Does School Prepare Children for the Real World Essay Example for Free

Does School Prepare Children for the Real World Essay â€Å"Getting a good education and make good grades no longer ensures success. † Because these would not merely help us to be a successful professionals. Not all things are being taught in school. Does school prepare children for the real world and ?. but rather the skills and knowledge you are able to apply with your income separates the lower middle class from the wealthy. study hard and get good grades and you will find a high paying job with great benefits for you to attain success in life. education is the foundation of success† â€Å"just as scholastic skills are very important, so are financial and communication skills. † Just as what it is stated, education plays an important role in life. For an individual to be a successful. The author tells us how to achieve success but with very disparate approaches Throughout the book, the author compares both fathers , their principles, ideas, financial practices, and degree of dynamism and how his real father, the poor, struggling but highly educated man, paled against his rich dad in terms of asset building. He compares his poor dad to those people who are perpetually scampering in the Rat Race, helplessly trapped in a vicious cycle of needing more but never able to satisfy their dreams for wealth because of one glaring lack: financial literacy. His rich dad, by contrast, represents the independently wealthy core of society who deliberately takes advantage of the power of corporations and their personal knowledge of tax. The book’s theme reduces to two fundamental concepts: a can-do attitude and fearless entrepreneurship. The author highlights these two concepts by providing multiple examples for each and focusing on the need for financial literacy, how the power of corporations contribute to making the wealthy even wealthier, minding your own business, overcoming obstacles by not fostering laziness, fear, cynicism and other negative attitudes, and recognizing the characteristics of humans and how their preconceived notions and upbringing hamper their financial freedom goals. For most parents today, they are having a hard time keeping their children in chool. But in light of our changing times, as parents, we need to be open to new and bold ideas. â€Å"life is the best lecturer in life† it does not require any moments of an indi Vidual but rather having it’s experiences in life. Some people may think of money that has been involve. But the more money you have it will put you into more depths. Always keep in mind of† knowing how to work for money† not â€Å"knowing how to ma ke money work for you. † â€Å"The more money you get, the more you spend. † If one is able to focus getting jobs that develop these three major skills sets, he is well on their way on the path to success. After sharing these main lessons of the rich, Kiyosaki goes a step further by addressing the 5 main obstacles keeping people from actually following through . first is Fear, Overcoming the fear of losing money. The fear of losing money is real. Everyone has it. The difference becomes how a rich and poor person handles the fear. Wealthy individuals use failure as a teaching moment and aren’t afraid to fail. Second is Cynicism, This deals mostly with those around you. Follow your own path, because at the end of the day, wealthy individuals are a small percentage who go against the grain and don’t follow the crowd. Thirdly is Laziness, One must be willing to put in the time and effort to build up their financial knowledge. This means being selfish and taking time out to build one’s personal wealth. Fourth is the Bad Habits, it is Reducing expenses is easier said than done, but one must be willing to break those bad spending and investing habits in order to be successful. And lastly is the Arrogance, Always be willing to reach out to those who are successful and those you want to emulate. To become wealthy, it’s often a collaborative effort, bouncing ideas from prospective mentors. â€Å"Its not what you say out of your mouth that determines your life, its what you whisper to yourself that has the most power! † it tells us of being a dependent individual. one must determine his/her life. By means of the application of business. Don’t lose hope, and move straight forward for the future ahead. let me give you an example to deeply understand these. Grace was a friend of mine. She was my best friend a long time ago. We had a promise of seeing each other again after 10 years. I’ve remember that she told that she would be a good doctor in a hospital. She always tell me that its her dream to be a doctor. We always spend time with each other saying our ambitions years from now. But years have passed, and life changes. She suddenly told me that she would stop after graduation and her ambition will go to an end because of some family problem. She told that her dream of becoming a doctor has come to an end. But as her best friend I’ve told her not to give up, and pursue her dreams. It must be a trial from god to see her faith and hope for him. And so she started again and start all over. Life is too short, so we must all enjoy what we have. And do even pursue more. â€Å"You’re only poor if you give up. The most important thing is that you did something. Most people only talk and dream of getting rich. You’ve done something. † in life, you must not give up. Every individual experiences a lot of things. Every time you fall, you must stand up. Face the reality. lways keep in mind that f you did something bad or good, you must not give up and not lose hope. Just don’t let it get to the point of hurting someone just for you to have a standard status in life. But as generations have passed, all people are know thinking of how to be rich. Richer in life. â€Å"Winners are not afraid of losing. But losers are. Failure is part of the process of success. People who avoid failure also avoid success. † In our generation today, people know are always taking risk on their fortunes, some of them are gabling on their lives just to let their status in life ranked high. Every individuals always think of having competition with each other. They always want to be called the winner in terms of their competition. So know, things have change as times passes by, they are now afraid of losing in any kinds of competition. But in vice versa. Always keep in mind that every failure is a part of every success of every individual in life. â€Å"The love of money is the root of all evil. The lack of money is the root of all evil. † We all know that the possession of money by a person makes him/her evil. Every individual who loves money. ill suddenly turn to a bad person when he/ she loves money so much that even he is consequently starts to forget all about his/herself and even his/her family loved ones. When it comes to money, people take their own risk in life. Many people strive hard just to save dollars. Always remember money is a form of power. But what is more powerful is financial education. Money comes and goes, but if you have the education about how money works, you would gain power over it and can begin building wealth. if you want something, work for it. We all wanted thengs to satisfy us. If you’re the kind of person who has no guts, you just give up every time life pushes you. If you’re that kind of person, you’ll live all your life playing it safe, doing the right things, saving yourself for something that never happens. Then, you die a boring old man. Life is the best teacher of all. Most of the time life does not talk to you. It’s just that it all pushes you around. Each push is a life saying there’s something I want to say to you, wake up and face a new life. â€Å"Intelligence solves problems produces money. Money without financial intelligence is money soon gone. Every individuals have rights to have education. â€Å"Getting a good education and make good grades no longer ensures success. † Because these would not merely help us to be a successful professionals. Not all things are being taught in school. but rather the skills and knowledge you are able to apply with your income separates the lower middle class from the wealthy. study hard and get good grades and you will find a high paying job with great benefits for you to attain success in life. â€Å"education is the foundation of success† â€Å"just as scholastic skills are very important, so are financial and communication skills. Just as what it is stated, education plays an important role in life. For an individual to be a successful. â€Å"Emotions are what make us human. Make us real. The word emotion stands for energy in motion. Be truthful about your emotions, and use your mind and emotions in your favor, not against yourself. † God created man with his own image and likeness. He created humans all complete. Emotions can served as the principle and aspects in decision making process of an individual. True person can be associated as real, if he/ she has it’s own true feelings and emotions. lways remember to be truthful abouy our emotions and use it in a proper way. â€Å"In school we learn that mistakes are bad, and we are punished for making them. Yet, if you look at the way humans are designed to learn, we learn by making mistakes. We learn to walk by falling down. If we never fell down, we would never walk. † â€Å"education is the foundation of success† â€Å"just as scholastic skills are very important, so are financial and communication skills. † Just as what it is stated, education plays an important role in life. For an individual to be a successful. For most parents today, they are having a hard time keeping their children in school. But in light of our changing times, as parents, we need to be open to new and bold ideas. â€Å"life is the best lecturer in life† it does not require any moments of an individual but rather having it’s experiences in life. Some people may think of money that has been involve. But the more money you have it will put you into more depths. Always keep in mind of† knowing how to work for money† not â€Å"knowing how to make money work for you. † â€Å"The more money you get, the more you spend. †

Plan Of Health Promotion Intervention Health And Social Care Essay

Plan Of Health Promotion Intervention Health And Social Care Essay BACKGROUND The relationship between people and their jobs is diverse and complex. People have many different reasons for working and have many different experiences during their working lives. They may, for example, change jobs, take a career break, or choose a different work pattern (Nice et al, 2008). For employers, promoting healthy eating and activity means ensuring that employees have access to a balanced range of food and drink which helps maintain their energy and productivity at work and which contributes to an overall balanced diet. However, while every employee must be free to choose what they eat, employers should support them in maintaining their health by raising awareness of how diet and physical activity contribute to their health and wellbeing; by ensuring that an appropriate range of healthier choices is available to them at work and by providing a physical and social environment that supports healthier choices (Department of Health, 1994). It is estimated that 60% of the popul ation do not participate in levels of physical activity that will promote good health. Many of these people are in employment. In todays society, sedentary lifestyles are on the increase and this is a growing concern, thus, it is important that people are targeted appropriately. With almost half the Irish population employed, what better place to encourage a more active lifestyle than in the workplace. It has also been shown by the centre for health promotion studies that the workplace has been suggested as a favourable area for the promotion of exercise: Because of established channels of communication, existing support network and opportunities for developing corporate norms of behaviour (Centre for health promotion studies, 2001) Current recommendations state that all adults need at least 30 minutes of moderate intensity physical activity on most days of the week which is necessary for health benefits (Health promotion unit, 2001). Recent research shows that most Irish people are not as active as they need to be for their health. Due to time constraints people are finding it more difficult to allocate parts of their day to physical activity because it can assist those who generally cannot find the time outside their working hours, for example, a 20 minute walk during lunch or walk to and from work. The national health and lifestyle survey (2003) showed that 21% of people do not take part in exercise at all in 1998, this figure increased to 28% for the year 2002. Therefore, it is evident from these figures that physical inactivity has increased which leaves people at risk of premature death, chronic disease and disability. However, it is clear that society today has become more competitive and this is reflected in the workplace. Stress-related illness is more frequent due to increasing stress levels in our daily life. It has been seen that, physical activity can reduce stress; therefore, facilitating physical activity initiatives will make a difference to the health and wellbeing of the workforce. OVERALL AIM OBJECTIVES OF THE PROJECT The overall aim is to provide working people with knowledge and resources for promoting physical activity in the workplace. We want to create a workplace where a strong link is seen between work and health, where everyone aspires to a healthy and fulfilling working life, and where health conditions and disabilities are not a barrier to enjoying the benefits of work. The objective of this is to promote the benefits of a physically active workforce and to provide a structure in order to make it easier to encourage the workforce to be more active through: Increasing awareness of the importance of physical activity, educate employees and how their health affects their health. To improve the health of employees. To help people help themselves. To get employees more active during their regular working days. An active workforce is a healthy and happy workforce!!! PLAN OF INVESTIGATION On March 22nd and 23rd 2010, a conference on the promotion of physical activities in the workplace will be held at Fermanagh House, Enniskillen. The two day meetings will provide an opportunity for small groups of local business men and women, invited using the network and community knowledge of the Fermanagh Community Development Agency to interact intensively; the conference format will allow an informal discussion after the presentation, sharing of information and perspectives among people of diverse interest, training and background. Additional areas explored during the conference will nclude: Objectives of health promotion programs. Definition of terms. Target population and types of health promotion programs. Communication and coordination within and between programs Employers involvement. Because of the complexity of the issues, a few background papers will be presented and discussed. Some of the areas to be highlighted in the presentation are methodologies, costs and funding, as well as management, social support networks and family. Implementation of the interventions within the Enniskillen community will be over a 12 week period (post conference meeting) so that we can work in different localities at appropriate times, to explore views before and after implementation of these changes. The focus group meetings every week promoting physical activity are likely to explore what the respondent understands by a healthy and physical active lifestyle and the effects on behaviours and also access to resources, motivation, family and social support networks, incentives and preferences for physical activity with reference to the local built environment, amenities and transport infrastructure. Schedule The following is the schedule for week one at baseline and week twelve post-intervention. It is hoped to visit these workforce groups commencing late March, early April. This is a twelve week program. On week one, I will visit the groups as a whole to give a one day conference meeting including a presentation on how to promote physical activity in and outside the workplace, issue activity quiz (appendix) and take information from each adult participating in the program. In the following eleven weeks, the sport and health outreach program will be introduced into the workplace (weekly activities recorded). Various activity programs will be undertaken by the adults to increase their health and activity levels. (Table 1) The following is a schedule of our programme of activities to be undertaken: SPORTS AND HEALTH OUTREACH PROGRAM SPORTS PROJECT Week Teaching Theme 1 Introduction To Sport for Life, Measurements (baseline) 2 Heart Health 1 3 Heart Health 2 : 60 minutes A Day of Active Play 4. Mr Ms Muscles 1 5. Mr Ms Muscles 2 6 Physical Activity Outdoor 7 Physical Activity Indoor 8 Eat Drink Smart 9 Eat 4 Energy 10 Eat Smart, Move More (energy in must equal energy out) 11. Feel Good 12 Team Building and Review What is Physical Activity? What is Health? Measurements ( post-intervention) Table 1 On the last week of the twelve week program, I will revisit the participants for a follow up conference meeting to give a final talk and discussion on health in the workplace and to evaluate the problems and issues which may have arisen. The following is a list of areas in which the sport and health outreach program will be undertaken: INTERVENTION AREAS FOR THE PROGRAM Week 1 12 ; Baseline and Post-intervention Areas Group 1 (Monday) Group 2 (Tuesday) Enniskillen Town Kesh Belcoo Tempo Ballyinamallard Edenery Evaluation of the intervention Evaluation should be considered as a tool designed to answer questions related to whether objectives are being met or not. Therefore, for evaluation purposes the nature of the planning process, copies of all material utilized and minutes of project meetings can be valuable in trying to correlate changes in dependent areas, such as awareness of the programs existence and what was being offered. To evaluate the project, a health survey will be completed by participants and used to gather baseline and post-intervention information. The health survey will include questions related to their current levels of physical activity. In addition to this participants will be asked to log onto a website where they will record the activities taken every week over a 12 week period. Team captions are able to view these details and encourage active participation in the staff challenges. LIMITATIONS OF PROPOSED INTERVENTION Sedentary work doesnt provide much opportunity for exercise/ long work hours. Lack of motivation to work/ prefer other forms of exercise. Cold weather during the start of the program/ end of day light. Conference room to big, people scattered in different groups Recruitment of people/ work involvement. Time constraints. SO.. PHYSICAL ACTIVITY IS GOOD FOR YOUR HEALTH AND GOOD FOR YOUR BUSINESS REFERENCES Centre for Health Promotion Studies, (2001), An evaluation of the happy heart at work programme: On behalf of the Irish Heart Foundation, National University of Ireland Galway; July 2001 Centre for Health Promotion Studies, (2003), The National Health and Lifestyle Surveys: results of National and Lifestyle Surveys SLAN {Survey of Lifestyle, Attitudes and Nutrition} HBSC {Health Behavious in school aged children}, National University of Ireland Galway; April 2003 Department of Health (2004) Choosing Health Making Healthy Choices Easier. London:TSO Fox, K., (1994), Understanding Young People and their Decisions about Physical Activity, B J P E, 25 (1), 15-19 Health Promotion Unit, (2001), Get a life, get active handbook. A handy guide of physical activity for a healthier heart, Ireland needs a change of heart campaign, 2001 Nice, K. (2008). Changing Perceptions about sickness and work: judging capacity for work and locating responsibility for rehabilitation. Social and public policy Review Volume 2, number 2; Berthoud, R. (2007). Work-rich and Work-poor: three decades of change The Policy Press and Joseph Rowntree Foundation; Waddell, G. and Burton, A. K. (2006). Is work good for your health and well-being? TSO. Trost SG, Sallis JF, Pate RR et al (2003), Evaluating a model of parental influence on youth physical activity. Am J Prev Med 2003; 25: 277-82

Free Essay: Analysis of Sonnet 64 :: Sonnet essays

Analysis of Sonnet 64 When I have seen by Time's fell hand defac'd The rich proud cost of outworn buried age; When sometime lofty towers I see down raz'd, And brass eternal slave to mortal rage; When I have seen the hungry ocean gain Advantage on the kingdom of the shore, And the firm soil win of the watery main, Increasing store with loss and loss with store: When I have seen such interchange of state, Or state itself confounded to decay, Ruin hath tought me thus to ruminate- That Time will come and take my love away. This thought is as a death, which cannot choose But weep to have that which it fears to lose. As A. Kent Hieatt did a great job in citing certain similarities in Sonnets to Spencer's Ruines of Rome: by Bellay, I was surprised enough not to dfind any parallels on sonnet 64 to that of Ruines of Rome. This sonnet delivers, moreso, the theme of Rome succumbing to time rather than textual correlations. I will provide a quatrain by quatrain explicaton that cites certain allusions to Spencer's text. In the first quatrain, time has destroyed Rome, the "buried age," having lived too long ("outworn") as a prosperous civilization. The "lofty towers" being "raz'd" echoes Rome being "Heapt hils on hils, to scale the starrie sky"; the first "hils" in Spencer refers to the Roman civilization and the physical buildings, whereas the latter "hils" refers to the mountains on which Rome was built. Thus, being "raz'd" are all of the monuments of Rome that are subject to mutability. Ambiguity in the second quatrain allows for two readings following the Roman theme. First, the "hungry ocean" is the sea itself which gains on Rome, "the kingdom of the shore," but if the ocean is rising against Rome, it is incongruous to say that the "firm soil" defeats the "watery main." A more appropriate alternate reading still refers to Rome as "the kingdom of the shore," but the "hungry ocean" refers to other civilizations that have tried to conquer Rome yet failed. 5-7: 'When I have seen usurping nations hostily advance towards Rome, and then steadfast Rome defeat the opposing navy,'. This latter reading more supports line 8, in which Rome 'increases [its] wealth through the gains of (Rome's) conquests [thus, "with loss"], and yet at the same time increases [its] loss "with store," (that is, time's store [of time])'.

lighthod Human Soul Exposed in Joseph Conrads Heart of Darkness :: Heart Darkness Essays

The Human Soul Exposed in The Heart of Darkness  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In Joseph Conrad's novel, The Heart of Darkness, Charlie Marlow narrates the story of his journey into the dark continent, Africa. Through his experiences he learns a lot about himself and about the nature of mankind. He discovers that all humans have the capability within themselves to do good or evil. Outside circumstances substantially influence which path a human will take. Marlow travels not only through the darkness of Africa, but also through the darkness of the human soul. England sent missionaries to help civilize the natives of Africa. To Marlow, this is the purpose of colonization. During his journey he comes to see how the Africans are exploited for their labor and the natural resources of the land. "They were dying slowly . . . nothing but black shadows of disease and starvation. . . brought from all the recesses of the coast in all the legality of time contracts, lost in uncongenial surroundings, fed on unfamiliar food, they sickened, became inefficient, and were then allowed to crawl away and rest." (p.83). As the quote implies, after the natives served their purpose they were just ignored. What started out to be a good cause became distorted by the greed for ivory and other riches. The natives were weak and no competition for the civilized economically motivated Englishmen. There was no resistance. "They were conquerors, and for that you want only brute force - nothing to boast of, when you have it, since your strength is just an accident arisi ng from the weakness of others. They grabbed what they could get for the sake of what was to be got." (p.70). Instead of being colonizers, the circumstances allowed the British to become conquerors. In the same way that England's motives changed, so does the motives of many of the individuals who enter the dark continent. Kurtz starts out being the best agent the Ivory Company sends to Africa. He comes there with good intentions, not only to do his job for the company, but also he wants to help the natives. As Kurtz himself states, "Each station should be like a beacon on the road towards better things, a centre for trade of course, but also for humanizing, improving, instructing." (p.104). Obsessed with meeting Kurtz, Marlow finally realizes the man he is seeking has become evil and is exploiting the same people that he initially wanted to help.

Agressive Personality Essay -- Psychology

Essay question #1 Cognition is the mental process of gaining knowledge through thinking, judging and solving problems. Cognition functions to provide human beings with the ability to use language, make perceptions, use the imagination and make decisions. These thought processes play a significant role in personality development. Both biological and environmental factors have been linked to cognition. Biological factors include our genetic makeup and hereditary factors. Genetic makeup determines the physical characteristics of eye color, hair color. Hereditary factors are those traits that are transferred from parents and blood relations. These inherited traits determine temperament of human beings. Both the biological traits of genetics and inheritance play a major role in how human beings perceive themselves and how others interact with them. This cognitive perception of self and others is believed to help determine one’s personality. Environmental factors include how a human being i s raised and how outside influences such as school, church, relationships and society shape their cognitive processes. An example of the relationship between cognition and personality would be of a child born of two different races. Physical characteristics are likely to be different with mixed races causing the child to perceive themselves as abnormal, thus leading to antisocial or introverted personality traits. Essay question #2 The aggressive personality is defined as an â€Å"individual’s whose overall style of interacting involves considerable, persistent, maladaptive aggression† (counselingresource.com). Evolutionary, biological and environmental factors are contributing components of the aggressive personality. Human beings ... ...sachusetts: Allyn And Bacon. Cloninger, S. C. (2008). Theories of Personality Understanding Persons.. Upper Saddle River, NJ: Prentice Hall. (Original work published 1996). CounsellingResource.com.CounsellingResource.com – Psychology, Therapy & Mental Health Resources. Retrieved December 6, 2011, from http://counsellingresource.com/features/2008/11/03/aggressive-personalities/ Friedman, H. S., & Schustack, M. W. (2006). Personality: classic theories and modern research. Needham Heights: Allyn And Bacon. (Original work published 1999) Simon, PhD, D. G. (2008, November 7). Understanding the Aggressive Personalities | CounsellingResource.com.CounsellingResource.com – Psychology, Therapy & Mental Health Resources. Retrieved December 6, 2011, from http://counsellingresource.com/features/2008/11/03/aggressive-personalities

Health Promotions and Disease Prevention Paper Essay

Elder Mistreatment Elder mistreatment is a widespread problem in our society that is often under-recognized by health care professionals. As a result of growing public outcry over the past 20 years, all states now have abuse laws that are specific to older adults; most states have mandated reporting by all health care professionals. The term â€Å"mistreatment† includes physical abuse and neglect, psychological abuse, financial exploitation and violation of rights. Poor health, physical or cognitive impairment, alcohol abuse and a history of domestic violence are some of the risk factors for elder mistreatment. Diagnosis of elder mistreatment depends on acquiring a detailed history from the patient and the caregiver. It also involves performing a comprehensive physical examination. Only through awareness, a healthy suspicion and the performing of certain procedures are physicians able to detect elder mistreatment. Once it is suspected, elder mistreatment should be reported to adult protective se rvices (HHS fact sheet, 2005). It is estimated that over 2 million older adults are mistreated each year in the United States. Elder mistreatment first gained attention as a medical and social problem about 20 years ago, when the term â€Å"granny battering† first appeared in a British medical journal. Since that time, elder mistreatment has become a matter of concern not only in the United States, but throughout the world. This heightened awareness has followed a growing awareness of child and spousal abuse. Nevertheless, because of differing definitions, poor detection and under-reporting, the extent of elder mistreatment is unknown. These same factors make the collection of data difficult and its accuracy questionable. Published studies estimate that the prevalence of elder mistreatment ranges from 1 to 5 percent (Healthy people, 2010). Most health care professionals are reluctant to address domestic violence. However, physicians are in an ideal position to detect and manage mistreatment, as they may be the only person outside the family/caregiver role who regularly sees the older adult. In addition, the  physician is the most likely person to order the testing, hospital admissions and support services that are sometimes needed to correct elder mistreatment. This paper will discuss the clinical, ethical and legal issues regarding elder mistreatment. The various forms of elder mistreatment are defined, including ways to identify patient and caregiver risk factors, and history and physical findings that suggest a diagnosis of elder mistreatment. Finally, a systematic approach to patient evaluation, documentation and reporting of suspected cases will be reviewed. Reasons elder abuse may be missed or not reported by health care professionals include unfavorable attitude toward older adults (ageism), little information in medical literature about elder mistreatment, reluctance to attribute signs of mistreatment (disbelief),isolation of victims (patient not seen often by physicians/health care providers), subtle presentation (i.e., poor hygiene or dehydration), reluctance/fear of confronting the offender, reluctance to report mistreatment that is only suspected, mistreated person requests that abuse not be reported (patient/physician privilege), lack of knowledge about proper reporting procedure, fear of jeopardizing relationship with hospital or nursing facility Types of elder abuse Physical Abuse- occurs when a person is touched in an inappropriate way, such as hitting, punching, kicking, slapping, and pushing. Physical abuse often leaves marks on the person’s body: bite marks, bruises, welts, and burn marks. Marks are often left on arms, wrists, face, neck, and abdomen area; Emotional/Psychological Abuse- occurs when a person is demeaning to another person. A person may treat the elder like a child or call them names. An elder may seem unusually depressed or may talk bad about themselves; Sexual abuse- among an elder occurs when sexual contact is made without consent. It also occurs when an elder is incapable of making such a decision, and is rape; Financial abuse- occurs when a person or persons take advantage of an elderly person financially. This includes stealing money, lying about how much the elder needs for certain care, or cashing the elder’s checks without permission; Neglect/Abandonment- occurs when the elder is not being properly cared for, such as not being fed, bathed, and properly medicated. This is also when the elder is being ignored. The care  giver refuses to give care to the individual (Physical abuse of the elderly, 2005). Elder Mistreatment: Definitions and Classifications In an effort to increase physicians’ awareness, facilitate accurate detection and promote further research, the American Medical Association published a position paper on elder mistreatment in 1987. This paper proposed a standard definition: â€Å"‘Abuse’ shall mean an act or omission which results in harm or threatened harm to the health or welfare of an elderly person. Abuse includes intentional infliction of physical or mental injury; sexual abuse; or withholding of necessary food, clothing, and medical care to meet the physical and mental needs of an elderly person by one having the care, custody or responsibility of an elderly person† (HHS fact sheet, 2005). Elder mistreatment may take many forms. Types of elder mistreatment are often classified as physical abuse and neglect, psychological abuse, financial exploitation and violation of rights. A major obstacle to prevention of and intervention for elder mistreatment is a lack of awareness on the part o f physicians and other health care professionals (LA4Seniors, 2005). Risk Factors and Prevention Cognitive impairment and the need for assistance with activities of daily living are important risk factors for elder mistreatment. Caregiver burnout and frustration can lead to elder mistreatment. Substance abuse by the caregiver or the patient, especially abuse of alcohol, significantly increases the risk of physical violence and neglect. Psychological and character pathology in the caregiver and patient are also major risk factors. Prevention of elder mistreatment is difficult and depends as much on the social support network as on the medical network. Preventing elder mistreatment involves identifying high-risk patients and caregivers, and attempting to address the underlying issues. Screening patients and caregivers before placement can be helpful, when it is feasible. Helping patients obtain county or state assistance can also help reduce some high-risk situations. Risk Factors for Elder Mistreatment Older age, lack of access to resources, low income, social isolation, minority status, low level of education, functional debility, substance  abuse by caregiver or by elderly person, psychological disorders and character pathology, previous history of family violence, caregiver burnout and frustration, and Cognitive impairment. History- Recognizing mistreatment is often difficult. The older adult may be unable to provide information because of cognitive impairment. The history is sometimes difficult to obtain from the victim, for fear of retaliation by the abuser. This retaliation can come in the form of physical punishment or threats of violence and abandonment. Older adults are often fearful of being placed in a nursing facility, and some may prefer to be abused in their own home rather than be moved to such a facility (LA4Seniors, 2005). The mistreated older adult often presents with somatic complaints. Physicians should ask older patients about rough handling, confinement and verbal or emotional abuse. Subtle or confusing complaints may actually be indicative of mistreatment. It is important to recognize that abuse and neglect are most often discovered during routine visits at the physician’s office or in the long term care facility. Generally, the patient should be interviewed without the caregiver(s) present. Cognitive impairment may limit the ability to obtain an accurate history. It is important to ask general questions about conditions in the home or nursing facility. The physician should try to obtain an accurate view of the patient’s daily life, including meals, medication, shopping and social outlets (HHS fact sheet, 2005). It is also important to ask the patient about the nature and quality of the relationship with the caregiver. It may be helpful to ask questions such as, â€Å"How do you and the caregiver get along?† and â€Å"Is the caregiver taking good care of you?† It is critical to assess the patient’s mental status for indicators of depression or alcohol and substance abuse. A discussion of the patientâ €™s financial situation may be appropriate. If issues of mistreatment are raised, the caregiver should be interviewed as well. The physician must be careful not to over interpret or to make suggestive comments, especially when the patient is cognitively impaired. Essential Features of the History in the Assessment of Mistreated Elders Medical problems/diagnoses, detailed description of home environment (adequacy of food, shelter, supplies), accurate description of events related to injury or trauma (instances of rough handling, confinement, verbal or emotional abuse), history of prior violence, description of prior injuries and events  surrounding them, description of berating, threats or emotional abuse, improper care of medical problems, untreated injuries, poor hygiene, prolonged period before presenting for medical attention, depression or other mental illness, extent of confusion or dementia, drug or alcohol abuse, quality/nature of relationships with caregivers. Physical Examination and Laboratory Tests The physical examination is often used as legal evidence of mistreatment. Laboratory and imaging studies should be performed to confirm any suspicious findings in the history and physical examination. The presence of dehydration and malnutrition can be established with simple laboratory tests such as a complete blood count and measurement of blood urea nitrogen, creatinine, protein and albumin levels. Radiographic studies provide evidence of old and new fractures. Unfortunately, proving that a fracture was caused by abuse can be difficult (HHS fact sheet, 2005). Role of advance nurse and nursing intervention strategies- The nurses can play a vital role as a case finder, manager, advocate, educator, researcher and caregiver to physically abused elderly and family or caregiver in a given community. Inform the decision makers about the magnitude, trends and characteristics of violent deaths; and, evaluate and continue to improve by educating the patient and the care giver, and if is necessary reporting the abuser to the authorities. Nurses should involve the case managers and the social workers, document all the findings accurately and report the mistreatment case as soon as possible. Documentation Documentation of all findings may be entered as evidence in criminal trials or in guardianship hearings. Documentation must be complete, thorough and legible. Such circumstances dictate that there is a â€Å"chain of evidence.† This need mandates a careful collection of physical evidence, which is critical in cases of suspected sexual or physical abuse. Laboratory data and, when possible, photographs should be used for verification of written documentation. Management Management of elder mistreatment first involves discussing the situation with the patient, if feasible. The patient should be allowed to play a role  in the ultimate resolution, if he or she is able to do so. First, the competency of the patient should be determined. Local and state social services have different methods of addressing mistreatment. Social workers from hospitals, clinics or long term care facilities are valuable resources and should be able to assist with these services. Multidisciplinary teams can be very effective. These teams typically include geriatricians, social workers, case management nurses and representatives from legal, financial and adult protective services. Multidisciplinary teams are often more effective in problem-solving and provide a forum for discussion with participants involved in the older adult’s care. Senior advocacy volunteer groups are also helpful. A senior advocate can provide information to the abused person and enable access to resources from community programs and social services. Basic Features of the Physical Examination Head- Traumatic alopecia or other evidence of direct physical violence; poor oral hygiene; Skin- Hematomas, welts, bite marks, burns, decubitus ulcers; Musculoskeletal- fractures or signs of previous fractures; Neurological- cognitive impairment that is a risk factor for mistreatment and influences management decisions regarding competency; Genito rectal- poor hygiene, inguinal rash, impaction of feces; General- weight loss, dehydration, poor hygiene, unkempt appearance (LA4Seniors, 2005). Reporting All health care providers (physicians, nurses, social workers, etc.) and administrators are mandated by law to report suspected elder mistreatment. The laws differ from state to state; physicians should determine the specific requirements in their states. Any other person may also report suspected abuse and neglect. All reporters are immune from civil liability if they act in good faith and without malice. They are also protected from termination of employment. Health care providers can be found to be negligent if they fail to report the suspected mistreatment. Penalties can include fines, imprisonment or loss of licensure. Reports of suspected elder mistreatment should be given to the state or county division of adult protective services. In the absence of such services, the reporter should contact the county extension office or the state’s office of child and  family services. In addition, any Area Agency on Aging would be able to provide assistance in reporting suspected mistreatment. The National Domestic Violence Hotline (telephone: 800-799-SAFE) or the Older Women’s League (telephone: 800-825-3695) could also help. Contacting the police is always an option, especially in an urgent situation (HHS fact sheet, 2005). In the event that the older adult is a resident of a long term care facility, a separate mechanism often exists for investigating suspected mistreatment through the state agency that surveys these facilities. Identifying the appropriate avenue for investigation can be done through the available adult protective service agency or the state department of child and family services (Elder Abuse, 2005). Once suspected mistreatment has been reported, the responsible agency will assign a social worker to investigate the case. The social worker will provide an accurate description of the home or nursing-facility environment. After assessment, the social worker may provide insight into some possible solutions to the problem and information about available resources. Unlike cases of child abuse, if the older adult is competent to make decisions, he or she may refuse intervention. If the older adult is not competent to make decisions, a guardian can be appointed by the state. The guardian can then direct care as needed until the problem is satisfactorily resolved. Injury Prevention- In healthy people there is no precise data specific for elder abuse, but these are related data from that site. The target rate for physical assault by intimate partner is 3.3 physical assaults per 1,000, and the baseline is 4.4 physical assaults per 1,000. The target rate for annual rate of rape is 0.7 rapes or attempted rapes per 1,000 persons, and the base line is 0.8 rapes or attempted rapes per 1,000 (Health people, 2010). Objectives from Healthy People 2010 Reduce injuries, disabilities, and deaths due to injuries and violence, and educating the primary care givers about the signs and symptoms of abuse or mistreatment, and educating them about alternative coping mechanisms. Several themes become evident when examining reports on injury prevention and control, including acute care, treatment, and rehabilitation. First, injury comprises a group of complex problems involving many different sectors of society. No single force working alone can accomplish everything  needed to reduce the number of injuries. Improved outcomes require the combined efforts of many fields, including health, education, law, and safety sciences. Second, many of the factors that cause injuries are closely associated with violent and abusive behavior (Health people, 2010). Violence and Abuse Prevention Violence in the United States is pervasive and can change quality of life. Reports of children killing children in schools are shocking and cause parents to worry about the safety of their children at school, and if the problem is untreated the aggression later on will turn on the parents or older adults. Reports of gang violence make people fearful for their safety. Although suicide rates began decreasing in the mid-1990s, prior increases among youth aged 10 to 19 years and adults aged 65 years and older have raised concerns about the vulnerability of these population groups. Intimate partner violence and sexual assault threaten people in all walks of life (Elder Abuse, 2005). Violence claims the lives of many of the Nation’s young persons and threatens the health and well-being of many persons of all ages in the United States. On an average day in America, 53 people die from homicide, and a minimum of 18,000 persons survive interpersonal assaults, and as many as 3,000 persons attempt suicide (Elder Abuse, 2005). Elderly, females, and children continue to be targets of both physical and sexual assaults, which are frequently perpetrated by individuals they know. Examples of general issues that impede the public health response to progress in this area include the lack of comparable data sources, lack of standardized definitions and definitional issues, lack of resources to establish adequately consistent tracking systems, and lack of resources to fund promising prevention programs. Disparities Adults aged 65 years and older are at increased risk of death from fire because they are more vulnerable to smoke inhalation and burns and are less likely to recover. Sense impairment (such as blindness or hearing loss) may prevent older adults from noticing a fire, and mobility impairment may prevent them from escaping its consequences. Older adults also are less likely to have learned fire safety behavior and prevention information,  because they grew up at a time when little fire safety was taught in schools, and most current educational programs target children (Healthy people, 2010). Opportunities To reduce the number and severity of injuries, prevention activities must focus on the type of injury—drowning, fall, fire or burn, firearm, or motor vehicle. Understanding injuries allows for development and implementation of effective prevention interventions. Some interventions can reduce injuries from violence-related episodes. For instance, efforts to promote awareness in society can help reduce the risk of assault, intentional self-inflicted and elder neglect and abuse. Higher taxes on alcoholic beverages are associated with lower death rates for some categories of violent crime, including mistreatment, abuse, and rape (Healthy people, 2010). Healthy People Objectives This organization encourages the Individuals, groups, and other organizations to use this framework and integrate it into their current programs, events, publications, and meetings, schools, colleges, and civic organizations to undertake activities in order to further the health of all members of their community. It is a national initiative that aims to improve the health of all Americans and eliminate disparities in health. Reducing the prevalence and overall number of people who suffer from different variety of diseases, and increase concerns for the nation’s elderly, and to reduce the overall rate of elder abuse, prevent its associated health problems, and educating the care givers and enhancing their coping mechanisms and alternative modalities to deal with the related stress. Health care providers can encourage their patients to pursue healthier lifestyles and to participate in community-based programs. By following the national objectives, individuals and organizations c an build an agenda for community health improvement and can monitor results over time. Healthy People objectives have been specified by Congress as the measure for assessing the progress of the Indian Health Care Improvement Act, the Maternal and Child Health Block Grant, and the Preventive Health and Health  Services Block Grant. Healthy People objectives have been used in performance measurement activities (Healthy people, 2010). Many objectives focus on interventions designed to reduce or eliminate illness, disability, and premature death among individuals and communities, and to educate the care giver regarding recognizing elder abuse, and prevention modalities; others focus on broader issues, such as improving access to quality health care, strengthening public health services, and improving the availability and dissemination of health-related information. Each objective has a target for specific improvements to be achieved by the year 2010. Together, these objectives reflect the depth of scientific knowledge as well as the breadth of diversity in the Nation’s communities. More importantly, they are designed to help the Nation achieve Healthy People 2010’s two overarching goals and realize the vision of healthy people living in healthy communities (Healthy people, 2010). Interim Progress toward Year 2000 Objectives Numerous objectives addressed injury prevention in Healthy People 2010. Twenty-six objectives were specific for unintentional injuries, and 19 objectives were specific for violence prevention. By the end of the decade, targets had been met for 11 objectives. Unintentional injury objectives showing achievement were unintentional injury hospitalizations, residential fire deaths, nonfatal head injuries, spinal cord injuries, nonfatal homicide poisonings, and pedestrian deaths. Violence prevention objectives that met their targets were, suicide, weapon carrying by adolescents, conflict resolution in schools, and child death review systems. REFERENCES Elder Abuse and Neglect Statistics (2005). In search of solutions. Retrieved on 8/20/05 from http://www.apa.org/pi/aging/eldabuse.html Healthy people 2010(2005). Retrieved on 8/20/05 from http://www.healthypeople.gov LA4Seniors (2005). A public service website for seniors and their families. Retrieved on 8/20/05 from www.la4seniors.com/elder abuse.htm National center on elder abuse (2005). Retrieved on 8/20/05 from http://www.elderabusecenter.org HHS fact sheet (2005). US department of health and human services. Retrieved on 8/20/05 from www.hhs.gov/news/press/2000pres/20000503b.html Physical abuse of the elderly (2005). Physical abuse of the elderly: signs, descriptions, and what you can do about it. Retrieved on 8/21/05 from http://de.essortment.com/physicalabusee_rfjb.htm

A Musical Evening Essay

No, I haven’t been to a musical (lately). But Friday â€Å"my† choir and I had an appointment with, well, the rest of the population here, really. The local choirs (5) and whoever else who wanted to come along, were gathered to sing. The choirs had 2-3 songs each in between, but the rest was pure singalong (not karaoke..). Before going I felt as if I was a hundred years old, because that’s what I expected the average age of the people attending to be – but no such thing. Admittedly, average age was possibly 50, but there was such a genial atmosphere, and fun songs to sing! It was great listening to the other choirs and there was even food and drink. Very un-Norwegianly, people smiled and talked to complete strangers, and I doubt not that the compere was right when he said you couldn’t sing and be a sourpuss. I didn’t feel like a hundred years old, and I even answered when called upon by strangers†¦ I’ll just give you a couple examples of the singalong (as usual, it’s sound only – for atmosphere, the localities where wrapped in semi-darkness). It’s not particularly beautiful, but it’s kind of silly-funny, it’s two songs phonetically translated to Norwegian – Ferje over Mjà ¸sa (= ferry cross Mjà ¸sa, from â€Å"ferry cross the Mersey†, of course – at least it’s about a ferry ride too) and Du kan godt fà ¥ sitte innte meg Leif (= feel free to move in closer, Leif, from â€Å"got to get you into my life† – it’s got absolutely nothing to do with the original, but it sounds like it†¦) Our performance? It wasn’t too bad, actually. We’d had two practice sessions before this evening†¦ The second song (a medley) I won’t go into, but the first one had several people coming over to us afterwards saying things like â€Å"most enchanting of the evening†, â€Å"most special† and â€Å"most true (= in tune) singing they’d ever heard†. I can live with that.