Diversity climate in an organization Research Paper

Diversity climate in an organization - Research Paper Example This paper illustrates that successfully managing an organization especially in today’s increasingly diverse workforce has become one of the most challenges faced by management and corporate leaders in recent years. Human capital is the most valuable and powerful asset and therefore it has been found that effectively managing the human resources is extremely critical to organizational success. Managing diversity climate effectively is one of the most significant elements of effective managing of the human capital as it can help the organization increase the productivity of its workforce, make them fully satisfied and highly committed to the job as well. Â  Diversity refers to the attributes and aspects that can be considered to be salient to an employer making him think that he is different from another individual. Gender, racio-ethnicity, nationality, age etc are some of the attributes that create and influence diversity within the organization. Diversity happens in an organ ization where its members’ have attitudes and perception towards people from cultural groups other than their own. Herdman and McMillan-Capehart described that diversity referred to the degree of inter-organizational representation of people in a way that different groups are inter-affiliated of cultural significance. A plurality of perspectives and experiences prevail in diversity climate and it serves as the strategic resource to the organization securing a competitive advantage. Â   They viewed diversity climate as an opportunity and a resource that the managers can turn them better strategy to increase organizational performance and achieve sustainable competitive advantage if the management is successful in managing it. As Garcia and Hoelscher (2010, p. 23) detailed, there are four different themes when it comes to diversity climate, they are: Perceptions of degree between group conflicts and a mind set to accept others, Level of institutional commitment to the diversity in the organization, Fairness, like lack of institutional bias, and A very generalized atmosphere for getting and giving respect each others. As today’s workforce has become increasingly diverse, diversity management has gained considerable attention and has emerged to be an important element of larger business strategy that can help an organization improve organizational competitiveness and effectiveness. As Hur, Strickland and Stefanovic (2009, p. 501) noted, many large organizations have recently given greater emphasis on identifying, considering and implementing varieties of practices that are designed and developed to foster better diversity business environment as well as to combat discrimination and all other legal risks in the workplace. Where diversity climate persists, there will be shared perceptions regarding the ways things are around there. Employees in such circumstances will be able to retrieve information from salient stimuli so that they can describe and interpret their work environment. They also can integrate the perceptions of unique workplace conditions and events in to quite a broader perceptions of organizational climate. A strategic method to analyze diversity climate There can be different cultural groups and people from different ethnic background in any organization. the workforce today is getting too much diverse. Diversity climate, as mentioned above, is the perception and attitude of people towards the culture of people other than their own. In a diversity culture, people are mentally capable of accepting other culture, groups and ethnic behaviors, rather than their ow

Global Warming Essay Example | Topics and Well Written Essays - 1000 words - 1

Global Warming - Essay Example This is a difficult dilemma, because the effects of climate change will manifest themselves in different ways in different regions, from pole to pole. The political reasoning of the problem solution suggests that all countries need to make coordinated and deliberate actions based on special international conventions on climate change. Scientists and international scientific community are now under a tremendous pressure, as a correct identification of climate change trends and its main consequences in the future will save humanity from immense ills and, vice versa, adoption of expensive measures without sufficient scientific grounds will lead to huge economic losses. Global Warming Its easiest definition runs that global warming is a gradual increase in average temperature of the Earth’s atmosphere and oceans in the 20th and 21st centuries. Scientific judgments, expressed by the UN Intergovernmental Panel on Climate Change, directly supported by National Academies of Sciences o f the Big Eight, say that the average temperature on Earth has risen by 0.7 Â ° C since the Industrial Revolution (the second half of the 18th century) and a considerable proportion of observed warming over the past 50 years was caused by human activities, primarily by gas emission (carbon dioxide (CO2) and methane (CH4)), that cause the greenhouse effect (Mank 1). The increase in average global temperature led to a decrease in continental glaciers. In addition, we should expect a decrease of the permafrost zone, which presently occupies a significant part of the planet, as well as anticipate changes in the methods of management, farming, construction, etc. in the zone itself. Measurements and calculations showed that for the last 100 years mountain glaciers have decreased by approximately 2.000 cubical kilometers; the annual decline averaged 0.06% of the total mass of Alpine ice. Signs of glaciers’ degradation are observed in all regions of the Arctic, where global warming manifests itself to the maximum extent. Climate warming leads to sea levels rise. Over the past 20 years the rate of increase has doubled and reached 2.5 cm/yr. This rise promises significant environmental consequences. Saltwater intrusion in deltas of the major rivers will destroy protected habitat for wild animals and birds, spawning grounds for fish. Sea level rise will increase a probability of devastating storms. The issue of dams’ building needs to be thought through today. About 70% of the seaside is currently being destroyed as a result of natural lift of water and increasing human activities. This process will be further exacerbated by global warming. So, according to the UN Environment Program data, in the Nile Delta, for example, one-fifth of the arable land of Egypt can be flooded by rising water, which will affect about 10 million people (Mank 3). Scientists state that in addition to sea-level rise, rise of global temperature will lead to changes in the quantity and distribution of precipitation. As a result, there is a strong possibility of natural disasters such as floods, droughts, hurricanes, etc.; harvests will fall in the affected areas and will increase in other zones (due to increasing concentration of carbon dioxide). Climate warming may cause a geographic

Introduction To Dual Diagnosis Health And Social Care Essay

Introduction To Dual Diagnosis Health And Social Care Essay Over the last ten years in mental health, there has been a significant change and considerable debate about the definition of dual diagnosis, this terminology refers to a mental health disorder combined with substance misuse (Department of Health, 2002). This can cover a broad range of disorders from learning disabilities and substance abuse of legal or illegal drugs to severe mental illness such as schizophrenia and substance misuse of cannabis or alcohol (Department of Health, 2002). However in medicine dual diagnosis is an umbrella term, for a primary and secondary disorder for example diabetes and hypertension (Sowers Epstein, 1995) This research proposal will focus on the client group duality of psychosis and substance misuse of cannabis or alcohol. Psychosis can be defined as a severe mental health disorder in which thought and emotions are significantly impaired, whereby people can lose contact with reality. However the symptoms can vary between negative and positive, the negative symptoms can cause apathy, a reduction or absence of social skills, resulting in confused thoughts which impair their ability to concentrate or complete instructions. The positive symptoms can be defined as either visual or auditory hallucinations or delusional thoughts, where a person may have an undeniable belief in something false (National Institute for Clinical Excellence (NICE), 2011). However substance abuse can aggravate psychosis leading to further hallucinations, which is associated with a wide range of negative outcomes, such as higher rates of relapse, increased hospitalisation (revolving door clients), suicide, housing issues and poorer levels of social functioning, such as poverty, violence, criminality and social exclusion, less compliance with treatment, greater service costs to National Health Service (NHS) or the criminal justice system and government services (Department of Health, 2007). More significantly The World Health Organization (WHO) reported 51,353 admissions of drug-related mental health disorders in 2010/11. These admissions have increased year on year and are now nearly twice as high as they were ten years ago, therefore families are at greater risk of having a family member diagnosed with dual diagnosis (The World Health Organization , 2012). Significantly the impact of the dually diagnosed within families is drastic, family dynamics are altered by challenging and difficult situations within the home, by displaying disruptive and aggressive behaviours (Biegel et al, 2007). Clearly people with dual disorders have strained interactions with their families. However when relationships are strained families might be less willing to help, the relative with dual diagnosis which could contribute to higher rates of homelessness and social problems (Clarke, R E; Drake, R E, 1994). Yet family members may have differing amounts of contact and distancing, because of the negative impacts of their behaviour. However someone in the family takes the role of main caregiver, being the person most directly linked to the caring of the dually diagnosed whilst care giving not only affects their QOL, it also impacts on possible depressive symptoms and research has indicated that care giving burden has a risk factor for early mortality (Biegel et al, 2007), (Marcon et al, 2012) (Walton-Moss et al, 2005) Yet a lack of social support, and informal and formal care, has been found to be the most important source that predicts the burden of family caregivers (Biegel et al, 2007) although informal caring occurs naturally within family relationships, which is typically unpaid, this goes beyond the caring expected of these relationships in contrast to a paid formal carer (Chaffey Fossey, 2004) additionally being a carer can raise difficult personal issues about duty, responsibility, adequacy and guilt (Shah et al, 2010). Research into the impact of care giving shows that carers suffer significant psychological distress and experience higher rates of mental ill health than the general population, the triggers for distress are as follows; worry, anger, guilt, and shame; financial and emotional strain; marital dissatisfaction, physical effects of the stress of living with a substance abuser (Biegel, et al 2007). However without the contribution of the UKs 6.4 million unpaid carers health and social care services would collapse. In 2037 its anticipated that the number of carers will increase to 9 million (Carers UK, 2012). Worldwide several authors have argued for service systems to acknowledge and address family members need to ensure their own well-being, as well as to ensure effective community support for people living with mental illness (Chaffey Fossey, 2004) (Igberase et al 2012) (Carey Leggatt, 1987). The last ten years have seen major reform of the law as it relates to carers; consequently families have been forced to give up work to care for their relatives. Family carers need assistance to prevent becoming unwell themselves (Carers UK, 2012). Therefore supporting carers must be a central part of government reform, which acknowledges the family as associated clients who desperately need support. This is paramount because relatives often know little about how the interactions between mental illness and substance misuse are interchangeable. Therefore families need practical information about dual disorders, to help recognise the signs of substance abuse, and strategies for its management for example medication adherence and recognising relapse triggers. Addressing these factors would enable the improvement in the dually diagnosed directly related to greater outcomes in the well-being of the family (Mueser Fox, 2002). Overview, context and background information relevant to topic It costs the UK Â £1.3 billion a year in carers benefits and lost taxes whereby family members are becoming increasingly responsible for providing support, although in 2012 the British government submitted the Care and Support Bill which will guide future services for caregivers. Families will no longer be treated as an extension of the person they are caring for, they will have a right to an assessment, this will give carers much better access to support them balance their caring roles and responsibilities (Carers UK, 2012). Yet informal carers may experience less choice about the discontinuation of care in comparison to volunteer or paid carers, possibly due to love of the family member and a sense of duty, it is essential that the family understand the facts about dual diagnosis, to have every hope for recovery of the family (Department of Health, 2007) Additionally health services should acknowledge the families by assessing them as associated clients so that carers can learn to recognise the triggers of caregiver burden and moreover be given general education and health promotion (Rethink, 2007). However in 2006, the College of Occupational Therapists (COT) announced a 10 year vision for occupational therapy in mental health which included by 2013 for practitioners to have extended their scope of practice across a range of agencies to meet the occupational needs of mental health services (COT, 2006) Statement of the problem proposed to be investigated The proposed research intends to investigate, what are the experiences of people who are carers for people with dual diagnosis? General aim(s) of the proposed research To find out how families cope living with someone with dual diagnosis? What are their biggest challenges? To identify the current experiences from the perspective of the carer regarding the impact of dual diagnosis, the burden; grief and the loss of their relative. Relevance, significance or need for the study The relevance to occupational therapy and the health service; carers are associated clients and therefore need to be taken into consideration when assessing this client group. Furthermore the lacking of occupational therapy literature in this area makes a clear case for the proposed research. Chapter 2: Literature Review Introduction to the chapter Literatures in dual diagnosis are largely separate, mainly based in substance abuse or mental health fields. However over the past decade, family work in dual diagnosis has been mainly focused on client outcomes and not the families well-being or quality of life QOL. However occupational therapy literature is also limited, lacking investigation of occupational needs identified from the families perspective. However a considerable amount of literature has been published on descriptions of occupational therapists roles by defining and establishing what an occupational therapist does within the multi-disciplinary team in mental health services, but not specifically to dual diagnosis (Brown, 2011) (Hyde, 2001)(Lloyd et al, 2008). Therefore it is beneficial for occupational therapists to have a better understanding of the families perspectives, as associated clients to enable additional support for the caregiver thus improving outcomes for the whole family. There is a plethora of literatures, on outcomes associated with family support for the dually diagnosed, the majority of studies examined the relationship between family involvement and client outcomes such as reduction in mental health symptoms, engagement in treatment services, lower hospitalisation rates, improved decrease in substance abuse, sustained remission (Clark, 2001) (Mueser Fox, 2002) (Biegel et al, 2007). Although the high service costs of treating the substance abuser and the frequent involvement of relatives in the lives of dually diagnosed clients, there are few resources to help clinicians engage and collaborate with families (Mueser Fox, 2002). This implies that families or informal carers can easily become the main source of care when treatment fails, the family being the last resort (Clark 2001). On the other hand, some research has shown that individuals with dual diagnosis are less satisfied with their family relationships than those with a severe mental illn ess alone (Kashner et al. 1991) and that receiving family support may exacerbate difficulties by increasing conflict (e.g. supply of additional money may be used for drugs, existing poor family dynamics worsen carer-client relationship). Conversely research is lacking in the support of families caring for the dually diagnosed (Biegel, et al, 2007) (Townsend, et al, 2006). In contrast families are often the most significant people in the dually diagnosed life, this unique relationship puts families in the central position of being able to encourage the dually diagnosed to take the necessary steps towards recovery by providing direct care such as practical help, personal care, emotional support as well as financial support (Clarke, R E; Drake, R E, 1994) (Shah et al, 2010) (Mueser Fox, 2002). The impact of mental illness on families is usually conceived in terms of caregiver burden, this experience may help determine the quality of life QOL for family members, the most significant being, isolation, coping with behavioural problems, and relationship problems between family members (Clark, 2001). Mueser et al, (2009) study of 108 families conducted a randomised control trial utilising Lehmans QOL interview instrument with satisfactory reliability and validity (Lehman, 1998) for the diagnosed, the caregiver was assessed using the family experiences interview schedule (FEIS) with established reliability and validity which did not incorporate the QOL for the family this was not addressed. The findings from this study found that motivating relatives, to participate in family intervention can address the disruptive effects. These stressors that affect quality of life include; worry, anger, guilt, and shame; financial and emotional strain; marital dissatisfaction, physical effects of stress of living with a substance abuser (Biegel et al, 2007). Additionally Biegel et al (2007) exploratory, non-experimental cross-sectional survey design conducted interviews / surveys with 82 females with dual diagnosis and 82 family members and considered the caregivers experience as moderate, and found that behavioural problems contribute to the burden affecting their quality of life, the strength of this study is acknowledging how substance abuse impacts on the role of care giving which was also tested by applying FEIS. Many studies of family carers of persons with mental health and or substance abuse issues consider how families quality of life is affected, the main themes highlighted that emerges throughout the reviewed literatures are caregiver burden which is documented as worry, anger, guilt, isolation, stress which results in a diminishment of QOL of family members (Biegel et al, 2007) (Chaffey Fossey, 2004) (Shah, Wadoo, Latoo, 2010) (Chan, 2010). Behavioural problems have been found to be the strongest predictor of caregiver burden across chronic illnesses (Biegel et al, 2007). In contrast Jokinen Brown, (2005) conducted a focus group study which included 15 subjects would argue that there are positive aspects of lifelong care giving and quality of family life, the study acknowledged the concerns for the health of all family members (Jokinen Brown, 2005). Research in the QOL of care giving highlights that carers suffer significant psychological, distress and experience higher rates of mental ill health than the general population. Therefore by improving the QOL of carers will likely to reduce caregiver burden that requires further research to explore the lived experiences of families living with the dually diagnosed (Shah et al, 2010). However, literatures addressing the family as a collective unit and the impact of care giving on each family members role is lacking therefore this literature reviews the research. The majority of family caregivers, mostly women report experiencing moderate to high levels of depression as well as stress, this type of informal care giving is taken on in addition to existing roles and responsibilities (Chaffey Fossey, 2004) (Biegel et al, 2007) (St-Onge Lavoie, 1997). Traditionally, informal care was supplied by women but nowadays women are not only more likely to work, but also likely to be significant contributors to family finances. For women, this implies that earnings will be lost due to informal care increasing. However women play a central role in care-giving which may impact on their well-being more than other members of the family (St-Onge Lavoie, 1997). Although according to shah et al (2010) women have higher rates of depression than men in the care-giving role (Shah et al, 2010). However male carers tend to have more of a managerial style that allows them to distance themselves from the stressful situation to some degree by delegating tasks (Shah et al, 2010). Significantly (Mays Holden Lund, 1999) Interviewed 10 male caregivers and the findings, men expressed their means of coping by being realistic and action-oriented in response to their feelings. However the effect of care giving on children can be considered by the physical changes to normal growth, for example migraines, inflammation of the lining of the colon, and ulcers (Biegel et al, 2007) (Townsend et al, 2006). Tracy Martin, (2006) examined the effects of dual diagnosis via cross-sectional survey design which examined the types of support provided by minor children and the differences in support perceived by the child versus the support perceived by the adult. The findings that the role of children is often ignored or neglected, the effects are referred to as a role reversal parental child or parentification thus resulting in negative developmental outcomes for the child, although a weakness with this study is the support perceived by the child is not the views of the children but by the mothers reporting on both, these findings represent a design bias (Tracy Martin, 2006). Significantly Rupert et al (2012) aim to identify the issues when engaging children whose parents have a dual diagnosis explored the perspectives of 12 children via semi-structured interviews. A strength with this study is that the authors were able to elicit the sensitive data ethically by gathering information about secrecy issues around their parents substance abuse and remaining loyal to their parents, children experience negative times spent with their parents, with family arguments and the knowledge of when the parent abuses substances these findings represent the need to acknowledge childrens perspectives as associated clients (Reuper et al, 2012). The authors acknowledge that the study does not recognise the other family members within the household that could provide an exploratory view of their perspective. Although the effect of care giving on siblings is lacking, Sin et al (2012) studied the phenomena of understanding the experiences of siblings of individuals with first episode psychosis. Qualitative semi-structured interviews with 31 sibling participants researched that they had somehow lost their brother or sister as his or her character had changed since the onset of their diagnosis (Sin et al, 2012) Younger siblings were much more likely to cope by withdrawing and not getting involved, they often reported that they were not made aware of information and resources available to help with the situation and were also less likely to want to know about the illness (Sin et al, 2012). Strength of this study is the qualitative exploratory semi-structured interviews, and the themes that emerged although this study does not address the issues of substance abuse or the quality of life of the other family members. The gap in the literature is that quality of life does not consider the affects of mental health and substance abuse on the family. This paper has not been able to locate any studies that consider the qualitative exploratory lived perspectives of all family members living with the dually diagnosed, and the impact on their quality of life, therefore due to the lack of research on families living with the dually diagnosed this research seeks to explore their perspectives. To conclude Health professionals should focus on the familys environmental context, and their perceptions of their relative with mental illness, thus by assuming that each family is different, clinicians should evaluate how family dynamics can affect the families quality of life and how theses interactions impact in their plan of care (Walton-Moss et al, 2005). However, numerous studies have looked at the effects of family involvement on the outcomes of the dually diagnosed, current literatures are lacking on the quality of life of family members, and does not consider the effects of mental health and substance abuse on the family, this provided the focus for the present research. The relevance to occupational therapy The relevance to occupational therapy services is to lessen the burden on the carers so that they can continue in their caring role, being fully informed of diagnosis, relapse triggers, substance abuse, and the available services so that they can continue their caring role. Statement of aims To explore the perspectives of carers of clients with dual diagnosis To explore the perspectives of the carers regarding substance misuse To find out how carers cope, living with someone with dual diagnosis, what are their biggest challenges? Research question proposed to be investigated To explore the lived experiences of a family that lives with the dually diagnosed client. Chapter 3: Methodology Description and justification of research Design A qualitative semi-structured interview which utilises open ended questions, has been chosen because these methods lend themselves to exploring the familys perspective and meanings of living with the dually diagnosed, this will permit individual members of the family narrative to be acknowledged. Moreover the researcher will ask questions in similar ways to all participants, which will attempt to maximise the confidence in the research reliability and validity (Hicks, 2009). This method will attempt to understand a complex novel phenomenon, whereby the researcher needs to understand that the concepts and variables that emerge may be different from the aims, sought by the study (Pope Mays, 2006). In contrast focus groups were not chosen due to the consensus of a group of people rather than the individual perspectives from the family (Pope Mays, 2006). The research will be conducted in the participants home, due to purposive sampling methods in which sites are selected on the basis that they are typical of the phenomenon being investigated (Pope Mays, 2006: 115). This will attempt to justify the rationale for the research taking place in the home in environment (Pope Mays, 2006). Moreover purposeful sampling techniques will be used to obtain participants whereby the researcher identifies specific people to take part (Hicks, 2004). However an aspect which illustrates rigour can be identified through member checking, whereby cross-checking findings with participants, can help to refine explanations, and aims to reduce subjectivity in processing of data analysis (Pope Mays, 2006). Therefore Living with dual diagnosis through the families eyes, can be addressed by using semi-structured interviews whereby rigor can be associated with this type of approach, due to data collected from as many appropriate sources to provide in-depth information (Pope Mays, 2006). Indication and justification of required number of Participants The participants will be family members of the dually diagnosed client, that attend a community mental health daycentre. However this study acknowledges the stigma attached to mental health services, as recent studies have shown that public education campaigns on mental illness and the integration have done little to alter the stigma associated with mental health (Schulze Angermeyer, 2003). Conversely the recruitment of participants may rely upon their visit to the day centre or if not appropriate for them then the dually diagnosed participation at the centre and the passing on of the flyer or information about the study, requiring no attendance at the day centre is necessary, due to the research being conducted in the participants family home. However It is argued by Crouch McKenzie (2006) that for in-depth qualitative studies small numbers of cases facilitates the researchers association with the participants, and enhances the validity therefore a maximum of 20 participants in total will be recruited to allow sufficient time to analyse the collected data (Crouch McKenzie, 2006). However snowballing sampling, was not the chosen method of recruitment because recruited participants in the study, would refer and reccommend future participants (Patton, 2002). Organisation of access to and recruitment of possible participants Participants for this study will be obtained through voluntary participation advertised via flyers and posters at a community mental health daycentre (Appendix 7), the flyers will provide instructions for participants to contact the researcher, the purpose of the study; requirements to be a volunteer, and the time commitment of the volunteers will be listed on the flyer, once families (maximum total of 20 people) are recruited for the study, the researcher will remove the flyers and posters. When volunteers respond, a telephone screening interview, approximately 5 minutes per person, will be conducted to determine if the individual family members meet the inclusion criteria. Families that respond and meet the inclusion criteria will be consented and assented (if appropriate) and recruited to participate in the study. The researcher will speak with the families, and communicate with each family member to set up a meeting time and place that is convenient for all members (Pope Mays, 2006). Inclusion/exclusion criteria of participants The validation for the inclusion and exclusion criteria relies on the family homogeneity that they are composed of being related and living together, therefore similar participants may enable a more in-depth enquiry into their shared and distinctive experiences (Hicks, 2004) The inclusion criteria eligibility: a) Family member is living with the person diagnosed with dual diagnosis. b) Family member is capable of engaging in verbal communication pertaining to semi-structured interviews. c) Family member is above 16 d) A family consisting of two or more members (max 4) not including the dually diagnosed client. e) English speaking and capacity to reflect participate. The exclusion criteria: a) Family member is below the age of 16. b) The diagnosed family member with dual diagnosis. c) No mental disorders or substance misuse disorders. d) Non-English speaking or with a cognitive deficit disorder. The semi-structured interviews may discuss topics or issues which are sensitive to the participants, these difficulties can be averted by a procedure of gaining on-going consent and assent for the 16-18 year olds (appendix 2) (Wiles et al, 2007). If distress occurs then the researcher can either stop the activity or will move on to the next area. It will be made clear to participants that they can decline to answer any particular questions or discuss topics that they feel uncomfortable with and can leave the research at any time, additional support and information will be available (Wiles et al, 2007). Indication of Ethical issue relevant to the proposal The researcher should at all times respect the autonomy of the individual by allowing the participant the freedom from control or influence of the study. Additionally the researcher has a duty to uphold beneficence which is the obligation to maximise benefits and minimise harm (Domholdt, 2000). Justice should be maintained throughout which is the obligation to treat each person in accordance with what is morally right and proper, therefore informed consent and ascent will be obtained via the Participant Information Sheet (approximately 30 min) (Appendix 1). Once the inclusion criteria has been met and each of the participants agree to join the study, a meeting time and place for informed consent, form review and data collection can be scheduled. The researcher will review (1) the purpose of the study, (2) an explanation of the procedures including the interviews, and the interview process, (3) an explanation of possible benefits and/or risks or discomforts (4) Consent to audiotape semi-structured interview (amended consent form), and an explanation of the subjects rights and confidentiality, the subjects will be asked to repeat their understanding of the study and procedures in their own words. Once full understanding has been demonstrated of the purpose and procedures of the study, the researcher will ask the participants to sign the consent form. Research approval General approval to be sought from Brunel University Research Ethics committees. Ethical approval for the research study is to be obtained from Brunel University, additional permission to be sought from the community mental health day centre (gatekeepers) to recruit participants via flyers and posters (Brunel University West London, 2010). Discussion of ethical considerations related to participation and consent Due to possibility of participants being aged from 16-18 assent will be required which is a term for participants too young to give informed consent but who are old enough to understand the proposed research, including the expected risks and possible benefits, and the activities expected of them as subjects. Assent by itself is not adequate, however. If assent is given, informed consent must still be obtained from the subjects parents or guardian (Domholdt, 2000). Ethical issues will arise throughout the research process, from initial planning to writing up and data analysis, due to interviews concerning private experience (Kvale, 2007). The researchers will respect the privacy of the participants by making it clear to them that they are free to decide what information they wish to share with the researcher and that they should feel under no pressure or obligation to discuss matters that they do not wish too. Data regarding the patient, family or the community, which will have the potential to identify them, will be omitted, Indication of any risks and benefits to participants and/or researcher The possible risk to the participant is the discussion of sensitive issues, due to the nature of the research and the psychological aspect of discussing experiences. If distress occurs then the researcher can either stop the activity or will move on to the next area. It will be made clear to participants that they can decline to answer particular questions or discuss particular topics (Wiles et al, 2007). Moreover the non-therapeutic approach, whilst designed to advance knowledge and therefore be of collective benefit, it is not expected to give a direct benefit to the research subject (Wiles, Crow, Charles, Heath, 2007). The risk to the researcher is conducting the study in the participants home, the researcher will have to abide by the Suzy Lamplugh Trust lone worker policy (Suzy Lamplugh Trust, 2012) (appendix 4 ) therefore a full risk assessment will need to be completed. Additionally the researcher will indemnifying against risk, to either the researcher or to participants, by taking out insurance for a period of time limited to the research process. Consideration of issues of confidentiality and data security In order to protect confidentiality, the researcher will identify the subjects for this study by the role that the participants fulfil in the family for example mother, son or daughter. Once all data is collected and analysed the interviews will be transcribed, and the audio tapes will be stored in a locked, secure location until the study is completed, after completion, the primary data will be destroyed and all other data will be destroyed and discarded according to data protocol up to two years (Brunel University West London, 2010). Materials or equipment The interviewer is the instrument in this type of evaluation; the instrument can be affected by factors like fatigue, personality, and knowledge, as well as levels of skill, training, and experience. According to (McNamara, 2009), the strength of the general interview guide approach is the ability of the researcher to ensure that the same general areas of information are collected from each interviewee. The equipment required to analyse the data is software for qualitative data analysis which is ATLAS.ti 7, as a tool for enhancing rigour this software is available at Brunel University (Atlas.ti Qualitative Data Analysis, 2012). The training implications required is a one hour training session. Additionally an audio tape recorder is required for the semi-structured interview; a limitation is that the interviewees may be unable to put their thoughts into words and difficulties of analysing data from semi-structured interviews (Atlas.ti Qualitative Data Analysis, 2012). Comprehensive description of Procedures The study will consist of 45 weeks part-time work (appendix 9) the research will be advertised through flyers and posters at the mental health day centre after seeking approval from the day centre (gatekeepers), The recruitment drive will be for two months via dually diagnosed participation at mental health day centre which the researchers have no affiliation too

Spanish Languages Influence on the Puerto Rican Identity Essay

Spanish Language's Influence on the Puerto Rican Identity The initial occupation of Puerto Rico by the Spaniards carries an important implication for language as part of the Puerto Rican identity. The Spanish language was imposed upon the inhabitants of the island, the Tainos, in the sixteenth century, when the Spanish inhabited the island in 1502, after the Spanish conquerors claimed the island in the name of Spain in 1493. Eventually, the Spanish had moved out or taken over the ways of the old and their culture infiltrated that of the Taino to create a new dimension of the first storey, where the Spanish language was incorporated as the building blocks of the foundation of the Puerto Rican identity (Figueroa, Sept.15). The Spanish maintained control over the island until 1898, when Spain relinquished Puerto Rico to the United States as a result of the Spanish American War. This change begins the construction of the third storey (the second storey involved the economic and political growth of the island under Spanish rule). The 400 years of Spanish history and influence on the island caused conflict for notions of identity and has great impact on Puerto Rican identity. Although the Spanish had come to the island and taken over, decimating the entire Taino population, Puerto Ricans now take pride in the fact that the Spanish contributes to their identity (a result of acculturation), and that they are a (mainly) Spanish speaking nation. Although it wasn't initially intended to be, the acquisition of Puerto Rico resulted in the island becoming an unincorporated territory (http://Welcome.ToPuertoRico.org/history.htm). The passing of various acts, such as the English Only Act (1902), the Foraker Law (1900- establishing un... ...". From Negrà ³n-Muntaner and Grosfoguel (Eds.), Puerto Rican Jam: Essays on Culture and Politics. Minneapolis: University of Minnesota Press, 257-285. Rivera, Angel, Q. "Music, Social Classes, and the National Question in Puerto Rico". In Glasser. Scarano, Francisco. "Sugar and Slavery in Puerto Rico, 1815-1849: An Overview," from Scarano, 1984, Sugar and Slavery in Puerto Rico: The Plantation Economy of Ponce, 1800-1850. Madison: U of Wisconsin Press. pp.3-34 Trà ­as-Monge, J. (1997). "The Shaping of a Colonial Policy". From Trà ­as-Monge, Puerto Rico: the Trials of the Oldest Colony of the World. New Haven: Yale University Press, 36-51. Walker, Rich. (1998). A Multicultural Alternative to Language and Nationalism. Http://frontpage.trincoll.edu/rwalker. Waxer, Lise. (October 29, 1998). Puerto Rican Music Between Rafael Hernandez and Rafael Cortijo.

Benefit of Hipaa

Benefits of HIPAA Larasha McAllister Kaplan University HS210: Medical Office Management Traci Clark March 18, 2013 Benefits of HIPAA How does the HIPAA Privacy and Security rule, benefit the healthcare industry? When all the commotion and fear related to HIPAA begins to subside, patient, health plan, healthcare providers and health care organization will recognize that HIPAA regulations benefit them. Who can argue with the benefits of reducing paper in healthcare industry?Also who will argue, against the benefit of standardized data, especially for the coordination of insurance benefit is simplification of data submission through standard transaction and code sets? Provider and health plan overhead cost reduction through standardization. A main benefit of healthcare industry begin required to use HIPAA standard data and format is that everyone sending claims will be doing it with the sane data elements and the same format. For instance, this allows billing offices to make away from h aving the accommodate different data and format needs for different payers(Young,2007).How does the HIPAA Privacy and Security rule benefit the patient? It benefits the patient by giving the patient more control over their medical records. Also patients are able to make informed choice regarding how their personal health information is used. Another benefit is it reduces the chance for inappropriate use and disclosure their personal information. Patients also benefit by the limit release of information to the minimum reasonably needed for the purpose of the disclosure.It empowers individuals to control certain uses and disclosure of their health information. The last benefit is it gives patients the right to examine and obtain a copy of their own health records and request corrections (Fryar, 2005). How does the HIPAA Privacy and Security rule benefit the physician? It benefits the physician by setting boundaries for the use and release of health records. It also helps establish app ropriate safeguard that health care providers and others must achieve to protect the privacy of health information.It holds violators accountable with civil and criminal penalties that can be imposed if they violate patient’s privacy rights. Another benefit is that it strikes a balance when possible responsibility supports disclosure of some form of data (Fryar, 2005). Reference Fryar, D. National Military Family Association, (2005). What is hipaa and what does it mean for me?. Retrieved from website: Military. com Young, A. P. (2007). Kinn’s the administrative medical assistant: An applied learning approach (6th ed. ). St. Louis, MO:Â   Saunders Elsevier

Childbirth and Midwifery Caring Person Essay

Midwifery became my passion at the age of 10, when my step-mother became pregnant. This sparked off my fascination with all aspects of pregnancy, insisting that I attended every antenatal appointment that I could. From this I discovered what a vital role midwives play in caring for mother and baby in the months leading up to the birth, the labour and the postnatal period. After having this interest for quite some time, I feel my aim now is to prosper in this subject by attending a university course; this will enable me to gain a greater understanding of the medical and practical side of midwifery. As two of my core qualities is to care and nurture, I feel I possess two of the vital attributes to pursue a career within the Health and My aspiration for a career in midwifery is reflected in my A-level choices, where good time keeping, self-motivated study skills and ability to cope under pressure and stress are essential. From studying Biology I have gained further knowledge of human biology, learning more about how our major body organs function and genes and genetic engineering. I found this particularly interesting as it is linked to reproduction. Since studying Psychology, I have gained a better understanding of people and how their minds perform. I can apply this knowledge to the way I interact and understand people in certain situations as my interpersonal skills have been expanded. Both of these subjects tested my ability to recall large volumes of knowledge, which has given me practice for similar situations that I will face whilst studying for a degree. Studying modules in Health and Social Care such as communication and values, and positive care environments has given me a greater awareness of how to communication verbally and physically to people, and how this is interpreted by them. Investigating disease has made me conscious of how easily diseases are spread, their effects and ways of preventing them. This is particularly important when working in a hospital environment, and being around pregnant women and young babies, as they are highly susceptible to infections. I am currently working on an Extended Project Qualification, my title is ‘What are the risks associated with teenage pregnancy and what are the roles of their midwives? ‘ Whilst carrying out this project I have learnt more about the challenges midwives face, and how they overcome them. It has also given me an insight into a specialist area of midwifery, caring for young people. Outside my academic studies, I volunteer at my local hospital. My role is to hand out beverages to the patients, and talk to them. This is important as it boosts their morale. I regularly volunteer on the maternity and gynaecology ward, and have experience on many other wards. This has given me an insight into the roles of different health professionals, and witness part of the process of midwifery. From this I have become more confident and comfortable in a hospital setting, and have a greater awareness of current NHS practices. This experience has also expanded my interpersonal and communication skills, I feel it also represents the committed and caring attitude of my personality. I have a part-time job in a clothes shop. From working in a retail environment and coming into contact with members of the public I have learnt how to work under pressure. It has also improved my organisational and time keeping skills and demonstrated the hardworking side of my character. I am excited by the prospect of having a high level of responsibility and independence that corresponds with university life. I am aware of the demands and challenges that I will face during my studies and within in a medical career, but my commitment and desire to become a midwife has been strengthened by my life and work experiences and the job satisfaction that I will gain from it. To gain practical experience I have recently applied

Steric Hyndrance Effects on Esters essays

Steric Hyndrance Effects on Esters essays Electronegative and Steric Hindrance Effects on Synthesized Esters Esters are made when an acid and an alcohol are mixed. The reaction causes the oxygen and hydrogen atoms to pair off, forming H20, leaving the rest of the compound to form the ester. The theory is that if a more electronegative element was added to the compound, it could increase the electronegativity in the whole molecule, and the ester could form more rapidly. The idea is that if you use a 3bromo1propanol alcohol mixed with ethanoic acid, the bromine should create enough electronegativity so that the ester would form with more quantity and speed. This should effect the formation more than steric hindrance because the bromine is attached to the third carbon, hence all the movement from steric hindrance shouldnt cause bulkiness. Bromine is used because it is a very electronegative atom and should act as a catalyst by speeding up the reaction rate. Synthesis of 3-bromopropyl acetate: 3- Bromo-1-propanol(11g, 117mmol) was added to two molar equivalents of ethanoic acid (13.992g, 233.2mmol). 3 drops of H2SO4 was added per every gram of the alcohol. It was refluxed for 30 minutes and allowed to cool overnight. The room temperature mixture was placed into a seperation funnel, where it was rinsed twice with distilled H2O, discarding as much of the aqueous layer as possible. It was then rinsed with 15 to 20 mL of NaHCO3 letting the pressure buildup escape at routine intervals until there was no more excessive pressure. This aqeous layer was tested with lithmus paper and was decided to be neutral. It was rinsed again with distilled H2O, and once again with the NaHCO3. It was then dried over 1.78g of MgSO4. The mixture was distilled and was discovered to have an 82% yield. Density of 1.489715, and a b.p. of 105.5C (literature 8027). NMR (CDCl3,300MgHz) 2.07797ppm (s,3H,CH3), 2. ...