at their own pace, but a growing number provide students with the flexibility to get extra help when they need it or move ahead when they don’t. 5. Online schools help students to develop independence. By their nature, online schools require students to develop the independence to work on their own and the responsibility to complete assignments by the deadline. Not all students are up for the challenge, but kids that develop these skills will be better prepared for completing further education and joining the workforce. 6. Online schools help students develop technology skills. Technology skills are essential in almost every field and there’s no way for students to learn online without developing at least some of these essential abilities. Online learners tend to become proficient with internet communication, learning management programs, word processors, and online conferencing. 7. Families have a greater educational choice when they are able to consider online schools. Many families feel like they are stuck with few educational options. There may be only a handful of public and private schools within driving distance (or, for rural families, there may only be a single school). Online schools open up an entirely new set of choices for concerned parents. Families can choose from state-run online schools, more independent virtual charter schools, and online private schools. There are schools designed for young actors, gifted learners, struggling students, and more. Not all schools will break the bank, either. Publicly-funded online schools allow students to learn without charge. They may even provide resources like laptop computers, learning supplies, and internet access.

Outsourcing Federal Healthcare (Operations Management) 2 Assignment

Outsourcing Federal Healthcare (Operations Management) 2 - Assignment Example Hospitals keep personal health records of patients and disseminate this information when it is needed. The other major stakeholder in the U.S. federal healthcare system includes employers; they take part in paying for the insurance costs of the employees. The goal of employers is to ensure that there is a contribution towards the insurance funds, which cater for the needs of employees (Harland, et. al., 2005). Another main stakeholder of the healthcare system in the U.S. includes patients, as well as consumers of the healthcare services, which are provided by the federal healthcare system. The goals of consumers include having access to adequate care from the government. Consumers also want to access affordable health services from the healthcare institutions. The needs of stakeholders are to get health services, which are within their reach and which can serve various health needs that they have. The federal government can also be regarded as one of the main stakeholders in healthca re provision, in the United States. As a stakeholder in the federal health system, the goal of the federal government includes providing affordable health services to the U.S. citizens. The other goal of the federal government is to ensure that medical services and facilities accessible to the United States citizens are of high quality (Medicare.gov, 2013). The current strategy of the federal government in the provision of health services, in the United States, focuses on the provision of affordable care to all citizens, in the United States. With the establishment of the Patient Protection and Affordable Care Act, the United States government aims at ensuring that there will remarkable changes, which will have an impact on all healthcare organizations. The current status of healthcare reform in the United States also aims at ensuring that there is access to universal healthcare by all. The strategy used by the federal government aims at ensuring that more money is spent on health t han in any other activity. In addition, the current status of healthcare reform in the U.S. aims at ensuring that Medicaid and Medicare become affordable to all. This covers all American citizens, including the poor and unemployed persons who may face challenges when accessing healthcare (Medicare.gov, 2013). The current status of healthcare in the United States faces certain strengths, weaknesses, opportunities, and threats. This warrants a SWOT analysis of the U.S. healthcare system. One of the strengths of the current healthcare plan is that it enables the government to spend money on healthcare. In addition, the system can be credited since it has led to a decrease in the infant mortality rates. One of the weaknesses of the system is that it does not guarantee access to health insurance for the majority of American citizens. For example, sixteen percent of the American population does not have access to health insurance (Medicare.gov, 2013). One of the opportunities that the cur rent healthcare system has is that it receives funding from stakeholders such as non-governmental organizations, which are interested in providing healthcare in the United States. There is also adequate support of the system from other remarkable players in the United States. Despite the opportunities that the system has there are also some threats that it poses. One of the threats is that it may make people over-dependent on the government for the provision of other needs, which

Job Satisfaction Research Paper Example | Topics and Well Written Essays - 250 words

Job Satisfaction - Research Paper Example In job satisfaction research, there are several variables (both quantitative and qualitative) that are vital while undertaking the research. Among the variables are gender (qualitative) and intrinsic (quantitative) components. Several studies suggest that demographic characteristics may be linked to a person’s satisfaction with their work. If gender relates to job satisfaction, this relation might be partly examined and explained by a mediating effect of another set of variables. However, the fact is there is no defined relationship between gender and job satisfaction. Inconsistencies in findings concerning the relationship between job satisfaction and gender may be because of various factors. Not only might females and males in the same firm differ in the job level, pay, promotion prospects and many more, but they may differ in the extent to which the same job satisfies their needs. Intrinsic rewards such as task significance, task autonomy, opportunities to learn new things, task involvement and recognition are vital antecedence to job satisfaction to employees in the organizations. The qualitative variable is a descriptive variable. They have a greater bearing on the result due to their manipulation of other parameters. Quantitative variables are variables that can be measured. They are purely mathematical in nature. In this study, gender is one of the qualitative variables it is descriptive in nature while intrinsic, benefits, departments and age can be measured hence they comprise the quantitative variables. The mean is 1.777778 while the standard deviation and sample variance are 0.423659 and 0.179487 respectively. At 95% confidence level, the SD is the deviation from the central mean. The skewness in -1.41623, therefore, job satisfaction tends to be skewed towards the men gender. The graphs explain that job satisfaction is fairly divided between males and females.

Terrorism in Sudan Essay Example | Topics and Well Written Essays - 1250 words

Terrorism in Sudan - Essay Example This research will begin with the statement that terrorism is one of the most complex problems facing the modern world at present. It is difficult to tackle terrorism effectively because of the wide spread roots of terrorism in different countries. Afghanistan, Pakistan, Iraq, Sudan etc are some countries from which the terrorists are operating. At present war on terror is going on in Iraq, Afghanistan, and Pakistan. However, Sudan has not faced such problems even though its role in encouraging terrorist activities suspected for the last few years. â€Å"The U.S. has charged the Sudanese government of being liable for the al-Qaeda attack on the USS Cole missile destroyer in 2000†. Moreover, U.S. believes that Sudan is supporting various terrorist organizations in many ways to conduct attacks in various parts of the world including America. Since Sudan is a country with a poor economy, it is easy for the terrorists to operate from its soil. It should be noted that poor countrie s normally have weaker administration and hence terrorists may not face many problems while operating from such countries. Poverty, unemployment, lack of education of the people, religious fundamentalism etc are some of the major factors which contribute heavily to the development of terrorism in Sudan. Sudan is a strategic location for many of the terrorists. Majority of the people in Sudan are Muslims and they do not have enough education. Moreover, it borders with some of the prominent Muslim states like Egypt, Libya and some of the Muslim dominated African countries. Religious fundamentalism is widespread in Sudan because of lack of education of its public. These are the factors, which encourage Osama Bin Laden and his followers to select Sudan as his country of operation in the 1990s. America knows very well that Sudan is playing a major role in the spreading of various kinds of terrorist activities all over the world. It is believed that Sudan is currently providing military training and support to terrorist organizations such as Hezbollah, Hamas, Palestinian Islamic Jihad, Egyptian Islamic Jihad, Algeria's Armed Islamic Group etc. Moreover, many of the Islamic terrorist groups in other parts of the world are sending their people to Sudan for getting proper training on conducting terrorist activities. The current Sudanese president is behaving like a dictator and he is using iron fist to suppress the agitations against his administration. Because of that, internal problems and political unrest are common in Sudan. The northern and southern regions of Sudan are behaving like independent states even though the current president is trying hard to stamp his authority all over Sudan. America has enforced lot of economic embargos and sanctions with the help of UN against Sudan for the last few years. They have also listed Sudan in the category of State Sponsors of Terrorism from 1993 onwards. From 1996 onwards, Sudan is under diplomatic sanctions by the UN.â€Å"The U.S. government offered to take Sudan off its State Sponsors of Terrorism list in exchange for the northern government allowing a referendum on southern secession to take place without obstruction† (U.S. Offers to Remove Sudan from State Sponsors of Terrorism List, p.39). However, the northern government is not much i nterested in this offer and hence internal agitations are still going on in Sudan. â€Å"In 2008, the International Criminal Court at The Hague charged Sudanese President Omar Hassan al-Bashir with crimes against humanity and genocide in Darfur† (National Security p.86). In fact, the ICC issued arrest warrant against the president in 2009. Even though human right activists have seen this arrest warrant as a positive step, so far the president has been successful in avoiding or ignoring the arrest warrant. Al-Bashir’s anti-American or anti-western stands are inspirational to the terrorists in Sudan. His remarks against America and

Strategies and Actions of African American Women to Overcome Essay

Strategies and Actions of African American Women to Overcome Race-Based or Gender-Based Discrimination - Essay Example It is this reinvigorated movement that opened to women the blue-collar jobs and professions that were traditionally reserved for their male counterparts. When it comes to the fight against race-based inequality, it is plausible that women formed a crucial segment of the Civil Rights Movement, with their contribution seen in their volunteering to organizational and grassroots leaders. Indeed, the women created, mobilized, energized, and spearheaded particular efforts in the movements, ostensibly serving as bridge builders to the rest of the society (Epstein 4-6). Women movements worked tirelessly behind the scenes to bring about the changes that everyone in the movement sought by taking the advantage of the white elite’s ignorance towards women power. Furthermore, women movements successfully framed oppression and discrimination as a political issue, thereby initiating public discussions on issues that were previously perceived as private, and hence beyond public scrutiny. It is evident that the modern expression of black power stemmed from two distinct, yet superimposed traditions that shaped black political activism before and after the Second World War. For instance, the New Negro radicalism during the 1920s and the subsequent freedom protests that preceded the Great Depression, and the Second World War era precipitated an enlarged vision of citizenship, democracy, and civil rights. While the legislative and legal victories of the civil rights era performed a fundamental role in these struggles. It is the black power that proved decisive in the inauguration of the first generation of black elected representatives (Ellis 46-63). It is also the black power that made the greatest contribution to the production of an eclectic array of multi-themed and multi-ethnic movements of social change.

Incentive Plan Assignment Example | Topics and Well Written Essays - 500 words

Incentive Plan - Assignment Example During the period 2001-2005 which was considered the worst period for airlines it still made money on each and every year. A key to its success is keeping its planes full by capturing enough flying passengers. However, there is one other key aspect of its success that is rarely talked about and that is its incentive plan for its employees. Southwest Airlines has an outstanding corporate culture that encourages all its employees to render extra services to make flying with them a satisfactory experience. The founder of Southwest Airlines, Mr. Herb Kelleher, attributes the airline’s success to its unique culture that is intangible and hard to imitate by its competitors. It is this spirit of competitiveness that has propelled the airline forward to continuous profits over the years. In this regard, the airline adopts the total rewards style of management that recognizes employee performance (Jenses, McMullen & Stark, 2007, p. 61). The management uses incentive plans so that it gets employee buy-in and total commitment to its corporate objectives. The purpose of the program is to attract and retain top talent. Southwest Airlines has one of the longest hiring policies that lasts up to about six weeks through a series of tests and interviews to make sure that prospective employees fit into its fun culture termed as â€Å"LUV† as hiring managers emphasize work attitudes more than work skills. Once hired, employees are expected to help keep costs down so the airline will remain profitable despite its low fares. A reason why Southwest is profitable is because its employees are very productive, using a ratio of passengers per employee (Southwest: 2,400:1, United: 1,175:1 & Continental: 1,125:1). All employees of Southwest Airlines are eligible for its incentive plan which is profit-sharing. In fact, the firm implemented the first

Walt Disney and Customer Relationship Marketing Research Paper

Walt Disney and Customer Relationship Marketing - Research Paper Example The theme parks are one of the most preferred attractions with every park exhibiting different appeal and feeling. The Magic Kingdom is based on the structure of Cinderella Castle, Epcot exhibits the structure of Spaceship Earth, Disney’s Hollywood Studio is based on the structure of the Sorcerer’s Hat and the Disney Animal Kingdom looks like the Tree of Life. It can be assumed that with different structure and appeal, Disney has been successful in attracting different customers and can be considered as a good strategy (Koenig, David (2007). However, with things settling down, same attracting structures need to add value in terms of keeping the feeling of being attracted alive. The discussion aims at highlighting the customer relationship management practices of Disney along with developing and designing new practices to address key issues like sliding attendance figures of employees and decreasing revenues along with customer’s shift of attention towards other recreational activities in the absence of innovative CRM practices. Customer relationship management is considered one of the most important management tools enhancing business prospects by earning the loyalty and trust of customers for a long period of time. The study is based on the customer relationship management practices of Disney that offered great presence, reach and acceptance in the past. However, with the change in the social and demographic factors embedded with customer preferences; Disney is facing new challenges in the form of customer turnoffs, less customer attendance and decline in the interest and urges to visit the park. The customer relationship management of the organization has been quite commendable considering the high pressure in the service industry. It included the balanced mixture of technology interfaces and human interfaces but issues were not addressed and answered creating a need for another CRM practices or program with better prospects and feasibility.

Incentive Plan Assignment Example | Topics and Well Written Essays - 500 words

Incentive Plan - Assignment Example During the period 2001-2005 which was considered the worst period for airlines it still made money on each and every year. A key to its success is keeping its planes full by capturing enough flying passengers. However, there is one other key aspect of its success that is rarely talked about and that is its incentive plan for its employees. Southwest Airlines has an outstanding corporate culture that encourages all its employees to render extra services to make flying with them a satisfactory experience. The founder of Southwest Airlines, Mr. Herb Kelleher, attributes the airline’s success to its unique culture that is intangible and hard to imitate by its competitors. It is this spirit of competitiveness that has propelled the airline forward to continuous profits over the years. In this regard, the airline adopts the total rewards style of management that recognizes employee performance (Jenses, McMullen & Stark, 2007, p. 61). The management uses incentive plans so that it gets employee buy-in and total commitment to its corporate objectives. The purpose of the program is to attract and retain top talent. Southwest Airlines has one of the longest hiring policies that lasts up to about six weeks through a series of tests and interviews to make sure that prospective employees fit into its fun culture termed as â€Å"LUV† as hiring managers emphasize work attitudes more than work skills. Once hired, employees are expected to help keep costs down so the airline will remain profitable despite its low fares. A reason why Southwest is profitable is because its employees are very productive, using a ratio of passengers per employee (Southwest: 2,400:1, United: 1,175:1 & Continental: 1,125:1). All employees of Southwest Airlines are eligible for its incentive plan which is profit-sharing. In fact, the firm implemented the first

Future Farmers of America Association Essay Example for Free

Future Farmers of America Association Essay Can you believe that the National FFA Organization (Future Farmers of America) has over 400,000 members and growing in the United States, Guam, Puerto Rico, and The Virgin Islands? The FFA is a National Organization devoted to teaching and introducing students to agricultural education. It has introduced a large impact on students, changed their views on agriculture, and given them the chances to carry them out. The history of FFA is quite a long one, starting back in 1925, when four agricultural education teachers organized the Future Farmers of Virginia, which would serve as a model for FFA, as well as the New Farmers of America. Then, in 1930, at the third National Convention, national competitions were restricted to only male competitors. The official creed, written by E. M. Tiffany, and official colors, national blue and corn gold, were adopted this year as well. In 1933, Ohio FFA members wore blue corduroy jackets with the FFA emblem printed on the back, and those were later immersed into the official uniform. Soon after, the NFA and the FFV merged together with the FFA. Later on, in 1988, the organizations name was changed from Future Farmers of America to FFA Organization and membership was extended to middle school students. Lastly, in 2006, the National Convention was at its maximum attendance, with a jaw-dropping amount of about fifty thousand attendants! The history if FFA will continue to become more memorable as long as new members join. The FFA training sequence consists of several areas, pertaining specifically to the SAE program, career opportunities, and chapter meetings. The Supervised Agricultural Experience, or SAE, Program is used to carry out a knowledgeable agriculture project. The project workers are often helped by their chapter advisor, depending on what area of study the project is from, choosing from ag production, food science, forestry, ag sales/ service, and horticulture. In some chapters, members are permitted to visit the chapter’s greenhouses/farms to expand and further pursue Ag education. They can choose to extend their knowledge in fields like farm economics, marketing, computer science, and biotechnology. Through chapter meetings, members will learn and develop public speaking skills and working for others. There are several activities to compete in and degrees to earn and receive in FFA. Members compete at local, state, and national levels in the fields of public speaking, Ag mechanics, dairy-cattle, livestock, poultry, dairy food, meat, and rabbit evaluations, floriculture, ornamental horticulture, parliamentary procedures, and nursery/ landscaping skills. The FFA also gives out four degrees to its members. The Discovery Degree is given to seventh and eight grade students. The Greenhand Degree is given to high school freshmen with knowledge, goals, and skills of FFA. After completing two semesters of Ag course work, you receive the Chapter Degree, with which you are entitled to wear a silver pin. The last degree, the State Degree, is obtained for outstanding achievements and for development of leadership skills. The receiver, however, must have also worked at least a minimum of 300 unpaid hours, and they receive with this honor a golden emblem pin. The FFA is definetly one of the younger organizations in the U. S. But, throughout the last ten years, it has delivered a tremendous impact to students, teachers, and the nation along with it’s future.

Relevance of Psychology in Primary Health Care Delivery

Relevance of Psychology in Primary Health Care Delivery Critically discuss how an understanding of psychology can enhance the delivery of primary health care. (District Nursing) Essay The concept of psychology as relevant to district nursing and the primary healthcare team can be examined on a number of different levels. An understanding of psychology is clearly important to the nurse when she interprets a patient’s reaction to events in their personal illness trajectory. (Yura H et al. 1998). It is equally important as she considers her professional approach to the patient and the understanding of how a patient will react to the delivery and impact of healthcare, particularly in her considerations of how to achieve maximum patient compliance in any given therapeutic regimen. (Dean A. 2002).There are other, arguably less immediately obvious, ramifications of the impact of psychological implications in the delivery of primary health care when one considers the interactions and dynamics of the primary healthcare team and the interplay between various members of the team. In this essay we shall consider all of these implications. We start with the general plan that the topic of psychology in this context is potentially vast and for this reason we shall consider individual illustrative episodes in some detail in order to demonstrate an overall understanding of the area. The perception of any given situation and indeed, the evaluation of the probabilities that arise from it, are generally dependent on its presentation. This in turn gives rise to differences and variations in the number and scope of the possible outcomes from that situation. This is the so called Theory of Rational Choice (De Martino B et al. 2006). The perception of a situation is dependent on its â€Å"framing†. It therefore follows that the outcome is also dependent on the same concept of framing of the presentation. This has great relevance to our question, as the District Nurse can make decisions that are influenced by the â€Å"framing† of the presentation by the patient, but more significantly, she can seek to modify the decisions that a patient ultimately makes by framing her presentation of the situation in a number of different ways. There is a substantial evidence base in the literature which cites examples of how decisions can be changed or even reversed if t hey are presented with different emphasis on different factors in the presentation (van Osch S M C et al. 2006). A full consideration of the implications of this statement will suggest that these psychological concepts will have a direct bearing on other professional considerations such as autonomy and other ethical issues. (Hendrick, J. 2000). How can a patient be considered to be making a truly autonomous decision if that decision is being influenced by the abilities of a nurse to â€Å"frame† the presentation of the relevant factors in order to suggest that one outcome is better than another? (Green J et al. 1998). How can a patient be considered to be â€Å"empowered and educated† about a course of treatment if the nurse has been selective in the way that treatment has been explained to the patient? (Sugarman J Sulmasy 2001). We do not presume to suggest that such concepts are necessarily wrong. It may be entirely reasonable for a nurse to use her professional skill and judgement to suggest to a patient that one particular course of action is preferable to another by framing the presentation in such a way that the patient is guided towards a certain decision. In a commonly experienced clinical situation such as a frightened patient with an extensive skin wound to the leg which clearly requires suturing and who is saying that they don‘t want anything to be done, we could probably all agree that it would be quite appropriate for a nurse to suggest that the procedure of suturing is not very painful and will give a good cosmetic result whereas to leave the wound open will give rise to infection and other difficulties. From an analytical viewpoint, this approach could be viewed as detracting from the patient’s autonomy and ability to make their own valid consent. (Gillon. R. 1997). A pragmatist mi ght equally suggest that the nurse is employing valid psychological principles in her professional desire to achieve what is probably the best outcome for the patient (Coulter A. 2002) One of the major areas that we shall consider in this appreciation of the significance of psychology in the delivery of healthcare, is that of attitude of those delivering the particular intervention to the patients concerned. This area is examined in commendable detail by the paper by Johansson (K et al. 2002) which specifically considered the effectiveness of the delivery of alcohol awareness programmes in a group of problem drinkers. The reason that we have selected this paper for an initial consideration is that, unusually for a research paper, it does not simply consider the efficacy of a particular healthcare package, but it reviews and critically analyses the attitudes of the healthcare professionals on the overall outcomes with specific focus on their readiness to participate in such a venture. This is seminal to the major thrust of this essay and therefore merits a detailed examination. In essence, the entry cohort to this study was a collection of about 150 primary healthcare team workers who could potentially be involved in the delivery of an alcohol awareness programme. Each was asked to fill in a questionnaire which was designed to evaluate a personal profile of the respondent and covered areas such as: experiences with patients with alcohol-related health problems, knowledge and perceived capacity concerning early identification and intervention, attitudes towards the role of primary care staff in early identification and intervention and current intervention methods in use at the health centre. The results are interesting insofar as there was general agreement that the likelihood of a patient generating or triggering an enquiry into their alcohol usage was most likely to be when issues relating to the alcohol-related health-risks were perceived by the healthcare professionals. The relevance of the psychological aspects of such an enquiry became clear when it was found that nurses were more likely to enquire than the doctors in the sample and that on average, nurses tended to drink less alcohol than doctors. (Dihn-Zarr, T et al. 1999) Those who drank the least were more likely to be concerned about the health risks than those who drank more. Clearly the effects of alcohol in any individual patient are specific, but the willingness of a healthcare professional to instigate healthcare measures to minimise the health-related effects of alcohol appears to be dependent on their own attitudes towards alcohol and this may be reflected in their own levels of consumption. There is an old adage that the definition of an alcoholic is a patient who drinks more than their doctor. (Fleming, M et al. 1999). In the light of this study, this comment may not be as flippant as it initially appears. In alcohol-related problems, there is frequently an element of denial, both in terms of alcohol intake and its effects. (Herbert, C et al. 1997). If the healthcare professional involved has a degree of denial of their own intake, clearly this will have repercussions on their presentation of the problem to the patient and their subsequent evaluation and willingness to invoke therapeutic or interventional measures for that patient. (Kaner, E. F. S et al. 1999) Other significant factors that contributed to the likelihood of a healthcare professional instigating therapeutic measures were found to be their individual perception of their own degree of knowledge on the subject, both in terms of the effects of alcohol on the body and also in terms of the interventions that were available. (Aalto, M. et al. 2001) Many nurses expressed the fact that they were concerned that patients might react negatively to such enquiries and that this would affect the degree of patient empathy. Doctors appeared to be generally more confident about handling the possibility of a negative reaction. The same study pointed to the fact that it appears that such fears were unfounded in reality, as the same proportion of patients reacted in a negative way in both groups. >From this brief overview, it can be seen that psychology plays a role at many different levels in what is basically a fairly straightforward healthcare professional / patient interchange, and the attitudes of both patient and healthcare professional can have a profound impact on the eventual outcome of the care package for the individual patient. The paper itself makes the comment that: Nurses appear to be an unexploited resource, in need of training and support. Nurses may need to be convinced that an active role does not interfere with the nurse–patient relationship. Building teams of GPs and nurses in primary care might enhance the dissemination of alcohol prevention into regular practice. A further psychological input that is relevant in this area is the perception of the healthcare professional of just how effective the intervention that is proposed is likely to be. A previous paper on the same subject (Andrà ©asson S et al. 2000), concluded that healthcare professionals were much more likely to recommend a healthcare intervention that they had personally experienced or witnessed as successful, with greater frequency than one which had been shown to have a secure evidence base in published literature. The paper concludes with the suggestion that specific training in the subject needs to be implemented and this training not only needs to address the knowledge gap that has been identified, but also the belief systems and attitudes of the healthcare professionals in the primary healthcare team in order that it can reach its maximum potential. Although this paper was targeted and written in relation to a specific alcohol related intervention, it is reasonable to assume that the selected comments cited in this essay are sufficiently general to apply to most specific health related interventions and we will consider and explore other psychological rationales in specific relation to Health Promotion initiatives together with the inferences that can be drawn in relation to team building issues at greater length later in this essay. One of the major areas where psychology is relevant to the success (or otherwise) of a particular treatment is encapsulated in the concept of empowerment and education. (Howe and Anderson 2003). The patient who is both empowered and educated by the nurse will approach their illness trajectory in a completely different psychological frame of mind than one who is not. Time spent in explanation to a patient of the parameters and reasons for their treatment is rarely wasted. (Holzemer W et al. 1994). Marinker’s concept of the differentiation of compliance and concordance. (Marinker M.1997) is particularly useful in this respect. Although his original paper was written with specific regard to the taking of medication, the principles that it expounds are sufficiently general that they are now commonly extrapolated to cover most aspects of the interaction between the healthcare professionals and the patient. The patient who understands why he is being asked to undergo a particular th erapeutic regimen is far more likely to complete is successfully than one who is simply told what to do. This can be encapsulated in the professional advice on the subject from the RCN Patients are as fully involved as practicable in the formulation and delivery of their care (e.g. through the use of self-care plans) Where appropriate, patients are offered treatments other than medication Treatment plans are individually tailored for each patient Patients are involved, unless impracticable, in any decisions about referral Where practicable, patients are informed of the reasons for referral to specialists or other professionals (cited in CSAG 1999) This element of compliance is frequently cited in many of the tools of quality indication that are used in formal studies in this area. The degree to which a patient complies (or concords) with instructions can be viewed as a measure of success of the presentation of that treatment directly to the patient. (Campbell S M et al. 2000) As we have intimated in the introduction, the title of this essay can be interpreted at several different levels. In this segment we shall consider the impact of formal psychology services in primary health care. The rationale for our consideration of this topic specifically lies in the fact that an understanding of basic psychological principles is fundamental in allowing the nurse to appreciate the elements of treatment commonly undertaken in a psychology clinic. The excellent and informative article by Sobel (A B et al. 2001) provides a good starting point for this consideration. In practical terms, the average attendance at a psychology clinic is about five outpatient attendances. (Arndorfer, R. E et al. 1999). This means that the contact of a patient with the primary healthcare team is likely to outnumber the attendances at the clinic over a period of time. To give a specific example, it is clearly important for the nurse, who may come into contact with (for example) an anorexic adolescent, to understand the issues revolving around body dysmorphia, self-image enhancement and self-esteem (Lavigne, J. V. et al. 1999) if they have been undergoing treatment, if the nurse is to consider giving any degree of holistic consideration to whatever problems are being presented to her at the time. It is clearly of little value, if requested to give advice on the subject of weight loss (which is a common enquiry at nurse-run clinics), (Hogston, R et al. 2002) . to attempt to give such advice without a background knowledge of the psychological principles that have been employed in trying to restore the patient’s eating habits to a more normal pattern. (La Greca, A. M. 1997). Equally the parents of a child who is undergoing treatment for enuresis may have questions that they have not felt able to ask at a busy clinic and these may be presented to the practice nurse. A background knowledge of current treatment (both interventional and behavioural) is clearly vital t o being able to answer the questions with a degree of professional confidence. Another area where the nurse’s knowledge of psychological issues may be important is that, given the fact that a comparatively high number of patients default from follow up before being formally discharged, the nurse should know that psychological treatment is rarely successful if the â€Å"less than optimum† course of treatment is completed. (Sobel, A. B et al. 2001). Encouragement to return to complete the full course may be a useful remit for the nurse confronted by a patient in this situation. It follows that a sensitive exploration of the reasons for default my also be helpful and a knowledge of the subject is clearly helpful here as well. The patient who has defaulted from follow up through apathy needs completely different handling from the patient who has defaulted because of a resurgence of painful or difficult memories during a course of cognitive behavioural therapy. (Street, L. L.et al. 2000). In the latter case, empathetic handling is of great importance a s the issues involved may have a deep significance for the patient and completion of the course may be fundamental to a complete resolution of the issues involved. (Mitchell M C et al. 2004). When dealing with the patient who has specific emotional or psychological issues, the professional nurse would commonly have to employ a degree of psychological understanding which may be deeper than in many other cases for both of the reasons set out above. Let us now consider a different aspect of psychology and its relevance to nursing practice in primary care. A large proportion of the work of the district nurses can be taken up with the care of the dying patient. The dying, or terminally ill patient typically has a psychological profile that is quite different to the â€Å"average† patient. This was explored in the fascinating and very well written paper by The (The et al. 2000) who considered the elements of denial and cognitive distortion exhibited by a patient when being given news that they do not want to hear. The diversity of psychology shown by these patients is virtually unique to this group and a firm grasp of the essential elements is vital if the district nurse is going to handle the situation both professionally and well. The concept of â€Å"a good death† (Seale C et al. 2003) is one that is frequently cited in the modern literature and a fundamental prerequisite to a good death is that the patient is surr ounded and treated by healthcare professionals who have broad understanding of the psychological issues that are relevant to this spectrum of patient. (Wilkerson, S. A et al. 1996) There are many patients who confront the inevitability of death with a stoical inevitability that makes their management a relatively straightforward matter (Wadensten et al. 2003). The patients that we shall specifically consider in this segment however, are those who have a positive diagnosis of a life threatening condition but employ a number of coping mechanisms so that they do not have to directly confront the possibility of imminent death. These mechanisms can range from false optimism right through to frank and abject denial (Weeks et al 1998). We have already considered some of the ethical implications of autonomy and consent earlier in this essay, but they also are of great relevance in this section. It follows that if a patient is to have any degree of meaningful input into their treatment plans and consideration of the various options that are open to them, they must be both fully aware of, and quite prepared to confront, the implications of the situation that they find themselves in. If they chose to distort some or any of the relevant facts of the case, it equally follows that they cannot make a reasoned and rational decision about the options and choices that they have in front of them. Once again we return to the issue and concept of framing the presentation, the only difference here is that it is generally the patient who deliberately distorts the frame rather than it being distorted or manipulated by the healthcare professionals. This specifically is the issue that The and his colleagues considered in their paper (The et al. 2000). We should start a consideration of this issue however, with a reference to an earlier paper by Jennings (1997) who described the â€Å"emotional roller coaster† experienced by patients who deal with a malignant diagnosis and that this â€Å"evolution of emotional landscapes† can be predicted with a degree of certainty. This can be best examined with a verbatim extract from the The paper which refers to patients with small cell carcinoma of the lung: â€Å"False optimism about recovery is usually developed during the (first) course of chemotherapy and was most prevalent when the cancer could no longer be seen in the x ray pictures. This optimism tended to vanish when the tumour recurred, but it could develop again, though to a lesser extent, during further courses of chemotherapy. Patients gradually found out the facts about their poor prognosis, partly because of physical deterioration and partly through contact with fellow patients who were in a more advanced stage of the illness and were dying. False optimism about recovery was the result an association between doctors activism and patients adherence to the treatment calendar and to the recovery plot, which allowed them not to acknowledge explicitly what they should and could know. The doctor did and did not want to pronounce a death sentence and the patient did and did not want to hear it. Clearly an understanding of the psychology of what colours the patient’s reactions is vital to the district nurse if she is to handle this type of situation both professionally and empathetically. If we take a completely detached and dispassionate consideration of this situation the healthcare professional can say with almost complete certainty, that the patient with a positive diagnosis of small cell carcinoma of the lung is going to die. Statistically we know that over 90% of patients are dead within two years of diagnosis and the overall five year survival figures are nil. (Seale C et al. 2003) The practicality of the situation is therefore that it clearly makes sense to discuss options in terms of treatment, palliation and support as soon as a positive diagnosis is made. In real terms, this is rarely done because healthcare professionals frequently find it difficult to effectively pronounce a â€Å"death sentence† on patients. In this respect the psychology of the situation is as much a reflection of the attitudes and feelings of the healthcare professionals as it is of the patient. On a fictional level one can cite the classic literary example of A J Cronin’s Dr Findlay (Cronin A J 1934) who disagreed with his partner Dr Cameron. Dr Findlay felt strongly that the eponymous Mrs McIver should be told of her hopeless prognosis on the grounds of being completely truthful with the patient and this was against the advice of the older, more experienced partner, Dr Cameron who had been hitherto managing the situation by keeping the lady’s spirits high by telling her how well she was looking at each occasion he had contact with her. Dr Findlay confronts the situation by telling Mrs McIver the truth and within a few days she has died. The relevance of the story is seen at the end where Dr Findlay is depicted talking to the dead lady’s husband and Dr Findlay expresses his shock at the speed at which the old lady died and the husband concludes the episode by observing that: â€Å"She was doing really well until you took away from her the one thing that she had left – and that was hope†. In short, this episode highlights some of the difficulties and dilemmas that are frequently faced by healthcare professionals in general and district nurses in particular. The practicality of the situation could have been handled better with a more thorough understanding of the thought processes and psychological mechanisms employed by Mrs McIver in her last few weeks. One can see the point of view of Dr Findlay who took the view that the lady would not have been in any realistic position to make appropriate arrangements to confront her own death if she had never faced the possibility in the management plan that Dr Cameron had adopted. Dr Findlay’s approach could be argued to have allowed her to consider a number of timely treatment options if the truth was confronted. The fact of the matter was that she chose to actively collude with the optimistic approach of Dr Cameron and she derived strength and the ability to cope from the transparent belief (a cognitive distortion) that her prognosis was not hopeless. Dr Cameron was clearly of the opinion that this was of greater benefit to her than confronting her imminent death. What the story does not tell us (and we can only surmise) is that Dr Cameron, in common with many other real healthcare professionals, also has psychological difficulties in dealing with the subject himself. A number of different mechanisms may be active in this situation. It is possible that, by telling a patient that they are soon to die, it may challenge the notion that medical science can cure everything and that healthcare professionals are infallible (sadly, a still all to common belief). Equally it could be that the healthcare professionals involved do not like to be vicariously reminded of their own mortality and therefore collude willingly with the patient’s false optimism. Others again may take a rational view that â€Å"if the patient wants to know the truth then they will ask, if they don’t want to know then they won’t ask† and thereby actively avoid confronting the situation (Curtis J R. 2000) The The paper examines this issue in considerable depth with a commendable degree of scientific scrutiny. In the words of the paper, the authors suggest that: The problem of patient / doctor collusion does actually require an â€Å"active, patient orientated approach from the doctor†. A practical and novel solution to this problem is suggested in the form of the use of a â€Å"treatment broker† who is defined as: â€Å"a person who is trusted by both patient and doctor and who can help both parties to clarify and communicate their (otherwise implicit) assumptions and expectations†. The’s analysis suggested that the majority of patients in the study did actively want to know if the illness that they had was terminal with over 85% stating that they would wish to be told the truth rather than be given false optimism in an unrealistic fashion. This is contrasted with the finding that, in the study, when a patient was given a terminal diagnosis, the next question was almost invariably a variation of â€Å"what are the chances of a cure?† (Meredith et al 1996). It is also the case that other studies on the psychology of this type of situation have shown that when patients ask about their condition (and this applies not specifically to terminal conditions) they do not want to hear anything other than good news (Costain et al 1999). This argument is extrapolated even further in a study by Leydon and his co-workers (Leydon et al 2000) who provide an excellent qualitative study into patient’s reactions and they cite examples of patients who were interviewed directly after a recorded conversation with a healthcare professional and who overtly denied that they had been given a terminal diagnosis even though this was demonstrably not true. An interesting twist in these discussions of the psychology of the situation is provided by Dean (Dean 2002), who offers a specific insight into the way patients perceive the differences between nurses and other healthcare professionals. He takes the arguments of false optimism and overt denial and examines them further. Again, this paper is specifically concerned with the patient with a terminal diagnosis, and it looked at the differences in the content and tone of the conversations that patients had with both doctors and nurses. A significant finding from this paper was that a patient may choose to overtly collude with the doctor during discussions of â€Å"a cure† but within a very short space of time may choose to talk in a much more open way with a nurse when pretences of a cure are actively dropped. Dean suggests that â€Å"such a dichotomy of approach is not unusual†. He suggests that: Patients may well feel a need for a theatrical faà §ade to bolster their own psychological states as well as to collude with the doctor and indicate that they are remaining positive and confident in the doctor’s ability to try to achieve a cure. And this suggestion is echoed and expanded in the Curtis paper (Curtis 2000) with the observation that, in their more candid moments patients may well wish to get a more â€Å"down to earthâ€Å" response, which they perceive that they will get from the nurse, who they think may not require a faà §ade or even indulge in the sophisticated game play of the doctor. Lynn (Lynn 2001) adds a counter-intuitive note of caution for the nurse with the thought that this situation requires a great deal of careful handling by the nurse, as the psychological mechanism that underlies the nursing approach is that the patient may actually be looking for reassurance and (possibly unexpected) reinforcement of their own false optimism. This is an exemplification of the constant calls in the literature for a holistic and patient centred approach to patient care rather than a blanket approach to this type of clinical problem. The rest of The’s paper is concerned with the psychological theory behind the explanations of just why it is that patients do adopt these defensive positions and just why it is that healthcare professionals frequently collude with them on this issue. It is not particularly relevant to explore this in any further detail as the point is clearly made that a basic understanding of the mechanisms by which patients cope with their adversity and the psychological constructs that are frequently presented in these circumstances is of great importance to the nurse who has to deal with, interpret and empathise with the patient’s particular needs at any given time in their illness trajectory. Nurses are often involved, both overtly and in their everyday work, in the business of Health Promotion. Psychology plays a very important part in the overall success and implementation of health promotion strategies on a both a population and an individual level. The theoretical basis of much recent work in the field of Health Promotion is in the concept of the Attitude-Behaviour theory (A-B theory) (Rise J 2000). This theory suggests that the optimum change in behaviour patterns (at least in the field of health and self-interest) is achieved with the optimum change in attitude (or â€Å"realignment† in the jargon). We opened this essay with a reference to the Theory of Rational Choice. An offshoot of this theory (the Theory of Reasoned Action) modifies the A-B Theory to the extent that it provides a model framework by which one can assess the many divergent processes by which attitudes guide behaviour. The hypothesis states that if people can become highly motivated to make a correct decision and are in a position (because they have been given relevant information), then they are likely to spontaneously engage in a â€Å"deliberate and thoughtful process in deciding how to behave† (Rise J 2000). In the context of Health Education (which was the field that the theories were originally developed in) the theory suggests that if people are given sufficient and persuasive information in relation to their health, then a significant proportion will spontaneously indulge in lifestyle changing activity which can be consistent with healthier living. The significance of these theories is that, if t he nurse has a remit to promote a healthier lifestyle (which is arguably part of a professional remit), she is most likely to have the greatest success in providing significant amounts of information to patients rather than simply dictating to them how they should alter their lifestyle without any significant explanation. This comment effectively brings us full circle to the concept of compliance and conformance as postulated by Marinker. Another issue that has deep seated psychological implications, is the current trend towards teambuilding in primary health care. The ramifications of this concept are huge, and therefore we intend to only discuss the issue by considering a number of the most relevant points. To a large extent, team building overlaps with the concept of multidisciplinary team working. This move has required a redistribution of both power and authority (and thereby a redistribution of responsibility) within the team. (Shortell S M et al. 1998).The psychological implications of this are that if one considers the NHS of more than about twenty years ago its structure was more isolationist and based on individual practice (DHSS 1988). Individual speciality teams and individuals worked in a degree of comparative isolation and this also implied a greater degree of individual responsibility than they have at present. This change has brought about a number of major changes in areas such as ethics and work prac tices which are not particularly relevant to our topic in this essay (and therefore will not be discussed further), and also the psychology of working, which clearly is. The first consideration is the psychology behind the concept of leadership. Leadership is clearly important if one is to have an effective team. In psychological terms styles of leadership can be divided into several categories. The two most prominent being congruent leadership and transformational leadership. A full discus