Special Populations Assignment Example | Topics and Well Written Essays - 1750 words

Special Populations - Assignment Example Still in these communities there are the vulnerable population integrated throughout (Nyamathi & Koniak, 2007). The discussion will focus on people with AIDS, as a vulnerable population in the society. In this case, it will discuss this group in details, their description, and their social and health problems. It will also focus on a program that will enable this group have a better stay in the society, also focusing on the ethical and legal implications and present strategies developed to diminish the cycle of vulnerability in the society. The welfare of the people with AIDS may it be adolescents, elderly and young adults mainly depends on trail of personal developments, economic and social experiences of the society and stressors that may be distinct to the diverse age groups or to communities at different times. Several vulnerable groups in the society fall prey into abuses by the rest of the people may it be physical, sexual, mental, social stigma, and financial, and they can still happen to people with AIDS. They can be susceptible to influences that are devastating to their well fare. There are more reported cases each year of abuse of this population and more that often occurs and not reported. This is evident from the reports produced each year by the health care sector in several countries (Nyamathi & Koniak, 2007). Awareness of the abuses of people with AIDS is essential since this group comprise of the fastest growing population in America among others. Most of the people with AIDS abuses occur within cultural, economic, racial, and ethnic groups regardless of the religion and socioeconomic status. The abuse of the group goes back a long way to the ancient times when they regarded people with AIDS as outcasts and discarded after contracting with HIV (Aday, 2001). Reports published in the year 1970 showed that the abuse of

Pregnancy, Labor and Birthday Practices of Asia (India) Essay

Pregnancy, Labor and Birthday Practices of Asia (India) - Essay Example All societies have their unique labor and birthing practices and India as a society is no different. This paper will be a discussion on laboring practices of Asia, India, focusing on the role of the family and taboos before, during and after birth. With over 375 million children, India accounts for the highest population of children in the world. A majority of these are Hindus but there are other minorities such as Sikh and Muslims. According to Info Change, a non-profit organization that concentrates on sustainable development and social justice in South East Asia, about 36 percent of the population lives below poverty line. Of this percentage, women and children account for 73 percent. These may be attributed to the socio-economic conditions and Hindu beliefs that greatly influence child rearing practices in India. Along with strict rearing practices of children in India come a number of practices that are associated with its coming into the world. First of all, eating patterns of a woman are restricted (NCBI 533). This ranges from the kinds of food that she can eat to the amount that is to be taken. It is believed that when a pregnant woman eats too much, the fetus will not have room to move. This is argued by the fact that the abdomen is supposed to contain both the food and the fetus, however, in this case, the latter’s space should be given more priority. Since women from poor backgrounds are still expected to work in the farm and around the house during early months of her pregnancy, it is believed that eating a lot would make them gain excess weight that would interfere with their productivity while working. There were some directions regarding taking hot or cold foods. In Asia, pregnancy is believed to be a hot condition; therefore foods that are considered hot are restricted. The body is believed to be already out of balance and hot foods would only make the condition worse (Greene 34). Another practice that is prevalent all over India is calle d the shrimata. When a woman is in the seventh month of her pregnancy, there are special rituals that are performed and special types of sweet are given to the parents to be. This is to encourage the woman for having reached near full term with the pregnancy as well as to give her moral support. This shows the connection that the community has. They all participate in welcoming a child. During this time, the family is especially helpful. They treat the expectant woman with a lot of care and assist her with anything that she may require, ensuring that she is completely comfortable. In the Asian Indian community, the actual birth process is mostly carried out by a traditional birth attendant or other close family members. Most women prefer their mothers’ to attend to attend to them when they are giving birth (Greene 33). However, a certain percentage of Indians go to the government hospital to give birth with an even smaller percentage opting for private hospitals. Men were not allowed to get in the room where the birth was taking place or if it had occurred in the open, they were not allowed to see the birth process. After the birth, there are some rituals conducted on the child. Mothers ceremoniously plunged the infant into the river, this was meant to strengthen the child and rid them of any deforms that

Stanley Kubrick’s Movie ”Full Metal Jacket” Analysis

Stanley Kubrick’s Movie †Full Metal Jacket† Analysis Table of Contents Section 1: Introduction Section 2: Background Section 3: Main Section 4: Conclusion Section 4: Bibliography Section 1: Introduction There were always a lot of different wars going on and even more war stories written down. These stories are usually very complicated and involve many characters, feelings and struggles. They show the war from different sides, describing the moments of intense battle as much as moments of soldiers’ soul torments. War stories mostly include different combats, a dramatic plot, sometimes a love line, and almost always an emotional finale. Some of these stories are quite positive and have happy endings; others try to show the real war. The director Stanley Kubrick also made a war story and named it â€Å"Full Metal Jacket†. This story turned out to be very unconventional and unusual, because it follows the mental development of the soldiers and their emotions rather than concentrating on the war itself. Kubrick’s movie observes the marines’ motivations, relationships between each other and their attitude to the war. The motive for fighting is a very important part of any war story. People have very different reasons for a war, such as money, freedom, territory, power and so on. Mostly characters in war stories clearly define their goals in the battle, and the reasons for them to be there. They ask themselves why they fight, think about their life before they got where they are, and examine their feelings and motives for continuing, although â€Å"Full Metal Jacket† leaves motives of the soldiers uncertain. That brings the audience to the question: Are there any reasons for these soldiers to fight or the deaths of their friends were vain? Maybe the war was completely meaningless from very beginning? Section 2: Background The film â€Å"Full Metal Jacket† follows a Marine reporter nicknamed Joker through his initiation into Marine boot camp and his involvement in the Vietnam War which lasts from December 1956 up to 30 April 1975. Although the reasons for Vietnam War start appearing much earlier. The situation becomes tense in the time when Indochina is still a French Colony. Different nationalistic groups come together with communist Ho Chi Minh to overthrow the French rule and become independent. So they start First Indochina war, and in 1954 France suffers a major military defeat. Signed in 1954 Geneva Accords ends French rule and United Nations divide Indochina into Laos, Cambodia, North Vietnam, which was ruled by communists, and democratic South Vietnam. Nationalists’ forces want to unify Vietnam under the communist government and start the war which is now known as a Vietnam War. In the same time America tries to prevent the spread of communism through the world. They believed in domino theory which held that if a country goes communist the neighboring countries are likely to go communist also. So US feel that if they stop communism from taking South Vietnam it will also keep other countries from it. So they support South Vietnam in the war. On the time period from 1965 until 1972 the Vietnam War keeps escalating. US send to the war about a half a million of their troops. America is very close to victory, but North Vietnamese army succeeds in breaking the will of the American People. Their military does not know what are they fighting for anymore and does not want to sacrifice their lives. And as the war goes on, the cost in blood seems to be extreme and worthless, so in 1972 US signs valueless peace agreement with North Vietnam which allows the retreating of American forces. But the armed conflict in Vietnam continues and in a few years in 1975 the North Vietnam takes up South Vietnam. Defeat of South Vietnam causes a massive genocide in Southern Asia resulting in the death of millions, while America suffers major political loss.[1] The movie â€Å"Full Metal Jacket† is a war story about that part of history, about the Vietnam War. It was directed in 1987 and is based on Gustav Hasfords semi-autobiographical novel â€Å"The Short-Timers†. [2] The author of the book, Gustav Hasford, was a US Marine Corps veteran and went through a Vietnam War; his experience and his feelings on this war formed the basis of his book and therefore the movie.[3] Section 3: Main The story of the movie begins the United States Marine Corps Training Camp. A group of young recruits are having their heads shaved and being prepared for military basic training by their new senior drill instructor, brutal Gunnery Sergeant called Hartman, whose work is to weed out all non-hackers[4]. During the training the sergeant often degrades each recruit; he uses many different psychological attacks such as repeated chants in training or insulting their masculinity (calling them sweethearts or ladies). He also gives certain men a ridiculous nickname based on their actions or characters: the pragmatic man who talks behind his back got a name Joker[5], a man from Texas became a Cowboy[6] and finally, Leonard Lawrence, an over-weighed, tall, not intelligent recruit becomes Private Gomer Pyle[7]. Hartman focus his attention on him, because the corpulent recruit cannot keep up with the others in the grueling trainings. The viewer can observe a slow dehumanization of recruits that occurs during the training. American boys are humiliated and worked to death. Finally they become totally broken and reconstructed as the perfect marines; they are taught that they are nothing more than bald-headed weapons of mass destruction in uniforms. Some of them could not handle this and slowly go insane, what is perfectly shown on the example of Private Pyle. This training seriously dements Private Gomer Pyle up until he becomes demented, maniacal, and suicidal. The scene where he is talking to his gun[8] shows just how much some people can be dehumanized by the experience of basic training. Private Pyle takes so much glory in his rifle that it starts to bother everybody in the training camp. When he reaches the certain state, Pyle feels like he has to not only kill his sergeant, but to eliminate himself from this world as well, and commits a suicide, even his fellow recruit Joker cannot change his mind[9]. The second part of the movie takes place already on the war. Each recruit got a Military Occupational Specialty. Joker, which is the main character, now becomes a military journalist. In the first minutes of the second part, Private Rafterman grumbles to Joker, You know what really pisses me off about these people? We are supposed to be helping them and they shit all over us every chance they get. I just can’t feature that. Joker then replies, Dont take it too hard, Rafterman. Its just business.[10] The way he answers demonstrates to the viewer that marines honestly do not understand why Vietnamese people dislike them, even though Americans fight for their freedom and protect them from going communists. Next scene, Joker is on the newspaper staff meeting, and the superior officer looks through the offered articles to verify that all the material would create the desired effect on the readers. Joker and his fellow journalists are ordered to only write articles that show that United Stated are the winners in this war, even if it implies that they have to make up some details[11]. Before Joker realizes that this not faithful reporting isn’t a right decision, he agrees with it because the happy stories would keep the troops in a good mood. Afterwards Joker and Rafterman take a helicopter ride[12]. While flight, the helicopter’s door gunner starts to shoot Vietnamese villagers and soon Joker asks him, How can you shoot women and children?, and the soldier answers, Easy! You just dont lead ‘em so much! Aint war hell?[13] These men on the war are losing their morality; killing women and children became totally normal, the only difference is that you use fewer bullets on them. The marines in this movie have no idea what they are doing in Vietnam, they were told to kill Vietnamese people and that is what they do. Later, when Joker and Private Rafterman meet Cowboys platoon for the first time, Joker and the marine nicknamed Animal Mother have a dispute. In a second Private Eightball comes to Joker and says, Now you may not believe it, but under fire Animal Mother is one of the finest human beings in the world. All he needs is someone to throw hand grenades at him the rest of his life.[14] Sergeant Animal Mother appears to be an ideal soldier: a man who has become desensitized due to warfare. There is a memorable scene where members of the platoon are standing around their recently killed comrades[15]. The camera turns around, focusing on each of them one by one as they give a comment about their opinions on deaths. Some are confused, one marine wishes them to rest in peace, and the next one adds at least they died for a good cause. Someone asks What cause is that? and the soldier replies, Freedom. The important line comes when Animal Mother suddenly says You think we waste gooks for freedom? This is a slaughter. If I’m going to get my balls blown off for a word my word is poon-tang.[16] This shows viewers some kind of idea about the characters and their thoughts, but there is still no particular idea about what they are actually there for. One of the most important proofs that the soldiers do not know what they are fighting for appears when a news team interviews a platoon, and they share their experiences and opinion about the war[17]. The answers are uncertain and reduced to the fact that the soldiers are only here to kill â€Å"Vietnamese gooks†, as they were ordered. The marines speak very insecure with a lot of pauses unable to put the words right; they never thought about the reason to fight. In a few days, the troop goes out on another patrol, in the ruins next to the place where the US army believes enemy’s troops have hidden[18]. The sky on the background is foggy showing some kind of uncertainty in soldiers’ souls. While observing the place, the leader of the squad dies by stepping on a mine and Cowboy takes the leadership. Very soon their squad becomes lost in the ruins and the unseen sniper shoots one of the marines, private Eightball. The platoon argues if they should take risk and try to save him or leave the dying comrade. This scene shows who of them still have something humane and who already became a â€Å"killing machine† as they were taught to be. The viewer can see how these people cannot take the decision. Then one man decides to take the chance and goes there. After the second soldier being shot the third marine goes and sacrifice himself too. That is the cost of being humane on the war. Finally the viewer reaches the last minutes ofFull Metal Jacket, when the platoon finds the sniper and Joker faces death for the first time. As he looks down on the Vietnamese sniper, we understand that Joker has never really been on the battlefield, he has never needed to kill, but when he needed those were only darkened figures in the distance. For the Joker, war and death was something that happens somewhere at the distance to the other people. He never looked the enemy directly in the eye before pulling the trigger. Being shot and surrounded by the enemies the sniper starts to pray, and then she begs them to shoot her. The marines need to take a difficult decision: or they should leave her to die from a blood loss or save her from suffering by killing her. Animal Mother agrees on a mercy killing but only if Joker will do it[19]. Before that Joker asked the helicopter gunner â€Å"How can you shoot women and children?† Suddenly this question comes back to him as Joker stands next to an enemy sniper who is and woman, and a child. After some hesitation, Joker shoots her. His fellow marines sarcastically congratulate Joker with his first corpse while he stares into nothing, having finally gotten his own brutalized gaze. In this scene he looks very similar to the private Pyle in the end of the first part. All the military philosophy is shown in this one battle where a small marine troop is trying to win a Vietcong sniper to gain one tiny piece of land among the ruins by sacrificing their fellows. And this tiny piece of land is not even important for this war. â€Å"Full Metal Jacket†ends with Joker marching with other marines and singing the Mickey Mouse Club theme song and then Joker narrates, â€Å"I am so happy that I am alive, in one piece and short. I’m in a world of shit†¦ yes. But I am alive. And I am not afraid.†[20] He is called the Joker, and â€Å"Full Metal Jacket† is the story of his aging, the story of his transformation from an innocent child to the killing machine, real soldier. During this war, he finds nothing but madness and cruelness in everything around him, starting with his drill instructor, Sergeant Hartman, to the Vietnamese enemies and his fellows, so the film does not really take anybody’s side. It does not tell you who the antagonists and who the protagonists are. More than that, this movie has a lot of dualities: the helmet with the peace symbol on one side and â€Å"Born to Kill† written on the other, even Joker himself explained it as a duality of a man[21]. The tragic deaths at the end of each part of the movie. Joker’s own desires to â€Å"get into shit† and to avoid it as much as possible. Him, being a Leonard’s tutor and the one who beats Pyle the hardest in the same time. The music use in different situations. The music choice in the movie also says a lot about the meaningless of the war. For example taking a Mickey Mouse song in the end tells about the innocence of these soldiers many years ago, when there was no war going on. A period of time many years ago when they were all children, contrasted to fighting soldiers which they became now. Kubrick used music in a quite sarcastic, absurd and tragicomic way: The Mickey Mouse march, which is supposed to be entertaining and happy, becomes a dead march spreading above the land of destruction and death. The title of the movie â€Å"Full Metal Jacket† is also given to it for a purpose. The Full Metal jacket bullets are bullets designed not to expand at all, thus they are considered ‘humane’, because they are less likely to kill (although more likely to maim)[22]. That fits the movie in a sense of how the marines had a distorted notion about what is humane and what is not. They believed that they are being humane because they are killing Vietcong people, who are communist and therefore ‘the bad guys’, and no matter if those are innocent or not. They were told that it is the right way for everybody, while in the reality they were just as bad, cruel and ferocious as Vietcong. Section 4: Conclusion The inscription â€Å"Born to Kill† on Jokers helmet versus the Peace symbol perfectly summarizes this film. There were no answers to any questions in the Vietnam War, the brink of honor and justice was lost. The gallant soldier is mocking while shoots a machine gun at innocent women and children, and nobody can even understand what are they fighting and die for, although they know that killing is their responsibility and mission. There, in Vietnam, even a prostitute can turn up to be a Vietcong spy. There the difference, the advantage of women and children is that you use fewer bullets to kill them. There is no place for weak people or pacifists, and even if the soldier has a piece symbol on him, this is easily compensated with an inscription â€Å"Born to Kill† on the helmet, which is explained just by duality of a human nature. Everybody, who understood what a war is, tried to stay humane and alive at the same time, died and instead of the funeral, a funny song with terrible words sounded over their bodies. Full Metal Jacket is a movie of contrast, where each minute contradicts the previous and the main character himself. All his doubts and compassionate in the beginning replaced with coolness and confidence in his decisions at the end. And finally a Hartmans mission is completed. An army of demoralized people, who is only able to kill, will return back home, because it is too difficult to stay human on the war. The end of this transformation in the huge heartless machine is seen when Private Joker kills a sniper and destroy a pacifist in himself, symbolizing the final decay of the soul and the conversion into a monster. In any war, if you kill a person in front of you, you kill a person inside yourself. And Kubrick perfectly showed how meaningless is that war in his movie called Full Metal Jacket. Section 4: Bibliography Sanders, Vivienne, 2007, â€Å"The USA and VIETNAM 1945-1975† Kubrick, Stanley, 1987,â€Å"Full Metal Jacket† Wikipedia: Vietnam War Wikipedia: Full Metal Jacket Wikipedia: Gustav Hasford Wikipedia: The Short-Timers Wikipedia: Full Metal Jacket bullet [1] The information for these paragraphs is taken from: Sanders, Vivienne, 2007, â€Å"The USA and VIETNAM 1945-1975† and Wikipedia’s article about the Vietnam War. [2] Wikipedia: Full Metal Jacket [3] Wikipedia: Gustav Hasford [4] †Full Metal Jacket†: 00:02:35-00:02:37 [5] †Full Metal Jacket†: 00:03:42-00:03:49 [6] †Full Metal Jacket†: 00:05:16-00:05:24 [7] †Full Metal Jacket†: 00:06:10-00:06:15 [8] †Full Metal Jacket†: 00:32:00-00:34:38 [9] †Full Metal Jacket†: 00:44:11-00:45:15 [10] †Full Metal Jacket†: 00:48:21-00:48:35 [11] †Full Metal Jacket†: 00:49:05-00:52:20 [12] †Full Metal Jacket†: 00:58:40-01:01:05 [13] †Full Metal Jacket†: 01:00:30-01:00:40 [14] †Full Metal Jacket†: 01:07:30-01:08:44 [15] †Full Metal Jacket†: 01:17:49-01:19:46 [16] †Full Metal Jacket†: 01:18:33-01:19:03 [17] †Full Metal Jacket†: 01:19:55-01:22:56 [18] †Full Metal Jacket†: 01:25:35-01:51:05 [19] †Full Metal Jacket†: 01:48:00-01:49:27 [20] †Full Metal Jacket†: 01:51:05-01:52:53 [21] †Full Metal Jacket†: 01:04:32-01:05:12 [22] Wikipedia: Full Metal Jacket Bullets

Meghans rough draft Essay -- Essays Papers

Meghan's rough draft For the past fifty years or so, Americans have had the great fortune of living safely in a relatively peaceful world. That perspective changed the moment a commercial airplane slammed into the World Trade Center on the morning of September 11th. Terrorists killed over 6,000 American citizens within a few hours. Suddenly, life as America knew it changed. Many stood in disbelief when they saw the joyous reactions of people cheering on the streets of Palestine. Our nation came to realize that we were truly hated, and that terrorist regimes rejoiced in our pain. The leader of one such a regime, Osama bin Laden, became America's clearly defined worst enemy. A war has begun between bin Laden and his terrorist followers, and all people who believe in freedom. Osama Bin Laden and the terrorists were unjustified in attacking America, and cannot rationally legitimize their actions. Evidence of this, as well as a better understanding of their reasoning, can be found through examination of Presi dent Bush's speech to the nation given on September 20th, and through examining additional information on Osama and his terrorist followers. It was the heavy influence of Islamic extremism at an early age, as well as his personal experiences fighting jihad, or holy war, that prompted Osama bin Laden to become a terrorist. During his speech, President Bush identified a terrorist regime named Al Qaeda as being responsible for the attacks, and said "a person named Osama bin Laden " (Bush, par. 16) was the leader of the group. Osama bin Laden was born in 1957 as one of fifty-some children sired by his father Mohammed Awad bin Laden. Due to his father's royal connections and construction business, his family had quite a bit of m... .... 2001. <http://www.msnbc.com/news/639057.asp> Zakaria, Fareed. "Islam and the West." Online posting. 12 Oct. 2001. Newsweek Live Talk. 15 Oct. 2001. <http://www.msnbc.com/m/nw/talk/talk.asp?lt=101201_islam> Miller, John. "Greetings, America. My Name Is Osama Bin Laden" Esquire. 1 Feb. 1999. Frontline. 2001. 15 Oct. 2001. <http://www.pbs.org/wgbh/pages/frontline/shows/binladen/who/miller.html> Doe, John. "A Biography of Osama bin Laden." Frontline. 15 Oct. 2001. <http://www.pbs.org/wgbh/pages/frontline/shows/binladen/who/bio.html> Doe, John. "Osama Bin Laden vs. the U.S.: Edicts and Statements." Frontline. 15 Oct. <2001. http://www.pbs.org/wgbh/pages/frontline/shows/binladen/who/edicts.html> Bush, George. "President Bush's Speech to the Nation September 20, 2001." 20 Sept. <2001. http://www.u.arizona.edu/~wendres/docs/bush_sept20.html>

Characters in Hamlet Essay

In Hamlet, Polonius interacts in very different ways with the various characters. While talking with Reynaldo, he speaks in a sneaky, sly and clever manner. When talking with his daughter Ophelia, he seems very concerned. When talking with Hamlet, he seems confused, not knowing what Hamlet is talking about. When talking with the Players, however, he acts imperiously, exerting his authority over them. When talking with Reynaldo, Polonius speaks in a clever and sneaky manner. He tells Reynaldo exactly how to speak to people while trying to find Laertes. He tells him exactly what to say so that the other person will be forced to tell him of the whereabouts of Laertes. He told him that he should say â€Å"you may say, not well. But, if ‘t be he I mean, he’s very wild.† Polonius’s sneakiness is seen through his clever tactic in sending Reynaldo to Paris for the purpose of discovering Laerte’s habits. When talking with his daughter Ophelia, however, he seems genuinely concerned. This is true because in regard to Laertes, Polonius was looking for an excuse to punish or disown him for leaving the country. However, by Ophelia, Polonius is really concerned. While speaking with Gertrude and Claudius, Polonius is very honest. He comes before the king and queen bringing good news. The good news is that he knows why Hamlet is so upset. The reason is because of Ophelia. After discovering Hamlet’s lust for his daughter, he told Ophelia to stop meeting Hamlet and to send back Hamlet’s love letters. Then, he asks the king and queen if there has ever been a time where he had not told the truth. Claudius responds â€Å"not that I know.† To prove his fidelity, he is prepared to have his head chopped off if he is wrong. When talking with Hamlet, Polonius is confused. Polonius does not understand what Hamlet is talking about. When confronting Hamlet, Hamlet is reading a book. When asked what kind of book he is reading, Hamlet responds â€Å"Slanders sir.† While speaking with the Players, Polonius is arrogantly domineering. The Players come to perform a play for hamlet in order to cheer him up. While  doing their play, Polonius rudely interrupts them. He makes comments such as â€Å"This is too long.† In addition, after the play, when Hamlet instructs Polonius to treat the Players well, Polonius responds arrogantly, â€Å"My lord, I will use them according to their desert.† In response to Polonius’s disrespectful statement, Hamlet says â€Å"God’s bodykin’s man, much better. Use every man after his desert, and who should ‘scape whipping? Use them after you honor and dignity.† In conclusion, Polonius’s character varies with every individual he interacts with. It varies to the extent that his character can change from extremely honest to sly and sneaky. Also, it can change from confused to arrogantly domineering. His unique character traits differ greatly to the extent that by the end of Act II, Polonius is viewed as a necessary and crucial character in the play.

Little Miss Sunshine Movie Essay

Little Miss Sunshine In the film, â€Å"Little Miss Sunshine† an extraordinary family explores many obstacles that troubles their way to their journey to Olive's (daughter) beauty pageant. Along the way the family learns to love, care and support each other. Little Miss Sunshine illustrated that love can be expressed through different forms. Firstly, the movie illustrated how the value of family is very important. The family uses everyone's strengths to support each other. During the movie, many challenges such as the unreliable VW bus and sneaking grandpa out of the hospital required the whole family to work together to accomplish a common goal.The Hoover family valued the family as a whole and would not leave anyone behind. An example is when they left Olive at the gas station and then came back to pick her up. Even though, Sheryl and Richard may have had some arguments,sometimes arguments can be used to strengthen a relationship. In Little Miss Sunshine, grandpa may seem fo ul-mouthed ,grouchy and rude but he still exhibits a caring side. When his son Richard is at the point of bankruptcy, grandpa goes to the front of the van to give Richard his support. Grandpa says a few words of encouragement and sincerely looks him in the eye.I believe that even though every family may encounter many problems, we grow stronger because of the bonds we make. I believe that the Hoover family valued their family by providing unconditional love and support, not leaving anyone behind and when Richard chose to trust Olive, when she said she'll win the pageant. Secondly, in Little Miss Sunshine the family provides many functions for one another. One of the functions they provide for one another is support. An example is, when Olive was about to perform her dance.When she was just about to go on stage both Dwain and Richard tried to stop Olive because they were afraid she was not good enough against the other girls. However, Sheryl( mother) argued that if Olive wanted to pe rform on stage,it was up to her and was ultimately her decision whether to perform or not. In the end, Olive decided to perform and made a fool out of herself, However her whole family came up on stage to support her. At that moment, the family did not care about anything else, except for Olive's happiness. Thirdly, in the movie the family provided love as another function for one another.An example is when Dwain realized that he might be colorblind when Olive tested his color vision. Dwain was mad, frustrated and out of control because his dream of becoming a fighter pilot was not possible now. In order to become a fighter pilot, Dwain needed good vision, including color vision. Dwain started kicking the van and soon the whole family gave Dwain some time to settle down. After a few minutes, Olive came over to offer her support (hugs) Dwain. He soon calms down and apologized for his actions and rude comments about the family. The family then resumed their journey to Olive's pageant. This scene demonstrated love because everyone in the family cared about Dwain's dream of becoming a fighter pilot, they knew exactly how he felt and how it must have hurt knowing that his dream was crushed, just like that. In the movie, a simple hug from Olive showed how love never fails. Lastly, I believe that a family doesn't need to be normal to function. It takes love , affection and support in order for a family to function. In the movie, love was present but expressed differently. An example would be when grandpa passed away, Sheryl told the family that no matter what happens she will still love each and everyone in the family.The father on the other hand, who is obsessed with the â€Å"9 steps to winning† program still loves Olive for who she is, even though in the end she didn't win the pageant. Support strengthens the family bond, love never fails and affection provides a lovable environment. Little Miss Sunshine illustrated how there are different families in societ y, but it doesn't necessarily take a normal family to function properly. Throughout this journey, the Hoover family learned to trust each other, to persevere through the difficult times and to always hope for the best.

Genealogy Research in Great Britain

Genealogy Research in Great Britain Once youve explored as much of your family tree as you can online, its time to head to Britain and the land of your ancestors. Nothing can compare to visiting the places where your ancestors once lived, and on-site research offers access to a variety of records that arent available elsewhere.   England Wales: If your family tree leads you to England or Wales, then London is a good place to start your research. This is where youll find most of Englands major repositories. Most people begin with the Family Records Centre, jointly operated by the General Register Office and the National Archives, as it holds the original indexes to the births, marriages and deaths registered in England and Wales from 1837. There are also other collections available for research, such as death duty registers, census returns and the Prerogative Court of Canterbury wills. If your short on research time, however, most of these records can also be searched online (most for a fee) in advance of your trip. Located within walking distance of the Family Records Centre, the library of the Society of Genealogists in London is another excellent place to start your search for British ancestry. Here youll find many published family histories and the largest collection of transcribed parish registers in England. The library also has census records for all of the British Isles, city directories, poll lists, wills, and an advice desk where you can get expert suggestions on how and where to continue your research. The National Archives in Kew, outside of London, has many records that are not available elsewhere, including nonconformist church records, probates, letters of administration, military records, taxation records, association oath rolls, maps, parliamentary papers, and court records. This is generally not the best place to start your research, but is a must-visit for anyone looking to follow up clues found in more basic records such as census enumerations and parish registers. The National Archives, which covers England, Wales and the central UK government, is especially important for anyone researching members of the armed forces. Before you visit, be sure to check out their online catalog and comprehensive research guides. Other important research repositories in London include the Guildhall Library, home to the parish records of the City of London and records of city guilds; the British Library, most notable for its manuscripts and Oriental and India Office collections; and the London Metropolitan Archives, which houses records of metropolitan London. For further Welsh research, the National Library of Wales in Aberystwyth is the main center for family history research in Wales. There you will find copies of parish registers and family collections of deeds, pedigrees and other genealogical material, as well as all wills proved in the Welsh diocesan courts. The twelve County Record Offices of Wales hold copies of the indexes for their respective areas, and most also hold microfilm copies of records such as census returns. Most also hold their local parish registers dating back to 1538 (including some that arent also kept at the National Library of Wales).   Scotland: In Scotland, most of the main national archives and genealogical repositories are housed in Edinburgh. This is where youll find the General Register Office of Scotland, which holds civil birth, marriage and death records from 1 January 1855, plus census returns and parish registers. Next door, the National Archives of Scotland preserves a host of genealogical material, including wills and testaments from the 16th century to the present day. Just down the road lies the National Library of Scotland where you can search trade and street directories, professional directories, family and local histories and an extensive map collection. The Library and Family History Centre of the Scottish Genealogy Society is also located in Edinburgh, and houses a unique collection of family histories, pedigrees and manuscripts.   Go Local Once youve explored the national and specialist repositories, the next stop is generally the county or municipal archive. This is also a good place to start if your time is limited and you are definite about the area where your ancestors lived. Most county archives include microfilm copies of national records, such as certificate indexes and census records, as well as important county collections, such as local wills, land records, family papers and parish registers. ARCHON, hosted by the National Archives, includes contact details for archives and other record repositories within the UK. Check the regional directory to find county archives, university archives and other unique resources in your area of interest.   Explore Your History Be sure to leave time on your journey to visit the places where your ancestors once lived, and explore the history of your family. Use census and civil registration records to identify the addresses where your ancestors resided, take a trip to their parish church or the cemetery where they are buried, enjoy dinner in a Scottish castle, or visit a specialty archive or museum to learn more about how your ancestors lived. Look for interesting stops such as the National Coal Museum in Wales; the West Highland Museum in Fort William, Scotland; or the National Army Museum in Chelsea, England. For those with Scottish roots, Ancestral Scotland offers a number of clan-themed iteneraries to help you walk in your ancestors footsteps.

How to keep Your New Year’s resolutions

How to keep Your New Year’s resolutions This is the time of year where everyone’s optimistic about how much better they’re going to do once the calendar flips over to January 1. We’re all going to be healthier, more motivated, more focused, and more zen, right? Sure. For a little while. Then reality hits, and those resolutions start looking more like quaint relics of last month. But we could all stand to be healthier, more productive, nicer, etc., so how do you make those stick well into February and beyond? Let’s look at some tips you can use to help make better, more achievable, and more successful personal and professional goals for the coming year.Build in some accountability.Some of us are better than others at self-motivation and keeping ourselves on track. For others of us, well, the excuses mount. I’m so busy. I’ll deal with this later. I can’t do this because X, Y, and Z. The main problem here is that you’re the one monitoring yourself, and you’re the one both making and accepting the decision to slack off on the resolutions. If that sounds painfully familiar (and if it does, I hear you), that’s why you need someone else to help keep you accountable to yourself.In my own life, I find I’m much more successful at staying on track when I know I’m going to have to talk about it with someone else. For example, it helps me hunker down and read my book club’s current book when I know I still have 50 pages to go, but there’s an official date and time set to talk about it with my friends.So basically, find a resolution buddy- or several buddies, for different things. That can be as simple as finding someone to go with you to the gym, making it more of an appointment than a chore. Or it can mean having regular check-ins or coffee dates where you talk about your progress on a particular goal. At work, it can be a colleague who’s also interested in taking on more projects or arriving on time every da y. Having someone else who knows what you’re up to can motivate you to make time for your task (whatever it may be), and give you a sense of purpose.Start small- and specific.If you want to make a lasting change, you’re setting yourself up to fail if you set a task so overwhelming or complicated that you’ll get frustrated right away. A frustrating resolution is often a failed resolution, so what’s the point of using â€Å"go big or go home† as your guiding principle here? For example, weight loss is a pretty common resolution for the new year. It’s also very vague. Sure, you want to lose weight. How much, and over how much time? Setting smaller, specific goals will help you chip away at the larger one.If you want to lose weight, say you’ll lose five pounds by February. Then another five pounds by March. Setting these smaller, month-by-month goals gives you milestones that you can hit, and feel proud about reaching. Feeling successful will make you more likely to stick with your new weight loss regime. On the other hand, if you say â€Å"I will lose 50 pounds next year† without really breaking down how that will happen, you’re more likely to feel overwhelmed about the massive change you need to make, and let the whole thing lapse.At work, think along the same lines. Say you want to be more organized at work. What specific steps can you take to get there? Maybe the first step is downloading a productivity app that can help you manage your schedule and projects, and the step after that is tackling your email inbox and organizing it into folders. These are specific, manageable tasks that contribute to the larger goal, but are easy to accomplish in, say, an afternoon instead of languishing on a mental â€Å"when I have time† list.Use the whole year.Part of the reason resolutions are such a popular idea is that we have this sense that once the year changes, everything should be different and bette r, instantly. The reality is that this new you should be an all-year thing, not an â€Å"everything right now† thing. Set mini-goals throughout the year, or think about the milestones you want to hit before next December.For example, if your goal is to save more money, put specific dollar amounts to that goal throughout the year, so you’re not scrambling (or giving up on the notion) all at once to meet the goal late in the year. You can set up automatic deposits on a regular basis. Moving, say, $25 from your paycheck to savings every pay period is going to be a lot less painful than trying to move over thousands of dollars all at once from checking to savings. Use the calendar to figure out how often you’ll need to do something to make your goal for the year.Be flexible.Things change in life. And sometimes they change quickly. So flexibility is a key quality of any resolution. When you’re thinking about your resolutions for the next year, think about pote ntial â€Å"plan B† goals as well. If you can’t get to the gym four mornings a week like you want to do, what other times could potentially work as well?Feel free to revisit any resolutions throughout the year, too. Maybe you were too optimistic about the number of online classes you would have time to take to build skills. Maybe you had some unexpected costs that put a dent in how much money you can sock away toward your savings goals. If something’s not working, for whatever reason, modify it in a way that does work for you.Expect to fail sometimes.If you were already perfect at something, it likely wouldn’t be on your resolutions list in the first place, right? Embrace the imperfections of this process. This is about being a better self, not necessarily the perfect self. (Let’s face it: a perfect self would be pretty boring, no?) And that means treating this like a journey, and learning from any failures or mistakes you make along that journey.I f you’ve set a goal for yourself of getting promoted or finding a new job within three months and that doesn’t happen, it doesn’t mean you’ve totally failed at your goal and should walk away. It just means you should ask yourself what worked and what didn’t, and try again.Reward yourself.Fun fact: bribes work wonderfully well when it comes to motivation, whether you’re a kid or a seasoned adult. So build in your own personal rewards program for achieving your milestone goals, or completing a full year of resolution-ing. And be creative- if your resolution is to lose weight and your standard self-reward is, say, ice cream, then your reward is undercutting your progress. But you could sub in a fun activity that you don’t get to do often, or buying yourself something you’ve had your eye on for a while. #treatyoselfThe reward doesn’t have to be anything extravagant or even all that personal. It could be as simple as allowing yourself a take-out lunch for every two weeks’ worth of lunches you pack and bring to work, or a 10-minute break for every two hours you go without checking your social media during the workday. Deprivation without any kind of reward can get unappealing fast, so if you can give yourself something to look forward to in exchange, you’re more likely to keep going with your progress.Take responsibility for your goals.Remember, this whole thing is about you and what you think will make you a happier, wealthier, wiser, more productive, or more successful person. You already know what needs to be done (hence the resolutions)- but you also know yourself better than anyone else does, so you know what your pitfalls, distractions, and weaknesses are likely to be. Even if you find an accountability buddy or tell the world about your grand plan to apply to grad school, it’s entirely on you to make these goals happen. The more control you accept and the more confidence you h ave in your ability to take concrete steps toward those goals, the easier it will be to make choices that support your resolutions.By setting realistic, achievable goals for yourself, and doing some planning ahead to keep yourself engaged in your self-improvement plan, you’re already stepping up your resolution game. It’s easy to say, â€Å"I should do X.† It’s much harder to say, â€Å"Here are the 10 things I need to do to achieve X, and here’s the timeline I want to follow.† But that commitment is worth it, because the more work you put in up front, the more work you’re going to want to do over the next year to make sure you’re getting something out of this process. We don’t get to be entirely new people at 12:01 on January 1, but with a little effort, we can feel more accomplished when the next round of New Year’s resolution-making hits. Good luck!

Advantages of Volunteering at American Institute for Medical and Biolo Essay

Advantages of Volunteering at American Institute for Medical and Biological Engineering The paper "Advantages of Volunteering at the American Institute for Medical and Biological Engineering" is a good example of an essay on social science. AIMBE has over 50,000 members who are in the medical and biological engineering. Volunteering at the organization will provide a platform to interact with other people in the same field. These interactions with different people at different stages of the biomedical engineering field will help grow my career by exposing me to different opportunities. I will also benefit from inspirations that come about from interacting with high achievers. Also, interacting with professionals and getting advice from them will also help in building my career and turn it into a great professionalism. Forging close friendships will also come in handy when looking for recommendations and introductions when it comes to work and career building. I will also get mentors who are experienced in the field to guide me and help me expound on my area of expertise . AIMBE sponsors a wide array of institutions including academic institutions, private industries, and other professional engineering societies (Johnson 2). By volunteering for the organization, I will get exposure to these organizations, Career-wise, this will help my development by opening a number of areas that I can major in and end up working there. The exposure will also provide an atmosphere of what is expected in professional development. Knowing what is expected from you and observing other professionals at work afford an advantage over many people in the job sector. The organization is also actively involved in researching new areas where the engineers can indulge. This expands to the fields where I can specialize in helping people and generally making the world a healthier place (Johnson 1).

Global communications Essay Example | Topics and Well Written Essays - 2500 words

Global communications - Essay Example ntinued to evolve as the marketers come to the realisation of how to communicate efficiently through modern-day advertising methods across a range of multifaceted and progressively competitive international marketplaces. This variety of marketing involves instituting a website, and then choosing interactive types of advertising; with the strategic intent being to cater to the domestic markets clients (Fill, 2005). In defining the functions of global marketing, the inferences for worldwide interactive advertising are usually centred on an ethnocentric market. This approach could be viewed as standardised. In the hybrid strategic method of international marketing, also referred to as "glocalisation†, the strategic aim is to utilise a centralised and planned "footprint" to create an international brand identity, while permitting flexibility that is country-specific in the communication and tactical mix decisions. When deciding what the strategic propositions are as far as international interactive advertising is concerned, the aspects of global marketing no longer make use of an ethnocentric perspective. Global marketing recognises and exercises strategic intent as a way to organise the blend of centralised brand or business directives with the more localised variations in management decision making, and interactive advertising placement. Therefore, global communications definitely suggest that the existence of international online clients is a strategically anticipated result of a hybrid strategic technique (Yeshin and Gilligan, 2000). Language constraints:   In most cases, advertisements have to be interpreted. This has to be according to local version of the generic language. In some circumstances, advertisements created in foreign languages are run intentionally in order to add an air of mystery to a commodity or good. Cultural Hindrances: Subtle cultural disparities may stop an advertisement from being viewed as acceptable in one nation, or be accepted in a

Black Studies The Urban Dilemma Essay Example | Topics and Well Written Essays - 500 words

Black Studies The Urban Dilemma - Essay Example With this rationale, they think that they have the right to impinge on the 'space' of other people. In his book entitled Black Corona: Race and the Politics of Place in an Urban Community, Steven Gregory (1998) enlightens the reader on the issue of contested space by using the experiences of the African American community in a New York setting collectively called Black Corona. In Gregory's work, we are made aware of a consultation conducted by an all-white Neighbourhood Stabilization to address the issues of latchkey kids, drug dealing and the lack of parental guidance. Although this consultation was designed to improve the security and safety of the whole community, the discussion and decision was left mostly to the white participants as the black participants were effectively prevented from participating. The blacks shied away from the discussion because they were implied to be the root of the problem. It was their kids who were menacing the library. It was their coming when the drug problem emerged. It was them who were mostly single parents. They were the problem and the white s had the right to correct them. The larger picture of what occurred in the consultation was that t

History in Distributed Databases Essay Example | Topics and Well Written Essays - 2500 words

History in Distributed Databases - Essay Example In this scenario, a distributed database design allows the organizations to divide a database over different hardware devices, but with a central management control. The basic purpose of implementing distributed databases is to offer higher reliability and superior performance. Without a doubt, the division of a database into multiple locations can provide a number of advantages to organizations (Holmes; Hoffer, Prescott and McFadden). Additionally, this way of data storage offers superior control over particular data. In this scenario, the load of the database management is divided among several hardware devices and burden of processing is shifted from a single location to multiple locations. Normally, a distributed database is developed on the basis of business departments, or geographical areas or companies. In view of the fact that the database appears at local location to each business department inside an organization hence it offers quicker response times for the database user s. In addition, these departments are also smaller as compared to the size of the overall organization, as a result the processing load over the server also reduces. The research has shown that the majority of organizations prefers to develop distinct business sectors for particular tasks. For instance, organizations can develop different organizational units for human resources, accounting, and sales departments. Moreover, they develop a distributed database to assist in running the operations of particular business units all the way through the company, at the same time as establishing and maintaining authority from a central server. This technique is also useful in separating the data and hardware all the way through the organization, as a result the performance and control over the database also improves (Holmes; Hoffer, Prescott and McFadden). Though, the distributed databases require the development of database using all the traditional techniques of database development excep t they are based on a different perspective. They are being developed to get the advantages of central access by company head office, at the same time as supporting local access for particular company sectors. In this scenario, this database design technique is very useful for organizations that are distributed all over the world. Additionally, these databases are also used by the companies that support multiple portfolios. For instance, a number of industries such as hospitality, manufacturing and banking can take benefits from the implementation of distributed databases. In addition, a distributed database can also be useful in supporting an organization in their accounting unit. Moreover, an international organization that has several offices in various countries of the world can normally develop a distributed database to support its business operations in each country. In this scenario, this division of geographical areas would allow the local country to get access to data and p erform operations faster. Also, the organization would be able to use the central database to get access to data available in each country without having an impact on local application. Without a doubt, distributed databases offer superior reliability and flexibility for the organizations. In view of the fact that the data is located on different servers, hence it can straightforwardly be copied onto new hardware devices and database structures all the way thro

Journal 16 Assignment Example | Topics and Well Written Essays - 500 words - 1

Journal 16 - Assignment Example He managed to make plenty of money from handling cases of poor immigrants in New York City. He attracts clients through promises and extorts theme to bits. He believes that earning money brings more pleasure. He adds that making more makes his family happier. He observes that money produces happiness and does not take the time to address his family. Tito regrets his past behavior and treatment to his family. He wishes that he had created more time to measure up to his mistakes. On the contrary, it becomes too late to accomplish all that he wanted to share. He cannot show a decent goodbye to the family. Even though, Tito had plenty of complaints against his wife, he believed that the wife had a critical role within his life in Cuba. She was the main reason that pushed him to make more money as a way of satisfying her. He was aware that this had to be the only way of holding together the relationship. Previously, Tito lived a life of misery and difficulty. His wife came into his life while his business was successful and ran advertisements on mass media. Currently, Tito considers his wife a greedy woman who constantly asks the husband to award her money to expense. The fact that she shares no feeling for her husband, she refuses to divorce him for his riches. He has difficulties relating with Ines and Jaime. Tito’s life is limited within the confines of making profit from everyone. This has strained his relationships with his wife and children. He considers making more money through doctoring birth certificates, forging employment records, thwarting deportation, securing sponsors, generating legitimate green cards and applying for political asylums. These contrasts depict how people perceive of money as a happiness equivalent. The thought of more money amounts to equal amounts of happiness is misguided. Tito’s story shows that money does not have a direct comparison with the amount of happiness derived. Politics displays the characters’ in two

A Customer who Has Language Barrier that Someone Has Trouble Understan Essay

A Customer who Has Language Barrier that Someone Has Trouble Understanding English - Essay Example This would forge loyal following among its customers who are foreign speakers many of which are big spenders. Customer service can also be easily facilitated if reps can understand the language of the customer. For the customers, this would be a wonderful experience for them to be truly understood by the store where they make their purchases. This would surely develop a strong following among the foreign segment of the market. 3. Include cultural sensitivity training to front liners. There is a significant portion of Macy’s customers who are of foreign origin like me. This would tremendously improve their customer interaction and ultimately customer satisfaction leading to repeat and loyal customers. This would also separate Macy’s from the competition is a more customer-oriented retail store. Macy would also have the benefit of widening its customer base to include foreigners and international students like me. Describe insights you gained by carrying out this ‘shopping trip’ under the consumer role you adopted. What occurred to you that you’ve never thought about before? How do these insights affect the way you think about consumer behaviors and serving consumer markets? Besides the shopper with the specific situation you were assigned, who else might benefit from changes to a store that would better accommodate that kind of shopper? This trip made me realized that customer service is, in fact, a science that retail stores spend time, money and effort to become good at. Reflecting on it, I understand why because if the product and price are the same or even slightly higher, I would tend to buy at the store where I was taken good cared of or had the better customer experience. The store would also benefit from this experience as customers become more conscious of their shopping experience and are likely to provide feedback which could help them improve their products and service.

David Cole Interviews Dr. Franciscek Piper Term Paper

David Cole Interviews Dr. Franciscek Piper - Term Paper Example According to Cole’s interview with Alicia, the tour guide, the gas chamber was in its original state. However, Dr. Piper contradicts this claim by stating that there were reconstructions made in the original gas chamber, which was later converted to air raid shelters. Another confusing information presented by Cole was about the use of Zyklon B. According to Dr. Piper, the traces of Zyklon B differed from those in the gas chamber and the disinfection chamber due to the difference in the number of hours both chambers were being used. At the end of the interview, Cole still did not come up with a conclusive view of the reality of the gas chamber in Auschwitz. The interview just leaves his audience with more questions. One was not enlightened on what is real and what is not. The history that we know is also based mostly on eyewitness accounts without much written documentation. One thinks that Cole failed in giving the documentation needed to debunk the Holocaust. A visit at the Auschwitz camp and interview with is Director was simply not enough to persuade the audience about Cole’s belief that everything was a

A Customer who Has Language Barrier that Someone Has Trouble Understan Essay

A Customer who Has Language Barrier that Someone Has Trouble Understanding English - Essay Example This would forge loyal following among its customers who are foreign speakers many of which are big spenders. Customer service can also be easily facilitated if reps can understand the language of the customer. For the customers, this would be a wonderful experience for them to be truly understood by the store where they make their purchases. This would surely develop a strong following among the foreign segment of the market. 3. Include cultural sensitivity training to front liners. There is a significant portion of Macy’s customers who are of foreign origin like me. This would tremendously improve their customer interaction and ultimately customer satisfaction leading to repeat and loyal customers. This would also separate Macy’s from the competition is a more customer-oriented retail store. Macy would also have the benefit of widening its customer base to include foreigners and international students like me. Describe insights you gained by carrying out this ‘shopping trip’ under the consumer role you adopted. What occurred to you that you’ve never thought about before? How do these insights affect the way you think about consumer behaviors and serving consumer markets? Besides the shopper with the specific situation you were assigned, who else might benefit from changes to a store that would better accommodate that kind of shopper? This trip made me realized that customer service is, in fact, a science that retail stores spend time, money and effort to become good at. Reflecting on it, I understand why because if the product and price are the same or even slightly higher, I would tend to buy at the store where I was taken good cared of or had the better customer experience. The store would also benefit from this experience as customers become more conscious of their shopping experience and are likely to provide feedback which could help them improve their products and service.

Home video game industry Essay Example for Free

Home video game industry Essay In 1972 founders Nolan Bushnell and Ted Dabney scrounged $50,000 from family, friends and local banks, formed their own company. They hired Alan Alcorn who created Pong and put a sample unit in Andy Capps Tavern in suburban Sunnyvale to see if anyone would play it. Twenty-four hours later, the owner called Bushnell in a rage and demanded that he get over to the bar with his tool kit as soon as possiblethe prototype game had broken down because it was being flooded with money. Pong was more than a game of Ping-Pong on a video screen. This was the beginning of Atari, while Atari made millions off the game consoles, they sold the software to many other major companies, and in turn they came out with their own version of pong. Although Atari saw profits from software royalties they kicked themselves out of the video game markets as other companies were using the pong model to penetrate the market. At the time of the U. S. crash, there were numerous consoles on the market, including the Atari 2600, Atari 5200, Bally Astrocade, ColecoVision, Emerson Arcadia 2001 Magnavox Odyssey 2,and the Vectrex. Home computers had more memory and faster processors than a console, they permitted more sophisticated games. They could also be used for tasks such as word processing and home accounting. Games were easier to duplicate, since they could be packaged as floppy disks or cassette tapes instead of ROM modules. This opened the field to third-party software developers. In 1986, Nintendo president Hiroshi Yamauchi noted that Atari collapsed because they gave too much freedom to third-party developers and the market was swamped with rubbish games. In response, Nintendo limited the number of titles that third-party developers could release for their system each year, and promoted its Seal of Quality, which it allowed to be used on games and peripherals by publishers that met Nintendos quality standards]. The North American video game crash had two long-lasting results. The first result was that dominance in the home console market shifted from the United States to Japan. When the video game market recovered in the late 1980s, Nintendos NES was by far the dominant console, leaving only a fraction of the market to a resurgent Atari battling Segas Master System for the number-two spot soon after. By 1989, home video game sales in the United States had reached $5 billion, surpassing the 1982 peak of $3 billion during the previous generation. A large majority of the market was controlled by Nintendo, whose NES ultimately sold more than 35 million units in the United States, exceeding the sales of other consoles and personal computers by a considerable margin With the introduction of the Sega Genesis in America, Sega of America launched an anti-Nintendo campaign to carry the momentum to the new generation of games, with its slogan Genesis does what Nintendont. This was initially implemented by Sega of America President Michael Katz. When Nintendo launched its Super Nintendo Entertainment System in 1991, Sega changed its slogan to Welcome to the next level. Sega re-branded itself with a new game and mascot, Sonic the Hedgehog. This shift led to a wider success for the Genesis and would eventually propel Sega to 65% of the market in North America for a brief time. On May 11, 1995, Sega released the Sega Saturn in the American market. Segas first CD console that was not an add on, utilized two 32-bit processors and preceded both the Sony PlayStation and the Nintendo 64 The lack of a strong Sonic and its high price in comparison to the PlayStation were among the reasons for the failure of the console. The 3DO Company lacked the resources to manufacture consoles themselves, and instead licensed the hardware to other companies for manufacturing. Trip Hawkins recounted that they approached every electronics manufacturer, but that their chief targets were Sony and Panasonic, the two largest consumer electronics companies in the world. Founder trip Hawkins thought by selling his software to the main markets he could penetrate the market with a high price brining in a high profit margin. The launch price of the Play Station in the American market was US$299, undercutting their competitors, but knew that they would sell more consoles and make profit in the long-term. Xbox entered the console market because of a direct threat from Sony. They thought that consoles would take over web-browsing and directly hurt their main network in home computer systems. With annual revenues of close to 20 billion dollars Microsoft decided to invest 4 billion to develop the Xbox. With already a huge brand name and high product value in the computer market, Xbox was a massive success in the gaming network knowing they had the capability to keep up with the technical aspects of the other competitors. While Nintendo’s Game Cube was a bust, Nintendo knew they needed to use knew software in order to compete with the dominating Xbox and Play Stations new motion sensitive technology was cheap to integrate in software and Nintendo took advantage of that market. The Nintendo Wii launched in 2007, used old game that branded the Nintendo name including The Mario Brothers, which appealed to both old and new generations. Technology is driving the new markets, but Nintendo, Sony and Microsoft control the gaming market of today because of their ability to create affordable gaming while still being innovating.

Analyse Contribution Of Engagement In Biopsychosocial Assessment Client Nursing Essay

Analyse Contribution Of Engagement In Biopsychosocial Assessment Client Nursing Essay In this essay the process of building a therapeutic relationship and assessing clients own circumstances within the inpatient admission and the framework found in practice will be uses analysed and criticized by using Johns (1994) model of reflection. The framework that has been used in mental health services is the Care Program Approach (CPA), which it has been profoundly criticised since it was introduced. Therefore the reflection will look into other model of nursing, Tidal Model, which offers a different philosophy of care. The reflection will also explore the interpersonal interactions theories which the nursed used during the assessment and how these aided to engage the client in the biopsychosocial assessing process. It also will be discussed other intervention models and the possible usage in similar situations. In order to begin the analysis of the above points, engagement needs to be defined. Thurgood (cited by Norman and Ryrie (2004) p.650) described it as: can be broadly defined as providing a service that is experienced by service users (including carers) as acceptable, accessible, positive and empowering. Although this definition gives an idea of the concept, it lacks to define the key elements of engagement, which Cutcliffe and Barker (2002) identified as forming a human to human relationship, expressing tolerance and acceptance, and hearing and understanding. Both definitions gather the professional values of the service and the interaction itself. Yet, Cutcliffe and Barker (2002) definition can be considered more practical when holistically assessing clients. However, these definitions do not acknowledge factors of engagement that are behind the interpersonal relationship, such as personal or organizational perspectives of engagement. The personal perspective for the nurses practice is underpinned by poor structural organization, occupational cultures and stress, bureaucratic constrains, lack of time and nursing culture driven by measurable targets (Hosany et al (2007) and Addis and Gamble (2004)). On the other hand, clients and their families are conditioned by the mental illness, their past experiences with other services, the trust in the service and the relevance of it. Additionally, the organizational issues effect upon engagement and care by reducing services budgets, by not providing resources and also by politics. Engagement has been recognized as an important part of mental health services users care. The National Service Framework (NSF), the National Institute for Clinical Excellence (NICE) and the Department of Health (DoH) appoint that users under CPA should be provided with resources to build a therapeutic relationship, optimise engagement and reduce risks. These documents also highlight the need to provide a therapeutic environment in order to provide best care and to engage the clients and their families with the service. Taking into account all the above information a reflective account will be taking place in the following pages by using Johns model of reflection (1994). 1. Description of the experience The clinical environment where this assessment took place was in an acute adult ward. The ward is based in an old mental health hospital, which has old and pilling off wooden windows, untidy roofs and old fashioned flooring. The ward had untidy carpets, the curtains did not draw appropriately and the painting on the walls was peeling off. These are the organisational barriers affecting engagement. This particular client was known by the service already, to protect his right to confidentiality he will be referred as John (NMC code of practice 2008). John had been stable for 10 years, but in the past few months his mental state had worsened. His psychosis and levels of anxiety increased; he distrusted neighbours and other acquaintances as well as strangers. Consequently, he stopped going out of his house and began to self medicate with over the counter sedatives. Crisis and Resolution Home Treatment Team (CRHTT) was involved and as they felt that John was not able to cope at home, they decided that an inpatient admission would be beneficial. Before the admission the CRHTT forwarded the CPA form 1A, which updated the ward staff about the latest assessment of the clients biopsychosocial needs. Once John arrived to the ward, he fully understood the situation where he was in. He was able to consent and had capacity to agree with treatment and, thus, he was admitted as an informal client. This facilitated the initial interaction and the initial grounding for the nurse/client relationship. Before the beginning of the assessment Tom (Johns named nurse) introduced everyone to John, roles were explained, a welcome pack with the ward information and a CPA booklet were given and Tom provided all the information in an oral and written manner. The nurse started the assessment by formulating open questions. However John gave single direct answers (yes, not, not sure ). Consequently, the nurse decided to change to more direct questioning. After that the client was very co-operative and was answering all the questions. He reported to be very anxious, which also was noticeable by looking to his body language (he was sweaty, clenching his fingers, rubbing his hands on the chairs arms and removing his spectacles several times during the interview). At this stage the nurse decided to undertake an anxiety assessment by using the scales tools available on the ward the Becks Anxiety Inventory (BAI, see Appendix 1). Following this assessment, John began to answer the questions more in depth and he appeared more eased, stating several times that he was in hospital for help and was going to do everything that was available for his recovery. Following the local trust policies and NICE guidelines, the CPA 1A assessment was concluded (as it must to be completed within 72 hours of the admission); the Integrated Care Pathway for Inpatient Safety and the Patient Property Liability Disclaimer were filled in and signed by nurse and client. 2. Reflection The whole assessment was intended to gather as much information as possible about John in order to understand the clients actual biopsychosocial situation (holistic assessment) and the context that led to the admission, which would highlight the needs and strengths of the client. However, inpatient admissions are more likely to focus on a more medical approach to health, mainly because social interventions cannot be implemented until the clients mental state has stabilized and he is ready to move on to community settings. Along this process the multi-disciplinary team organizes care to build up the grounds to enable recovery (Simpson 2009). This particular ward was focus on treatment and stabilizing, working on one to one interventions (nurse-client), building a therapeutic relationship through structured and unstructured interventions, and used CPA as a nursing intervention framework. Alongside these individual interactions, the activity nurses and the occupational therapist offered daily social and leisure activities. These groups provided skills and entertainment to the clients on the ward, but did not follow a particular model of nursing, such as the Tidal Model, and they offered activities to spare the free time on the ward without promoting recovery. The Tidal Model provides structured group-work centred on recovery (Barker and Buchanan-Barker 2005). This model centres its assessment on a holistic approach for the short and long term needs, viewing the mental illness as a unique experience of each individual, their families and social environment. It looks into the lowest point of the illness (such as an inpatient admission like Johns) as the point where the recovery begins with a positive approach to the illness. There are three working groups recommended in this model: discovery, solutions and information (see appendix 3), where therapeutic relationship is built and issues common to the individual and others are discussed and explored. As mentioned above, the ward nurses had more structured interventions with clients, and the issues discussed in these interviews were correlated to the Tidals Model theme groups. In these interviews the clients engage with their primary nurses and they discuss their concerns in relation to their care or other personal matters. These interventions or interviews were intended to happen at least twice weekly for at least an hour. However, for organizational issues (usually low number of staffing) not all the clients had the opportunity to benefit from these one to one interventions on a regular basis. Initially, the Tidal Model research was criticised for being bias, for lacking to fully describe clients pre and post intervention with the model, not taking into account Hawthorne effect and most of physiological factors and by not reasoning the need for a new model in mental health care (Noak 2001). However, further research and analysis showed that the Tidal Model provides tools and structure to improve care in acute ward admissions filling the gaps in care pointed in the NSF and The Sainsbury Centre for Mental Health (Gordon et al 2005). One could say that this model has been shown to improve mental health services, fulfil the historical gaps within nursing practice and to be grounded on evidence-based practice. However, the author of this essay believes, after reading the relevant literature, that for the implementation of the Tidal Model the levels of staffing (and therefore the service budget) should be increased and nursing practice cultures must be changed by re-educating th e workforce. Arguably both implementations are very difficult to achieve as the health service has seen budgets cut downs in the recent years and nurses practiced has been subject to negative ward cultures towards nursing models. On the other hand CPA, which is the framework used on the ward, was first designed after a series of fatal incidents which involved mentally ill people. It was aimed to be introduced in Wales by 2004 (in England was done by 1991). CPA is person centred focus which promotes social inclusion and recovery, through assessment and planning of individualized needs and strengths, working with the clients and their families or carers (Care Programme Approach Association (CPAA) 2008). Despite the initial intention that the CPA was brought to improve service users quality of care, to increase inter agencies communication and to be a case management tool, some critiques appeared. Simpson et al (2003a) researched showed CPA was thought to be an over-bureaucratic duty within the professionals. The author of this paper has observed in practice, not in this particular assessment, that some professional do not reassess clients when they are admitted. Instead the latest CPA 1A form (usually filled in by the CRHTT) is photocopied or copied-pasted and re-used to speed up the process. This would be acceptable if the client was assessed the day or night before the admission, because the social, psychological or biological needs would have not changed in that period of time. When older assessments are used, changes in circumstances might have not been updated. In the worst case scenario a health professional could have misunderstood the clients needs and have documented them wrongly. This misunderstanding could be carried over, therefore care would be affected. This hypothetical scenario shows that CPA assessments should be done every time when needed. CPA as a case management tool fails to compile the most important features which promote therapeutic relationship. In contrast with other case managements models the role of the care co-ordinator is more of an administrative and as an alternative service prescriber (Simpson et al 2003a). This means that there is no need for a specific training or skills related to therapeutic relationship, partly because other services (or service providers) will engage with the client, and the care co-ordinator just oversees the process of care. Moreover, CPA also lacks a nursing model background and fails to define specific roles within the multi-disciplinary team. These factors reduce the teamness feeling between the health professional (Simpson et al 2003b). Although, it could be argued that the reason, why CPA is lacking nursing background, is that it was not designed as a mental health nursing framework but for the use of mental health services. In this particular reflexion the care co-ordinato r was not present in the admission and never mention during the assessment. Whether it was a usual situation or not it is something that never was discussed, but it shows Simpson et al (2003a and 2003b) critiques of CPA as a case management were factual. CPA and Tidal Model are intended to provide holistic care for clients and their families. However, the Tidal Model is more clients centred than CPA, and it also looks into the more positive side of the clients situation, foreseen the now and future as a whole. It explains the illness as an accumulation of life factors. The Tidal Model complements other health and social care professionals, as well as it searches to nurse by building a special relationship between health practitioner and client. Moreover, CPA always looks for risk signs in the short-term and from a psychiatric approach. As this assessment took place in an inpatient admission it is important to bear in mind that in this particular environment CPA forms (1A, 2, 2A and 4) were used for assessment, planning, implementing and evaluation of inpatient care and for the liaison with other health professional in tertiary care (such as physiotherapist, dietician or occupational therapist). Perhaps CPA would benefit from sharing some principles of a nursing model (like the Tidal Model), by using it as a tool more than as a paperwork and from a better staff training and promoting adherence to nursing models (Barker 2001). Whether the ward uses Tidal Model or CPA to structure care, an inpatient admission is always stressful and uncomfortable experience for clients and their families. John saw the nurse as a stranger in an unfamiliar place, however, Tom was there to guide the client throughout his care, to provide information and to be somebody he could relay on. This first encounter related to the orientation phase described by Peplau (1952) (cited by Sheldon (2005), see Appendix 2). In this phase Johns past experiences, expectancies, culture and believes were to condition the initial interaction. Following this phase John went into the identification stage, where he sought assistance for anxiety relief techniques, shared needs and strengths when and co-designed care plans and began to have feelings of belonging and capability, therefore decreasing negative feelings. This exchange of feelings is going to lead to exploitation and resolution phases, where John will engaged with treatment (medical, physic al and social), having different needs at different times, starting to be informed about all the help available towards the final stage, feeling as an important part of the whole nursing process and finally ending the professional relationship when discharged. The exploitation and resolution phases were not observe as at the time of writing John was still an inpatient. John had had previously one bad inpatient admission. He reported that he was very unhappy when he was in the other hospital 10 years ago. He explained that the bad experience was related to the other clients and organizational issues rather than staff. John stated that he was feeling anxious but happy that he was getting help. His positive attitude helped to engage him in the assessment process and on the ward activities, which were the first steps towards the identification phase. Therefore, John could begin to have professional input from other members of the multi-disciplinary team. Tom interacted in a way that John felt understood, respected and individualized. Tom did not appear to have preconceived ideas of the client after reading the CPA forma 1A. And certainly, Tom treated John respectfully and as an equal human being. He followed the NMC code of practice 2008, which states that: you must treat people as individuals and not to discriminate in any way those in your care. Tom tried to adapt the pace of the questioning to the clients needs, involving him and asking in a respectful manner. Tom also acknowledged Johns anxiety feelings, and showed it when taking further (BAI see appendix 1) assessments to empathize more with Johns situation. This reinforced the approachability and genuineness of the nurse and led John to open and engage with the assessment process and the health professional. 3. Influencing factors John scored 45 points in the BAI (see appendix 1), which is a high scoring. This could have been influenced by the hospital admission and the assessment process. Despite these factors and Johns actual mental state he engaged in the assessment actively. The BAI scales consist of 21 observable and self-rating symptoms of anxiety, rated from 0 to 3 (0 being the lowest score), which can also be easily transformed in direct questions or self rating. At the end of the assessment the scores are added up and compared against the scales. There are several assessment tools available such as Hospital Anxiety and Depression Scales (HADS) or Hamilton Anxiety Scales (a collection of them can be found in the Appendix 1 reference). The BAI is shown to be a quick and reliable when measuring clients anxiety levels and it also differentiates General Anxiety Depression and depression (Fydrich et al 1992). Although, these characteristics appear to be positive, it could be argued that BAI is just a merely adaptation of the DSM-IV panic symptoms and therefore it could also be said that measures panic attacks rather than anxiety levels (Cox et al 1996 and de Beurs et al 1997). On the other hand, HADS which achieves good levels of anxiety and depression screening could have been more appropriate for hospital settings and more accurate (Bjelland et al 2002). It is important to point out that NICE clinical guideline for management of Anxiety (2004) does not recommend a specific tool for assessment of anxiety, which gives to the professional practitioner choice on the usage of available tools. This affects practice as these scales are not used as often as they should be. Most practitioners relay on their observations and experience to perform informal assessments, rather than using research based scales. It is perhaps understandable when dealing with clients unable to fully understand these assessments. But in practice it can be noticed that nurses do not tend to use anxiety inventory even with clients that could engage with the process. Tom designed care plans in partnership with John and made him realise which were more realistic goals in the short and long term. Tom had shown knowledge and understanding of the professional capabilities that the NSF defined in the documents The Ten Essential Shared Capabilities (2004) and The Capable Practitioner (2001). These documents set basic principles that underpin positive mental health practice as well as providing the basic grounding for service workers to continue developing and learning skills. Therefore, it was observed during the placement that along the whole admission the nursing team also guided care and practice as appointed by these documents. They provided patient-centred care, which is accountable for each client and respecting the individual. The team also had a broad knowledge of national legislations as well as local policies and services, and worked under the same professional and ethical principles recognizing the rights of the clients and their families. T hey promoted recovery and self-realisation by identifying people needs/strengths and empowering the individuals. Most of the team members were undertaking further training, to keep their skills up-to-date or be able to transfer their existing skills to new environments. They also worked in partnership with family, carers, lay people and external agencies, such as community care services, voluntary associations and vocational services. 4. Evaluation In the interview Tom used a Rogerian approach (Roger (1961) cited by Sheldon (2005)). He also showed knowledge of Peplaus interpersonal theories and applied them in practice by creating a shared experience of care. However, it also would be appropriate to use the Herons six-category intervention framework (Heron 1989). This framework was designed to enable a practitioner (nurse) taking the lead to facilitate the clients specific needs or arising issues. Therefore this intervention could have been used in the admissions assessment and the following one to one sessions, which have been described in this essay. The framework is made off two categories, which are subdivided in three more. The first category is authoritative which it can be prescriptive, in which the nurse influences and directs behaviour, gives advice and prescribe goals. It also can be informative providing information or giving feedback for the clients behaviour. The third subcategory is confronting, in which the pract itioner challenges the clients beliefs or actions. The second category is the facilitative which is divided into cathartic, in which the nurse tries to release the clients painful feelings and talks about or express them with actions (tears, anger or shouts). Next subcategory is catalytic, where the nurse tries to help the client and encourage self-discovery and learning. Finally, supportive is the category where the client is supported in an unqualified manner. The facilitative stage of the framework would have been the most appropriate to use in the first assessment. Johns mental state would not have benefit from an authoritative approach as he might have felt threatened by the staff, therefore his willingness to engage with the service could have reduced greatly. This approach shares the same goals as the one that Tom used. The outcome would have been the same, which was the beginning to build a relationship towards recovery. However, it is important to know different ways to practice and to interact in order to provide an individualised care. This principle is shared by the models discussed in the essay (CPA and Tidal Model) and also by the nursing professional code (NMC code of practice 2008). 5. Learning Although, it was difficult to deal with Johns anxiety levels and his initial unwillingness to engage with the assessment, it was possible to create a therapeutic relationship between nurse and client. After this reflexion it was learnt that nurses knowledge and usage of the right nursing models, strategies and tools can be adapted to individual situations and their own circumstances. It is also important to share principles of care and to change some nurses cultures regarding models of care. It was positive to reflect upon this experience and, therefore, to realise how the theory learnt was applied in practice. Since nursing studies and practice are moved towards research based knowledge it seems that the human connection and relationship building have lost their place in the nursing profession. As a student it is good to see that values based nursing promoted safe, trustful and supporting environment, which led to a healthy therapeutic relationship (Hewitt 2009). In conclusion, the reflection and analysis of engagement through a biopsychosocial assessment illustrated how personal and organizational factors effect on clients care. It was found out that applying specific intervention techniques, mental health screening tools and the adequate adaptation to the individual and the situation promote engagement and build a healthy therapeutic relationship. Furthermore, the research showed that the relevant mental health regulations and nursing professional code recognise the need to keep up-to-dated knowledge and skills in order to provide the best care. All the above techniques and tools were found to be used in a very individual way between the nursing professionals. In addition to this, it was found that theses personal adaptations to practice and clients care were beneficial when reducing barriers for engagement and personalising the care. The positive and negative characteristics of the actual mental health framework CPA were brought forward and it was found that it lacks a nursing model background. CPA and Tidal Model when compared and contrasted, showed that both mental health frameworks differ gratefully from each other but at the same time they could benefit from each other. Despite the ward worked under CPA and used a more medical approach to nursing, the nursing team shared the same professional capabilities and worked towards holistic goals and recovery. Over all, in order to engage and to provide relevant services for clients and cares biopsychosocial needs there should be a continues connection between practice and theory in nursing. References Addis J Gamble C (2004) Assertive outreach nurses experience of engagement. Journal of Psychiatric Mental Health Nursing 11 (4) 452-460. Barker P (2001) The Tidal Model: developing an empowering, person-centred approach to recovery within psychiatric and mental health nursing. Journal of Psychiatric and Mental Health Nursing 8 233-240. Barker P Buchanan-Barker P (2005) Tidal Model: A guide for mental health professional. Brunner-Routledge. Hove. UK. Bjelland I Dahl A A Haug T T (2002) The validity of the Hospital Anxiety and Depression Scale: An updated literature review. Journal of Psychosomatic Research 55(2) 69-77. Cox B J Cohen E Direnfeld D M Swinson R P (1997) Does the Beck Anxiety Inventory measure anything beyond panic attacks? Behaviour Research Therapy 34 (11/12) 949-954. Cutcliffe J R Barker P (2002) Considering the care of the suicidal client and the case for engagement and inspiring hope or observations. Journal of Psychiatric Mental Health Nursing 9 611-621. Department of Health (2002) Mental Health Policy Implementation Guide: Adult Acute Inpatient Care Provision. Department of Health (2004) The Ten Essential Shared Capabilities. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4087169 Accessed: 29/12/09 de Beurs E Wilson K A Chambless D L Goldstein A J Ulrike Feske U (1997) Convergent and divergent validity of the Beck Anxiety Inventory for patients with panic disorder and agoraphobia Depression and Anxiety 6 140-146. Fydrich T Dowdall D Chambless D L (1992) Reliability and Validity of the Beck Anxiety Inventory. Journal of Anxiety Disorders 6 55-61. Gordon W Morton T Brooks G (2005) Launching the Tidal Model: evaluating the evidence. Journal of Psychiatric Mental Health Nursing 12 (6) 703-712. Heron J (1989) Six-Category Intervention Analysis (3rd EDN) Human Potential Resource Group, University of Surrey, Surrey, UK. Hewitt J (2009) Redressing the balance in mental health nursing education: Arguments for a values-based approach International Journal of Mental Health Nursing 18 368-379. Hosany Z Wellman N Lowe T (2007) Fostering a culture of engagement: a pilot study of the outcomes of training mental health nurses working in two UK acute admission units in brief solution-focused therapy techniques. Journal of Psychiatric Mental Health Nursing 14 (7) 688-695. Johns C Graham J (1996) Using a Reflective Model of Nursing and Guided Reflection. Nursing Standard 11 (2) 34-38. National Institute for Clinical Excellence (NICE) Clinical Guideline for Management of Anxiety (2004) http://www.nice.org.uk/nicemedia/pdf/cg022fullguideline.pdf Accessed: 26/11/09 National Service Framework (NSF) Modern Standards and Service Models for Mental Health (1999) NHS our Healthier Nation. Noak J (2001) Do we need another model for mental health care? Nursing Standard 16 (8) 33-35. Norman I Ryrie I (2004) The Art and Science of Mental Health Nursing: A Textbook of Principles. Open University Press. Maidenhead. UK. Nursing and Midwifery Council (NMC) (2008) The Code. (NMC, London). Sheldon L K (2005) Communication for Nurses: Talking with Patients. Sudbury; Jones and Bartlett. Simpson A (2009) The acute care setting. In Barker P (2009) Psychiatric and Mental Health Nursing: The craft of caring. Edward Arnold Ltd. London. Simpson A Miller C Bowers L (2003a) Case management models and the care programme approach: how to make the CPA effective and credible. Journal of Psychiatric and Mental Health Nursing 10, 472-483. Simpson A Miller C Bowers L (2003b) The history of the Care Programme Approach in England: Where did it go wrong? Journal of Psychiatric and Mental Health Nursing 10, 489-504. The Sainsbury Centre for Mental Health (2001) The Capable Practitioner. http://www.scmh.org.uk/publications/capable_practitioner.aspx?ID=552 Accessed: 29/12/09 Appendixes Appendix 1 Beck Anxiety Inventory Below is a list of common symptoms of anxiety. Please carefully read each item in the list. Indicate how much you have been bothered by that symptom during the past month, including today, by circling the number in the corresponding space in the column next to each symptom. Not At All Mildly but it didnt bother me much. Moderately it wasnt pleasant at times Severely it bothered me a lot Numbness or tingling 0 1 2 3 Feeling hot 0 1 2 3 Wobbliness in legs 0 1 2 3 Unable to relax 0 1 2 3 Fear of worst happening 0 1 2 3 Dizzy or lightheaded 0 1 2 3 Heart pounding/racing 0 1 2 3 Unsteady 0 1 2 3 Terrified or afraid 0 1 2 3 Nervous 0 1 2 3 Feeling of choking 0 1 2 3 Hands trembling 0 1 2 3 Shaky / unsteady 0 1 2 3 Fear of losing control 0 1 2 3 Difficulty in breathing 0 1 2 3 Fear of dying 0 1 2 3 Scared 0 1 2 3 Indigestion 0 1 2 3 Faint / lightheaded 0 1 2 3 Face flushed 0 1 2 3 Hot/cold sweats 0 1 2 3 Column Sum Scoring Sum each column. Then sum the column totals to achieve a grand score. Write that score here ____________ . Interpretation A grand sum between 0 21 indicates very low anxiety. That is usually a good thing. However, it is possible that you might be unrealistic in either your assessment which would be denial or that you have learned to mask the symptoms commonly associated with anxiety. Too little anxiety could indicate that you are detached from yourself, others, or your environment. A grand sum between 22 35 indicates moderate anxiety. Your bod