Thursday, October 31, 2019

Critical Commentary on a video clip-400-500 word Essay

Critical Commentary on a video clip-400-500 word - Essay Example Global media includes the following channels to provide information to the world. The channels are; through television, cinema, music industry, newspapers, magazines, the internet, books, advertising, video games and even through the use of mobile phones. Let’s pick up the industry of music as a means of global media. The most basic quality or characteristic of music is that, whatever your location, whatever your mood, whatever the work your doing, as soon as you hear any kind of music it catches your attention. When a product uses a song as a form of advertisement to the masses it actually creates an audio form of recognition for that particular product because when you hear that product’s specific music you instantly realize what product it is being talked about. (Music: Its roles, qualities and influence) Another quality of using music is that one song is used for one region or maybe even more thus bringing the concept of globalization into the world. When the same thing or the same music is being used throughout the world it brings a sense of harmony through that product and brings the realization that where ever you are in the world that product that you have in your homeland is also over there. When China conducted its first Olympics in Beijing 2008, it used a theme song called â€Å"You and Me†. China used this song to create a sense of harmony through the athletes of the world regardless of color, religion, creed, sex, and culture. The song has in itself a sense of bringing the world together on one common ground for a common goal. The words â€Å"You and Me† as the title states gives the listener a sense of friendship where ever or who they might be. When a person listens to this song he or she will feel that all the feelings regarding hatred for each other will disappear and in return it will leave behind a sense of beauty, peace, harmony and being one. This song also emphasizes on one world and one dream, which means that

Tuesday, October 29, 2019

Todays Woman Essay Example | Topics and Well Written Essays - 1750 words

Todays Woman - Essay Example For example, in the bible when the first human was created who is Adam, God saw that the man was very lonely and he need a companion and a helper as he was in-charge of the whole world. God created the woman (Eve) from the ribs of Adam and therefore human beings have interpreted that the woman is inferior to man. As a result of her supposed inferiority, the woman took the female role of being a house wife and a helper to the man and all the decisions were made by the man and in some of the cultures, this has been the trend to this day. Most of the time much of the women’s work has remained unrecognized and to some extent, undervalued, be it economically, politically, socially, or culturally. For example, many house chores are seen to be very easy, but in a day, a woman is supposed to prepare meals three times and at the same time do the cleaning while also taking care of the kids. If the total number of hours that both women and men work is put together, the woman works for mo re hours compared to a man (Gupta 73). In today’s society, the world is going through social change and the role of women as being house wives is changing. Today women are being educated and as a result, they are occupying high powered positions and influential careers, which have brought a fresh outlook and a positive impact in the society. This paper discusses the positions of women in today’s society and the positive impacts they are making. The Role of Women in Literature Many women have been victimized for their attempts in the field of writing. This is because literature was a male dominated field and for a woman to get a position in literature, it has not been an easy task. Most women in these patriarchal societies have seen their gender as being a very big and painful obstacle towards the success of their writing careers. The nineteenth century saw the emergence of elite and educated women in America and Europe. Since then, this has presented threats to the soc ieties which are very rooted in patriarchy, as women can represent themselves even in public arenas and that means empowering women (Pastor and Lloyd 2-3). During the second half of the twentieth century, Latin America saw an emerging and influential group of women writers, who have left an authoritative legacy through their literature. Most of these writers concentrated on their historical marginalization, but the trend is changing and the modern women writers have embarked on different themes like those of science and mathematics among others. The women are now seen to have positive impacts in the society from all aspects of their literature. In America, there have been many women writers who have contributed a lot to literature. Examples of these women include Zora Neale Hurston and Toni Morrison among others. Zora Neale Hurston (1891-1960) is a re-known folklorist and writer, who is celebrated for her great impact on the culture of the African American society of the rural south (Britannica Educational Publishing, American Literature 131). She is also remembered for the contributions that she had on the Harlem Renaissance. Harlem Renaissance was an African American culture, which involved creative arts and that had a lot of influence in the African American history. The impact of this was that it helped the black people to be proud of their heritage and re-conceptualize the stereotypes from the whites that had affected their heritage to each other. It has also served as the basis of all African American literature as well as black literature worldwide (Britannica Educa

Sunday, October 27, 2019

Role of the Nurse in HIV Prevention and Care

Role of the Nurse in HIV Prevention and Care INTRODUCTION This brief considers role of the nurse in the HIV prevention and care in the black African community. The document considers empirical literature from academic, governmental, and other sources. It is argued that the available evidence is too scant to warrant conclusive inferences about the role of nurses in HIV care and management for this ethnic group. This is compounded by ambiguities about the role of nurses in promoting sexual health, and uncertainty about the appropriate criteria for evaluating their impact on the African community. Black Africans in Britain According to the Department of Health (2005b) approximately 480,000 people living in England (less than 1% of the population) have Sub-Saharan African heritage, by birth and /or descent. More than 75% live in the Greater London area, mostly in inner London Boroughs. Compared to the rest of the UK population, Africans tend to be younger, well educated (just 13% of Africans reported have no educational qualifications), more likely to be unemployed and living in rented (often overcrowded) accommodation. Asylum legislation has meant that a significant proportion of the population has questionable migration status in the UK. New arrivals in the UK, including asylum seekers, are offered a medical examination that may include a HIV test if this is requested, or the medical examiner judges that a test is necessary. The test result is not necessarily considered when an asylum application is processed. Many Africans live in isolation, separated from friends and family back in Africa, (for asylum seekers), with no access to public funds, and struggling to adapt to a new culture (Millar Murray, 1999). Many are struggling to learn English. Sexuality is heavily influenced by traditional (tribal) beliefs, taboos, customs, religion, and spirituality. HIV is virtually a taboo subject. Thus, a sero-positive status has a significant effect on various aspects of a persons life, including problems dealing with the diagnosis, ambivalence about whether or not to test, gender issues (e.g. whether or not to breastfeed), and coming to terms with the possibility of death (e.g. implications for children, family) (Miller and Murray, 1999; Doyal Anderson, 2005). The prevalence of HIV infection is high in both the immigrant and British born/resident African populations. Asylum seekers and others with unsatisfactory immigration status have limited access to public funds, live in poverty, and generally avoid utilising public health services, until illness is at an advanced stage. Black Women There is considerable research on the plight of African women as distinct from men (e.g. Withell, 2000; Tabi Frimpong, 2003). Much of this literature highlights aspects of their increased susceptibility, or predisposing factors or experiences. Motherhood is an extremely important goal for many African women, so that unprotected sex becomes a cultural necessity. Doyal and Anderson (2004) document the devastating impact of HIV on the lives of African women living in Britain. Many women harbour serious concerns about the health of their offspring. There is a distinct reluctance to give birth to a sick (HIV-positive child). Many women have a vague immigration status, whereby they may not be entitled to state benefits, have no work permit and/or rely on charities for subsistence. The immigration issue is multidimensional. Many women live with a chronic fear of deportation, perhaps remaining in doors for days at a time, and/or refusing to open the door when the bell rings. Then there is the poor housing. Some put up with unsanitary and crumbling accommodation due to lack of funds and the awareness that housing conditions back home in Africa are much worse. Furthermore, some individuals become distressed or depressed because they are isolated from friends and family back home, and for a prolonged (and perhaps indefinite) period of time. Finally, many women may be unsure of their health care entitlements in the UK, and hence be unaware off and/or fail to utilise appropriate HIV care services. Additionally, religious faith remains a stable and salient characteristic of Black African culture. In the face of adversity many women turn to religion for hope and deliverance. Doyal and Anderson (2004) quote one woman: I have turned to God. I have really got to know more about God now. I know God exists . God is in control. I know there is an afterlife here (p.1736). The danger is that some women may seek therapeutic remedy from God, as a substitute for seeking medical care. Epidemiology According to Department of Health (2005a) figures provided by the Communicable Disease Surveillance Center (CDSC), up to 12,558 black Africans living in England by 2003 were HIV-positive. This figure was based records from HIV treatment clinics and care centers in England, and accounts for 36% of the total number of people in England living with HIV. In 2003 69% of heterosexual HIV-positive people (or 2624 individuals) were probably infected in sub-Saharan Africa. The majority of cases (65%) were female. In 2002 black Africans accounted for 70% of the total number of diagnosed HIV infections. Furthermore, â€Å"of the 15,726 heterosexual men and women seen for care in England, Wales, and Northern Ireland in 2003 for whom ethnicity was reported, 70% (11068) were black African, 19% (3009) were white and 4% (657) black Caribbean. Africans feature in all the main transmission routes for HIV†¦Ã¢â‚¬  (p.12) (see Figure 1). HIV positive Africans tend to be diagnosed much later in the course of the HIV disease, and show low uptake of clinical monitoring and antiretroviral treatments. Focus: The North West of England The North West HIV/AIDS Monitoring Unit (2005a, 2005b), based at the Center for Public Health at Liverpool John Moores University, regularly and comprehensively Figure 1 Distribution of HIV infections (those seen for care) across ethnic groups in 2003 monitors HIV trends in Northwest of England. The surveys are supported by the Health Protection Agency and the Northwest Public Health Observatory, and cover three main regions: Cumbria and Lancashire, Cheshire and Merseyside, and Greater Manchester. The Units data reflects both new and total HIV cases and dates back to 1996. The total number of HIV cases virtually doubled over the nine-year period from 1996 to 2005, rising from fewer than 300 in 1996 to over 600 by mid 2005. The data suggests that black Africans living in the Northwest have an unusually highly risk of contracting HIV compared to other ethnic groups. This trend applies to both newly diagnosed HIV cases from January to December in 2004 and 2005, and total HIV cases by the end of these periods. Also, this pattern seems to echo national trends. Africans accounted for almost a quarter (23.1%) of total HIV/AIDS cases (3574), by far the highest figure of all ethnic minority groups. For comparison, black Caribbeans made up less than one percent (0.7%, or 26 cases). The vast majority of black Africans (93.1%, or 769 of 826 cases) contracted HIV through heterosexual interactions. This contrasts sharply with Caucasian cases, of whom more than three-quarters (75.2%) contracted the virus through homosexual intercourse. When the data was collapsed by gender, again, black African women accounted for the majority (63.4%) of the 857 females diagnosed with HIV. These findings may be confounded by significant variations in the distribution of ethnic groups across the UK and native (British born) versus immigrant status. For example, population census figures show a much higher population density for black Africans compared with black Caribbeans in the Northwest regions. This may partly account for the over representation of Africans in some categories. Furthermore, it is not clear whether patterns observed are statistically significant. On the other hand the proportion of Africans amongst new and total HIV cases is over represented when compared with the proportion of Africans in the overall UK population. Current Health Strategies Prior to 2001 there was no official health strategy for promoting sexual health in Britain. In July 1999 the Secretary of State for Health presented a white paper to Her Majesty, the Queen, titled Saving Lives: Our Healthier Nation (The Stationary Office, 1999). Curiously the HIV/AIDS threat received little mention in what was otherwise a comprehensive document on the Governments health policy. The lack of an elaborate national strategy for HIV/AIDS meant that the steady increases through the 1990s in HIV-related morbidity and mortality (North West HIV/AIDS Monitoring Unit, 2005a) went virtually unchecked. This all changed in 2001 when the Department of Health published the National Strategy for Sexual Health and HIV (Department of Health, 2001, 2002, 2005a, 2005b). The strategy outlines several generic aims: Reducing the transmission of HIV and other STIs (Sexually Transmitted Infections); Reducing the prevalence of undiagnosed HIV and STIs (in other words, increasing HIV testing for people at risk). Improve health and social care for HIV-infected people; Reducing the social stigma associated with sexually transmitted diseases, notably HIV. In 2005 the Department of Health published more detailed objectives for HIV prevention specifically within the African community (Department of Health, 2005b). These objectives were as follows; HIV Prevention: 1.Reducing transmission (sexual and vertical); 2.Reducing prevalence of undiagnosed HIV cases; 3.Eliminating the stigma associated with sero-positive status. Health and Social Care: 1.Ensuring that HIV-positive Africans have equal access to services; 2.Ensuring that those services are culturally sensitive; 3.Ensuring that service delivery is based on assessment of individual need; 4.Facilitating access to testing; 5.Making special provision for children and adolescents; 6.Improving adherence to anti-HIV treatment regimes; 7.Creating better access to education, employment and leisure; 8.Supporting carers and families; Eliminating social exclusion is minimized. Several strategies for prevention are outlined. The first plan is that HIV prevention must operate at both an individual and structural level. Prevention activity at the individual level must address knowledge deficiencies (e.g., awareness of available health services), tackle inappropriate attitudes, beliefs, perceptions, and intentions, and teach relevant skills (e.g., condom negotiation). These goals can be achieved through various interventions including one-to-one counseling, out-reach work, telephone help lines, the internet, provision of sperm washing services, and clinical interventions to prevent mother-to-child transmission. Structural prevention measures include reducing poverty, introducing and implementing appropriate laws and regulations, and modifying societal factors (e.g., social norms, stigma, discrimination), and organisational factors (e.g., supporting community health organisations). Structural change can be achieved through group, community, and socio-political level interventions. Strategies for social care include: making peer support available at special ‘flashpoints’ of maximum need (such as at diagnosis, or during times of emotional distress), in order to improve adherence to treatment regimes; and providing support, advice, and education to sero-positive people, to help them to return to education. Additionally, the Department of Health (2005a) has clarified how the National Strategy for Sexual Health can be implemented by primary medical services, through four contracting routes: Primary Medical Services (PMS), General Medical Services (GMS), Alternative Provider Medical Services (APMS), and PCT-led Medical Services (PCTMS). All four services rely heavily on nurses, and â€Å"provide flexibility and opportunities to tailor services around the needs of the patients† (p.17). Thus, in theory, the current sexual health strategy can be tailored to meet the needs of minority ethnic groups. RATIONALE Black Africans are the minority ethnic subgroup most at risk for contracting HIV/AIDS in the UK. It is therefore widely acknowledged that this group has special care and management requirements (Department of Health, 2005a). Gaps in Care and Practice This report reviews the literature on nursing HIV care provision specifically for the black African community. The review identifies various salient issues that need to be addressed: 1. Uncertainty about the role and effectiveness of nurses in prevention and care of this ethnic group. 2. Insufficient empirical evidence on various aspects of prevention/care including; the role of nurse in facilitating uptake of antenatal testing by African women, and HIV testing by Africans in general; the degree of involvement and effectiveness of nurses in community-based African HIV/AIDS projects; sensitivity to cultural factors in, palliative care, and self-management; Dealing with the HIV stigma and its effect on health service utilisation; and nurses roles in supporting involuntary care provision. 3. Inadequate evidence on the role that African nurses can play in reducing cultural barriers, and providing liaison and training services. LITERATURE REVIEW Literature searches were performed using several electronic data bases: PSYCHINFO (BIDS), INTERNURSE, Academic Search Premier (EBSCOhost databases), British Medical Journal On-line, HIGHWIRE Press, SOCIAL CARE Online, Department of Health database, and the Internet. Various combinations of the following key words were used: nurse, nursing, care, African, black, ethnic, minority, women, sub-Saharan Africa, community, HIV, AIDS, palliative, and antenatal[1]. Priority was given to studies published from the late 1990s, although due to the paucity of literature some earlier studies are reviewed. Furthermore, emphasis was placed on UK studies. However, limited evidence from Sub-Saharan Africa is considered to highlight certain cultural issues. Finally, the review is structured in relation to prevention (including antenatal testing and transmission through breastfeeding), and health and social care (Department of Health, 2005a). The Nurses Role The National Strategy for Sexual Health and HIV (Department of Health, 2001, 2002) illuminated the rise in HIV sero-prevalence for ethnic minority groups in Britain. Nursing care was identified as essential in managing sexually transmitted diseases and promoting sexual health in these groups. The prevention and care strategies for African communities, specified by the Department of Health (2005b), provide a framework for nurses to tailor their roles to meet the cultural needs of sero-positive Africans. Miller and Murray ((1999) provide a comprehensive account of some of these cultural characteristics, specifically regarding response to a positive diagnosis, parenting issues especially for HIV-infected mothers, problems of disclosure, attitudes towards death, immigration issues, and common health care dilemmas, and effective engagement between carer and patient. Training According to the Medical Foundation for AIDS and Sexual Health (2003) nurses do not receive any special training in HIV care and prevention. The Nursing and Midwifery Council (NMC) approves special HIV training courses for nurses but these are not offered in all universities and colleges, and may be optional at institutions that offer them. According to Campbell (2004, p.169), Pre-registration training for nurses does not include mandatory education relating to sexual health services. Nurses working in sexual health gain post-basic education in an ad-hoc manner through working in the specialty, and by undertaking specialist post-registration courses. Moreover, although the NMC regularly monitors courses, it does not scrutinise individual courses that confer no special qualification, so that they may be considerable variability in the quality of courses offered in different institutions. Thus, it is possible that a large percentage of nurses have no special knowledge or skills in HIV prevention/care for ethnic minority groups. It follows that many nurses that may be ill prepared to deal with the particular HIV needs of African communities. However, nurses who work in Greater London, and hence are regularly exposed to African patients/communities, may quickly acquire some degree of ad-hoc expertise. By contrast nurses based in other parts of the country with smaller African communities may be especially uninformed and inexperienced. Role Ambiguity In the absence of mandatory HIV training, there may be some ambiguity about the precise roles/tasks nurses are required to perform in HIV care/prevention. Campbell (2004) notes that career pathways are patchy and ill defined, and it may be necessary for nurses to undertake placements in key areas of sexual health. Certain aspects of HIV care are applicable to other diseases, and hence may form part of a nurse’s standard training and job description (e.g. antenatal testing, patient pre-admission assessments). However, certain tasks are specific to HIV and/or a particular population group. Some nurses may be uncertain whether such roles are within their jurisdiction. For example, whose job is it to reduce the powerful HIV stigma that prevents many sero-positive Africans from testing for HIV, and/or benefiting from family support? Who is responsible for addressing cultural taboos and totems? Palliative Care This refers to nursing care aimed at maximising the quality of life for terminally ill patients, for example by reducing pain and discomfort. The National Council for Hospice and Specialist Palliative Care Services (NCH-SPCS) identifies seven domains of palliative care: increasing patient/carer understanding of diagnosis/prognosis; alleviating pain/symptoms; facilitating patient independence; reducing patients/carers negative affect (e.g. anxiety, depression); soliciting support from other agencies; advising on appropriate care locations as illness progresses; supporting families/carers, before/after death. To what extent do nurses meet these requirements met in sero-positive black African patients? There is a paucity of research addressing the palliative care needs of black African patients specifically. However, some studies have examined the needs of ethnic minority groups in general (Jack et al, 2001; Diver et al, 2003). Various barriers to effective palliative care for ethnic minorities have been identified including communication difficulties and the lack of trained interpreters (Jack et al, 2001). Diver et al (2003) conducted a qualitative study to identify the specific palliative needs of ethnic minority patients attending a groups regarding palliative care. Participants comprised two Jamaicans, one Indian, and one from the Ukraine, but no black Africans, who attended the day-care center once or twice weekly, for up to a year. Several key themes emerged. One concerned the individual needs of the patients, which were not related specifically related to culture (e.g. diet, religion, day care, avoiding social isolation). Two other themes highlighted attempts to fit in with the dominant culture, for example by eating English foods and communicating with staff in English. Another theme highlighted positive perceptions of palliative care: participants expressed gratitude to staff, with one individual noting â€Å"the Macmillan nurse had been sympathetic and had not pressurised her when she decided to stop having chemotherapy† (p.395). However, participants reported that staf f had not inquired about their culture albeit they simultaneously felt their cultural needs were being addressed. Although Diver et al’s (2003) study involved a very small sample, the findings suggest that nursing staff can effectively meet the palliative needs of minority patients. Some evidence suggests that nursing care can be more effective when a liaison professional is involved. Jack et al (2001) assessed the value of a ‘liaison’ worker that mediates between ethnic minority patients, their families, and health care staff. This study focused on the role of an ethnic minorities ‘liaison’ officer, appointed in May 2000. The workers brief is to facilitate palliative care amongst the Asian community specifically. Thus, he/she helps with communication, religious, gender-specific, bereavement, and other issues. However, several case studies are presented that illustrate the difficulties inherent in using a liaison person. For example, the liaison role is emotionally demanding and health care staff sometimes assume the liaison worker has medical expertise. Nevertheless, the concept of a liaison worker may improve the job performance of nursing staff involved in palliative care. Hill and Penso (1995) make recommendations that tailor palliative care to the needs of ethnic minority groups. These include: ethnic monitoring; having an equal opportunity policy; enforcing a code of conduct; staff recruitment/training; developing a communication strategy; health promotion; facilitating culture-specific care provision; appropriate food policies; community health initiatives. Given the paucity of research evidence focusing of HIV-positive black African patients in the UK, it remains unclear the extent to which these strategies facilitate effective palliative care in this population group. Some evidence is available concerning palliative care delivery in sero-positive women living in Sub-Saharan Africa (Defilippi, 2000; Gwyther, 2005). This evidence may provide additional insights that may apply to the care of black Africans who have emigrated to the UK. Gwyther (2005) documents the nature of palliative care in South Africa. Here, hospice care is primarily performed at home, with only a few inpatient units available on a short-term basis to selected patients (e.g. those with serve symptom control problems). A comprehensive community-based home care programme has been established, in which patient care is provided by the local community (e.g. extended family, neighbours), but managed by health care (hospice) staff. Thus, there has been a shift away from the conventional hospice domiciliary nurse as the primary caregiver to community care workers, who are trained, supervised, and supported by the professional nurse (p.113). This South African model has several advantages when applied to the UK theatre: Firstly, training extended family members (and perhaps even neighbours) in palliative care, with the aim of managing AIDS, and decreasing transmission of the HIV virus, may help resolve problems of communication, diet, custom, and other culture-specific issues that the patient considers relevant. This model goes some way to address Hill and Pensos (1995) recommendations for recruitment/training, effective communication, culture-specific care, suitable food policies, and community health initiatives. The professional nurse, free from some primary responsibilities of care, may be able to commit more resources to ethnic monitoring, enforcing codes of conduct, and ensuring equal opportunities in practice. Evidence-Based Practice There is a growing requirement in nursing and (other medical specialties) for evidence-based medicine/decision making (Thompson, et al, 2004). Evidence-based practice is particularly essential in the care of minority groups due to the relatively greater level of cultural ignorance in health care about ethnic minority customs compared with the dominant culture (Serrant-Green, 2004). There is a paucity of research assessing the degree to which nurses refer to empirical evidence when making clinical decisions about black African HIV patients. Thompson et al (2004) suggest that, in reality, nurses rarely consult evidence when making clinical decisions, irrespective of the patients’ background. Instead they are much more likely to consult their colleagues for information for advice. This is worrying because clinical decisions can be made about black-African patients based on incorrect assumptions rather than fact. For example, Gibb et al (1998) highlight the possibility that nurse midwifes may fail to offer antenatal HIV-testing to black African women, for fear of appearing discriminatory. Yet, there is little or no evidence about how black women may actually perceive such offers. Overall, there is a paucity of research on the role and effectiveness of nurses in delivering health and social care to the African community. Studies that focus on â€Å"black† patients (i.e. Afro-Caribbean or African parentage) cannot be generalised to Sub-Saharan Africans as HIV/AIDS incidence and prevalence is significantly different for these groups, suggesting different health care requirements. Similarly, data collected from Asians, Bangladeshis and other UK minority groups is generally inapplicable as the cultures are vastly different. The role of African Nurses A significant number of black African nurses work for the NHS. These individuals may play an important role in facilitating HIV prevention and care in the African community (Andalo, 2004; UNISON, 2005). There are two ways this may happen. Firstly, African nurses can serve as in-house liaison workers, improving communication and eliminating cultural barriers between the health service and African communities. Secondly, African nurses can help in educating other health-professionals on fundamental cultural issues, both in relation to the African community as whole, and individual sero-positive patients. The Department of Health (2000b) acknowledges the significant contributions of African nurses to sexual (and other) health issues in the African community, in the form of the Mary Seacole Leadership Awards. A recent article published by BioMedCentral (Batata, 2005) indicates that over 3000 nurses trained in Sub-Saharan Africa were registered to work in the UK in 2002/2003. These nurses originated from eight countries (South Africa, Nigeria, Zimbabwe, Kenya, Zambia, Malawi, Botwana and Mauritius), most of which have high HIV sero-positive prevalence rates. It therefore follows that these professionals will be very familiar with HIV preventive and care measures that work effectively with African communities. Approximately a quarter of all the foreign trained nurses registered during 2002/2003 (i.e. including nurses from non-African countries) worked in or near London, with 49% based in other parts of England, suggesting that there is a significant nurse pool available to support African communities in the London area. Unfortunately, there is a lack of research evidence on the role of African nurses in facilitating HIV care and prevention in African communities. Most studies focus on immigration, recruitment, or discrimination issues, rather than job performance and impact on care provision for local communities. The World Health Organisation (2003) indicates that one of the three top non-EU source countries for international nurses working in the NHS is from a Sub-Saharan African country (South Africa). The number of nurses recruited from Zimbabwe has increased recently. Nevertheless, recruitment and retention remain a problem. Although the NHS is thought to have one of the most effective nurse recruitment schemes in the public sector, there are still problems recruiting African nurses. For example, Andalo (2004, p.17) notes that although there has a been a significant increase in the number of Africans applying for nurse diploma courses, the rejection rate was more than fifty percent higher for African compared with white applicants. However, an argument for more recruitment can be better formulated given empirical evidence on the value of African nurses in promoting HIV prevention and care in their community. Department of Health (2005b) highlights the â€Å"need for basic information regarding HIV transmission, testing, and treatment. In particular, cultural practices that place some Africans at particular risk of transmitting or acquiring HIV requires specific, culturally competent attention† (p.13). Community nurses play an important role in this regard (Hoskins, 2000). Moreover, effective dissemination of knowledge requires collaborations between health professionals and agencies, access to services, and other recommended measures (Department of Health, 2000a, 2001, 2002, 2005a, 2005b). Community Nursing Community nursing care for sero-positive Africans in Britain has expanded rapidly over the last decade, reflecting a national shift in emphasis towards community care (McGarry, 2004). The Department of Health framework for prevention and care emphasised the importance of partnerships between HIV prevention agencies, Primary Care Trusts, local African community-based organisations, and other establishments (Department of Health, 2005b). According to the Department of Health (2005b), over 75% of black Africans in Britain live within Greater London. The largest concentrations live in Inner London Boroughs, which also have high sero-prevalence rates. Thus, the role of community nursing in the Greater London area is of particular interest. There is some evidence of collaboration between different agencies. One south London HIV partnership incorporates up to fourteen HIV prevention organisations, including several African-based projects: One African project covers up to nine catchment areas (Croydon, Kingston, Lambeth, Lewisham, Merton, Richmond, Southwark, Sutton, Wandsworth), and promotes the access to and utilisation of local HIV care and support services. This project recently launched a new treatment service designed to encourage men to adhere to treatment regimens. There is a paucity of research on the efficacy of such partnerships in reducing the spread of HIV in the black African Community. More importantly, there is limited empirical evidence on the involvement and impact of community nurses in these projects. The partnership in south London offers complementary HIV care services across the local area. Some of these services are available from local HIV clinics, were nursing staff presumably play a key role. Furthermore, there appears to be specific community nursing provision for children and families. For example a childrens hospital in Croydon offers nursing care for HIV-infected children and their families. Community nursing services are also available for adults. A study was commissioned to review progress on African HIV prevention initiatives in Enfield and Haringey, from 1997 to 2002. The investigation collected data on HIV-prevention needs, and voluntary and statutory sector provision, all of which are implemented by nurses (e.g. health visitors, community nurses, nurse midwifes). It was found that a lay referral system, operated solely by friends and family, worked effectively. Medical support from nurses and other health professionals was requested when symptoms become too serious. Compared with other ethnic groups HIV-positive Africans were more reluctant to test for HIV, and those who were sero-positive showed lower uptake of anti-retroviral treatments. Furthermore, there was evidence of poor attendance at clinical monitoring sessions, and it was argued that lat

Friday, October 25, 2019

Technolgy in The Kalinagos,Taino and Mayan Cultures :: essays research papers

Technology Taino Taino had very simple life styles but they had some technological advances. Some examples are Hut building, Fishing and Pottery. Hut building – there were larger huts built with a center pole, which gave extra support to the roof. It was considered important for resisting heavy gales. It had no windows and doors. Wooden posts were placed firmly in the ground to form a circle about five paces apart and laced together with springy branches and grass. Transverse beams were tied on top of the posts, and a pole placed in the center of the structure. The center pole and the transverse beams were then connected with thin poles, and these were covered with grass or palm leaves to form a conical roof. Fishing- Arawaks used nets, lines with hooks, a bone or turtle shell and harpoons to capture fish. In Cuba artificial pools were created to keep excess fish until they were needed .The Arawaks used the sucking fish (Remora). Pottery- this was made from the local red, brown and gray clays. Pots were not glazed but decorated with markings different for each village. They were made in shapes of frogs, birds or heads with wide eyes and large ears for handles. Basketwork cylinders – These were made to extract the poisonous juice of cassava. Cassava was the Arawaks main food, they made cassava cakes, pepperpot with cassava and a sauce called cassareep. Kalinago They painted their bodies to protect against the heat and insect bites made from vegetable dye and oil. Fishing arrows and Spears were tipped with shell and bone and battle arrows were tipped with fire and poison. Boat Building- Caribs’ canoes might have been up to 6 metres long. It was made out of tree trunks. The trunk was charred then hollowed with stone axes and left to season, after which it was buried in moist sand. Bars were placed across the opening to the force out the sides and it was left in place until wood had dried and hardened. Then triangular boards were wedged at the bow and stern so that the water could not enter the boat, and the sides were raised by fastening sticks bound with fibres and coated with gum to the upper edges.

Thursday, October 24, 2019

Being Organized

ing Natacha Petit-frere Professor Donigan December 1, 2011 Being Organized Many of us are incompatible of being organized. Organization is a skill that must be learned and practice by an individual. It’s a rare person among us who doesn’t feel the need to get more organized. I consider myself fairly organized I show my organization skills by coordinating my clothes by style, color coding sections for my college courses, having a sheet of paper, a calendar and a white board.A lot of us always just throw our clothes in the closet and its always out of order. Especially when pants, shirts and dresses are anywhere. On the other hand, we don’t know exactly where they can be found. This can be terrible when we know what we want to put on but can’t find it. In my closet I have my clothing in coordinating order. I put jackets in the front and pants in the back. The type of color style I use is darks in front and lights in back. Having this type of organization in my closet is very helpful.I’m a visual person, and I find that color-coding sections for my college courses minimizes the time I have to spend looking for them. This works especially well while I’m in class. I dumped every class syllabus into a green folder called class syllabus, and then color-coded every class period blue for paper due, yellow for quiz, red for test, etc. It took awhile to set up, sure, but for the rest of the semester I only had to glance at class syllabus to get a very clear idea of what kind of week I was going to have.Thinking if I didn’t have this type of organization for school I would be kind of stress out. When I’m not in school I’ll be using color-coding for work assignments also. I’ve found that the easiest way to organize days, myself and so forth is a good paper calendar, a sheet of paper that I divide into four sections and a medium sized white board. For my paper the top left section is my actual running to d o list for today. The top right section is my running grocery list, or list of things I must purchase.The bottom left is for notes such as calls I made, individuals I spoke to, and appointment dates. The bottom right is whatever I need to move to another day. If I’m told to call back on Monday, then I note that on the calendar. As for the white board, my family can make notes. Can I borrow some money on Friday? , Grandma called, and I also jot down things that I feel are important to them. My calendar, and the white board are in the same location, so I can transfer short notes if need be.I carry my paper task list with me everywhere, so I can make notes at any given moment. Finally, Whatever electronics or paper you use, make them work for you not the other way around. Does coordinating our clothes really have to stay in color coding order or using a sheet of paper every 5 minutes? Maybe, but I bet you’ll get a whole lot more done if you check it a few times per day. T hat goes for the Blackberry too! After all, there are so many tools, and one to fit everyone and that’s why I’m happy with the organizational system I use.

Wednesday, October 23, 2019

Social welfare

Social welfare Is based upon the premise that In an Ideal place, all people are treated with respect and dignity, and that; for a community to be responsive, It needs to be a place where members are valued for who they are and what they can offer the community. The goal of social welfare Is to fulfill the social, financial, health and recreational needs of all Individuals In a society. Social welfare seeks to enhance the social functioning of all age groups, both rich and poor.When other institutions in our society such as family and market economy fails, at times, to meet the basic deeds of individuals, or groups of people, then social welfare is needed and demanded. Richard Times argued that social welfare is much more than aid to the poor, and in fact, represents a broader system of support to the middle and upper class. It is the business of social welfare to: Find homes for apparentness children. Rehabilitate people who are addicted to alcohol.Make life more meaningful to older adults Provide vocational rehabilitation for persons with physical and mental dillydally Meet flannel needs of the poor Rehabilitate Juveniles and adults who have committed criminal offense End all hypes of discrimination and oppression Counteract violence in family including child abuse Provide services to people with WAITS and to their families and friends Counsel individuals and groups experiencing a variety of personal and social difficulties Serve families struck by physical disasters such as fire, hurricanes Provide housing for the homeless When a society strives for community betterment by developing methods and programs to promote social Justice and address social needs, this effort Is referred to as social welfare. However, the [perceptions of social welfare vary and there are several definitions of social welfare. Times, 1995, defines social welfare as: 1.The assignment of claims from one set of people who are said to produce or earn the national product to another set of people who may merit compassion and charity but not economic rewards for productive service. 2. Collective interventions to meet certain needs of individuals and to serve the wider interest of society Other available definitions include: 3. A system of social services and institutions designed to aid individuals and groups o attain satisfying standards of life, health and personal social relationships which permit them to develop their full capacities and promote their well being In harmony with the needs of the families and community (Friendlier,1 995, P. 140) 4. A subject of social policy which may be defined as the formal and consistent ordering of affairs (Gagger & Stores, 2010, P. 3) 5.A nations system of programs, benefits, and services that help people meet those social, economic, education and health needs that are encompasses people health, economic condition, happiness and quality of life. (Seal &Brzuzy,1998, P. ) 7. Society's organized way to provide for the persistent ne eds of all people for health, education, socio-economic support, personal rights and political freedom. Mamma 1995, P. 6) Own definition of social welfare The common themes in the definition above are: 1. Social welfare includes a variety of programs and services that benefit a target group. 2. Beneficiaries are not able to meet their basic needs on their own and so qualify for charity 3.Social welfare involves a system of programs designed to meet the needs of a people socio-economically and social well-being 4. End result of social lifer is to improve well-being of individuals/groups or organizations Therefore, according to me, social welfare refers to a variety of systems, programs and services designed and provided by a society, either on its own or in partnership with other institutions, to meet the specific needs of individual members, groups or communities to ensure a life of dignity for all its members and development of capacities for productive services. Definitions of oth er relevant terms Social services: Services delivered by social welfare agencies. May include individual services or institutional services e. Income projects, housing projects Welfare: Refers to the provision of minimal level of well-being and social support for all citizens, sometimes referred to as public aid. In developed countries, welfare is largely provided by the government and to a lesser extent, charities, informal groups, religious groups and intergovernmental organizations. Social Justice: Refers to ideal conditions in which all members of a society have the same basic rights, protection, opportunities, obligations and social benefit Social welfare policy: A designed framework, sometimes legislated, that offers a remark on how social welfare is provided by the government.Human services: Refers to welfare programs administered by the federal government and by non-profit and for-profit agencies The residual concept asserts that people should take care of themselves and rel y on charity from the government or non-governmental agencies for support only in times of crisis or emergencies. Characteristics of residual social welfare 1. In residual welfare, people are not considered eligible for help until all of their won private resources, which include family wealth and inheritance, help from church, friends, employers and so no, have been exploited. 2. Social services are only welfare one must prove their inability to provide for themselves and their families and this must be documented 4.Beneficiaries are routinely rectified for continued eligibility every few months to determine that they are still unable to meet their needs Residual welfare is mostly carried out by governments using tax funds. It is criticized for being too rigid. Critics say it can create a barrier for those who seek assistance due to the numerous eligibility criteria, which often causes clients to produce a variety of supporting documents and cause clients to forgo assistance even w hen the need is persistent due to the routine recertification processes. Beneficiaries in residual programs also carry stigma as they are often regarded as failures, labeled lazy, lacking in morals and dishonest and are often accused of making bad decisions and of needing constant monitoring because of their untrustworthiness. Social welfare Social welfare Is based upon the premise that In an Ideal place, all people are treated with respect and dignity, and that; for a community to be responsive, It needs to be a place where members are valued for who they are and what they can offer the community. The goal of social welfare Is to fulfill the social, financial, health and recreational needs of all Individuals In a society. Social welfare seeks to enhance the social functioning of all age groups, both rich and poor.When other institutions in our society such as family and market economy fails, at times, to meet the basic deeds of individuals, or groups of people, then social welfare is needed and demanded. Richard Times argued that social welfare is much more than aid to the poor, and in fact, represents a broader system of support to the middle and upper class. It is the business of social welfare to: Find homes for apparentness children. Rehabilitate people who are addicted to alcohol.Make life more meaningful to older adults Provide vocational rehabilitation for persons with physical and mental dillydally Meet flannel needs of the poor Rehabilitate Juveniles and adults who have committed criminal offense End all hypes of discrimination and oppression Counteract violence in family including child abuse Provide services to people with WAITS and to their families and friends Counsel individuals and groups experiencing a variety of personal and social difficulties Serve families struck by physical disasters such as fire, hurricanes Provide housing for the homeless When a society strives for community betterment by developing methods and programs to promote social Justice and address social needs, this effort Is referred to as social welfare. However, the [perceptions of social welfare vary and there are several definitions of social welfare. Times, 1995, defines social welfare as: 1.The assignment of claims from one set of people who are said to produce or earn the national product to another set of people who may merit compassion and charity but not economic rewards for productive service. 2. Collective interventions to meet certain needs of individuals and to serve the wider interest of society Other available definitions include: 3. A system of social services and institutions designed to aid individuals and groups o attain satisfying standards of life, health and personal social relationships which permit them to develop their full capacities and promote their well being In harmony with the needs of the families and community (Friendlier,1 995, P. 140) 4. A subject of social policy which may be defined as the formal and consistent ordering of affairs (Gagger & Stores, 2010, P. 3) 5.A nations system of programs, benefits, and services that help people meet those social, economic, education and health needs that are encompasses people health, economic condition, happiness and quality of life. (Seal &Brzuzy,1998, P. ) 7. Society's organized way to provide for the persistent ne eds of all people for health, education, socio-economic support, personal rights and political freedom. Mamma 1995, P. 6) Own definition of social welfare The common themes in the definition above are: 1. Social welfare includes a variety of programs and services that benefit a target group. 2. Beneficiaries are not able to meet their basic needs on their own and so qualify for charity 3.Social welfare involves a system of programs designed to meet the needs of a people socio-economically and social well-being 4. End result of social lifer is to improve well-being of individuals/groups or organizations Therefore, according to me, social welfare refers to a variety of systems, programs and services designed and provided by a society, either on its own or in partnership with other institutions, to meet the specific needs of individual members, groups or communities to ensure a life of dignity for all its members and development of capacities for productive services. Definitions of oth er relevant terms Social services: Services delivered by social welfare agencies. May include individual services or institutional services e. Income projects, housing projects Welfare: Refers to the provision of minimal level of well-being and social support for all citizens, sometimes referred to as public aid. In developed countries, welfare is largely provided by the government and to a lesser extent, charities, informal groups, religious groups and intergovernmental organizations. Social Justice: Refers to ideal conditions in which all members of a society have the same basic rights, protection, opportunities, obligations and social benefit Social welfare policy: A designed framework, sometimes legislated, that offers a remark on how social welfare is provided by the government.Human services: Refers to welfare programs administered by the federal government and by non-profit and for-profit agencies The residual concept asserts that people should take care of themselves and rel y on charity from the government or non-governmental agencies for support only in times of crisis or emergencies. Characteristics of residual social welfare 1. In residual welfare, people are not considered eligible for help until all of their won private resources, which include family wealth and inheritance, help from church, friends, employers and so no, have been exploited. 2. Social services are only welfare one must prove their inability to provide for themselves and their families and this must be documented 4.Beneficiaries are routinely rectified for continued eligibility every few months to determine that they are still unable to meet their needs Residual welfare is mostly carried out by governments using tax funds. It is criticized for being too rigid. Critics say it can create a barrier for those who seek assistance due to the numerous eligibility criteria, which often causes clients to produce a variety of supporting documents and cause clients to forgo assistance even w hen the need is persistent due to the routine recertification processes. Beneficiaries in residual programs also carry stigma as they are often regarded as failures, labeled lazy, lacking in morals and dishonest and are often accused of making bad decisions and of needing constant monitoring because of their untrustworthiness.