Job Organization and Information Essay Example for Free

Job Organization and Information Essay The job description might be broadened to form a person specification or may be known as Terms Of Reference Roles and responsibilities A job description may include relationships with other people in the organization: Supervisory level, managerial requirements, and relationships with other colleagues. Goals A job description need not be limited to explaining the current situation, or work that is currently expected; it may also set out goals for what might be achieved in future. Limitations Job descriptions may not be suitable for some senior managers as they should have the freedom to take the initiative and find fruitful new directions; †¢Job descriptions may be too inflexible in a rapidly-changing organization, for instance in an area subject to rapid technological change; †¢Other changes in job content may lead to the job description being out of date; †¢The process that an organization uses to create job descriptions may not be optimal.

Helpful and intelligent Essay Example for Free

Helpful and intelligent Essay From his hovel, the monster notices a nearby cottage occupied by the De Lacey family. He observes them cautiously from a safe distance as he now recognises mans potential to be cruel. This shows us again that the monster is constantly developing, and experiencing a variety of different emotions, such as love. Love is portrayed in Frankenstein after he watches the daily routine of the De Laceys (through a small gap in the wooden panes, previous to where the window was. This is a sign that they were not very wealthy). He discovers the sound of music through the old, blind man playing his recorder. This enchants him and he begins to admire this family. After this point his mixed emotions are so strong when watching Agathe and the old man, so strong that he cannot bear to watch the family anymore. (the music touched his heart and he felt a mixture of both pain and pleasure with love) He gradually learns more about them and increases his intelligence while doing so. He knows that they live in poverty and so his admiration grows for them, also for their wonderful appearance, as he is unaware of ugliness and deformity. He shows a caring side of himself when he became devoted to help the De Laceys by cutting wood. This monster becomes generous, helpful and intelligent. He also decided to satisfy himself with berries, nuts and roots instead of eating tastier food that they ate. This implies that this so called brute was also thoughtful. The monsters narrative tells us that he is determined character who would do anything to belong, he attempted to learn the English language to hopefully reason with the De Laceys and make them realise that he wasnt a wretched evil brute but a kind-hearted being. He was doing well until he saw his reflection in a pool of water. This part of the story (Chapter 12, page 109) is significant in tracing the change of his character because he was mortified with his appearance and became miserable. He now knew entirely why he was hated in the previous village; it was for his monstrous, alien appearance. He became aware of all the racial prejudice in the world and realised that this was the source of all his problems. Knowing this made the monster bitter at man, however he still thought of the De Lacey family as wonderful and still he wanted to restore happiness to these deserving people.  Other experiences the monster undergoes during Chapter 12 are his first realisations of the four seasons. This happens when he found that different flowers grew at different times of the year. This is another example of his developing intelligence. The next vital point in the development and change of the monster is the arrival of Safie, an Arabian woman not knowing the English language. This immensely profited him because during Safies stay with the De Laceys she began to take lessons to speak English. The monster therefore also learned the language at a rapid pace. Also in Chapter 13 we see a very sensitive side of the Monster when he is describing the nature surrounding him. (innumerable flowers, sweet to the scent and the eyes, stars of pale radiance among the moonlight woods) While Safie remains in the De Lacey household the monster begins to learn more about human nature, especially involving the love between a man (Felix) and a woman (Safie). He could not believe the ecstatic joy that Felix was in when meeting Safie, when before he seemed to be so miserable. He realises that they were both affected by different feelings, Felix by the way his cheeks flushed with pleasure and Safie by how she wiped tears from her lovely eyes. The monster observes more involving human nature when he heard of the difference of sexes and the birth and growth of children, he also heard of the different relationships between humans such as mother, father, brother and sister. This is the first stage of his life when he asks himself, where are my friends and relations? To his recollection he has had no one to care for him and remembers nothing before his first account in his narrative story. He genuinely questions what and who he is and so again we feel sympathy. The monster emotionally develops from what he learns of human nature, this occurs when Safie sings to Agatha and the old man. This deeply moves him as her voice at once brought tears of delight and joy from his eyes. He described the music as a rich cadence, swelling or dying away like a nightingale of the woods. His reaction to her singing again brings out his sensitivity.  The monster while constantly developing his knowledge of English, (now with the help of Safies lessons) still longs companionship with the De Laceys. He feels that he needs to be part of this wonderful family. Although he understands that he has been previously rejected and seen as an ugly wretch, he believes that the power of language can overcome the deformity of his face. However much he hopes that he will be accepted, he still remains conscious of his previous encounters with man. The monster remains fearful of how the De Laceys will react to him.  The next part of the monsters narrative (Chapter 14) relates little to himself but his knowledge increases of the De Laceys history, before they moved to Germany. The monster discovered such information from several letters written from Safie to Felix. Here we find that he has learnt more skills, the skills to read and write. The monster later decides to copy these letters himself to bring truth to his tale, for Victor Frankenstein. From these letters we learn an awful lot about the De Laceys, such as that previously they led wealthy lifestyles in Paris. He learnt that their wealth was lost when a Turkish merchant was condemned to death for becoming obnoxious towards the French government. This affected the De Laceys because Felix vowed to help the Turk escape and did so. (In return he was offered a reward but he declined; however he agreed to marry the merchants daughter, Safie) When learning from the De Laceys he also confirmed the relationship between the family. The old man is known as De Lacey and is father to Felix and Agatha. It was of course illegal to do this and so this resulted in the De Laceys being exiled. Knowing all this improved the monsters understanding of why the De Laceys seemed so unhappy and he now fully realised the poverty they were in.

Impact of Aphasia on Health and Well-being

Impact of Aphasia on Health and Well-being Abstract This discussion paper considers the impact of aphasia on health and well-being, and following an in-depth exploration of relevant literature, provides suggestions for appropriate nursing interventions in respect of this relatively common condition following stroke. The introduction states that effective communication is essential to holistic care and positive outcomes for individuals affected by aphasia. However, when verbal communication is absent, nurses fail to adequately utilise alternative strategies so that the standard of nurse/patient communication is frequently poor. The discussion introduces the Theory of Human Scale Development. This theory emphasises that quality of life depends as much upon self-actualisation and relation-building as on physical health. The theory is used as a framework within the discussion in order to highlight the significance of communication to quality of life, and how its loss has profound psychological and social consequences. By utilising the theory, the discussion demonstrates that nursing care delivery must address loss of self-actualisation and relationship-building abilities, as well as physiological communication skills. The discussion reflects upon how aphasia results in loss of self, and how the situation is exacerbated by inadequate healthcare communication strategies such as nurse-controlled conversation, talking-over, and elderspeak. Suggestions are offered regarding more appropriate strategies. Efficacy of family input is considered; nursing competence regarding language practice therapies is discussed, and the quest approach is explored. Next, the discussion reflects upon the impact of aphasia on relationships. Aphasia denies access to support networks and results in isolation, stress, and loneliness. The individuals predicament is worsened by negative nursing responses such as communication filtering and avoidance tactics. The discussion reflects upon positive nursing strategies, which alleviate effects of aphasia on individuals social health. Concept analysis and self-awareness exercises as methods of enhancing compassion skills are explored. The social model of disability is discussed in order to highlight the benefits to individuals of environmental adaptations. Also, the social benefits of aphasia-group affiliation are discussed. The discussion concludes by emphasising that fundamental human needs involve social and psychological as well as physical aspects. Nursing interventions must therefore address all needs in order to provide holistic care in its fullest sense. Key Words Aphasia: nursing: relationships: self: Theory of Human Scale Development Summary Statements What is already known about this topic Good communication between nurses and patients is essential to the provision of quality healthcare that protects patients rights, autonomy and choice. Aphasia compromises nurse/patient communication leading to discrimination in health services, suboptimal care, poor long-term outcomes, and restricted rights. Communication difficulties faced by individuals with aphasia risks loss of self, and diminishes the beneficial impact of social integration on health. What this paper adds The multifarious impact of aphasia on the lives of individuals with the condition must be recognised and acknowledged by nurses. During their day-to-day nursing activities, nurses can facilitate the immediate communication needs of individuals with aphasia. Nurses can initiate aphasic individuals abilities to function independently and autonomously in the wider world via supporting the maintenance of personal identity and social integration. Introduction It has long been acknowledged and purported that good communication is essential to the provision of quality healthcare as it is integral to effective clinical assessment, health promotion, and patient choice and autonomy. Models of communication and research studies (Peplau, 1952; Fosbinder, 1994; Charlton et al, 2008) suggest that care delivery and health outcomes are improved when nurses use communication as a reciprocal interaction to express concern and commitment, and in return invite trust and human connection. These texts demonstrate that proficient interpersonal skills transform patients from objective clinical tasks to individuals meriting empathic, holistic care. However, because most communication strategies depend upon speech, the expediency of interpersonal relationships becomes severely compromised for individuals who experience aphasia as a consequence of stroke. Indeed, although the World Health Organisations (2001) definition of communication impairment encompasses verbal, non-verbal and graphic abilities, Finke et als (2008) systematic review finds that nurses continue to focus on stroke patients inadequate ability to verbally meet communication needs. Non-verbal messages are assigned a secondary, supporting role, and are therefore not adequately exploited as legitimate alternative strategies. The subsequent poor standard of professional/patient communication, described as appalling in the United Kingdoms National Sentinel Stroke Audit (Intercollegiate Stroke Working Party, 2009, p.12) has serious ramifications. O Halloran et als (2008) literature review suggests that health professionals inability or unwillingness to effectively enga ge with individuals affected by aphasia leads to discrimination in stroke services, suboptimal care, poor long-term outcomes, and restricted rights. Theory of Human Scale Development To avoid the suboptimal care of patients with aphasia, nurses must realise the necessity of effective communication to health and well-being. If nurses are to be motivated to explore, improve and exploit communication strategies as therapeutic tools, they must, in the first instance, understand the devastating impact of aphasia on quality of life. An analysis of aphasia in relation to the Theory of Human-Scale Development (Max-Neef et al, 1991) helps to illustrate its effect on the individual. According to the Theory of Human-Scale Development, quality of life depends upon the satisfaction of nine classes of interrelated ontological fundamental human needs (figure 1). Of these, only subsistence relates to physical health, the others being concerned with psychological and social issues associated with the sense of self and relationships. Because quality of life correlates with the number of satisfied needs, if a synergic satisfier (one satisfier that satisfies multiple needs) such as the ability to fluently verbally communicate, is removed, the impact on life quality is devastating (figure 2). Charmaz (1983; 1995; 1999) symbolic interactionist perspective reaches similar conclusions. These grounded theory studies of chronic illness demonstrate that the self is developed and maintained via self-actualisation and social relationships. Where illness reduces individuals participation in society, and prompts negative reactions from others, feelings of discreditation and loneline ss follow. Individuals beliefs that they are encumbrances on society rather than valuable contributors, lead to suffering and the loss of self. It is essential, therefore, that rehabilitative therapies should result in a synergic effect so that self, relationships, and thus quality of life are improved and maintained to the highest possible level (figure 2). However, many individuals with aphasia bemoan the fact that health professionals consistently focus on physical, biomedical definitions which view the condition as synonymous with physiological stroke events, rather than separate aphasia disability experiences (Liechty and Heinzekehr, 2007; Shadden et al, 2008; Wertheimer, 2008). This leads to the dismissal of psychological and social aspects of communication impairment and a thwarting of attempts to address them. Thus, the biomedical perspective, which defines aphasia as an inability to use or comprehend language as a consequence of injury to the cerebral cortex, results in the comment, I have aphasia, generating the response, You mean you had a stroke (Liechty and Heinzekehr, 2007, p.316). But, as Liechtys autobiographical account illustrates, aphasia is not an objective condition but a subjective reality, and focusing on the physiological brain damage both de-emphasises the pain that aphasia causes and denies the continual struggl es faced (p.316). Liechtys experience suggests that a psychosocial definition is more appropriate to describe the full extent of the consequences of aphasia to the individual. Sundin et als (2000) wider definition describes the condition as a defect in the use of language which causes extensive damage to psychological and social well-being resulting in isolation and depression. This study suggests that understanding the meaning of the illness for the individual rather than concentrating on the underlying physical causes, is the true initiator of holistic healing. O Halloran et al (2008) agree. This systematic review proposes that a biomedical perspective impoverishes care delivery because attributing communication breakdown to the disease process reduces nurses responsibility and motivation to develop ongoing communication strategies. The review suggests that a psychosocial perspective where nurses view communication impairment as an illness experience as well as a medical phenomenon, promotes the ide a that difficulties result from impaired interaction between nurse and patient. This increases nurses feelings of responsibility to overcome communication barriers and seek out the individual behind the disease. It is apparent, then, that reference to the Theory of Human-Scale Development helps to illustrate how a professional attitude which attempts to satisfy all fundamental human needs, not just the physical need of subsistence, subsequently leads to richer, more meaningful outcomes. Although fundamental human needs are to an extent, interrelated (figure 1), they are broadly split into three categories. The discussion paper will explore the impact of aphasia by focusing on self-actualisation and relationship needs. Self-Actualisation Needs Impact of Aphasia on the Self Rogers (1967) personality theory states that self-concept and self-perception are fundamental components of personal identity. He proposes that because life-meaning and behaviour are essentially purposeful, individuals require freedom to make choices, and create and develop their own personalities, in order to construct a valid presence in the world. Of course, language is the core of this process of self-construction. Without language, the ability to narrate lived experiences is lost. The individual cannot inform the world who and what he/she is, or understand who and what others are, hence is unable to find an appropriate place in the scheme of things. Shaddens (2005) literature review describes this predicament as identity theft, a state of affairs in which individuals with aphasia are ignored and invisible. However, Kagans (1995) masking of competence model refutes this, proposing that the individual is transformed rather than rendered invisible by aphasia. The model states that because communication impairment makes it difficult to perceive the individuals functional mind, it becomes difficult to envisage capacity. With capacity hidden, the individual is transformed from a person to a mere physical presence and is often viewed as a burden with little social value. According to Charmaz (1983), witnessing ones former self-image crumbling away is itself a fundamental form of suffering (p.168). Time and again, autobiographical narratives refer to the pain experienced when the self is reduced by an assumption that language loss is synonymous with the loss of intellectual and cognitive abilities (Neal, 1988; Bauby, 2008; Liechty and H einzekehr, 2007). Bauby (2008) summarises the feeling thus, [They] left no doubt that henceforth I belonged on a vegetable stall and not to the human race (p.90). Buber (1958) refers to this objectivising of people as an I-It relationship (as oppose to an I-Thou relationship defined by its reciprocal and mutually respectful nature). Aphasia renders the establishment of a nurse/patient I-Thou therapeutic relationship particularly challenging, because sharing and understanding become difficult to achieve. Unfortunately, this often results in I-It communication within the healthcare arena, which in nursing, is intrinsic to detached task-orientated care. According to Gordon et al (2008), this denies individuals with aphasia the freedom to control and direct their own lives. Gordon et als (2008) observational study concludes that staff control conversations and focus dialogue on their own nursing-task goals. The studys use of conversation analysis demonstrates that patients rarely initiate conversations and therefore have little influence over topics. In addition, due to heavy reliance on the sequential context of dialogue in order to maximise unde rstanding, individuals with aphasia find it difficult to alter the course of conversation to suit their requirements. Such asymmetrical, task-orientated communication is neither therapeutic or responsive to holistic needs. This results in a reduction of the self and a denial of individuals rights to participate in their own care or in the creation of their own future. According to Wertheimer (2008), curbing the freedom to express the self commonly leads to feelings of entrapment. Wertheimers (2008) detailed analysis of post-subarachnoid haemorrhage experiences suggests that language difficulties and loss of control during hospitalisation contribute to depression, and dreams and hallucinations, which frequently involve images of imprisonment and dictatorial authoritarianism. The negative impact of nurse-controlled conversation is exacerbated further by persistent occurrences of talking over patients. Flegels (2008) short article acts as a reminder that talking over is unethical because it contradicts health professionals codes of conduct that stipulate patient autonomy is paramount during care delivery. Quoting Kants (1785) argument that autonomy depends upon the hypothesis that all individuals have unconditional worth, Flegel (2008) believes that talking over signifies to patients that their presence is of no consequence and therefore they are not autonomous. Elderspeak also diminishes autonomy. This speech style is generally used as a means to communicate with elderly patients, but research confirms that it is commonly used by nurses when encountering individuals with physical, cognitive and communication disabilities (Kemper et al, 1998; Williams et al 2004; Melton and Shadden, 2005). Williams et al (2004) describe elderspeak as a demeaning mode of communication similar to baby talk that features exaggerated, simplified, repetitive language. Because elderspeak stereotypes elderly and disabled patients as incompetent and incapable, individual potential and progress may be ignored, thus reducing control and the sense of self even further. Reactions to Loss of Self Unsurprisingly, individuals with aphasia struggle to instigate the fight to rescue the self, and often surrender to discreditation. Charmaz (1983) explanation that self-concept depends upon reflected images of the self by others is confirmed by Simmons-Mackie and Damico (2008). This study of communication therapy sessions suggests that external negative responses to individuals with aphasia leads to internal negative perceptions of the self and a silencing of the voice. Poor nurse communication techniques based on task-orientated conversation, elderspeak and talking over compound this internalisation process. According to Ryan et als (1986) seminal literature review and subsequent theory of dependency over-accommodation, implications of incompetence and diminished capacity which arise from such condescending speech styles lower individuals confidence and self-esteem. This increases dependency and passive acceptance of care, and consequently promotes feelings of worthlessness and powe rlessness. Parr et al (2003) agree. This literature review reports that individuals faced with inadequate communication attempts of service providers, feel so diminished that they often apologise for their own existence. By reflecting on the impact of aphasia on self-actualisation needs, it seems that the nursing role in care delivery should involve supporting the individual to both recover the pre-aphasic self and connect this self to the new disabled identity. In order to achieve this, the nurse must firstly get to know the patient as a person, then secondly, empower that person to regain the creativity, confidence and freedom required to control his/her own life. Nursing Implications Use of Family Liaschenko and Fisher (1999) identify person knowledge as integral to the establishment of effective therapeutic communication and holistic care. The acquisition of this knowledge involves knowing the patients private biography with a view to revealing the unique individual. Where aphasia inhibits direct verbal interaction between nurse and patient, family and friends can relay information and re-construct much history, therefore contributing to the satisfaction of a range of fundamental human needs. According to Williams and Davis (2004), this indirect narrative is invaluable as it allows the nurse to participate in individualised communication when speaking directly to the patient. This deters any tendency for task-focused interaction or elderspeak, which in turn, reinforces the individuals sense of self. There are barriers to implementing such interaction however. Paradoxically, despite, for example, British Government calls for improved professional/patient/carer communication (Intercollegiate Stroke Working Party, 2009), some studies report that nurses efforts to personalise care by informal chat with patients and families are thwarted by sociopolitical systems that prioritise task completion over person knowledge. (McCabe, 2004; Speed and Luker, 2004). Also, Fairburns (1994) study of attitudes to visiting hours reports that nurses often feel patients and relatives resent staff presence as an intrusion upon their private time together. Perhaps the use of patient diaries can help overcome these barriers. Combes (2005) introduction of diaries in the intensive care setting demonstrates that by encouraging families to produce ongoing written narratives, which are left at the patients bedside, readily accessible relevant information concerning what is significant and individual to the patient is made available. This data can be utilised and built upon in later nurse/patient interactions. Research into the use of diaries in aphasia care should therefore be undertaken. Families are also useful when nurses are trying to ascertain the individual with aphasias immediate concerns and opinions. Goodwins (1995) well-cited case study illustrates that needs are more easily interpreted when relatives, familiar with the individuals gestures, facial expressions and idiosyncrasies, and who share common social contexts with him/her, are on hand to translate. Indeed, Finke et als (2008) systematic review finds that, where nurses are prepared to ask families for suggestions, or written directives, regarding the meanings of the individuals non-verbal strategies, communication is much more efficacious. In terms of advocacy, Hedberg et als (2008) study of multi-disciplinary care-planning meetings demonstrates that an in-depth knowledge of the individual with aphasias life and views, equips family members to act as advocates in the negotiation of care needs and future plans. The research therefore concludes that nurses require training in how best to involve relatives in the decision-making process in order to ensure individual needs remain salient. While the recommendation to involve families in the communication process is essentially sound, much of the proposing nursing literature quoted above nevertheless fails to fully explore the potential risks to patient autonomy of relying heavily on alliances with relatives. Translation literature (Englund-Dimitrova, 1997; Bradby, 2001; Leininger and McFarland, 2002) confirms that any form of interpretation via a third person amplifies the chances of misinterpretation. However, the risk is further heightened by relatives conscious or subconscious propensity to distort, omit or add to the patients messages and opinions in order to address their own concerns. Shadden et als (2008) review of autobiographical narratives reports that, while the well-being of patients is the central concern of most families, disability caused by stroke has a significant negative impact on the lives of all close family members. This may result in the interpretation of aphasic communication being influenced by the intermediarys own slanted perspectives. Thus, relatives feelings of guilt, fear, stress, and fatigue may filter out some of the true messages that the individual with aphasia is trying to express. Ryan et al (1986) offers a more cynical consequence to family advocacy by suggesting that it may undermine the individuals power to control situations, and can even disguise the sense of self by recreating and redefining elements of the individuals history, personality and wishes during the advocacy process. Hence, although it is helpful to use family knowledge to obtain patient information, nurses must recognise that individuals needs may not be adequately supplied by biased intermediaries. Nurses must therefore be able to use their own disinterested objective strategies to reach an understanding of the individual with aphasias meaning. Nursing Implications Competence Theory and research which explores the meaning of caring (Halldorsdottir and Hamrin, 1997; Brilowski and Wendler, 2005; Chang et al, 2005) states that a fundamental strategy when nursing any illness is the alleviation of the patients fear that nothing can be done to treat the condition. This literature reveals that while patients appreciate expressive caring behaviours, competence when performing instrumental therapies, is considered imperative to a secure caring base. As Halldorsdottir and Hamrin (1997) assert, caring without competence is meaningless (p.123). It is apparent that in aphasia, where preservation of the self is at stake, the nurse needs to convey competence and confidence in attitude and execution of language practice therapies, so that the individual with aphasia feels secure in the knowledge that recovery of identity is possible and in hand. Nystroms (2009) phenomenological study of interviews and biographies finds that such provision of security via nursing competence encourages patient hope, motivation, and fighting spirit (p.2509). Finke et al (2008) believes that nursing competence in language practice therapy requires training in basic speech therapy, familiarity with augmentative and alternative communication, and regular consultations with speech and language therapists. However, currently, none of these schemes are widely implemented. Hemsley et al (2001) suggests this is due to individual and organisational attitude barriers, which view specialised communication techniques as both too time-consuming and beyond the remit of nurses. Finke et al (2008), proposes that time and resources spent on enhancing nurses communication competence may prove more efficient than relying on minimal task-orientated interactions. This is because ineffective interactions are at high risk of misinterpretation, ineffective at meeting individual needs, result in frustration, fear and despondency, and may contribute to depression. Also, Nystrom (2009) finds that extended time periods required for personal care support, provide ideal opportunities for skilled practitioners to simultaneously offer language practice (thus reducing rehabilitation time and resources), while allaying patient fears. A participant in the research is quoted thus, One nurse talked to me while helping me to eat and get dressed†¦that made me feel calm and secure (pp.2507-8). Nursing Implications Quest Approach Aphasia traps individuals in the present. Struggling to express details of past achievements, individuals situations are worsened by an inability to shape the future. In effect, individuals have lost both identity, and the freedom and creativity to restore it. They have lost their place in the world. Nystrom (2009) believes that the optimal method of regaining place is to defer to individuals pre-stroke identities. An awareness of individuals previous competencies, allows the nurse to personalise language practice, communication strategies and conversation by basing subject matters on familiar contexts of family, work, interests, and achievements. This enables individuals with aphasia to grasp meanings more easily, but it also helps to maintain a sense of the old valued, accomplished self, thus providing a structure on which to base rehabilitation goals. This method, defined by Moss et al (2004) as a restitution approach, is fundamentally flawed because it overlooks the fact that for many individuals, aphasia remains a permanent disability. Preoccupation with the old self could therefore lead to a painful mourning for what is lost. It could even exacerbate feelings of worthlessness by highlighting comparisons between past abilities and present inabilities. Moss et als (2004) exploration of online illness narratives purports that a quest approach is more psychologically healthy. Here, individuals are encouraged to accept their changed circumstances, and envisage and create a different future. For the nurse, this involves using the individuals history, not as a source of goals, but a source of interests on which new modified goals can be built. This requires strong multi-disciplinary co-ordination skills to bring patient, nurse, speech therapist and occupational therapist together in order to fully explore interests, resources, potential and progress. Furthermore, according to Vickery et als (2009) quantitative analysis of self-esteem scales, the nurse must kindly but firmly guide individuals to a realisation of their limitations so that the risk of disappointment is reduced. However, simultaneously, the nurse should demonstrate motivating and commendatory attitudes that elicit a sense of pride from individuals in their gains and success es, which ultimately increases confidence, self-worth and a sense of freedom. Relationship Needs Impact of Aphasia on Relationships Berkman et als (2000) review of social integration theory demonstrates that relationships and affiliations are formidable influences on physical and psychological health. The study explains that relationships provide informational, instrumental (practical), appraisal (decision-making) and emotional support, as well as opportunities for social engagement. All these aspects are essential to the endorsement of meaningful roles, the reinforcement of participation and belonging, and the promotion of affection and pleasure. Charmaz (1983; 1999) reiterates that these factors add to the sense of self as a valuable entity. Any process or condition which leads to alienation, separation or disconnectedness from society, adversely impacts on mental well-being and mortality (figure 2). Generative studies by Durkheim (1952) and Bowlby (1991) suggest that relationships serve to buffer detrimental influences of stressful events. These texts illustrate that when consistent, reliable relationships are absent or damaged, psychological stability is weakened and the risk of depression increases. Berkmans (1988) hypothesis takes this concept further by suggesting that social isolation is itself a chronic stressor resulting in persistent heightened hypothalamic-pituitary-adrenal (HPA) axis responses which consequently accelerate physiologic aging and functional decline. Because conversation is pivotal to interaction and relationship building, aphasia inhibits individuals from exploiting the health benefits of social integration. Pound et al (2006) believe that conversation is primarily transactional, enabling individuals to participate within a supportive society consisting of mutually supportive relationships. Aphasia therefore, results in an inability to access support strategies resulting in isolation and stress. For example, appraisal support is compromised because individuals with aphasia are unable to talk problems over with friends. Likewise, informational and instrumental support may be inaccessible if individuals cannot express their opinions and needs, nor comprehend disseminated messages. While Laver (1975) acknowledges the transactional element of conversation, he also emphasises its interactional nature, which allows the development of social connections. He explains that it is a bonding ritual, which explores and categorises social position, conveys intimacy, conspiracy, affection and belonging, and as such, its loss can lead to a devastating sense of loneliness. For individuals with aphasia, whose health is already severely impaired by stroke, it is imperative that nurses are able to support the relationship-building process, and hence, diminish risks of further health problems associated with social isolation. Ramos (1992) research concludes that this is best achieved by establishing reciprocal or connected nurse-patient relationships which involve the development of emotional and cognitive bonds that persuade the individual to feel the nurse is taking on part of the burden (p.503). Reciprocation also encourages nurses to perceive coping with illness as a shared responsibility. Pound et al (2006) agree, stating that if professionals acknowledge patients are not solo performers, but part of a company of players (p.18), then this idea of joint responsibility is accentuated. However, poor therapeutic relationship development in aphasia remains a common problem. Perhaps this can be explained by Hindles (2003) suggestion that any phenomenon, which undermines nurses competence as communicators, leads to the implementation of communication filter barriers, such as rationalisation and projection. Sundin et al (2000) believe aphasia is a relationship leveller because both nurse and individual with aphasia have difficulty being understood by, and understanding, each other. This situation is uncomfortable for nurses working in a healthcare social construction that is founded upon competency achievement and proficient practice. Balandin et als research (2007) validates this idea. This small qualitative study finds that the undermining of competence and power results in rationalisation and projection in the form of defensive attitudes such as its not my job or the patient doesnt need to communicate (p.58). These avoidance tactics have been so widespread that Stock well (1972) included individuals with aphasia in her list of unpopular patients. Reactions to Diminished Relationships Charmaz (1983) research, confirmed by Davidson et als (2008) case study, reveals how unwillingness or inability of family, friends and professionals to establish effective relationships with individuals affected by aphasia leads to feelings of rejection. This in turn erodes patients perseverance to pursue support and comfort, often resulting in retreat and the seeking of solitude. Lyon (1998) refers to this behaviour as constructive because it provides a protective cocoon (p.12) in which individuals can rest and quietly contemplate their situation. Likewise, Shadden et al (2008) believe solitude-seeking is beneficial as it allows individuals to recapture the self which appears to bolster self-esteem. The authors quote from a patient interv

Jack and Simon in Chapter Three of the Lord of the Flies Essay example

Jack and Simon in Chapter Three of the Lord of the Flies In the Lord of the Flies, William Golding makes many contrasts between his symbolic characters. For example in chapter three, 'Huts on the beach', many contrasts and similarities are made between the two characters Jack and Simon. These descriptions give an idea to their personality and feelings. The description of Simon in the jungle, and Jack in the woods highlights many of their differences. Jack is alone and descriptions like, 'with flared nostrils', and 'ape- like' suggest he is behaving like an animal. Jack's appearance is also starting to resemble animals, as his hair has grown, 'longer', and his skin darker with, 'a mess of dark freckles'. Simon's appearance is described similarly to jacks. He has ' a coarse mop of black hair,' which was 'long' Simon on bare feet, like jack and he has dark skin and only wears, 'the remains of shorts'. This shows that both characters do not take much care in their appearance. In this sense, living on the island has effected them both in the same way. Jack has changed in himself by becoming less prim and proper. He has started to swear, become more dirty and tatty, 'streaked with brown earth' and he is wearing only, 'tattered shorts', these factors all show how jack is loosing his inhibitions and that from the start of the book he has changed greatly. The settings of the wood and jungle are quite similar, although the way Golding presents them greatly changed the perception of Jack and Simon. Simon, in the jungle is presented in an attractive way by descriptions like, 'the scent of ripeness' and, 'flower and fruit grow together on the same tree'. When Simon walks past the candle buds, the quote, 'the ... ... but it is evident that he has much wisdom, and says well thought through comments. An example of this is when Jack and Ralph are speaking, and Simon abruptly joins in their conversation by saying, 'as if it was not a good island'. This is meant in a way to try and make Jack and Ralph consider the point. Then he goes on to say, 'as if the beastie, the beastie or the snake- thing was real'. Simon unlike Ralph and Jack, does not find the beastie a threat, and does not seem scared or frightened about it. Jack and Ralph both like having the role as leader, and have a want for power over the lives of the group. Jack says to Ralph, ''you're chief. You tell 'em off', in a harsh tone, showing he is jealous about Ralph being leader. Simon, unlike Jack and Ralph shows no desire to be leader. This reinforces the idea that Simon could be compared to Jesus figure.

The Differences in Josephine and Mrs. Mallard of Kate Chopins The Stor

The Differences in Josephine and Mrs. Mallard of Kate Chopin's The Story of an Hour "'Free! Body and soul free!'", Mrs. Mallard kept whispering. One person's ultimate freedom may be seen as a tragedy to another. Kate Chopin illustrates this idea in "The Story of an Hour." The story is set in the nineteenth century. Chopin uses the death of Mr. Mallard to show the reader Mrs. Mallard's deep feelings. In the story, Josephine and Mrs. Mallard are sisters. Although the women come from the same background, live in the same city, and outwardly appear to be satisfied with their lives, their attitudes are very different. Chopin uses these two women as foil characters in the story. The differences in the women are seen in their reactions to Mr. Mallard's death. Although both women are expected to maintain a certain role in society, Mrs Mallard, unlike Josephine, is not satisfied with her life due to the societal restrictions. At the end of the story, Josephine and Mrs. Mallard respond very differently to Mr. Mallard's coming home. Josephine and Mrs. Mallard feel very differently about the societal restrictions placed on them. Josephine is portrayed as the perfect nineteenth-century woman. She fulfills her duty as care-giver. This duty is seen when Josephine is kneeling before Mrs. Mallard's locked door pleading for admission: "'Louise, open the door! I beg; open the door-you will make yourself ill,'" Josephine implores. Josephine is concerned about the well-being of her sister. She is present when Mrs. Mallard hears the news of her husband's death and provides comfort and compassion. On the other hand, Mrs. Mallard feels trapped and burdened by the restriction placed on her by society. Mrs. Mallard longs to be an individual who d... ...els. When Mrs. Mallard sees her husband, the chains of bondage are thrown back onto her. The reviving and refreshing experience she has just had in her room is put out, and she dies. The doctors say that Mrs. Mallard dies "of joy that kills." Actually, her soul cannot handle the oppression after it has felt such freedom. Josephine's and Mrs. Mallard's differences are reflected in their reactions to Mr. Mallard's coming home. In Kate Chopin's "The Story of an Hour," Josephine and Mrs. Mallard are foil characters. The behaviors and values of one contrast with the other. Josephine is presented as a content woman in the nineteenth century. Mrs. Mallard is struggling for freedom. The differences in these women are seen in their reactions to Mr. Mallard's death and return. Chopin uses this story to point out the importance of being an individual and developing oneself.

Science Fiction Explored in Frankenstein, Dr Jekyll and Mr Hyde and The

The Legacy of Science Fiction Explored in Frankenstein, Dr Jekyll and Mr Hyde and The Invisible Man Science Fiction is a branch of literature that explores the possibilities of human scientific advances, especially technological ones. Mary Shelley's Frankenstein (published in 1818) was a precursor of the genre which was established by Jules Verne's novels of the late 1800's. HG Wells at the turn of the twentieth century brought more scientific rigour in his works, such as The Time Machine, The Invisible Man and The War of the Worlds. Isaac Asimov and Arthur C Clarke are among the most familiar writers of science fiction of the modern era (Cambridge Encyclopaedia, 1994). However, works from an earlier time, Frankenstein, Robert Louis Stevenson's Dr Jekyll and Mr Hyde and H.G.Wells' The Invisible Man, have had a profound influence on thinking about science and its relationship to humanity and the world we live in. [AU1]This essay explores the cultural legacy of these three works and seeks to explain why they have been so influential. Frankenstein explores many issues related to science and humanity[AU2]. Behrendt has identified some of the themes as individual and class alienation, social conditioning, gender stereotyping, conflict between rational intellect and intuitive emotion and the revisionist Romantic view of the relation between God and humanity [AU3](1990). Alienation is seen in the fact that Frankenstein left community to do his experiments, and refused to share with others what he had found; at the same time he utterly abandoned the life that he created (Madigan 2000, cited in Penner nd). [AU4]Gender stereotyping is noted by Johnson (1987) who sees the novel as the story of a man who usurps the female role b... ...984) Science and society: A brief look at the Invisible Man. The Wellsian, 7: 19-23[AU11] Suvin, D (1991) Wells as the Turning Point of SF tradition. In J Huntington (ed) (1991). Critical essays on H.G. Wells. Boston: G.K. Hall[AU12]. US National Library of Medicine (Feb 2002) Frankenstein: Penetrating the secrets of Nature. [Online] Available: http://www.nlm.nih.gov/hmd/frankenstein/frank.birth.html [Accessed 13 June 2002] [AU1]Thesis statement [AU2]Topic sentence [AU3]Year of pub put here to mark off Behrendt from next reference [AU4] Content-prominent reference because it is not controversial [AU5]Author-prominent because it is an opinion. [AU6]Topic sentence [AU7]Direct quotation [AU8]Link with preceding paragraph [AU9]Conclusion [AU10]Chapter in book edited by two authors [AU11]Journal article [AU12]Chapter in book edited by one author

Aphra Bhen’s Oroonoko “The royal Slave” and “Candide, Or Optimism” Essay

Aphra Bhen was a prolific female playwright and author during the restoration period of English history. Bhen herself stood by the power of the monarchy. Her book ‘_Oroonoko_’ has hints within the text that royalty is seen as set apart from the rest of society; and that rank is the natural order of things. Though little is really known about Behn’s early years, evidence suggests that she may have had a Catholic upbringing; (1) however, in considering the text for analysis, Bhen’s position on religion shows that she found religion very constrictive to society, which I will discuss in detail later. Franà §ois-Marie Arouet who is also known by his nom de plume Voltaire, was famous for his wit and for his advocacy of civil liberties, including freedom of religion, freedom of expression, free trade and separation of church and state. He was a French Enlightenment writer, historian and philosopher, and his Book ‘_Candide or Optimism’_ is a satirical philosophical tale which I will also discuss in detail later. The first text to be analysed is found on page 11 of ‘_Oroonoko_’. The text depicts the â€Å"Indian† natives of Surinam, how they appear to the narrator, how they show love to each other and how they interact with the English governor. The text begins with a vivid description of the natives. ‘they are extreme modest bashful, very shy and nice of being touched†¦Ã¢â‚¬â„¢ [†¦] ‘†¦and though they are all thus naked if one lives forever among them, there is not seen an indecent action or glance.’ This is a vivid description of innocence, and leads to the use of poetic language when discussing erotic love: eg :-‘he pursues her with eyes and sighs were all his language’ while she: ‘†¦looked  down with all blushing modesty.’. This is also a clever use of the narrative structure known as vocalisation, and gives a powerful impression of how the natives feel for each other. However the tone she uses in the text is also hyperbolic, in as much as she romanticises the natives she describes. Also by doing this the natives are shown as passive. The text also contains Biblical perspective and religious connotations. In the first quarter of the narrative she states ‘†¦so like our parents before the fall†¦Ã¢â‚¬â„¢ which she also connects with: ‘†¦and these people represented to me an absolute idea of the first state of innocence, before man knew how to sin†¦Ã¢â‚¬â„¢ By placing these comments in this conjunction, together with the innocence she creates, she thus connects both the native man and the woman to Adam and Eve within their setting:- the jungle of Surinam, which thus creates an impression of the Garden of Eden as described in the Bible, in Genesis 3. This is something that her audience, having known the Biblical text accurately, would have been able to understand and thus take into consideration, when thinking about a man and a woman from a country a long way away. The narrator considers this noble; when she sees their culture free from the social parameters of religion and informs the reader thus: ‘Nature is the most harmless, inoffensive, and virtuous mistress, it is she alone, if she were permitted, that better instructs the world than the inventions of man; religion would here destroy that tranquillity that they possess by ignorance.’ But she also sates in the first quarter of the text . ‘It seems as if they had no wishes, and nothing to heighten their curiosity’; and later adds: ‘where there is no novelty there is no curiosity.’ when this is considered with the biblical connections, there is the possible implication of rank detachment thus separating the natives from the Christian-European culture which she and her readers are a part of. At the end of the text, she separates the natives even further from the colonists, when she describes a meeting with the Governor. When the Governor cannot make the trip to see them, the natives conclude that he must be dead. When this it is seen that this is not the case, the natives call the Governor ‘a liar and guilty of that infamy’. On one level, this could be seen as ‘native justice’ as she calls it. However, it also implies that the natives are limited in their understanding, and possibly suggesting that colonisation is acceptable, moreover necessary for their development. The second texts is seen on Pages 40 to 42 of Voltaire’s ‘Candide or Optimism’ and are contained in chapter 16 of the main text. The scene depicts Candide and Cacambo entering the Jungle of Orillion, Their entrapment by the Orillians’; Cacambo’s discourse with the Orillians, who then release Candide and Cacambo from captivity, and ends with Candide’s exclamation as to how nice the Orillians are. ‘It’s a Jesuit it’s a Jesuit we will be avenged! And we’ll eat the Jesuit! ‘ say the Orillians after capturing Candide. Here Voltaire is seeing the native as very savage. But he is also viscously satirical and ironic, as Voltaire himself was taught by the Jesuit order. The omniscient narrator here gives us insight into what the natives are saying, and this adds to the viscous humour and the irony. Candide then considers the philosophy of optimism which is the underpinning continuing theme within the text ‘All is for the best, no doubt, but I must say that it’s a cruel thing to have lost Mademoiselle Cunà ©gonde and be roasted on a spit by the Orillions.’ Cacambo comes to the rescue by reasoning with the natives. Here Voltaire does not see a race that is inferior to the culture in Europe, but simply another form human being that can be reasoned with. As Cacambo states: that: ‘natural law teaches us to kill our neighbour all the world over’. [†¦] ‘The Orillians might be cannibals’ but as he says ‘We Europeans have other means of eating well’ thus suggesting that there is little that separates modern society from the native, other than money. The Orrillians are convinced by Cacambo’s reasoned speech and not only do they let them go, they give them women and are treated with â€Å"every civility† again underlining the ‘civility’ of the native population and thus informing the reader of the day that the natives are civilised in their behaviour, despite where they live and what they wear and try to do. As the piece end’s, Candide is overcome both by his deliverance but also by the natives themselves â€Å"what men! What customs!† he says, going back to the theory of Optimism and the issues that relate to cause and effect: ‘ if I had not run my sword right through Cunà ©gonde’s brother, I would have been eaten alive without fail.’ [†¦] ‘It seems to me that nature is a good thing, since these people, instead of eating me, showed me a thousand civilities just as soon as they know I was not a Jesuit.’ In its tone style and genre ‘_Candide or Optimism’_ is a sharply satirical, philosophical tale that stands against the Leibnitz’s argument for philosophical optimism which is summed up in the words of Alexander pope: ‘whatever IS, IS RIGHT’. (2) In its tone style and genre ‘Oroonoko’ is a classical tradgedy where the hero is brought low by personal character flaws or outside circumstances. In comparing and contrasting the texts, both consider colonisation and exploration: In considering the concept of exploration within ‘_Oroonoko_’ Bhen paints a vivid picture of the passivity and the beauty of the natural order, and how this justifies hierarchal society, Whereas, in ‘_Candide_’ Voltaire paints a very different picture, where humanity as a whole is struggling with its very nature, and only reason and enlightenment can help humanity progress. In considering colonisation, Bhen supports the idea of colonisation as a means of financial gain for the homeland. Therefore the natives are shown as a species on their own but a secondary species, next to the European colonists which thus supports the idea of slavery, as a means to an end, despite the suffering that slavery incurs. This is seen in how she considers the natives in the text, who are considered, on the whole as naà ¯ve. In ‘_Candide_’ Voltaire gives us a very complex picture of a world with complex cultures that simply do not interact well. Suggesting that colonisation is an imposition of one culture upon another for the sake of greed. This too is seen in the way he portrays the natives in the text, and though both consider religion to be a man-made construct that is difficult and dangerous to impose upon another culture. It is Bhen’s perspective of the natives that is demeaning, whereas Voltaire’s position is one of equality where we are all the same ‘the world over’. ‘_Oroonoko_’ by Aphra Bhen and ‘_Candide_’ by Voltaire, Both have varied and complex arguments relating to slavery and the plight of humanity. Both are very different and tell two very different stories of life in other lands. The fact that they are still in print now, is a reflection of their importance in understanding the attitudes and cultural aspects of the time that they were written. This in turn, still makes them as important as they were when they were first written. 1. Todd J Introduction xviii Oroonoko 2. Pope A _Essay of man p 45-6_ Fraiser R Voltaire â€Å"_candide, or optimism†_ P 182 renaissance and the long 18th Century (ed) Pacheo A, Johnson D, Open university press. Biblography Bhen A. Oroonoko William canning (1688) (ed) Todd J. penguin classics(2004) Voltaire Candide or Optimism (ed) T. Cuffe Penguin classics (2005) The Renaissance and long eighteenth century (ed) Pacheo A, Johnson D, Open university press.(2008)