Explanation of I Believe That Deep Down All Human Beings Are Really Essay

Explanation of I Believe That Deep Down All Human Beings Are Really Good Quote by Anne Frank - Essay Example The Holocaust, which claimed the writer’s life, involved the killing of hundreds of thousands of innocent Jews. The author believed that the evil would soon end, and peace would prevail. She had the belief that the people who were undertaking the massacre would come to their mind and realize the harm that they cause, realizing the good that is still in their hearts. The quote means that people have two sides, the good and the bad, and no matter how the evil side is, the good side can still be portrayed. I disagree with this quote. People do certainly have good sides, but they do not apply to everybody that they interact with. For this quote to be applicable to all humans, people would be considering the implications of their actions on others before undertaking these activities. In the worst scenario, if all humans had some good on them, they would see how other people are suffering and have empathy for them. The mere assumption that humans are capable of changing does not mean that everybody can. Some people are stuck in beliefs that good will happen to them if they commit heinous actions. There are occurrences that prove not all humans have good in them. One critical phenomenon is the historical Johnstown massacre in the US 1978 which claimed the lives of over 900 people (The Guardian, n.p). The cult leader Jim Jones forced his followed to drink poisoned juice. Those who declined were injected with the poisoned or shot dead (The Guardian, n.p). Another issue that proves not all humans have good in them is the presence of terrorist organizations such as ISIS. The ISIS members behead people and kill people in painful and horrible ways. If these people had any slight good in them, these atrocities would not be happening. Â  

Health and Social Care Essay Example for Free

Health and Social Care Essay Introduction The aim of this essay is to review and learn about the perspectives of health and well-being, perspective measures and job roles, factors affecting health and well being, and to do a health promotion campaign. To do this we will look in books and on the internet to research each of these then once we have a good knowledge of them we will produce a campaign to teach to people on a health promotion topic. Defining Health I am doing first part of the essay on health and how people define it. To do this I will be handing out questionnaires and looking through my class notes and reviewing them. There are many definitions of health, but the way you define it depends on the person e.g. â€Å"Being without illness.† this means to have no illnesses or diseases, â€Å"Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.† this statement is trying to say you don’t just have to have an illness to be unwell it also depends on your social and mental state, and how you feel about yourself (W.H.O. 1948), â€Å"Just being happy.† this statement is just saying your healthy if your happy with yourself and your life, â€Å"Health is the extent to which an individual I wear skirts or group is able, on the one hand to realise aspiration and needs; and on the other hand, to change or cope with the environment. Health is therefore seen as a resource for everyday life, not the object of living. It is positive concept emphasing social and personal resources, as well as physical capacities.† (W. H.O. 1986) etc. (All of these are from class notes) However these views have a negative and positive point side to them such as â€Å"Being without illness† which is negative, because it’s just saying, if you not injured or you don’t have and illness your in good health, but it also depends on a persons state of mind, and how the truly feel about themselves also this is a bit to straight forward, and in considerate of all the other aspects of health (PI.E.S.) because it just says it in a more scientific way (bio-medical – see the body as a machine). Another view on health is â€Å"Being fit. Being the correct weight and height for your age. Feeling well in your self† (Appendix 2) these is a positive and negative view on health because it sees the fact that you can be unhealthy but still be happy and feel good. Bio-medial Model of Health This model of health dominates all other models of health. The Bio-medical or scientific model of health is when you see the body as a machine, so if it’s broken it can be fixed by repairing the damaged part e.g. Car Person Car wont start Person feels ill Call garage Go to G.P. Service Examination Diagnosis Diagnosis Mended Treatment offered Car runs Feeling better (Health and social care ocr: a. fisher etc.: p 78) This form of health doesn’t focus on the mind or the social circumstance; it focuses on understanding how a disease works or how the person can be cured. An example of some one using this form of health care is when a doctor and other qualified people decide on a treatment or diagnosis for a patient, e.g. looking at medical tests and notes to reach a diagnosis. Also there can be a few disadvantages to this model of health e.g. it’s not as suitable for people with long term illnesses or people with disabilities because they can not always be cured, and this form of treatment can be quite intrusive because of tests etc., so some people may not like it and it may make them feel uncomfortable. Another disadvantage is that because it doesn’t look at the social aspects of the patient’s life they may not find the origin of the problem, so the person could become ill again. Social Model of Health This form of health is more about the origins of health in a social situation such as housing, social groups etc., and understanding where the problem started and finding a better way to test the situation for example cleaning the house for dust so it doesn’t aggravate a person’s asthma. Also due to this health model the mortality has dramatically decreased during the 20th century, because people have found the original source of the problem and done something about it and they did it so you can increase a person’s quality of life and decrease illness. However there are disadvantages to this medical model because finding and solving the problems can be hard and it ignores the biomedical model of health. Government Initiative Saving Lives: Our Healthier Nation For my health promotion campaign I’m doing smoking so this government initiative links into it. The aim of this government initiative is to improve everyone’s health, and the people who are severally affected in particular. By 2010 they want to †¢ Reduce the death rate from cancer in people under the age of 75 by at least 1/5 †¢ Reduce the death rate from coronary heart disease, stroke and other related illnesses in people under the age of 75 by at least 2/5 †¢ Reduce the death rate from accidents by at least 1/5 and to reduce the rate of serious injury from accidents by at least 1/10 †¢ Reduce the death rate from suicide and undetermined injury by at least 1/5 (Class notes) Due to these things the government brought in some measures to help deal with these problems which are tackling smoking which is one of the biggest causes of ill health along with alcohol, also to tackle sexual health, drugs, food safety, water fluoridation, and communicable diseases, to put more money in the NHS, local authorities and the government focusing on improving health. (Appendix 1) Illness impairment of normal physiological function affecting part or all of an organism. (http://uk.ask.com/reference/dictionary/wordnetuk/81070/illness) The Illness Wellness Continuum According to The Illness Wellness Continuum the less well you are the closer you are to premature death (as shown by the diagram above left = death right = high level of wellness). This also relates to the government initiative because the government wants to reduce mortality by reducing illness. Reviewing Questionnaires This is a graph to show the amount of people who took the questionnaire and are either service users or service providers. This graph shows the number of men and women who took the questionnaire, and as you can see the main amount of people who took the questionnaire were women. Stop Smoking Advisor The Stop Smoking Advisor works with patients in the community, to provide stop smoking support, treatment and advice set by local and national standards. A Smoking Advisor works with the Stop Smoking Specialists to give one-to-one and group support so their work means they have to travel all around the country to many different places such as health centres, hospitals, community buildings, working men’s clubs, Sure Start buildings etc. To give support and inform people about the dangers of smoking they may do a presentation or bring in videos for people to watch such as the NHS (National Health Service) smoking adverts on T.V., also the advisor may bring in graphic pictures to shock people and make them understand what they’re doing to their bodies’ e.g. The responsibilities and skills needed to be a smoking advisor are as follows: (http://www.jobs.nhs.uk/cgi-bin/vacdetails.cgi?search_db_no=2selection=911717227vn=2) Health Visitor Health visitors are registered nurses or midwives who work to promote good health, and prevent illness in the community. But spend most of their day visiting people in their homes and helping with tasks. Health visitors work with many different people in the community such as the elderly, disabled, and the long-term sick, and offers them support and advice to help people overcome their disabilities. Health visitors have many duties they need to do: †¢ Advising the elderly on health issues – telling people about proper care needed to maintain equipment e.g. catheter care. †¢ Advising new mothers on issues such as hygiene, safety, feeding and sleeping this is because a new mother may not no about all the responsibilities that come with a child so the will need to be informed. †¢ Counselling people on issues such as post-natal depression, bereavement, or being diagnosed HIV positive. †¢ Co-ordinating child immunisation programmes. †¢ Organising special clinics or drop-in centres. (http://www.learndirect-advice.co.uk/helpwithyourcareer/jobprofiles/profiles/profile429/) To be a health visitor, you should be able to do all these things: †¢ Be able to get on well with all sorts of people – this is because they work with a wind range of people in all different circumstances. †¢ Be interested in and aware of health and social issues –this is so they can communicate with all different sorts of people and be aware of any issues that need addressing. †¢ Have very good communication and listening skills – this is so the patient can trust the health visitor and in turn give better care. †¢ Be patient and persuasive – this is because it may be hard for people to do certain things or they may have learning difficulties which may hinder their care. †¢ Be able to understand body language and other non-verbal communication – this is so you can make the best of a situation by interpreting it. Also it may improve communication. †¢ Be responsible and be good time management – this is also to improve the relation ship between patients and the health visitor because if there late the patient may feel they are not wanted of no one has time for them. †¢ Be able to work on your own – this is because a health visitor mainly works on their own in homes so you need to be independent. †¢ Be mature and be able to deal with distressing issues. Training As a qualified nurse or midwife it is necessary to take a degree or postgraduate course in public health nursing/health visiting if you wish to become a health visitor. Courses last one year full-time or two years part-time and are available at colleges and universities throughout the UK. Courses use both the theoretical (studying subjects such as community practice and public health, counselling and social policy), and practical placements supervised by an experienced health visitor. Qualified health visitors are expected to keep their skills up to date through continuous development. A health visitor also runs immunisation programmes set by the local government initiative i.e. in certain areas different illnesses may be more prominent so they will have different vaccines to immunise them. Factors That Affect Health Factors that affect health can be this such as eating habits, exercise, life style, attitudes and prejudices’, income, physical factors, environment etc. but there are many different views that go along with them, so to see if these descriptions meet with what normal civilians think are right (compared to professionals) I am going to do two interviews with two different people and see if there social factors and financial factors go along with these professional descriptions. Financial Factors Income factors are probably one of the main problems with trying to get good health care, this is when you do not earn enough money to get the things you need to survive and be well. If you do not have enough money to get adequate health care you may become unwell, also if you are unable to afford things such as health food, housing, etc. it could increase your chances of getting ill. Also this may lead to the life changes or factors that affect your health, because you are unable to get what you want and need. Social Factors Social factors or social class are tied in with income because what group you’re in depends on how much you earn. Social circumstances contribute a lot to a person’s health because usually if you’re higher up the socio-economic ladder you will have more money and be able to afford better health care. These social factors also relate to family and culture. †¢ Family – how many people in your family, how they affect your life etc. †¢ Culture – how people live their lives such as following religions (for example Jehovah’s witnesses don’t allow blood transfusions) etc. Poor social and economic circumstances affect health and well being all the way through life. People further down the social ladder are usually twice as likely to be at risk of serious illness and premature death. (Appendix 15) Also in certain classes things such as smoking or binge drinking can be more usual than in other classes. For example: †¢ Children in a lower group are five times more likely to die from an accident, than those in a higher group. †¢ People in class five are three times more likely to have a stroke than someone in class one. †¢ Infant mortality is higher in the lower groups. And all this is mainly because they cannot afford better health care and housing, healthier food etc. (N, Moonie: p138) Life Style People see Life style a choice you make such as drinking sensibly or the practice of safe sex. However, it can be more complicated than that e.g. if you have a low income it may be harder for you to eat healthier than those people who can afford a healthier life style. This is because trying to live a healthy life style is expensive, especially health food because it takes longer to prepare, also if you don’t have a local store that sales heath food i.e. organic things with no preservatives it can be hard. Also due to many other factors such as up bringing, social factors etc. it may be hard to lead a healthy life according to the government views, because doing all the things you may need to do to keep healthy can be expensive so some people may not be able to afford it, also it can be hard to change you ways and if your set in a unhealthy routine you will only get more unwell. A recent survey says 46% of people agreed that there are too many factors out side a single person’s health. (N, Moonie: p123) Attitudes and Prejudices This relates to the preconceived ideal people have about each other and how they act around different people. Environment Factors Your environment is all the things around you that affect your health such as housing e.g. if your child has asthma and you have a dusty house it may aggravate the condition and make the child unwell. Physical Factors This factor is al about you physical state i.e. healthy according to the government guidelines and whether you have any physical disabilities. If you have a disability it may restrict you from accessing all the services you need. Regular strenuous physical activity has a protective effect for heart disease and stroke, builds bone mass, improves posture and helps control body weight. Physical activity can also improve mental health and well-being. (All of these factors are from N, Moonie: p131-145) Interviews First of all I chose two factors that affect health, which were financial factors and social factors, next I came up with eight questions (five on finance and three on social factors see Appendix 12). After creating the interview I arranged a time with two people and asked them my questions. I started both interviews by saying â€Å"all the information I get will remain confidential and it will only be used in my course work†. Financial factors: 1. Does income affect how you want to live your life? Both the people I interviewed believed they don’t always have enough money to live the life they want but for two separate reasons the first person said â€Å"my wages are not rising with rate of inflation† so this person doesn’t believe they earn enough with the cost of things in this country i.e. things cost more because of inflation. The second person said â€Å"some times I don’t have enough money to do the things I want e.g. go away on holiday with my friends. But I am unemployed at the moment so that doesn’t help† so the reason this person cannot afford the life style they want is because they are unemployed and are currently out of money. 2. Or how does your life affect your income? Both the people say their social lives and bills are too expensive so they don’t always have the amount of money they want. 3. What things do you feel you are unable to access due to your income? Person 1 – this person doesn’t believe they can access holidays etc. so in other words time to relax and get away. Person 2 – this person believes that they are unable to socialise some times because of their income and this is a major part of their life. 4. What things do you feel you are able to access due to your income? Both people feel they are able to access all the important and necessary things and the stuff they want to do for themselves. 5. Do you think your income affects your health in any way? Both believe that there income doesn’t affect their life in any major way. Social Factors: 6. Do you follow your friend’s example i.e. peer pressure? Person 1 – this person does the things they want to do when they want to do them and doesn’t follow their friend’s example. Person 2 – this person says â€Å"Yes, but not peer pressure† so they follow what their friends do but they don’t believe there being forced or persuaded to do something they don’t want to do. 7. Is your family a positive or negative affect on your life and health? Person 1 – this person thinks that their family are a positive affect on their life. Person 2 – person 2 thinks â€Å"Yes and no because my family are just annoying and stress me out, but the support me when I need it†. Like in most families some things get on each others nerves but when you really need them they are there for you. 8. Does your social class affect your life style or health? Person 1 – they think there social class doesn’t affect their life in any way. Person 2 – they think that it does because if they were higher up the ladder they would have more money and be able to do more of the things they want and need. In conclusion my primary research (the interviews) show that the definitions of the two factors I chose are correct and they say the same as the interviewees but in more detail. My definition gathered from research in books etc. â€Å"this is when you do not earn enough money to get the things you need to survive and be well. If you do not have enough money to get adequate health care you may become unwell† this is basically the same as what the interviewees said i.e. â€Å"Both the people say their social lives and bills are too expensive so they don’t always have the amount of money they want† so in other words both the definition and people say they don’t all ways have enough money do the things they like or access all the things they need. Plan (Appendix 19) Aims and Objectives In a group of three, me and the other people in my group did a presentation to a thirty-seven different people aged 15 18 in ten different groups about the dangers of smoking. At the beginning and end of each group we gave them a questionnaire to test their knowledge before and after and we took 12 samples of each from different groups to test if they had learnt anything. We found out that before they only had a basic knowledge about smoking and after they had a more extensive knowledge and knew about smoking and its dangers in better detail. We knew this because we looked at the sample of questionnaires and saw how in much more detail they answered the questions. So we must have had an impact on their knowledge and views. However, we didn’t change some people views on smoking because they were slightly arrogant and just believed their life was their life. Aims: To produce a presentation to inform people about the dangers of smoking and inform people on ways they can quit e.g. NHS help line. Objectives: †¢ To know what’s offered by the NHS to help quit. †¢ By the end they should be able to identify the 3 main diseases caused by smoking and some substances in a cigarette. †¢ Raise awareness that smoking kills. Key Tasks/Activities: To produce: †¢ Make and collect in before and after questionnaires about smoking. †¢ Take part in talking to the people at the presentation. †¢ Posters and leaflets. †¢ Handouts with second hand smoke, dangers etc †¢ Power point presentation with the main major facts about smoking such as second hand smoke, the dangers of smoking, withdrawal symptoms etc. also videos showing the dangers of smoking e.g. NHS adverts from T.V. and shocking things about smoking Results: What do you hope will change as a result of your activities? To help people understand the dangers of smoking and hope they change their behaviour as a result of the presentation. Measures: How will you measure if the described change is occurring? Has occurred? To measure my presentation and see if the desired results have happened I will look at the before and after questionnaires and see if there knowledge has improved. Evaluation Skills: Communication skills I think my communication skills were quite good as I took it in turns with the people in my group to talk to people however one of the other people in the group spoke a lot more than the rest. Also because I was working the power point presentation there was a barrier between us all, so people may not have opened up as much and spoken as much as they might have if it wasn’t there. Team Work and Work Load Yes I believe the work load and team fork was shared fairly. Also I think it was appropriate for the people in the group. Resources used We used quite a lot of resources such as books like Moonie and the NHS booklets also I’ve been on the NHS web site and looked at the stop smoking advice they give. Activities used The activities we used to show people about the dangers of smoking are handouts a PowerPoint presentation with videos and a large poster with lots of information on. Also during the presentation we had small discussions about the material and answered any question the people had. The Environment We did the presentation in a classroom with the others in our class but there was three different groups doing different things. One of the other groups had a loud video, which sometimes overpowered what we were doing and was a distraction. Also we had 2 change rooms at the start because the room was needed for a test by another class, so we had to move all the equipment and reorganise the set out. Health and Safety The only health and social issues I think there were was the electricity we had to use to power every thing however there were floor plugs with caps on and we weren’t messing about with anything. Also all the cables were hidden out the way so no one could trip over them. Were the Aims and Objectivities Achieved? Yes all the aims and objectives were achieved because we saw from the questionnaires that their knowledge improved and they knew the main diseases and more substances in a cigarette. Also we produced an interesting presentation. For example of questionnaires and to see if the people’s knowledge improved see (Appendix 17 and 18) Would You Do Anything Differently Next Time? If I were doing the presentation again I would use a separate room so there were no interruptions, and I would try and be more involved and speak more. Conclusion In conclusion there are many things that contribute to people health such as life style, attitudes and prejudices etc. and they affect different people in different ways. This is why we looked at them in detail first because if we didn’t fully understand all the things that affect health, we wouldn’t have been able to do an affective campaign.

Hemagglutinin and a Future Cure for Influenza Essay -- Influenza Virus

Final Project: Hemagglutinin Abstract Hemagglutinin is membrane protein found on the influenza virus. This project focuses on hemagglutinin subtype H1, the one involved in the 1918 Spanish influenza. The project concentrates on explaining the structure and function of the protein, while trying to give an accurate account of the molecular interactions between the protein and the host cell membrane. Specifically, hemagglutinin is a protein composed of three monomer protein strands. Each monomer consists of three important subdomains called the fusion subdomain, the receptor binding subdomain, and the vestigial esterase subdomain. Each has an important function in a virus infection. This project hopes to provide info for future research into preventing and perhaps curing influenza. Background Viruses use simple mechanisms to attack and infect their hosts. One step in a virus attack is the binding of the virus to the host cell. The virus does this by using surface proteins that can recognize and attach to receptors on the cell membrane and somehow injects its genetic material into the host cell.3 Hemagglutinin is a kind of surface protein found on the lipid envelopes of the influenza virus. Hemagglutinin gets its name from its effect on making red blood cells clump together and agglutinate. The influenza virus has many hemagglutinin proteins, and each can attach to a red blood cell, causing the red blood cells to come together around the virus. This causes thickening of the blood and affects the clotting ability of blood.2 There are 16 different subtypes of the protein, ranging from H1 to H16. The more important ones are H1, H2, and H3, the subtypes found on the human influenza virus.2 This proj... ... - Wikipedia, the free encyclopedia. 3 Mar 2004. 2 Aug 2007 . 3. "Influenza." Main Page - Wikipedia, the free encyclopedia. 9 Apr 2002. 2 Aug 2007 . 4. Marcey, David, and Eric Mazur. "Influenza Hamagglutinin." California Lutheran University - Welcome. 22 Jan 2005. 2 Aug 2007 . 5. Woods, Heather. "Structural Analysis of Hemagglutinin from the 1918 Influenza Pandemic." SSRL- Stanford Synchrotron Radiation Laboratory. 30 Aug 2004. 2 Aug 2007 . 6. The Structure and Receptor Binding Properties of the 1918 Influenza Hemagglutinin Science 303, 1838 (2004); DOI: 10.1126/science.1093155

Student-Centered Learning :: Education Teaching Papers

Student-Centered Learning Recently, the buzzword for school wide educational reform is student-centered learning. My last year teaching, the administration threw around this term, yet no in-services were in place on this subject in order to accomplish the goal. Even Atlanta Public School's strategic technology plan uses the common student-centered learning phrase, " Teachers will move from mentor in the center to guide on the side." However, very few teachers actually use this approach in their classrooms. One example of an excellent student-centered learning activity was "Biomes in a Box." A colleague of mine used this project, her students work in teams to research and create a biome of a particular climate of their choosing. I observed students using various forms of media including the Internet and CD-ROM resources to research their particular biome. They constructed the climate conditions of that biome using various raw materials at their disposal. In the end, they presented their biome to the class with an oral discussion of the climatic elements involved with that biome. The students were so proud and so actively involved in their learning. It was a great success. I am sure that "Biomes in a Box" will be one lesson those students learned in that school. Even though some teachers use this new approach successfully in their class, my concern is that not all of the teachers can or even know how to change from the "mentor in the center" to "guide on the side." Has the school systems come up with way to change the mindsets of these teachers and show them how to make their classrooms active learning environments? No, they are just content to throw the phrase around without determining how to bring about student-centered learning in the classrooms. So what is Student centered learning? Is it the cure all for the ailing public education system? What tools need to be in place in order to facilitate a student-centered learning environment? What kind of in-service or extra training will be necessary in order to foster the student-centered classroom? In this paper, I will define student-centered learning, explain the key attributes to this type of learning process, and identify the tools that will facilitate its growth. From Mentor in the Center to Guide on the Side "Students should be presented with real life problems and then helped to discover information required to solve them" John Dewey

Attachment, Loss and Bereavement

This essay describes and evaluates the contributions of Bowlby, Ainsworth, Murray-Parkes, Kubler-Ross and Worden, as well as later theorists, to their respective fields. I demonstrate how I already work with some of these models, highlighting my strengths and areas for development. I emphasise some influences on Bowlby’s work, leading to his trilogy Attachment 1969; Separation 1973; and Loss, Sadness and Depression 1980; demonstrating how attachments in infancy may shape our attachment styles in later life.Pietromonaco and Barrett posit â€Å"A central tenet of attachment theory is that people develop mental representations, or internal working models that consist of expectations about the self, significant others and the relationship between the two. † (Pietromonaco and Barrett, 2000, 4:2, p156). I illustrate how this internal working model is developed via the relationship between infant and primary caregiver, demonstrating that maternal deprivation can create a †˜faulty’ internal working model, which may lead to psychopathology in later life.I also demonstrate how these internal working models influence our reactions to loss and bereavement in adulthood and their potential impact on the counselling relationship. In addition, I explore the multi-layered losses experienced by HIV+ gay men and finally draw some conclusions. Freud’s view on the infant’s attachment to its mother was quite simple â€Å"the reason why the infant in arms wants to perceive the presence of its mother is only because it already knows by experience that she satisfies all its needs without delay.† (Freud, 1924, p188 cited in Eysenck, 2005, p103).In contrast, behaviourists believed that feeding played a central role in the development of attachment. (Pendry, 1998; Eysenck, 2005). These theories were termed ‘secondary-drive theories’. In 1980, Bowlby recalled â€Å"this [secondary drive] theory did not seem to me to fit the facts †¦. but, if the secondary dependency was inadequate, what was the alternative? † (Bowlby,1980, p650 cited in Cassidy and Shaver, 1999, p3).Bowlby’s theory was influenced by his paper â€Å"Forty Four Juvenile Thieves†, where he concluded a correlation exists between maternal deprivation in infancy, leading to affectionless psychopathology and subsequent criminal behaviour in adolescents. (Bowlby, 1944, 25, p19-52). This led to him researching the impact of loss on children displaced through war and institutionalisation, resulting in ‘Maternal Care and Mental Health’ (1952), where he confirms a link between ‘environmental trauma’ and resultant disturbances in child development.As a result of this research, Bowlby concluded â€Å"it is psychological deprivation rather than the economic, nutritional or medical deprivation that is the cause of troubled children. † (Bowlby in Coates, 2004, 52, p577). He was further influenced by L orenz who found that goslings would follow and ‘attach’ themselves to the first moving object they saw. This following of the first moving object was called ‘imprinting’. (Lorenz, 1937 cited in Kaplan, 1998, p124).Clearly babies cannot follow at will – to compensate for this, †Bowlby noted that ‘imprinting’ manifested itself as a spectacularly more complex phenomenon in primates, including man, which he later labelled ‘attachment’. † (Hoover, 2004, 11:1, p58-60). He also embraced the work of Harlow and Zimmerman who worked with infant rhesus monkeys demonstrating that not only did the need for attachment give them security, but that this need took priority over their need for food. (Harlow and Zimmerman 1959 cited in Green and Scholes, 2003, p9).Dissatisfied with traditional theories, Bowlby embraced new understandings through discussion with colleagues from such fields as developmental psychology, ethology, cont rol systems theory and cognitive science, leading him to formulate his theory that the mechanisms underlying the infant’s tie to the mother originally emerged as a result of evolutionary and biological pressures. (Cassidy and Shaver, 1999; Green and Scholes, 2003).Defining his attachment theory as â€Å"a way of conceptualising the propensity of human beings to make strong affectional bonds to particular others.† (Bowlby, 1979 cited in Green and Scholes, 2003, p7), he posited â€Å"that it is our affectional bonds to attachment figures that engage us in our most intense emotions. † and that â€Å"this occurs during their formation (we call that ‘falling in love), in their maintenance (which we describe as ‘loving) and in their loss (which we know as ‘grieving’), (Green and Scholes, 2003, p8), thereby replacing the secondary-drive theory with a model emphasising the role relationships play in attachment and loss. (Waters, Crowell, Elliot t et all, 2002, 4, p230-242).Disregarding what he called Freud's ‘cupboard love’ theory of attachment, he believed instead that a child is born ‘biologically pre-disposed’ to become attached to its mother, claiming this bond has two essential features: the biological function of securing protection for survival and the physiological and psychological need for security. (Green and Scholes, 2003; Schaffer, 2004). Sonkin (2005) describes four features to this bond: secure base, separation protest, safe haven and proximity maintenance.The concept of a secure base is fundamental to attachment theory and is used to describe a dependable attachment to a primary caregiver. This secure base is established by providing consistent levels of safety, responsiveness and emotional comfort from within which the infant can explore his or her external and internal worlds and to which they can return, thus providing a sense of security. Separation protest is exhibited as a si gn of the distress experienced upon separation from an attachment figure, who may also be used as a safe haven to turn to for comfort in times of distress.When safety is threatened, infants attract the attention of their primary caregiver through crying or screaming. Maintaining attention and interest, e. g. vocalising and smiling, and seeking or maintaining proximity, e. g. following or clinging, all serve to promote the safety provided by the secure base (providing of course that parents respond appropriately). (Holmes, 1993; Cassidy and Shaver 1999; Becket, 2002; Green and Scholes, 2003).Proximity seeking is a two way process, for example child seeking parent or parent seeking child. (Weiss in Murray-Parkes, Stevenson-Hinde and Marris, 1991; Becket, 2004; Sonkin, 2007). Bowlby also recognised ‘unwilling’ separation caused by parents who were phsycially present but not able to respond, or who deprived infants of love or ill-treated them, left them with a sense of imme nse deprivation and that this unwilling separation and resultant loss leads to deep emotional distress. (Green and Scholes, 2003).At a recent conference, the Centre for Attachment based Psychoanalytical Psychotherapy (CAPP) asserts â€Å"Early interactions with significant others in which there are fundamental failures of empathy, attunement, recognition and regulation of emotional states, have been shown to cause the global breakdown of any coherent attachment strategy, thus engendering fears of disintegration and threatening psychic survival. In the face of such experiences, powerful dissociative defences may be employed, encapsulating overwhelming feelings of fear, rage and shame. † (CAPP, 2007).Together with Robertson and Rosenbluth, Bowlby demonstrated that even brief separation from the mother has profound emotional effects on the infant. Their research highlighted a three stage behavioural response to this separation: protest – related to separation anxiety; des pair – related to grief and mourning; and detachment – related to defences. (Robertson, Rosenbluth, Bowlby, 1952 in Murray-Parkes, Stevenson-Hinde and Marris, 1991). Ainsworth, Blehar, Waters and Wall (1978) later established the inter-relatedness between attachment behaviour, maternal sensitivity and exploration in the child.Under clinical settings, they sought to observe the effects of temporary separation from the mother, which was assessed via the ‘strange situation’ procedure. This study involved children between the ages of 12 to 18 months who experienced separation from their mother, introduction to an unfamiliar adult and finally reunion with their mother. Ainsworth et al reasoned that if attachment was strong, mother would be used as a secure base from which the infant could explore, thereby promoting self-reliance and autonomy. Upon separation, infants usually demonstrated separation anxiety.Upon re-union, the mother’s maternal sensitivity and the child’s responses were observed, thus providing a link between Bowlby’s theory and its application to individual experience. The trust/mistrust in the infant’s ability to explore their world from the secure base is re-inforced by Erikson’s (1965) examination of early development and the child’s experiencing of the world as a place that is nurturing, reliable and trustworthy (or not). Influenced by Ainsworth’s previous work in Uganda, the ‘strange situation’ led to the classification of secure or insecure attachment styles in infants.Insecure styles were further grouped into insecure/avoidant and insecure/resistant (ambivalent). (Pendry, 1998; Holmes, 2001; Eysenck, 2005). Main and Solomon later added a fourth attachment style – insecure/disorganised. (Main and Solomon, 1986 in Cassidy and Shaver, 1999, p290). Throughout all of these interactions, an ‘internal working model’ is developed, the cultivat ion of which relies on the dyadic patterns of relating between primary caregiver and infant (Bretherton, 1992, 28, p759-775), comprising the complex monitoring of internal states of primary caregiver and infant.  (Waters, Crowell, Elliott et al, 2002, 4, p230-242).According to Schore â€Å"These formative experiences are embedded in the developing attachment relationship – nature and nurture first come together in mother-infant psychobiological interactions. † (Schore, 2001, 17, p26). Over time, this leads to the infant’s ability to self-monitor their emotions (affect regulation), but until such time, Bowlby posited the mother acts as the child’s ego and super-ego †She orients him in space and time, provides his environment, permits the satisfaction of some impulses, restricts others.She is his ego and his super-ego. † (Bowlby, 1951, p53 cited in Bretherton, 1992, 28, p765). Bowlby concluded a healthy internal working model is â€Å"a worki ng model of an attachment figure who is conceived as accessible, trustworthy and ready to help when called upon†, whilst a ‘faulty’ model is â€Å"a working model of an attachment figure to whom are attributed such characteristics as uncertain accessibility, unwilllingness to respond helpfully, or perhaps the likelihood of responding hostilely. † (Bowlby, 1979, p141).Ainsworth suggests that positive attachment is more than explicit behaviour â€Å"it is built into the nervous system, in the course and as a result of the infant’s experience of his transactions with the mother. † (Ainsworth, 1967, p429), thus supporting Bowlby’s theory. Later descriptions of attachment styles describe secure attachment as â€Å"the development of the basic machinery to self-regulate affects later in life†, (Fonagy, Gergely and Jurist, 2002 cited in Sarkar and Adshead, 2006, 12, p297), whilst insecure attachment â€Å"prevents the development of a proper affect regulatory capacity.† (Sarkar and Adshead, 2006, 12, p297).This is supported by Schore (2003) who alludes to developmental affective neuroscience to set out a framework for affect regulation and dysregulation. Based on research into the development of the infant brain, he reviews neuro-scientific evidence to confirm the infant’s relationship with the primary caregiver has a direct effect on the development of brain structures and pathways involved in both affect regulation and dysregulation.The research and evidence suggests the internal working model begins as soon as the child is born and is the model upon which future relationships are formed. The quality of the primary caregiver’s response to infant distress provides the foundation upon which behavioural and cognitive strategies are developed, which in the longer term influence thoughts, feelings and behaviours in adult relationships. (Cardwell, Wadeley and Murphy, 2000; Pietromonaco and Barrett , 2000, 4:2, p155; Madigan, Moran and Pederson, 2006, 42:2, p293).A healthy, secure attachment to the primary caregiver would therefore appear essential for a child’s social, emotional and intellectual development, whilst interruption to this attachment would appear to promote the premise of psychopathology in later life. Whilst some evidence exists to demonstrate internal working models can be modified by different environmental experiences, (Riggs, Vosvick and Stallings, 2007, 12:6, p922-936), the extent to which they can change remains in question.Bowlby himself postulated â€Å"clinical evidence suggests that the necessary revisions of the model are not always easy to achieve. Usually they are completed but only slowly, often they are done imperfectly, and sometimes done not at all. † (Bowlby, 1969, p83). Whilst change may be possible, the unconscious aspects of internal working models are deemed to be specifically resistant to such change. (Prior and Glaser, 2006) . We can safely assume therefore, that in the majority of cases, internal working models tend to persist for life.I concur with Rutter’s criticism of Bowlby's concept of ‘monotropy’, i.e. Bowlby’s belief that babies develop one primary attachment, usually the mother, (Rutter, 1981 cited in Lucas, 2007, 13, p156 and in Eysenck 2005), accepting instead that infants form multiple attachments. This is supported by a study by Shaffer and Emmerson (1964) who concluded infants form a ‘hierarchy’ of attachments, often with the mother as the primary attachment figure, although nearly a third of children observed highlighted the father as the primary attachment figure. (Schaffer and Emmerson, 1964 in Cassidy and Shaver, 1999, p44-67).Collins, Dunlop and Chrysler criticise Bowlby’s ‘lens’ in that it was â€Å"limited by his own cultural, historical and class position. Bowlby’s culturally biased assumptions and empiricist metho ds of inquiry concentrated on individualised detachment and loss as part of the normal course of mourning loss, which perpetuated the Western tradition of preserving the autonomous individual self as the normal goal of development. † (Collins, Dunlop and Chrysler, 2002, p98), leading them to conclude Bowlby’s assumptions ignored other cultural practices (as did Ainsworths), with which I agree.They also suggest Bowlby’s concept of maternal deprivation was perhaps exploited to get women to return to the home post World War II – â€Å"Characterised as a choice, this ‘homeward bound’ movement was supported by the various governments, whose maternalist and pronatalist ideology of the 1930s continued into the post-war period to provide a rationale for sending women home to reproduce †¦ maternalism and the maternal deprivation hypothesis provided one conceptual framework for pronatal ideology as it intersected  with the demands of governments and industrialists. † (Collins, Dunlap and Chrysler, 2002, p102).We must also remember that Bowlby’s observations â€Å"were based on children who had been separated from their primary caregivers during the Second World War† (Lemma, 2003 cited in Lucas, 2007, 13, p156), and that these procedures â€Å"were based on behaviours that occurred during stressful situations rather than under normal circumstances. † (Lucas, 2007, 13, p156) [this latter criticism also applies to Ainsworth’s work].Nonetheless, in highlighting the damaging effects of institutionalised care on young children, Bowlby’s strengths lie in drawing attention to the role attachment, attachment behaviour and attachment behavioural systems play in a child’s development and the subsequent potential consequences of disruption to the bond between infant and primary caregiver. I concur with Cassidy and Shaver’s (1999) criticisms of the strange situation in that there a re too many unconsidered variables for a firm theory to be established at the time of Ainsworth’s writings, accepting their view that she did not consider the mood nor temperament of the child.Nonetheless, Ainsworth et al have provided a tool with which to measure attachment styles in infants, which is still in use today. Later research by George, Kaplan and Main assesses adult internal models through the use of the Adult Attachment Interview. This classification of adult attachment styles promotes the idea of models extending into adulthood as a template for future relationships. (George, Kaplan and Main 1985 cited in Pendry, 1998).Hazan and Shaver continued this line of research identifying patterns of attachment behavior in adult romantic relationships, concluding the same four attachment styles identified in infancy remain true for adult relationships. (Hazan and Shaver 1987 in Cassidy and Shaver, 1999, p355-377). Although theoretically rooted in the same innate system, a dult romantic attachment styles differ from parent-child bonds to include reciprocity of attachment and caregiving, as well as sexual mating.  (Hazan and Zeifman, 1999 in Cassidy and Shaver, 1999, p336-354).The literature on bereavement has become inseparable from Bowlby’s theory of attachment and, following from this, the way in which people react to the loss of this attachment. On reflecting on losses in adult life, Weinstein (2008) observes Bowlby’s persistence of formative attachments and how the pattern of protest, despair and detachment that follows a baby’s separation from its primary caregiver is re-activated and presented in full force in adult loss.Weinstein writes â€Å"The ability of the adult to cope with attachment in intimate relationships to negotiate independence, dependency and inter-dependency; and to manage loss is all about how successfully they coped with separation as an infant. As a baby they had to retain their sense of their mother e ven in her absence and now as adults, as part of the mourning process, they strengthen their own identity with the support of the internalised object. † (Weinstein, 2008, p34).According to Murray-Parkes (1996), the intensity and duration of this grief is relative to what is lost and the grief process is an emotional response to this loss. Murray-Parkes joined Bowlby at the Tavistock Centre in 1962. Together they presented a paper linking the protests of separation highlighted by Robertson, Rosenbluth and Bowlby (1952) in young children separated from their mothers, to grief in adults. (Bowlby and Murray-Parkes, 1970 in Murray-Parkes, Stevenson-Hinde and Marris, 1991, p20).Around the same time, Murray-Parkes visited Kubler-Ross who was conducting her own research into death and dying. This work was later published in ‘On Death and Dying’ (1969) which examines the process of coming to terms with terminal illness or grief in five stages: denial; anger; bargaining; de pression and acceptance. Murray-Parkes later produced a four-phase grief model consisting: shock or numbness; yearning and pining; disorganisation and despair; and re-organisation.In contrast to the passive staged/phased approaches by Kubler-Ross and Murray-Parkes, and perhaps more in line with Freud’s concept of having ‘to do grief work’, Worden developed a four-staged, task-based grief model: â€Å"to accept the reality of the loss; to work through the pain of grief; to adjust to an environment in which the deceased is missing; and to emotionally relocate the deceased and move on with life. † (Worden, 2003). All three models are deemed to be therapeutically useful in that they recognise grief as a process and provide a framework of descriptors for ‘normalising’ grief reactions.That said, they are clearly prescriptive and caution should be exercised in taking any of these prescriptive stages, phases or tasks literally. It is equally important to recognise the uniqueness of individual responses to loss and to avoid prescribing where a client ‘ought’ to be in their grieving process. Since these models were never designed as a linear process, it is likewise important not to steer clients through these stages. This is supported by Schuchter and Zisook (1993), who assert â€Å"Grief is not a linear process with concrete boundaries but, rather, a composite of overlapping, fluid phases that vary from person to person.† (Schuchter and Zisook, 1993 in Stroebe, Stroebe and Hansson, 1993, p23).I agree with Servaty-Seib’s observations â€Å"the stage/phase approaches emerged solely from a death-loss focus †¦ Worden’s work was an important development in the understanding of the process of coping adaptively with bereavement as each task is clearly defined in an action-oriented manner. † (Servaty-Seib, 2004, 26:2, p125). Stroebe and Schut’s dual process model brings together death- loss focus and task-based models. (Stroebe and Schut, 2001 cited in Servaty-Seib, 2004, 26:2, p125).In my work at Positive East, I work with HIV+ gay men experiencing multi-layered loss. My philosophy is to build and maintain a therapeutic relationship within a safe, confidential, contained space where clients can explore their issues. The archetype ‘working towards a model of gay affirmative therapy’ (Davies and Neal, 1996, p24-40) provides me with a framework within which to explore gay culture and to apply an assenting approach to the work, which I believe promotes empathy and helps me to work in the best interests of the client.Conducting my own assessments, I complete a full client history, genogram and timeline, which provides a comprehensive insight into clients attachments and losses. It is important to acknowledge the social context within which multi-layered loss takes place (e. g. heterosexism, homophobia, HIV-related stigma) as well as recognising that indiv idual attachment styles may influence individual reactions to these losses and may also impact on the counselling relationship.Losses experienced by HIV+ gay men include loss of identity, health, appearance, mobility, self-respect, career, financial security, relationships and intimacy. (Riggs, Vosvick and Stallings, 2007, 12:6, p922-936; Koopman, Gore-Felton, Marouf et al, 2000, 12:5, p663-672; Fernandez and Ruiz, 2006, p356). Corr, Nabe and Corr (1997) describe these losses as the cognitive, affective and behavioural responses to the impact of the loss. In identifying attachment styles in HIV+ adults, Riggs, Vosvick and Stallings (2007) found that 90% of gay and bisexual HIV+ adults recruited into their study demonstrated insecure attachment.They suggest the diagnosis of HIV produces a strong trauma reaction, impacting on adult attachment style. In the same study, they found that HIV+ heterosexual adults were more likely to be secure, whereas gay and bisexual adults were more like ly to be fearful, preoccupied, avoidant; or dismissing, respectively. This led them to conclude that gay and bisexual people must therefore contend with societal forces that their heterosexual counterparts do not.They hypothesise â€Å"A diagnosis of HIV may be reminiscent of the coming out process, particularly with respect to concerns regarding stigma and disclosure, and thus may provoke similar fears about rejection by loved ones and society as a whole that contribute to greater attachment insecurity. † (Riggs, Vosvick and Stallings, 2007, 12:6, p931). This is supported by Koopman, Gore-Felton, Marouf et al (2000) who cite attachment style as a contributing factor associated with the high levels of stress experienced by HIV+ individuals.They comment â€Å"From this perspective, perceived stress is likely to be greater among [HIV+] persons having a highly anxious attachment style because their hypervigilance in interpersonal relationships leads to misinterpreting othersâ⠂¬â„¢ behaviours as rejecting or critical of themselves. † (Koopman, Gore-Felton, Marouf et al, 2000, 12:5, p670). This would suggest that HIV+ gay men with insecure attachment style may experience difficulties in developing and maintaining relationships, which, in turn, may impact on the therapeutic relationship.Additionally, according to Kelly, Murphy, Bahr et al â€Å"Dependable and supportive attachments play a crucial role in adjusting to HIV infection. Lack of such attachments and social support has been shown to be a significant predictor of emotional stress among HIV+ adults. † (Kelly, Murphy, Bahr et al, 1993, 12:3, p215-219). This has significant implications for the psychological well being of HIV+ gay men whom, considering their perceived attachment difficulties, may experience difficulties in forming such supportive relationships.In examining the suitability of the common grief models when working with this client group, I accept Copp’s criticism of the Kubler-Ross model for its focus on psychosocial dynamics â€Å"to the exclusion of physical, and to a lesser extent, spiritual dimensions. † (Copp, 1998, 28:2, p383). I also agree with Knapp’s criticisms of the staged/phased grief models espoused by Kubler-Ross and Murray-Parkes. Knapp observes â€Å"while both of these models may be applicable to those experiencing a singular loss, neither model takes into  consideration the multiplicity of losses thrust upon the seropositive gay male population.These men experience overlapping losses, resulting in them being at differing stages with respect to different losses. † (Knapp, 2000, 6:2, p143). Knapp offers a similar criticism of the Worden model in that â€Å"task models fail to account for the continuity of loss in the lives of seropositive gay men. † (Knapp, 2000, 6:2, p143), with which I also concur. In addition, all three models incorporate an end point, which suggests the completion of a cycle, th ereby pre-supposing some sort of finality.These models are therefore limited in their application to my own work, since, as new losses take the place of old, my clients find themselves in a continual cycle of loss without the comfort of such an end point. Processing the loss of the ‘pre-infected self’ and re-defining the ‘HIV+ self’ often means working with the stage of identity vs role confusion in Erikson’s (1965) psychosocial model. Additionally, where partners stay together, a revisiting and re-negotiation of the adult stage of intimacy may be required since intimacy is often disrupted and sometimes lost due to HIV infection.This stage is also revisited by clients where a partner chooses to end the relationship with a HIV+ partner. Working through the loss of the partner (usually due to fear of infection); as well as other significant relationships (usually due to HIV related stigma); is also key to the work. To support this work, I use the †™multi-dimensional’ grief model by Schuchter and Zisook (1993), adopting four of their five dimensions: emotional and cognitive responses; emotional pain; changes in relationships and changes in identity.  (Schuchter and Zisook, 1993 in Stroebe, Stroebe and Hansson, 1993, p26-43).I have also used Worden’s grief model in supporting a HIV+ client whose HIV infected partner committed suicide. This work is clearly demanding and is informed by the client’s internal working model of self and other. Due to perceived stigma and fear of rejection, it is not unusual for the client’s attachment behavioural system to be activated throughout the therapeutic relationship. Recent research highlights the mirroring of Bowlby’s theory within such a relationship.Parish and Eagle (2003) and Sonkin (2005) draw attention to the manifestation of clients seeking proximity maintenance to the therapist; experiencing distress when the therapist is not available; seeking a safe haven when in distress; and using the therapist as a secure base. To cater for this, I strive to provide a secure base in therapy, ensuring I remain boundaried, punctual and professional, informing clients of any breaks and provide opportunities for clients to explore their anxieties. Clients in particular distress may also contact the agency, who in turn may contact me.My experience has taught me that clients with avoidant attachment styles take time to build trust in the therapeutic relationship. I have also found the avoidant attached usually need permission/re-assurance to grieve their losses, whilst the anxiously attached require permission/re-assurance to stop grieving their losses. I am cognisant that the therapeutic relationship promotes attachment yet at the same time acknowledge the paradox in severing this attachment at the end of therapy. Ending sensitively is therefore crucial. I recognise that clients may develop co-morbid conditions such as alcohol and recreati onal drug abuse.In line with the BACP ethical principles of beneficence, non-maleficence and self-respect (BACP Ethical Framework, 2007), I use supervision to monitor any emerging signs of such abuse, where a decision may be reached to refer these clients to external agencies or other, suitably experienced, internal counsellors. In assessing my strengths and areas for development, I am now much more aware of how early attachment experiences and internal working models impact on how clients process their losses as well as their potential impact on the counselling relationship and process.I have extensive experience of working with loss and bereavement, which is underpinned by my specialist training and practice at Positive East, as a bereavement counsellor with the Bereavement Service and as a counsellor providing support to those bereaved through homicide at Victim Support. I believe a healthy, secure attachment to a primary caregiver is necessary for a child’s social, emotio nal and intellectual development. In turn this promotes the development of a healthy internal working model, disruption to which may lead to psychopathology in later life.Whilst the internal working model tends to persist through the life course, I believe it can be modified by divergent experiences, but acknowledge this change may be difficult. Whilst I have extensive experience of working with loss, I now appreciate how early formative attachments influence our reactions to such loss and how these reactions may impact on the therapeutic relationship. Popular grief models clearly fall short in addressing the multi-layered losses experienced by this client group, demanding instead the integration of what is currently available.The high level of insecure attachment style demonstrated in HIV+ gay men may be due in part to the unique challenges they face within the context of HIV related stigma and negative social experiences. Finally, I believe my knowledge of theory and sensitive app lication of skills has proved to be an effective strategy in working competently, sensitively and safely with this client group. Nonetheless, I recognise the need for continuous professional development and aim to attend workshops on attachment; and mental health and HIV during the summer.

Durkheim essays

Durkheim essays The famous Emile Durkheim was one of the most significant functionalists during the nineteenth century. Most of his scholarly work centered on one basic concept which dealt with what held society together. As a functionalist, Durkheim tried to argue that society is a social system consisting of various integrated parts, he called this Functional Interdependence or Organic Solidarity. This meant that our society is like a living organism with separate parts, each of these parts fulfills a specific role that contributes to the overall functioning of society. For Durkheim elements such as cohesion, laws, and order were vital for groups and individuals to maintain a balanced society. When he talked about law, he specifically divided them into 2 parts; Repressive law, which was basically punishment that was publicly viewed, it is to show what the individuals should not be doing, and it had strong moral ground. The other was Restitutive law, which was characterized by modern societ ies and their bureaucratic legal system in which punishments would be paying fines and imprisonment. He thought deviance was a natural part of society and that it was a guideline, it lets society know what they should avoid taking part in. A concept which strongly defined moral consensus was called the Collective Conscious. It consisted of 4 elements. The first is volume, it dealt with the amount of people that believe in a certain set of morals. The second intensity, which, referred to how much faith people had in those morals. The third rigidity, and that was how clearly defined and solid the beliefs are and the finally the fourth was content. Content is what words make up the collective conscious. Durkheim said that the growth of individualism and division of labor lower all four contents of the collective conscious. In addition to all of the topics discussed, Durkheim was one of the first sociologists to link suicide to the soci ...

Free Essays on Adolesent Depression

The under acknowledged disease called depression is a disease that afflicts the human psyche in such a way that the afflicted tends to act and react abnormally toward others and themselves. Therefore it comes to no surprise to discover that adolescent depression is strongly linked to teen suicide. Adolescent suicide is now responsible for more deaths in youth’s aged 15 to 19 than cardiovascular disease or cancer (Blackman, 1995). Recent studies have shown that greater than 20% of adolescents in the general population have emotional problems and one-third of adolescents attending psychiatric clinics suffer from depression. Despite this increased suicide rate, depression in this age group is greatly under diagnosed and leads to serious difficulties in school, work and personal adjustment, which may often continue, into adulthood. How prevalent are mood disorders in children and when should an adolescent with changes in mood be considered clinically depressed? Brown (1996) has said the reason why depression is often over looked in children and adolescents are because â€Å"children are not always able to express how they feel.† Sometimes the symptoms of mood disorders take on different forms in children than in adults. Adolescence is a time of emotional turmoil, mood swings, gloomy thoughts, and heightened sensitivity. It is a time of rebellion and experimentation. Blackman (1996) observed that the â€Å"challenge is to identify depressive symptomatology which may be superimposed on the backdrop of a more transient, but expected, developmental storm.† Therefore, diagnosis should not lie only in the physician’s hands but be associated with parents, teachers and anyone who interacts with the patient on a daily basis. Unlike adult depression, symptoms of youth depression are often masked. Instead of expressing sadness, teenagers may express boredom and irritability, or may choose to engage in risky behaviors (Oster & Montgomery... Free Essays on Adolesent Depression Free Essays on Adolesent Depression The under acknowledged disease called depression is a disease that afflicts the human psyche in such a way that the afflicted tends to act and react abnormally toward others and themselves. Therefore it comes to no surprise to discover that adolescent depression is strongly linked to teen suicide. Adolescent suicide is now responsible for more deaths in youth’s aged 15 to 19 than cardiovascular disease or cancer (Blackman, 1995). Recent studies have shown that greater than 20% of adolescents in the general population have emotional problems and one-third of adolescents attending psychiatric clinics suffer from depression. Despite this increased suicide rate, depression in this age group is greatly under diagnosed and leads to serious difficulties in school, work and personal adjustment, which may often continue, into adulthood. How prevalent are mood disorders in children and when should an adolescent with changes in mood be considered clinically depressed? Brown (1996) has said the reason why depression is often over looked in children and adolescents are because â€Å"children are not always able to express how they feel.† Sometimes the symptoms of mood disorders take on different forms in children than in adults. Adolescence is a time of emotional turmoil, mood swings, gloomy thoughts, and heightened sensitivity. It is a time of rebellion and experimentation. Blackman (1996) observed that the â€Å"challenge is to identify depressive symptomatology which may be superimposed on the backdrop of a more transient, but expected, developmental storm.† Therefore, diagnosis should not lie only in the physician’s hands but be associated with parents, teachers and anyone who interacts with the patient on a daily basis. Unlike adult depression, symptoms of youth depression are often masked. Instead of expressing sadness, teenagers may express boredom and irritability, or may choose to engage in risky behaviors (Oster & Montgomery...

Recognizing Employee Contributions with Pay

Recognizing Employee Contributions with Pay Introduction Compensation presents one of the most preferable ways through which employee contributions are recognized. Compensation program s is evaluated based on various job responsibilities which are assigned specified monetary value. However, various forms of compensation are undertaken based on federal laws of which organization managers are expected to be familiar with.Advertising We will write a custom essay sample on Recognizing Employee Contributions with Pay specifically for you for only $16.05 $11/page Learn More Payment for individuals, groups or excellent performances are done in form of executive pay, incentive pay as well as balanced scorecard. Organizations compensate their workers through various incentives supported by their company objectives. However, incentive pay for executives within an organization is usually different from that of other employees hence requires special attention. Such incentives either long-term or short-term are ne cessary for the purposes of developing some sense of commitment within organization’s leadership and workforce (Noe et al., 2009). Review of the case Considering that Xcel is a company dealing with environmental issues, Merit pay may not work well with its strategy on improving operations at the lowest cost. According to the case study, merit raise, works best during hard economic times since it caters for high cost of living. At the same time there are always high possibilities of prevailing conditions to shrink available range of increases. Additionally, merit pay spread pay increment evenly across all employees hence rewarding poor performance on the same level as good performance. Such method may ultimately not concur with the company’s strategy on lowering costs since it is expensive (Fossum, 2002). Spreading the merit pay evenly across all employees may benefit those who lazy around and cause frustration to hardworking employees. Suggestions might at times look a ppropriate but might not work well in line with the company’s business objectives (Gerhart and Milkovich, 1990). To ensure that incentives work for the benefit of the company, they will require improvement within communication channel and at the same time increase level of employee participation. Xcel should incorporate employees in pay-related decision since there contributions at times reflect hands-on knowledge on kinds of behavior essential for organization improvement (Gowen, and Jennings, 1991).Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Since Xcel focuses on being one of the most celebrated top utility facilities offering efficient services at low cost, there goals and performances should be based on cooperation. Applying such principles would make employees feel more concerned about changes and goals of the company. They will always be eager to put across their contributions. Improvement on merit pay system For improvement purposes the company can include profit-sharing plan within the pay system. This is because merit pay is more directly linked to individual behavior compared to profit sharing plan. This is capable of linking to the strategy since it assists in increasing employees’ commitment towards organizational goals. Additionally, Xcel can utilize the use of balanced scorecard which enables combination of performance measures towards organizational goals. This enables easy utilization of employees’ potential through customization of balanced scorecards which would clearly distinguish Xcel’s operations based on strategy (Gerhart and Milkovich, 1990). Extension of the stock plan to other low-level employees might also be good idea for progress. This is since stock ownership plan contributes towards creation of some sense of ownership within employees. It makes them feel part owners of the organization hence maki ng them to focus more on ideas contributing towards success of the company (Gerhart and Milkovich, 1990). Conclusion Organizations use various ways to reward employee performances and at the same time measure such performances in terms of profits and stock prices. Incentive pay presents one of the most notable ways of organizations use for the purposes of ensuring that employees focus on company’s success goals. Such incentives ensure that employees realign their activities towards organization’s goals. References Fossum, J. (2002). Labor Relation. New York: McGraw-Hill Gerhart, B, Milkovich, G. (1990). Organizational Differences in Managerial Compensation and Financial Performance. Academy of Management Journal 33 (1), 663–91.Advertising We will write a custom essay sample on Recognizing Employee Contributions with Pay specifically for you for only $16.05 $11/page Learn More Gowen, C, Jennings, S.(1991). The Effects of Changes in Par ticipation and Group Size on Gainsharing Success: A Case Study. Journal of Organizational Behavior Management 11 (1), 147–69. Noe, R., Hollenbeck, J., Gerhart, B., Wright, P. (2009). Fundamentals of human  Resource management, 3rd edition. New York, NY: McGraw-Hill/Irwin.

Gender Bias Essay Example | Topics and Well Written Essays - 500 words

Gender Bias - Essay Example To start with, the author of the text is definitely a man. This is easy to tell since the work has been written from the third person perspective. This simply means that he is sharing experiences that are foreign to him. The author uses simple sentences and a limited description of objects, people and events. This is common among men who are unable to express their feeling accurately using words. His reference to the imagery of the â€Å"American wife† clearly shows the author is a man as all other men do in the American society (Hemingway 695). The description of how she went out to look for the cat shows the caring and compassionate nature of women while her husband accompanies her although he is unwilling. This shows that the author is a man since he clearly captures her husband’s reaction. The author explains how the woman is attracted to the hotel keeper who is described as being serious, mature and cold. The author captures the manly features that attract the woman to the hotel keeper. He states that the woman is interested in fine things, romantic dining, long hair and a cat (Hemingway 695). He describes these things as being foreign to him and could have described them better if he were a woman. The author vividly points out her husband’s interests and this could only mean that he is a man as well. This text clearly shows the plight of an African-American woman who works hard by cleaning laundry for the white people. From the beginning of the text, it can be seen that the author is a woman from the way that she describes Delia as being a hard worker and provides for her husband Sykes. On the other hand, her husband is depicted as being lazy and does not treat her well too (Hurston 697). He once played a trick on her by placing the bullwhip in her laundry. He was well aware of the fact that Delia was scare of snakes. This shows that he is

Nursing Occupational Stress Research Paper Example | Topics and Well Written Essays - 7500 words

Nursing Occupational Stress - Research Paper Example In recent years, humans are experiencing increased pressure not only in their everyday life but also at their work place due to the multifarious nature of their roles in the current society. The complexity and multiplicity of people's role and the ensuing stress that they are subjected to, have evoked the interest of researchers, and a considerable body of studies have accumulated on 'stress'. In the process of trying to explain the exact meaning of the word stress, scientists have offered a variety of differing definitions. Willner (1993) finds that "giving one definition to stress is rather problematic." If people are asked to define the word stress, they will all tend to give varying definitions of the same. This is because each individual experiences stress in a different way. Consequently, researchers who conducted studies on the subject offered different explanations of stress. According to Abouderie (1996), stress is "a complex experience, which has been explained and investig ated in various different ways and in general terms, and it originates from over-demanding situations." On the other hand, Hans Seleys (1936) defines stress as "an unspecified reaction of the body to the everyday pressure and needs which results in pleasant or painful outcomes." According to Richard (Please indicate the year of publication), the term stress is defined as "the state of anxiety constructed from an event or responsibility that someone cannot deal with." A more exhaustive explanation of the term can be found in the definition that "stress is commonly accepted as a mental, emotional, psychological or physiological disruptive condition resulting from excessive pressure being placed on an individual." (Deane, Chummun and Prashad 2001 and Occupational Hazards 2004). Stress can be the outcome of an anxious day at work or a terrible flight to New York. Hans Selye (1936) concludes that stress is "a way of life" and he goes beyond by saying that: "Everyone knows what stress is, but nobody really knows." What is work stress One of the most important types of stress common to the modern world is work stress. A study by Lehtinen, Haditaja and Hinkkanen (2003) concludes that "occupational stress was found to be the second most frequent occupational health problem which is affecting 28% of employees in the European Union." Consequently, occupational psychologists researched the field of occupational stress in order to prevent the negative impacts that stress causes at the workplace environment as well as to the individuals. In addition, researchers who examined the field of occupational stress identified the factors that cause it. Psychologists, after exhaustive research, find that "occupational stress was the psychological and emotional reactions that arise when employees experience an imbalance between their occupation demands and their capability and/or resources to congregate these demands." (Deane et al, 2001 and Bekker, Jong , Zijlstra and Van Landeghem 2000). In more simplistic terms, occupational st ress can be discerned as the pressure which an individual experiences in the workplace environment. PMI- measure of occupational stress There are also many synonyms used to replace the word

Google Case Study Essay Example | Topics and Well Written Essays - 2250 words

Google Case Study - Essay Example Employees at Google work in teams, and are rarely assigned to an independent office.   In fact, even cubicles are frowned upon.   Teams are encourage to work together in what is dubbed ‘cubes, yurts, and huddle rooms’ where each person can share ideas with one another.   There is no competition to do better than the next person, as the teams success is what really matters.   To engage employees, the atmosphere is pleasant and conducive to discussions and conversations taking place everywhere.   Even going from one place to another within the same facility is made a bit entertaining, and time efficient, as bicycles or scooters are provided throughout.   In addi-tion, there are items such as lava lamps, massage chairs, and large inflatable balls to help em-ployees feel comfortable in whatever work environment they may find themselves in.   Google is also different from many large companies in that all levels of staff are really treated equally.   In fact, e ven new employees are encouraged to make decisions that even upper management will buy into.   Upper managers are approachable and do not use titles.   In essence, Google is naturally like any other company in that they have a hierarchy and system of seniority, but it is not utilised in the daily decision making process.   If one individual needs assistance, they will engage the employee that they feel can provide them with the best possible assistance, without considering one’s actual job title or time of service with the company.   This has worked to fully engage em-ployees that work for Google.

Instructional Technology of Nursing Essay Example | Topics and Well Written Essays - 1000 words

Instructional Technology of Nursing - Essay Example They discuss the notes on a chat program. This creates a virtual classroom which necessitates more interaction between the students and the lecturers. Students normally attend classes while other s (distance learners) attends the online lessons. All the resources needed for each particular lecture is available in the black board.Since nursing and healthcare are living subjects, the learning resources keep on changing each and every day. Use of intranet-based instruction strategies help ease the art of syllabus revision. It also helps lecturers to serve a large number of students at a time without much effort. The theories used in treatment and prevention procedures are adapted to the learning systems in real time. Most educational institutions that offer nursing and healthcare courses are usually in conjunction with health institutions like hospitals and nursing homes. These institutions gradually undergo technological transformations as need and capacity increases. This in turn crea tes a need to include more updated studies to cover the changes. The changes are made simpler through the use of online libraries (databases) and lecture forums (web-conferencing).   These resources are easy to update, share (1 copy for thousands of students), demonstrate and serve the students.Management in nursing is quite practical and needs more involvement than just web-conferencing. Nurses studying management normally combine lectures (theory) with practice. his helps them to understand the way nursing centers operate.... All the resources needed for each particular lecture is available in the black board. Since nursing and healthcare are living subjects, the learning resources keep on changing each and every day. Use of intranet-based instruction strategies help ease the art of syllabus revision. It also helps lecturers to serve a large number of students at a time without much effort. The theories used in treatment and prevention procedures are adapted to the learning systems in real time. Most educational institutions that offer nursing and healthcare courses are usually in conjunction with health institutions like hospitals and nursing homes. These institutions gradually undergo technological transformations as need and capacity increases. This in turn creates a need to include more updated studies to cover the changes. The changes are made simpler through the use of online libraries (databases) and lecture forums (web-conferencing). These resources are easy to update, share (1 copy for thousands of students), demonstrate and serve the students. Management in nursing is quite practical and needs more involvement than just web-conferencing. Nurses studying management normally combine lectures (theory) with practice. They train to use information management systems in their respective universities. They use the systems to record, manage data, generate reports, analyze statistics, plan projects, schedule activities, assess clinical practice among other uses. This helps them to understand the way nursing centers operate and face the real world challenges in their career (Krautscheid L. & Burton D. 2003). Practice in nursing usually applies the real technologies used in health institutions. Students visit nursing centers and observe

Marketing reformation, retention and development of competitive Essay

Marketing reformation, retention and development of competitive advantage - Essay Example The most important way to success in any industry has been always considered orientation on the customer needs and its satisfaction. Working in that direction provides guarantee to selling final products and in gradual increase of outputs. It is equally important to build networks with other stakeholders such as suppliers, distributors or intermediaries. Professional approach to dealing with all the stakeholders is crucial in sustaining competitive advantage vis-a-via the competitors outside the network. Using example of Tesco chain of groceries I will further discuss the ways in which the company sustains its leading position on the market and define current strategies as well as opportunities and threats that the company faces in today's competitive world. Many retail shopping centers have tried and failed to perform excellently outside their home markets. Likewise, some retailers have led astray trying to develop Internet shopping. As a result, TESCO, the United Kingdom's biggest grocer, has drawn significiant attention because of its ambitious overseas strategy and its successful on-line home delivery service. Another successful key factor that inputs to TESCO sustainable development and growth is the marketing communication plan that provides the detailed overview of the Company's fiscal policies as for meeting the clients' needs and providing competitive prices within wisely located grocers all over the world. TESCO understands that successful marketing strategy should be based on customers' need, that is why the Mission Statement declared for the Company sounds as it follows: "One of our values is to understand customers better than anyone. We go to great lengths to ask customers what they think, listen to their views, and then a ct on them. We look both at what customers say and what they do. This feedback guides the decisions we tale" (www.TESCO.com) Executive Summary TESCO s proved to be a ledng grocery chn n the Unted Kngdom nd lso the bggest grocery of the world. There re bout 2290 stores wth more then 296000 people employed ll over the world nd t hs ttrcted consderble ttenton becuse of ts mbtous overses strtegy nd ts successful on-lne home delvery servce. Relyng on sles of non-food tems nd on nterntonl sles--prtculrly n emergng mrkets--for n mportnt prt of the compny's future expnson, TESCO hs delvered one of the fstest orgnc growth rtes of ny mjor retler n the world. ts nonfood busness rose by 18 percent n 2000-01, nd ts nterntonl busness, whch begn wth lunch n Hungry n 1994, now ccounts for more thn 40 percent of the group's floor spce. TESCO lso hppens to be the undsputed world leder n nternet grocery sles (www.TESCO.com). ts on-lne home delvery servce s now proftble, TESCO sys, nd t hs struck del n the Unted Sttes wth Sfewy, whch wll use TESCO's system for home-shoppng servce. Underpnnng TESCO's success s excellent mngement nd n obsesson w th opertonl effcency nd productvty gns, whch the compny uses to keep prces low or to mprove servce rther thn to ncrese ts opertng mrgns. Despte ths mpressve record, TESCO s stll reltvely smll compred wth the lkes of Crrefour nd Wl-Mrt, but t s growng fster.Despte ths mpressve record TESCO stll fces number of chllenges during the fiscal year. The UK retler is smll n comprson wth the lke s

Instructional Technology of Nursing Essay Example | Topics and Well Written Essays - 1000 words

Instructional Technology of Nursing - Essay Example They discuss the notes on a chat program. This creates a virtual classroom which necessitates more interaction between the students and the lecturers. Students normally attend classes while other s (distance learners) attends the online lessons. All the resources needed for each particular lecture is available in the black board.Since nursing and healthcare are living subjects, the learning resources keep on changing each and every day. Use of intranet-based instruction strategies help ease the art of syllabus revision. It also helps lecturers to serve a large number of students at a time without much effort. The theories used in treatment and prevention procedures are adapted to the learning systems in real time. Most educational institutions that offer nursing and healthcare courses are usually in conjunction with health institutions like hospitals and nursing homes. These institutions gradually undergo technological transformations as need and capacity increases. This in turn crea tes a need to include more updated studies to cover the changes. The changes are made simpler through the use of online libraries (databases) and lecture forums (web-conferencing).   These resources are easy to update, share (1 copy for thousands of students), demonstrate and serve the students.Management in nursing is quite practical and needs more involvement than just web-conferencing. Nurses studying management normally combine lectures (theory) with practice. his helps them to understand the way nursing centers operate.... All the resources needed for each particular lecture is available in the black board. Since nursing and healthcare are living subjects, the learning resources keep on changing each and every day. Use of intranet-based instruction strategies help ease the art of syllabus revision. It also helps lecturers to serve a large number of students at a time without much effort. The theories used in treatment and prevention procedures are adapted to the learning systems in real time. Most educational institutions that offer nursing and healthcare courses are usually in conjunction with health institutions like hospitals and nursing homes. These institutions gradually undergo technological transformations as need and capacity increases. This in turn creates a need to include more updated studies to cover the changes. The changes are made simpler through the use of online libraries (databases) and lecture forums (web-conferencing). These resources are easy to update, share (1 copy for thousands of students), demonstrate and serve the students. Management in nursing is quite practical and needs more involvement than just web-conferencing. Nurses studying management normally combine lectures (theory) with practice. They train to use information management systems in their respective universities. They use the systems to record, manage data, generate reports, analyze statistics, plan projects, schedule activities, assess clinical practice among other uses. This helps them to understand the way nursing centers operate and face the real world challenges in their career (Krautscheid L. & Burton D. 2003). Practice in nursing usually applies the real technologies used in health institutions. Students visit nursing centers and observe

The Criminal Trial Essay Example | Topics and Well Written Essays - 500 words

The Criminal Trial - Essay Example When the trial begins, the prosecution and the defense make their opening statements to the jury. The purpose of these statements are to â€Å"provide an outline of the case that each side expects to prove (Bergman & Barrett, 2009).† The statements only include what the attorneys know that they can present to the jury. The prosecutor then presents its principal case by means of direct examination of prosecution witnesses by the prosecutor themselves. At this time, the defense is allowed to cross-examine the prosecution witnesses; the prosecution is then allowed to re-examine its witnesses. After this procedure, the prosecution is done with presenting their case. The defense is then given the chance to dismiss the charges if they feel that the prosecution failed at providing enough relevant evidence to support a guilty verdict for the person being charged. The judge denies the motion to dismiss, an act that is rare but still seen. It is now the defense’s turn to present their case through means of direct examination of the defense witnesses. The prosecutor is given the opportunity to cross-examine the defense witnesses, followed by a re-examination of the defense witnesses. The defense is then finished presenting their case. The prosecution gives its closing argument, â€Å"summarizing the evidence as the prosecution sees it and explaining why the jury should render a guilty verdict (Neubauer, 2010).† The defense makes a similar closing argument, though they explain to the jury why they should not render a guilty verdict, or, at the very least, declare a guilty verdict on a lesser charge, known as a plea bargain. The prosecution is offered a final closing argument if they wish to argue their plausible evidence that supports a guilty verdict. The jury is given instructions by the judge on what law to apply to the case and how they should carry out their duties. The jury deliberates and attempts to reach a verdict; in most cases, a unanimous agreement

Child’s behavior Essay Example for Free

Child’s behavior Essay Action speaks louder than words, the adage goes. The same applies for child rearing, specifically in setting a childs behavior. Verbal admonitions, advices, and instructions are important to make it obvious to the child what the parent expects him to follow and do. Words specifically define the desired behavior parents want from their children. However, children are easily distracted, especially with long sentences, so that while talking to them, their attention or their mind strays from grasping every word thus deterring understanding. Another, words oftentimes have ambiguous meanings to the child so that the latter might not get it in spite of having been told. Actions leave more imprints into a childs memory compared to words because actions explain more than words could express. Usually, when a parent verbalizes an instruction, he accompanies it with action. This is because the more senses are involved during the comprehension process, the better and more lasting the comprehension. Actions involve more senses. They engage the child more into the character-building process because they do not just hear; they also see it in action through their parents. Furthermore, when the parents behavior contradicts with what they say, it confuses the child and might diminish the parents trustworthiness and authority in the eyes of the child. Children imitate grown-ups a lot during their formative years since they still have to develop their own individual personalities and judgments. Children tend to think that whatever their parents do are always the right things. After all, in their yet young lives, parents have been doing a lot of things for them, feeding them, taking care of them, dressing them, etc. By doing the right and proper actions, therefore, the child would confidently follow—with this knowledge that whatever their parents might be doing could be right.

Pregnancy Foetus Mother

Pregnancy Foetus Mother Pregnancy is a state whereby there is a symbiotic union between a mother and her foetus. During this period, all systems of the body change to accommodate the trophoblast, the immune system (a complex biological signalling system responsible for protecting us against infection, disease and foreign objects due to its ability to differentiate between self and non self) being one of these systems also undergoes a number of changes (Markert, 2005). The foetus is like a homograft attached to the uterine wall of the mother via the placenta, it inherits half its genetic makeup from its mother and the other half from its father. The paternal genes that it expresses are seen as antigens by the mothers immune system and are expected to cause the rejection of the foetus as a semi-allogenic tissue graft(2). Instead, the mothers immune system teaches itself to tolerate these genes and the development of the foetus is supported and regulated (Marker, 2005). The immunological puzzle that leads to t he sustainment of the foetus for the 9 months gestation period is known as the â€Å"immunological paradox of pregnancy† (Claman. 1993). A question that begets to be asked is how does the maternal body prevent rejection of the histoincompatible foetus and at the same time maintain enough maternal host defence mechanisms to fight disease and infection? To date it is not fully understood how this takes place, but it is known that in order to allow the foetus to escape rejection and immunological attacks by the maternal immune system, this symbiotic relationship must have distinctive immuno-regulatory actions. At the same time the mothers immune system must also provide protection against foreign antigens for her as well as her young. A number of explanations have been proposed during the last century as to why foetal rejection does not take place in healthy pregnancies. It is now agreed upon that the placenta plays an important role in this. The placenta is a very important organ because not only does it aid the transportation of nutrients and waste products and immunity between mother and foetus, it acts as an endocrine organ because it secretes growth factors and female hormones which helps maintain and support the pregnancy (Knobil and Neil, 1994) and finally the placental expression patterns of majorhistocompatibility complexes (MHC) is one of the vital factors that determine if a foetus is accepted or rejected, in humans these complexes are known as human leukocyte antigen (HLA) complexes (Claman. 1993). Although the mechanism for the maternal tolerance of the MHCs expressed by the fetus is still not fully known it is known that in humans, a number of HLA class I expressions have been detected in the placent a, these include HLA-C and HLA-G complexes. HLA-G is essential for the successful implantation of trophoblast and its protection from invasion. It does so by binding inhibitory receptors on T-lymphocytes and maternal uterine natural killer cells and thus protects the trophblast from maternal attacks caused by these cells. They also regulate cytokine secretion of cells, thus offering protection to the foetus (hla class 1 molecules reference). A recent study has also shown that HLA-G might inhibit the migration of NK cells across the placental endothelial cells. Till this day, no evidence has been brought forward to suggest that HLA-A, HLA-B and Class II MHCs are expressed in the placenta thus it is inferred that they are normally absent from the placenta during pregnancy (Bulmer and Johnson, 1985). Foetuses are protected not only from rejection during the gestation period but also from infections by the transmission of passive immunity from the mother.In 1892, Paul Erlich used mouse models to demonstrate that fetuses and neonates acquire protective immunity from their mothers both in utero and through breast milk. It has been shown that this involves the active transport of IgG from mother to her offspring. Passive immunity is transferred from the mother to her foetus through the placenta in the form of immunoglobulin G (IgG) and also via breast milk postnatally (Arvola et al 2000). IgG is the main defence against bacteria thus it accounts for 70-75% of antibodies found in human serum. Before birth the foetus is immunologically naà ¯ve because its synthesis of antibodies is very low. The immature immune system of the foetus is compensated for by the active transport of maternal IgG across the placenta into the foetal circulation. Before IgG reaches the foetal circulation, it h as to cross two cellular barriers, the barrier in contact with the maternal blood known as the syncythiotrophoblast and the capillary epithelium of the foetus. IgG antibodies are conveyed across the placenta and the intestinal epithelium via the human Fc receptor (add more). Although the ability of IgG to cross the placenta acts to convey passive immunity to the foetus there are instances where its ability to cross the placenta can have detrimental effects on the baby. An example of this is a condition called haemolytic disease of the new born (HDN). HDN is an alloimmune disease that develops in rhesus positive foetuses that have a rhesus negative mother. the mother produces IgG antibodies against the rhesus positive red blood cells which cross the placenta and attack red blood cells in the foetal circulation. It has been established that breast milk are rich in maternal cells including small proportions of epithelial cells, macrophages, leukocytes and T and B lymphocytes which make up a majority of cells found in milk on the other hand, 80% of the total cells found in the colostrum (first milk secreted after delivery) are mononuclear phagocytes. These cells aid the neonate by protecting the lumen of its gut and transferring immunity passively. Breast milk macrophages enter breast milk via the epithelium of the mammary gland, they are found to be highly phagocytic in breast milk and can easily be differentiated from other cells by the lipid rich inclusions found in their cytoplasm (breast milk macrophages reference). Milk and colostrum are also rich in the dimeric immunoglobin A. IgA antibodies are very important to the newborn because they are highly specific for pathogens found in the mucosae of the gut. This form of passive immunity from the mother thus conveys protection to the newborn until its immune response is mature enough to mount a good enough response (PDF2D). As well as transference of immunity, a mother can also convey infections to her foetus. The maternal transmission of an infection such as HIV, Hepatitis B and syphilis to foetus in utero, as a result of body fluid transmission during child birth and through breast milk is known as vertical transmission. During pregnancy, the maternal transmission of infection can result in a number of sequela. Infections found in mother have the potential of infecting the foetus or newborn. Side effects of infections include abortion or stillbirth, acute illnesses, congenital abnormalities, neonatal death and many more. The newborn can acquire infections in utero also known as intrauterine (congenital), during child birth (intrapartum) or after birth (postpartum). Different forms of infections can be vertically transmitted, these include viral and bacterial infections which are both covered in this essay. The most common examples of viral infections transferred from mother to her unborn child are cytomegalovirus, rubella both of which may cause severe neonatal disease or congenital defects, HIV and Hepatitis B. The human immunodeficiency virus (HIV) is a sexually transmitted virus that attacks the immune system by infecting CD4 cells thus leaving the host vulnerable to other infections. This virus can lead to the acquired immunodeficiency syndrome which is characterised by a very low CD4 cell count (less than 200/ml). The transmission of this virus from mother to child can occur in utero, during child birth and via breast milk. The most common mode of transmission of HIV occurs during labour or at child birth, about 50-80% of vertical transmission occurs via this route. The reason being that the fetus is in direct contact with infected blood and secretions, as a result of ruptured membranes and transmission of maternal blood to the foetus during labour (birth by caesarean section before the beginning of labour and membrane rupture is proven to reduce this risk of transmission of HIV) (www.aafp.org). HIV transmission can also occur in utero. The foetus can become infected if it comes in contact with infected maternal blood and secretions. This contact can be the result of placental haemorrhage or by the foetus swallowing some amniotic fluid (www. the-aids-pandemic.blogspot.com). The final mechanism by which vertical transmission if HIV can take place is through breast milk which occurs in 16-29% of cases (www. the-aids-pandemic.blogspot.com). Hepatitis B is a viral infection of the liver caused by the hepatitis B virus (a double stranded DNA virus which caused liver damage). In 2004, Zhang et al provided evidence that the main route of transmission of hepatitis from mother to foetus was via the placenta. Mothers that have the acute form of the virus and that are also infected in the first trimester of pregnancy have a 10% chance of passing the virus to their neonates. This percentage increases to a staggering 80-90% if the mothers were infected in the 3rd trimester. 90% of neonates on the other hand acquire the infection if the virus chronically infected the women (Hieber et al 1977). Transmission is also caused by the exposure of the foetus to infected blood and body fluids. A hepatitis positive mother has a 20% chance of passing the infection to her offspring during child birth, this risk increases to 90% if the mother is also positive for the hepatitis B e antigen (www.perinatology.com). According to Hill et al (2002), breast milk of infected individuals contains HBV DNA, but using appropriate immunoprophylaxis nullifies the transmission of HBV. Rubella (the German measles) is a condition caused by the rubella virus. This virus is moderately contagious. It can cross the placenta causing a condition known as congenital rubella syndrome (CRS) which leads to a number of side effects to the baby including low birth weight, deafness, mental retardation, congenital heart failure and death. The severity of the effect depends on the period that the fetus is infected; during the first two months of gestation the chances of foetal damage caused by infection is 65-0%, this chance decreases to 30-35% during the third month and finally to a mere 1-2% in the 20th week. There are two routes through which a newborn can acquire a bacterial infection, these routes include intraturerine (transplacental and assending infection) and intrapartum when the new born comes in contact with infected secretions and blood during delivery. Congenital syphilis is a severe and life threatning multisystem infection caused by the vertical transmission of the spirochete Treponema palladium to the foetus. The transplacental transmission rate is 60-80% Vertical transmission of congenital syphilis can occur at anytime during pregnancy although the infection is more likely to be transmitted by women in the primary and secondary stages of the disease as opposed to the latent stage.Just like in adult syphilis, this infection is categorised into early disease which is seen in children two years or younger and late disease which is seen in children over the age of two(http://www.merck.com). During child birth organisms such as N. gonorrhoea, B. streptococci and C. trachomonas bacteria that are naturally found in the female reproductive system can also colonise the newborn. A list of these bacteria are shown in fig 1 of the appendix attached. Vertical transmission of Immunity during pregnancy is complex and one that intrigues many a soul. Till this date its mechanisms are not fully known. What is known is that a number of complex systems are involved in the process and without the foetus will either be rejected or infected by pathogens.