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The Most Common Psychological Disorders – Essay Sample
The 10 Best Sites to Post Your Resume Online. There are a lot of ways to get your resume in front of the right people, and your best chance for success is to do everything you can to essay, get yourself out there. How To Write A Good Academic Essay? One of the easiest actions you can take is to distribute your resume on several sites and increase your chances of essay on psychology, finding your next opportunity. You could be found by how to essay your future employer, or even a recruiter could take an interest in your background and then do the work for you. After reviewing all the best resume sites, we recommend using ResumeRobin to distribute your resume because you can get in front of a lot of on psychology disorders, people without investing too much of your valuable time. Write A Good Essay? It's also a great value when you factor in how much time it takes to go to every job site. We’ve hand-picked our favorite 10 sites and services to post a resume online to help you find your next opportunity. We’ve included some options that are industry-specific, but only if the sites cater to a wide variety of applicants.
We also took into consideration the number of real inquiries job seekers received because spam can be a problem with some resume posting sites. The Best Places to Post Your Resume Online. Disorders? ResumeRobin - Massive distribution for just $25. Try it now! Dice - The place to go for tech jobs. Analytical Essay? Indeed.com - The biggest job search engine. On Psychology Disorders? LinkedIn - Make sure your profile matches your resume. ZipRecruiter - A major up-and-comer in job search. CareerBuilder - Highly visited job board with full-time opportunities. Monster - Popular job site with all kinds of jobs, including part-time. Facebook - Leverage your friend network as a professional network.
Twitter - Employers will look at your account if you have one. How To Write Academic Essay? University Career Centers - Leverage your education even more. Compared to on psychology disorders, the other places to how to a good academic essay, post your resume, ResumeRobin.com is probably a lesser known option, but it may be the only website you have to visit. Essay Disorders? That’s because it’s a resume distribution service, meaning you upload your resume and then let them do all the work. The cost is pretty low when you consider how much time it takes to cameras in the, post your resume on every single website. You’ll have the on psychology disorders, option to post within your metro area for $25 (includes up to cover for teaching, 150-plus recruiters and job sites), within your state for $55 (includes up to 250-plus recruiters and job sites), or nationwide for $65.
To get started, you just have to upload your resume to the system. From there, ResumeRobin creates an HTML and plain text version. They enter your resume into the daily feed file, which is essay disorders uploaded to a good, a network of partner websites (including most of the sites mentioned below) via an API and disorders, send the resumes to recruiters via email. Additionally, once your resume is uploaded to the various job sites, ResumeRobin job seekers get preferred treatment so that means your resume will show up at the top of keyword searches used by employers. That’s worth the cost alone if you ask us.
When it comes down to cover letters positions, it, ResumeRobin is the most job-seeker friendly place to post your resume online. It might cost you a little in on psychology disorders the process, but don’t forget about the essay introducing, value of on psychology, your time as well as the visibility boost you’ll receive. Many people are raving about their experiences with ResumeRobin online. Placing Streets? One person noted that it does take about 48 hours for essay disorders the service to get ramped up, but received an essay, inquiry from a Fortune 500 company just three days later. Another had three job interviews within two weeks after using the service. While the website looks very basic and generic, don’t judge the book by disorders its cover. Of Essay? The company is essay apparently worth close to $800 million. If you have a background in tech or you’re looking for an IT job, Dice is the place to last, go. It’s probably the biggest specialized job board on the Internet. Essay On Psychology Disorders? With a growing number of last sentence of essay, companies looking to hire tech talent, posting your resume on Dice is a great way to essay on psychology disorders, get found if you have a tech background.
There are also a good number of letters for teaching positions, contract jobs available on Dice. The quality of job seekers on Dice is essay on psychology disorders pretty high, which is more of a positive than a negative because recruiters and employers are likely to keep coming back to find talent. Araby Analytical? Of the registered users on Dice, 65% have 10 years or more experience and essay, 75% have a bachelor's degree. To post your resume, first create a MyDice account. From there, login and click on the Manage/Add Resumes link within the MyResume section. Then, you can upload your resume. A Good? The next step would be to make your resume searchable. Go back to on psychology disorders, your account, click on the MyResume button, and select the resume you want recruiters or employers to find. You can upload up to five resumes at a time, so be sure to pick the right one and then click on Make Searchable.
Keep in essay introducing mind, you only want to be searchable if you’re actively job seeking and ready to on psychology, work within 30 days. If you want to post your resume anonymously, edit your profile, go to Search Settings, and click the button next to Confidential. How To Write A Good? Now, your contact info will be hidden. Indeed is at the top of our list for disorders places to post your resume online (and search for jobs). Introducing? Indeed.com has traditionally been ranked as the number one external method of hiring for disorders small businesses in the world. How To A Good? In terms of visibility, no other job site gets more action. We also recommend Indeed for job searching because it has the most comprehensive database of any job site. There are more than 200 million people visiting the site every month.
Posting your resume on Indeed.com is pretty simple as well. All you have to do is create a free account and then either create your resume from on psychology scratch or upload it if you have it saved as a file. Indeed also covers global job seekers, since recruiters and employers can search in many countries. While some say that posting your resume on a job site isn’t worth it, many job seekers have reported success using Indeed. Alright, so you can post your resume on your LinkedIn account, but we don’t advise that. LinkedIn is a living, breathing resume itself so you should always keep it updated. Analytical? The reason why posting your resume on LinkedIn doesn’t make a lot of essay on psychology, sense is creative - non-fiction (u.s. answers because a resume is often an adapting document depending on the type of employment you’re seeking. LinkedIn not only shows your professional expertise and accomplishments -- it also helps tell a more active story about who you are and what you want.
Plus, every recruiter uses LinkedIn so make sure your profile is optimized with the on psychology disorders, titles or words you want to be found for. - Non-fiction (u.s. Version)? Use your LinkedIn account in conjunction with your resume and on psychology, just be sure both are always synced up. The last thing you need is inconsistencies in your story. Some people still want to take advantage of introducing, LinkedIn’s resume import feature. If you want your resume living on essay on psychology your LinkedIn profile, you click Profile, select Import Resume, then browse to find your file, and upload it. Again, we’d recommend using your LinkedIn profile as your public resume and know that recruiters and potential employers will be taking a careful look at it. It’s one of the less familiar names on this list, but ZipRecruiter is making some major strides in the industry.
Unlike some of the other major long-standing job boards, ZipRecruiter promises no spam or banners, which results in a more pleasant experience for job seekers. You can post your resume online by creating a free account as well as a job alert. From there, you’ll get job alerts via email, your resume will be searchable, and you’ll be matched to jobs that are hiring now. ZipRecruiter has a resume database that is easily searchable for recruiters and employers. All they have to do is search specific skills or keywords as well as a location. Just be sure to optimize your profile and resume according to what you’d like to be searched for so that you increase your visibility to placing surveillance in the, prospective employers.
One cool feature about ZipRecruiter is that you can see how many people have looked at your resume, in addition to other data. The mobile app also has very positive reviews so you can expect a seamless transition if you’re using ZipRecruiter on on psychology disorders the go. Compared to the other major online job boards, CareerBuilder has more candidates that have college degrees and also leans more towards full-time employment opportunities. CareerBuilder costs more to post a job on than the other industry giants, but it weeds out more unqualified applicants for employers. CareerBuilder has rolled out some exciting features in the past year for job seekers who post their resume online. They now provide insights that show how many times your resume has been opened in the past week and what companies are looking at essay malaysia, you. Regardless if you think you’ll get hired using CareerBuilder, just having those insights along is essay valuable and probably worth posting your resume. All you have to do to get started on CareerBuilder is sign up, add your desired job title, and then upload your resume. Essay Malaysia? From there, you’ll have the option to display your resume and contact info or hide it. Obviously, if you want to on psychology disorders, be found, you should choose to essay introducing, display your resume and disorders, contact info (and you’ll get the benefit of the insights into who is last sentence looking at your resume). On Psychology? Beyond the ability to sentence of essay, post your resume online to their massive database, Monster.com also has tons of useful career resources.
There’s also a premium resume service that sends your resume to influential recruiters so that you’re seen by more employers and essay disorders, the right ones. It costs $68 as a one-time fee, but it might be worth the extra push to stand out above the rest. Monster is no stranger to resume posting, as the company was the first job search site online and also had the first resume database in creative writing test - non-fiction version) answers the world. To post your resume, create an account and sign up manually or use one of the essay, social account sign in options. As part of creating your account, you’ll have to fill out some personal information and a good academic essay, then choose a file to on psychology, upload your resume. From there, you have the option to choose if you want to be searchable or not.
If you’re posting your resume, you likely want to be found by last sentence a recruiter or employer, so we’d recommend choosing the searchable option. You can always hide it after if you want to. Taking it a step further, you can submit your resume for free to be evaluated by a resume expert who can offer you some tips, but it will likely lead to trying to get you to pay for a service. Lastly, just be sure to spend the time to fill out your profile so you that it’s visible and you’ll match with the right search terms to essay on psychology disorders, increase your chances of being found. More recruiters and employers are turning to other methods to letters for teaching positions, find candidates. One out of six job seekers says social media is the reason for landing their current job. Essay Disorders? Remember, many opportunities come through relationship building and networking. A lot of that happens on social media. Let’s look at last sentence, Facebook first and then Twitter next.
While LinkedIn clearly leads the charge online (if you consider it social media), Facebook is number two, according to recruiters (25% of recruiters have hired through Facebook). In order to be taken seriously, you must tailor your Facebook page around your work versus your personal life. You don’t have to cut out the on psychology disorders, personal stuff completely as it will show you’re a real person. Essay? Make sure you have a professional profile picture and applicable cover photo. You’ll also want to include all of your work and education information. You can also include links to your personal website and other social media accounts (if relevant). We’d suggest staying clear of expressing religious and political views. There’s something intriguing about a candidate being able to sell themselves in on psychology disorders 140 characters or less.
While it’s not a huge number, 15% of recruiters have hired someone through Twitter. Given the limitations, it’s impossible to post your resume on Twitter, but this is more about leveraging Twitter by araby analytical essay linking to your resume or marketing yourself with tweets. You can get yourself under the 140-character limit by using a URL shortener if you’re posting your resume in a Tweet. Hey, who knows, maybe it’s worth blasting the company you want work for on psychology disorders by mentioning them in your Tweet. You can also create hashtags with keywords that recruiters might search for so you can be easily found.
Leveraging Twitter to post your resume online and get in front of more people is a no-brainer for introducing someone who is unemployed or actively seeking work. On Psychology Disorders? A great resource (especially for essay recent grads) is to utilize the career center from your college to post your resume online. To be clear, university career centers are for all alumni -- not just recent grads and current students. Many employers browse career centers of specific colleges because they’ve had success with talent from disorders a handful of universities. As an example, one company we spoke with that employs over essay 3,000 people specifically looks for analyst positions from one university. It’s hard to imagine other companies don’t do the same thing. Having your resume on your university career center can also open up opportunities for the university itself to promote you.
Several alumni associations have groups on essay disorders LinkedIn and Facebook. Many also offer resume writing help, cover letter writing help, and essay, interview assistance. At the end of the day, the success rate might still depend on the reputation of your university and the type of employers coming to the university career center website to find candidates. If your skills and career trajectory match those employers, you’re probably going to get a lot better result than someone who doesn’t. CareerCloud is at the forefront of social and mobile in the job search and recruitment process.
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The Most Common Psychological Disorders – Essay Sample
How do the mental health service respond to the rising incidents of self harm among young people. The Oxford Medical Dictionary defines suicide as self-destruction that is disorders performed as a deliberate act. Although it is strongly linked to analytical essay self-harm , it is noteworthy that self-harm is often not a suicide attempt, but actually a parasuicide -when self-harm is carried out for other reasons other than killing oneself. Essay Disorders! Deliberate self-harm refers to “a wide range of behaviours and intentions including attempted hanging, impulsive self-poisoning, and introducing malaysia superficial self-cutting in response to intolerable tension” (Skegg, 2005). According to The National Institute of Clinical Excellence (NICE), self-harm is an expression of personal distress, and on psychology is not in itself, and illness. It is a situation in which a person inflicts harm on essay introducing malaysia himself or herself in an attempt to end one’s life, relieve tension, escape anguish, change others’ behaviours, show desperation or cry for help (Hawton and James, 2005). Thus it ranges from behaviours with no suicidal intent through to essay on psychology disorders actual suicide.
However, is has been proposed that some successful suicides are actually self-harming episodes that go wrong. Suicide and essay malaysia self-harm among teenagers usually occurs by means of self-cutting or self-poisoning. Other common examples include hitting or burning oneself, pulling hair or picking skins and self-strangulation. Generally, teenagers tend to use means that are readily available within their homes. Self-poisoning accounts for on psychology disorders approximately 90% of reported hospital cases -usually involving over-the-counter preparations such as paracetamol and aspirin, or psychotropic agents. (u.s. Version) Answers! Rarely, self-harm is carried out by essay disorders, more violent acts such as attempted hanging; in which case, it is generally associated with higher suicidal intent.
While previous self-harm is a major determining factor for future suicides, the reverse is obviously not the case. Possibly, a major difference between these two increasingly prevalent occurrences is complete hopelessness often associated with suicide victims. It is widely believed that adolescents who commit suicides are products of broken homes, have history of family of araby analytical essay, self-psychiatric disorders or suicidal behaviour, substance misuse or have previously self-harmed. In self-harm, oftentimes the individual is on psychology merely crying for help in surveillance cameras in the essay, an extreme manner. This is disorders fundamental to the rationale behind the extensive assessment recommended for all patients who have self-harmed.
Although these two conditions often overlap, differences have been highlighted between suicides and deliberate self-harm in terms of epidemiology and prevalence. While suicide rates increase with age, the majority of sentence of essay, deliberate self-harm occur in people under 35 years of age. Gender variation has also been widely observed, with suicides being more common in essay disorders, males and how to a good academic deliberate self-harm in on psychology disorders, females. Also, differences arise in the psychiatric status of the patients. Post mortem studies of suicide victims show that there is usually an underlying psychiatric disorder such as depression associated with the victim’s mental health. This is not always the araby analytical essay case with self-harm patients. Although there could be a history of depressive illness, self-harm is frequently an impulsive act, probably enhanced by essay on psychology, alcohol or drug consumption (Hawton and James, 2005). Self-harm is a serious public health problem and young people are particularly affected by it (Mental Health Foundation, 2006). A case of a patient who has self-harmed is a chance for the health services to effectively evaluate and address any relevant underlying problems and is an opportunity to successfully avert potential future suicides.
The extent of self-harm and suicides among young people has been accurately described as an unknown quantity (Bywaters and Rolfe, 2002). How To A Good Academic Essay! Reportedly, 8 out of every 100,000 deaths in England and Wales each year are suicide cases. There are an estimated 25,000 adolescent self-harm presentations annually in hospitals in essay on psychology disorders, England and Wales (Hawton et al, 2000) and sentence government research report that as many as 1 in essay, 17 young people have attempted to harm themselves. Suicide is the second most common cause of death among 15- to placing cameras essay 34-year olds. These rates are even higher (20-50 times) in psychotic patients than in the general population. The often-vast variation between different prevalence sources is most likely an indicator of geographic, epidemiogical and cultural variation in self-harm trends. Global suicide rates in essay disorders, young people have increased during the past three decades. According to sentence the Office of National Statistics (1999), 1.3% of 5-10 year olds have tried to harm, hurt or kill himself/herself.
More than four times this proportion (5.8%) of the older children aged 11 to 15 years old report having attempted to self-harm or commit suicide. Most child and adolescent mental the health services take the disorders school-leaving age of how to write academic essay, 16 as their upper limit. On Psychology Disorders! Thus most available statistics are only for children up to the age of 16. Araby Analytical! It is important that children who fall within this narrow and oft-omitted age-gap (16-18 year olds) are not neglected, and are properly catered for. The statistics also show that among the 5-10 year olds, boys were almost twice as likely to self-harm than their female counterparts. Essay On Psychology! Likewise, children of single-parent homes also had more tendencies for deliberate self-harm than children of couple-parent families. Surprisingly, children with no siblings had slightly more chance of committing self-harm than children from larger families.
40% of these children who had tried to academic self-harm had a mental disorder, and one in essay disorders, three had experienced 3 or more stressful life events. In contrast, among the 11-15 year olds, self-harm appears to be more prevalent among girls (58%) than boys. However, these older children are apparently more likely to self-harm if they have a lot of siblings. 50% of surveillance in the streets essay, these adolescents who had tried to harm, hurt or kill themselves had a mental disorder and over 40% had experienced 3 or more stressful life events. Parents generally tend to underestimate their children’s self-harm tendencies and history, as illustrated by the vast differences in parents and on psychology disorders children’s accounts of self-harm and suicide attempts. This gives an letters insight into the level of shrouding and on psychology secrecy that is associated with these phenomena and casts doubts on essay introducing the validity and reliability of these widely accepted statistics. Stigmatisation and ostracization commonly associated with suicide and self-harm victims and families is the most likely reason behind under-reporting and denial. In addition, prevalence of suicides is largely underestimated because of reluctance of coroners to classify cause of death as suicides, especially in children.
A large proportion of the so-called “open verdicts” are, in fact, suicides (Hawton and James, 2005). Self-harm techniques such as self-cutting usually go unnoticed. As the most common method of DSH by teenagers, the implications are that the rates of on psychology, self-harm amongst adolescents are grossly under-reported. Placing Surveillance Streets! Thus it is important to on psychology disorders note that these daunting statistics might actually represent a conservative estimate of the reality of self-harm and suicide attempts among young people . Investigating potential socio-demographic and clinical predictors of suicide, Cooper et al (2005) concluded that there was an approximately 30-fold increase in risk of suicide in deliberate self-harm patients than in the general population. Surveillance In The Streets Essay! Furthermore, suicide rates were found to be highest within the on psychology first 6 months after the last initial self-harm episode. This is the basis for early assessment and essay treatment as will be discussed in subsequent sections. Examining trends and characteristics of self-harm in introducing malaysia, adolescents between 1990 and essay on psychology 2000, Hawton et al (2003) found that the prevalence of self-harm among young females was on the increase.
These rising rates could reflect latent negative effects of a number of social changes. Possible reasons for this increase include increased rates of family breakdowns, increasing rates of substance misuse, media influences and how to write a good academic essay common peer behaviours. In a self-report survey, Hawton et al (2002) studied the prevalence of essay, deliberate self-harm in adolescents aged 15 and 16 years old, and the factors associated with it. In this age group, females were more likely to self-harm than males. Ethnicity-wise, teenagers of white origin were more likely to self-harm than their Asian counterparts. Black young people were the least likely to self-harm. In addition, teenagers who lived with other family members apart from their parents were more likely to self-harm than those who live with one or both parents. Smokers also had more incidents of self-harm than non-smokers, with frequency increasing with number of cigarettes smoked in essay, girls. Similar trends were observed with young people who consumed alcohol. Expectedly, bullying and other forms of abuse (physical or sexual) was a major determining factor for adolescents who self-harm. Other factors which played a role in self-harm amongst young people were sexual orientation worries, trouble with police and family or friends who harm themselves.
Although self-harm is observed in all age-groups, it has an average age of onset of 12 years old (Fox and Hawton, 2004). Essay On Psychology Disorders! Thus the importance of a good essay, addressing this problem in essay, adolescents is blatantly obvious. Factors that have been substantiated to be strongly associated with self-harm amongst adolescents are very similar to characteristics associated with suicidal patients. These include: Depression Substance misuse Physical or sexual abuse Low self esteem Physical ill-health Disputes with parents, siblings or friends School or work problems. In an ecological and person-based study, Hawton et al (2001) investigated the essay introducing malaysia influence of the economic and social environment on on psychology disorders deliberate self-harm and suicide. Improving on (u.s. answers the methodical limitations of essay on psychology disorders, previous studies, the sentence of essay researchers studied DSH patients over 10 years.
The relationship between socio-economic deprivations was shown to be very significant in males and females. These findings have been collaborated by a more specific study (patients under 18 years old). Socio-economic deprivation was significantly associated with overdose, self-injury and poisoning by illicit substances (Ayton et al, 2003). Accounting for confounding factors, correlations remained significant, further validating the results of the study. Although the relationship between ethnic density and deliberate self-harm tendencies is not well established, Neeleman and colleagues (2001) demonstrated variable deliberate self-harm rates in various minority groups, suggesting protection and risk in different areas. This is a gap in the literature for future research. School stress has also been shown to play a role in DSH in teenagers (Hawton et al, 2003). The findings from widespread international research suggest that the most determining risk factors for youth suicide are mental disorders and a history of psychopathology (Beautrais, 2000). Others could be individual and personal vulnerabilities, social, cultural and contextual factors. Possible motives for essay on psychology disorders self-harming behaviour other than death are highlighted below (Hawton and analytical James, 2005): To escape from unbearable anguish.
To change the behaviour of others. To escape from a situation. To show desperation to others. To make others feel guilty. To gain relief of on psychology, tension. To seek help.
Furthermore, research has provided a useful insight into the factors that can influence repetitive self-harm behaviours despite aftercare and treatment. This is important in the assessment of patients who have self-harmed to identify those who are likely to self-harm again and prevent such episodes. Factors that are associated with repeated self-harm as highlighted by Hawton and James (2005) include personality disturbance, depression, alcohol or substance misuse, disturbed family relationships, social isolation and poor school records. Hawton et al (1999) demonstrated that self-harm repeaters differed from the placing surveillance non-repeaters in having higher scores for depression, hopelessness and trait anger, and lower scores for on psychology disorders self-esteem. Specific reasons that have been cited for self-harm by young people, as highlighted by the National Inquiry (2006) include: · Strained relationships with parents. · Worry about academic performance.
· Childhood abuse (sexual, physical or emotional) · Low self-esteem or rejection. · Problems to do with race, culture or religion. 2. Surveillance Cameras Streets! Responding To Young People Who Self-Harm. 2.1 Guidelines And Evidence For Good Practice. The National Institute for Clinical Excellence (NICE, 2004) has proposed guidelines for the short-term physical and psychological management and secondary prevention of on psychology disorders, self-harm in primary and secondary care. Write A Good! In addition, The Royal College of Psychiatrists (RCPSYCH) also provides guidance on managing young people up to the age of on psychology, 16 who deliberately harm themselves.
Such guidelines are readily applicable to the Health service i.e. Accident and Emergency departments and Child and write Adolescents Mental Health Services. Integrating these treatment guidelines and the findings of related research, the management of these young self-harm patients will be extensively discussed under the following sub-titles: Assessment Treatment planning Admission to hospital Treatment options Medical and surgical management Referral and discharge following self-harm Pharmacological interventions Family support Prevention. A comprehensive child and adolescent mental health service needs to take all the above facets into consideration when treating this group of extremely vulnerable patients.
The NICE guidelines (2004) emphasize the importance of treating patients who have self-harmed with the same care, respect and privacy as any other patient. In fact, the essay on psychology likely distress associated with self-harm may necessitate additional care and tact when dealing with these patients. Also, health services are urged to provide appropriate training to all staff (clinical and non-clinical) that has any form of last of essay, contact with the patients to fully equip them with the necessary skills and knowledge to effectively understand and care for essay on psychology people who have self-harmed. Introducing! Ideally, training should cover areas such as crisis counselling, risk assessment, stress management, mental health triage, cultural awareness, working with families and confidentiality issues (Wynaden et al, 2000). Clearly, the importance of ensuring patients’ safety while in hospital is colossal. These patients should be offered an environment that is essay on psychology disorders safe, supportive and minimises any distress. The NICE guidelines (2004) suggest a separate, quiet room with supervision and regular contact with a named member of a good academic essay, staff to ensure safety at essay all times.
The high rate of self-harm patients who repeatedly self-harm or go ahead to commit suicide in the future makes it imperative to conduct an extensive and detailed assessment of young people who self-harm . Young people who have self-harmed in a potentially serious or violent way should be assessed either by a child and adolescent psychiatrist, a specialist mental worker, a psychologist, a psychotherapist or a psychiatric nurse (Hawton and James, 2005). Surveillance Cameras In The Streets Essay! The NICE guidelines propose that all people who have self-harmed should be offered this preliminary assessment at triage, regardless of the essay on psychology disorders severity of the attack. Apart from the obligatory emergency physical assessment, this will give an insight into creative writing - non-fiction, the patient’s mental health, the level of distress and their willingness to on psychology co-operate with the medical team. In addition, the how to write essay patient’s psychosocial situation and the ability of parents or guardians to ensure their safety should be addressed (RCPSYCH, 2006). As the first point of contact, ambulance staff have a crucial role to play in essay on psychology disorders, the initial assessment of young people who have self-harmed (NICE, 2004). The Australian Mental Health Triage Scale is placing surveillance streets a validated comprehensive assessment scale that provides a means of on psychology, efficiently rating clinical urgency so that patients can be seen in cameras essay, a timely manner. This scale has been shown to improve staff confidence and essay disorders attitudes in dealing with clients with mental health problems, thus improving patients’ outcomes in the long-run (Broadbent et al, 2004). Research has shown the importance of write a good academic, cultural, ethnic and essay disorders racial awareness and sensitivity in surveillance cameras streets, the assessment process.
Some cultures regard suicide attempts as taboo, and essay on psychology it is sentence always good practice to take such factors into consideration. In addition, a language interpreter may be required to communicate effectively with the patient and disorders family. 2.1.2 Treatment Planning. Following the preliminary assessment, it is considered good practice to have an action or treatment plan (Hawton and James, 2005). The treatment plan should take into account all aspects of the patient’s management in hospital, ranging from write a good academic treatment options to pharmacological and psychological interventions to discharge planning. 2.1.3 Admission To Hospital. At this point, temporary admission should be considered especially for patients who are who are very distressed, for essay disorders people who may be returning to essay introducing an unsafe or harmful environment and for essay people in whom psychosocial assessment proves too difficult for any number of reasons (NICE, 2004). If admission is a good academic essay indicated, a paediatric, medical adolescent, or designated unit should be utilised as appropriate. Despite the essay on psychology disorders NICE guidelines, some schools of though believe that regardless of the toxicological or physical state of the young person, hospital admission is streets essay desirable, so that adequate further physical and psychosocial assessments can be carried out, and management/crisis interventions can be planned and initiated (Hawton and James, 2000). On Psychology! The paediatric ward will usually suffice, unless, and especially with patients in the older end of the age range, there is a more suitable unit available.
Waterhouse and Platt (1990) investigated the difference in essay malaysia, outcomes between self-harm patients who were admitted to hospital and those were discharged as outpatients. The findings of the study showed slight significance between the two intervention groups. It is the role of the admitting staff to on psychology disorders obtain agreement for the mental health assessment of the patient from parents or relevant guardians, and to surveillance in the streets essay alert all members of staff of each young person’s needs. As with all in-patients, hospitalised young patients who have self-harmed should be properly cared for and monitored. In addition, responsibilities of staff of the mental health team will include providing consultation to disorders the young person and his/her family, the paediatric team and staff of the social services and education departments. The Crisis Recovery Unit at the Bethlem Hospital in London, a national specialist unit for people of creative writing - non-fiction version), 17 years and above who repeatedly self-harm, have a different and essay slightly radical approach to the in-patient treatment of these patients (Mental Health Foundation, 2006). Their philosophy is that the individuals should take responsibility for their actions. This practice-supported technique focuses on helping young people realise for themselves that self-harm is not an effective strategy for dealing with their problems.
It encourages these patients to talk about write a good essay their problems and explore alternative coping strategies, including strategies for dealing with the urge to self-harm. However, the effectiveness of such an intervention in younger patients (11-16) is not certain, as these children might not be mentally mature for such self-realisation tactics. 2.1.4 Treatment Options. Treatment options for essay adolescents who have harmed themselves could be individual-based, family-based or group-based. Individual-based interventions include but are not limited to problem-solving, cognitive behavioural therapy and anger management. Family therapy could be in the form of problem-solving or structural or systemic therapy, and group therapy could involve any of these techniques performed in teams or groups. Problem-solving therapy or brief psychological therapy as it is otherwise known, is creative - non-fiction answers a brief treatment that is aimed at helping the young patient to acquire basic-problem solving skills to disorders identify and prioritise their problems (Mental Health Foundation, 2006). The process involves implementing discussed possible solutions to a specific problem, and reassessing the situation to review progress -sort of like a self-audit process. The basics of problem-solving therapy as identified by Hawton and James (2006) are highlighted below: · Identifying and in the deciding what problems to tackle first. · Agreeing goals of therapy with the patient as much as is possible.
· Working out disorders steps to achieve goals. · Deciding how to tackle the first step. · Dealing with psychological factors that obstruct progress. · Working through subsequent steps. This method of problem-solving therapy appears to introducing improve depression, hopelessness and general problems in deliberate self-harm patients significantly more than control therapy (Townsend et al, 2001). This finding has been variously collaborated in other studies and the results are considered reliable. This therapeutic process usually takes 5 to 6 one-hour sessions, and can be delivered by any experienced mental health professional with suitable training and supervision (Mental Health Foundation, 2006). It is direct and easily understood and is thus suitable for essay disorders the younger patients. It helps the adolescent when he or she is faced with future crisis or trigger factors. Cognitive Behavioural Therapy. This form of psychotherapy is based on the belief that psychological problems are the product of an individual’s faulty way of viewing the world.
In this case, the araby analytical essay therapist aims to modify the patients’ cognitive processes and beliefs using techniques that are similar to those described above (problem-solving therapy), but with behavioural techniques. Although widely used adopted in essay, psychotherapy in the treatment of depression, cognitive behavioural therapy (CBT) has limited evidence of use in self-harm patients. Even in depression, its use has been shown to be less effective as monotherapy than fluoxetine monotherapy and in combination with fluoxetine (March et al, 2004). Dialectical Behaviour Therapy. Dialectical Behaviour Therapy (DBT) is an intensive therapeutic technique that was introduced to help those who repeatedly harm themselves. Essay Introducing Malaysia! It could involve as long as a full year of essay on psychology disorders, individual therapy, group sessions, social skills training and access to crisis contact (Mental Health Foundation, 2006). Fewer behavioural incidents have been reported with this treatment when compared with an input unit run on psycho dynamically oriented principles (Katz et al, 2004), thus strengthening findings by Rathus and Miller in 2002. In addition, an older study (Linehan et al, 1991) had shown very significant differences in likeliness to repeat self-harm in patients undergoing dialectical behaviour therapy and the control group.
The NICE guidelines (2004) suggest the use of dialectical behaviour therapy in self-harm patients who have a diagnosis of letters positions, borderline personality disorder, but stress that this should not preclude the use of other strongly validated psychological treatments with vast evidence-based support. As the name implies, family therapy is essay on psychology disorders a branch of psychotherapy that treats family problems as a source of the adolescent’s underlying therapy. Family interventions can be structured or systemic and can also be home-based. Basic aspects of this treatment option would include improvement of specific skills and emotions to promote sharing of feelings and negotiation between family members. Elements of assessment of families of self-harm victim should include (Hawton and James, 2005): · Family structure and test - non-fiction version) relationships. · Recent family life events, e.g. death, relocation, divorce e.t.c.
· History of essay, psychiatric disorder, including suicide attempts in the family. There is some anecdotal evidence that demonstrate the importance of cameras essay, family therapy in young people who self-harm, especially those have well-documented family issues or strained family relationships. However, evidence base to support the use of on psychology disorders, family therapy interventions is scarce and quite weak. Last Of Essay! In a randomly controlled case study, Harrington et al (1998) compared an intensive family therapy intervention with standard self-harm aftercare. The results of the study found no significant differences between the two groups of subjects in terms of essay, improved outcomes. Group therapy could include the placing essay previously discussed problem solving and cognitive behavioural therapy. The Oxford Medical Dictionary defines group therapy as psychotherapy involving at least two patients and a therapist. Essay Disorders! Simply put, it is the administration of any psychological therapeutic methods described above in groups.
Normally, people with similar problems meet to discuss and analyse their problems and possible ways of overcoming them. Although this intervention could be time-saving, the essay possibility of confrontation and tension between the group members is a potential barrier to essay disorders its effective implementation. Also, the negative connotation of suicide and essay self-harm might prevent patients from effectively participating in disorders, such group sessions. In a small-randomised parallel trial in Manchester, England, Wood et al (2001) strove to evaluate the effectiveness of group therapy for repeated deliberate self-harm in adolescents by comparing combination of letters positions, routine care and group therapy with routine care alone. Results showed that adolescents who had group therapy were less likely to repeat self-harm than those who only received routine therapy. Overall, the evidence for clinical management and prevention of repeated episodes of essay, deliberate self-harm in young people is limited. A systematic review by Burns and placing cameras in the streets essay colleagues (2005) found that group therapy was the only specific programme that had significant effects on the rates of essay on psychology, repetition of self-harm. Expensive interventions such as intensive aftercare have no clear advantages over standard aftercare. 2.1.5 Medical And Surgical Management.
Clearly a person who has harmed himself/ herself will have some form of injury, whether superficial or systemic. Cover For Teaching Positions! Responding to adolescents who self-harm will obviously include treatment of essay, consequences of the self-afflicted injury. The treatment of self-injury would be the same as for araby essay any other injury, taking into account the level of distress and emotional disturbance experienced by the patient (NICE, 2004). The most common products of self-injury -wounds and poisoning must be treated accordingly. Wounds may require wound assessment and exploration and together with a full discussion of the patient’s preferences should be cleaned and dressed appropriately. On Psychology! In more severe cases, minor surgery might be necessary to properly mend any damages. Treatment for ingested substances would be dependent on the nature of the letters for teaching positions poison. Samples should be collected as soon as possible for laboratory analysis. The overall aim would be to reduce absorption, increase elimination or chemically neutralize the adverse biological effects of the poison.
The guidelines proposed by the National Institute of Clinical Excellence emphasizes the consideration of gastro-intestinal decontamination only in essay disorders, self-harm patients who present early, are fully conscious with a protected airway, and are at risk of significant harm as a result of the poisoning. Activated charcoal could be administered 1 to 2 hours after ingestion. Emetics and write a good cathartics should not be used in the management of on psychology, self-poisoning. Recommendations by TOXBASE or the National Poisons Information Service (NPIS) should be followed to prevent further complications and harm. Gastric lavage and whole bowel irrigation should only be used when specifically recommended by relevant bodies.
2.1.6 Pharmacological Interventions. Generally, the use of pharmacological agents in a good academic essay, treating adolescents who have self-harmed is built on essay the basis that depression is an underlying problem in these patients. Comparing antidepressant therapy with placebo in patients who had deliberately initiated self-poisoning or self-injury, significant odds ratios were achieved. Furthermore, significantly reduced rates of further self-harm were observed for depot flupenthixol compared to placebo. The current controversy over selective serotonin reuptake inhibitors in children and adolescents (Wong et al, 2004), especially those with suicidal ideation must be taken into account when prescribing for this group of patients. Like with all aspects of last of essay, health care, and particularly mental health care, the choice of intervention depends on the individual patient’s condition. Montgomery et al (1979) have demonstrated a significantly greater likelihood of repeated self-harm in patients treated with the placebo agent compared with those treated with flupenthixol.
Differences in the outcomes of patients treated with antidepressants and essay those treated with placebo, though not as large, were still significant (Montgomery et al, 1983). The introduction of pharmacological agents in the management of placing in the, such patients would ultimately depend on the outcomes of psychosocial and physical assessment, and should be aimed at treating the patient’s underlying problems or particular diagnosis rather than simply treating self-harming behaviour. Whatever, therapeutic decisions are made, clinicians should ensure that the patient (or where not possible, parents or guardians) are made aware of the on psychology treatment options available, including the likely advantages and disadvantages, and essay malaysia involved in making a choice. 2.1.7 Referral and Discharge Following Self-Harm. Referral and discharge of an adolescent after self-harm would depend on the outcomes of the essay extensive assessment that would have been previously conducted (section 2.1.1).
It is important that the araby analytical patient remains as involved as possible in essay on psychology disorders, decisions that are made regarding his/ her management. Adolescents who have harmed themselves may need a range of other health or social services. Referral to these professionals and other relevant agencies bears witness to araby analytical the importance of adopting a multi agency approach (section 2.3). Proper documentation of all relevant interventions and conversations will ensure a seamless transfer from one health service to another and culminate in improved quality of care and better outcomes. 2.1.8 Family Support. This is quite different from family therapy as discussed under treatment options (section 2.1.4). Rather than attempt to disorders resolve underlying family problems in a bid to address the source of the academic essay adolescent’s problems like the latter, family support refers to moves that could be taken to help parents and siblings deal with the traumatic experience of self-harm in the family. Common family reactions following suicide or self-harm by adolescents include denial, guilt, shame, anger, depression, substance misuse and overprotection of other children and siblings.
These issues have to be addressed effectively and in a timely manner to avert further tragic family occurrences. It would be the responsibility of the on psychology resident psychologist to evaluate family members and provide the appropriate counselling and placing surveillance cameras essay treatment. A large part of responding to the increasing rates of self-harm among adolescents in the UK is initiating preventive measures. The National Inquiry into self-harm among young people found that school-based work appears to be one of the most promising areas where prevention of self-harm among young people can be effectively tackled. Also it is widely recognised that young people would rather turn to disorders young people than adults in their time of need. In response to this, schools have started implementing peer support schemes. It must be appreciated that prevention strategies should be both primary and secondary, i.e. Cover Letters! should target self-harmers as well as the general young population as appropriate. Child and adolescent mental health services must put in essay disorders, place programmes to effectively reach their target population.
Measures should be put into action to promote good mental health and emotional well being (Mental Health Foundation, 2006). In addition, educational awareness programmes should be initiated to provide information to the general public towards reducing the stigmatisation associated with self-harm and suicides. The mental health service could pilot a 24-hour help line to address adolescent’s problems. Letters Positions! This would provide an avenue to on psychology disorders discuss one’s problems and obtain advice and surveillance streets support on essay on psychology how to deal with them. Cover Letters! 25% of young people who were asked what could be done to prevent adolescents from harming themselves responded that someone to listen, advise and support in times of need would be beneficial (Fortune et al, 2005). Secondary prevention is essay disorders even more crucial as a 30-fold increase in risk of suicide has been demonstrated in young people who had previously self-harmed.
Direct intervention is indicated for these patients to prevent repeated self-harm. Various distraction techniques have been reported by last of essay, these young people as helping to take their minds off the urge to inflict harm on themselves. These include physical exercise, writing negative feelings on paper and ripping it up, using a red felt-pen to mark instead of cut, hitting a punch bag to vent anger and frustration, writing in a diary and talking to a friend (Mental Health Foundation, 2006). Professional prevention of on psychology, repeated episodes of self-harm would include psychological and psychosocial assessment and interventions as described in earlier sections to try and resolve causal problems and improve emotional well being and general mental health. 2.2 Assessing The Needs And Risks of Young People Who Have Self-Harmed.
Psychosocial assessment in patients who have self-harmed can be classified broadly into assessment of need and assessment of risks. Specialist mental health professionals should carry out both assessments. Last! Research has found typical psychological and psychosocial factors associated with deliberate self-harm (Webb, 2002). However, the breadth and on psychology sensitivity of tools and methods utilised in these studies mean that psychosocial factors have been less consistently measured. In fact, it has been suggested that positive psychosocial factors might actually play a role in providing protection against self-harming behaviour. Assessment of Needs. Needs assessment should be comprehensive and include evaluation of the social, psychological and motivational factors specific to cover letters for teaching positions the individual’s act of self-harm, current suicidal intent and hopelessness (NICE, 2004). In addition, a full mental health and social needs assessment must be included. As always, all conversations and interventions must be clearly documented in the patients’ notes to ensure seamless transition from one healthcare professional to another, and to essay on psychology enable follow-up. Assessment of cover letters, Risks. This should include identification of the main clinical and demographic characteristics that are potential risk factors for repeated self-harm or suicide (NICE, 2004).
A standardised risk assessment scale could be used, but should complement rather than replace extensive individual assessment. Psychosocial assessment is important because it provides an insight into the longer-term needs and risks of the patient and disorders forms a basis for therapeutic decisions. 2.3 The Multi Agency Approach To Management of Adolescents Who Self-Harm. The involvement of how to write, multiple agencies or services in the care of patients who have self-harmed is essay on psychology crucial to obtaining good outcomes. This approach is much more than the usual inter-professional approaches to patient care as recommended in hospitals.
Matter-of-fact, inter-professional patient care merely forms a small part of the araby multi agency approach in essay disorders, mental health care. The Royal College of Psychiatry (2006) emphasizes the importance of a full and longer-term approach to providing care for self-harm patients that will require the co-ordinated activities of local and araby analytical essay health authorities together with an awareness of the essay disorders important role that non-statutory sector agencies play. The nature of these episodes of self-harm and the age group being considered necessitates the involvement of placing cameras in the essay, a wide range of professionals in health and non-health sectors in order to address all aspects of the incidence appropriately. Health professionals who will be invariably involved in management of these patient groups are emergency department staff, paramedical and ambulance staff, general practitioners, pharmacists, counsellors, paediatricians, paediatric nurses, psychiatrists, prison health staff, clinical psychologists, mental health nurses, community psychiatric nurses and social workers. Other public services professionals may have direct contact or be involved in the care of these patients. These include occupational therapists, art therapists, the essay on psychology police and professionals who work in the criminal justice and education sectors (NICE, 2004). In addition, child protection services may be involved depending on placing surveillance in the streets the family background. Essay On Psychology! Thus it is introducing clear that the full range of resources and essay disorders interventions required by young people who harm themselves span the responsibilities of a range of agencies and sectors of care (RCPSYCH, 1998). Paramedical and Ambulance Staff.
As the placing surveillance cameras first health care contacts that an adolescent will have after a self-harm episode, ambulance staff and paramedics have an increasingly important role in early assessment and treatment of self-harm. Urgently needed at this point is an assessment of disorders, physical risk to ascertain the extent of the injury and araby analytical essay provide first-aid treatment at on psychology disorders once. In cases of self-poisoning, ambulance staff should ensure to obtain all substances and/or medications found at the scene and hand them over at creative writing version) answers the emergency department. They should be well trained and equipped to assess and make quick life-saving interventions. Disorders! Training should address in particular, the write academic different methods of on psychology, self-harm and the appropriate treatments. NICE guidelines (2004) recommend that ambulance trusts, the emergency department and mental health trusts should work in partnership to develop locally agreed protocols for ambulance staff to follow in the care and transport of self-harm patients.
Emergency Department Staff. The accident and emergency (AE) staff in sentence, the hospital are probably the main care-providers for essay on psychology these patients at this acute stage. It is positions their responsibility to keep the injured patient alive and prevent as much damage as possible. If this is not achieved, all subsequent care providers may have no role to play (in the event of death of patient). They should be properly trained to recognise and counter common self-inflicted injury. Essay Disorders! These professionals often have direct contact with the sentence of essay ambulance staff and proper communication between these two services is critical. General Practitioners and Paediatricians.
Effective communication between primary and secondary care is necessary in order to allow continuity of care for these patients. Paediatricians are especially involved to provide adequate care for children. Mental Health Services. The role of essay, mental health professionals such as psychiatrists, psychologists, and mental health nurses in providing care to self-harming young people is very evident. How To A Good Academic Essay! It is their duty to assess and treat any mental health problems such as depression, schizophrenia e.t.c. All the psychosocial and psychological assessments and interventions previously discussed is their responsibility. When problems are identified in living conditions or other social aspects of the young person’s life, social workers are brought in to address these, and where necessary, make alternative arrangements to resolve the disorders problems.
In the for teaching positions infrequent case of illegal activities associated with the incidence of essay disorders, adolescents’ self-harm, members of the police force or other criminal justice professionals are required to resolve these issues. Cover Positions! For example, underlying sexual abuse as a trigger factor for self-harm would necessitate police intervention. Child protection procedures must also be implemented when a young person’s self-harming is indicative of mistreatment. Children and adolescents spend most of disorders, their time in school, and thus the school staff could have a major role to play in taking care of young people who have self-harmed. Caution should be applied when dealing with children.
In particular, children and adolescents with learning disability should be treated with care, and if necessary enrolled in a special needs institution. Given that the arrangement of the various units that provide the different services may be complex, integrating these services could seem quite chaotic and disorganised. The health authority/board should work with partner local authorities, trusts and last of essay primary care groups to ensure that inter-agency boundaries do not create fault lines in service delivery (RCPSYCH, 2006). Essay! There should be accurately developed policies to ensure that all the provider agencies have service agreements that enable and govern protocols for assessing and treating young people who harm themselves to be implemented and used effectively. The fundamental idea of malaysia, a comprehensive child and adolescent mental health service provider is the disorders takes a multi agency approach and is not restricted solely to a psychiatric service (Morley and Wilson, 2001). Cover Letters! The four tiers of intervention that should be included in such services are outlined below (National Health Service, 1995): Tier 1: Non-mental health specialists.
These are professionals who by virtue of their work with children, young people and families, are in a position to identify early signs of mental health problems. These could be midwives, health visitors, school nurses and counsellors. These practitioners can provide general advice and disorders treatment for less severe problems, and contribute towards mental health promotion. Tier 2: Child and adolescent mental health specialists working in community and essay primary care settings. E.g. On Psychology! primary mental health workers, psychologists and counsellors in GP practices, paediatric clinics, schools and youth services. How To A Good Essay! They can provide more specialist interventions and essay disorders training to practitioners at tier 1 level. Tier 3: At this stage, the multi-disciplinary and multi agency specialist child and cover positions adolescent mental health professionals work as team, as appropriate to provide extensive assessment and treatment to children and young people with more complex and essay on psychology disorders persistent disorders.
Tier 4: In-patient and highly specialised child and write a good essay adolescent mental health services, including specialist and forensic units usually offering services across several areas. These are essential tertiary level services for children and young people with the most serious problems. They can include secure forensic adolescent units, eating disorders units, specialist neuro-psychiatric teams, and other specialist teams (for children who have been sexually abused, for example), usually serving more than one district or region. 3. General Discussion. The reality of disorders, self-harm in essay, adolescents paints a grim and depressing picture. The vulnerable nature of the patient group makes management and treatment interventions even more difficult to essay on psychology implement effectively. With increased access to a good academic televisions, the Internet and other sources of information and entertainment, young people today are exposed to all sorts of on psychology, negative influences that could hamper mental health and emotional well being. These, combined with numerous other factors are possible factors behind the surveillance cameras in the streets essay rising incidents of self-harm among young people in on psychology disorders, the United Kingdom.
Despite the placing surveillance in the magnitude of the problem, there is a baffling dearth of research investigations into this area. Applying the essay on psychology disorders findings of the self-harm studies and adhering to available guidelines, a comprehensive child and adolescent mental health service can be established to effectively target all aspects of underlying factors in self-harm. Ethnicity distribution findings has useful implications for management of suicidal behaviour, and for teaching positions should always be taken into consideration during assessment when predicting risk of repeated self-harming episodes. Likewise, other potential risk factors and confounding factors should be accounted for in individual cases. Assessment should always look out for features that are indicators of strong suicidal intent, high lethality, extreme precautions against being discovered and underlying psychiatric illness. Despite little evidence to show advantages over discharge, guidelines recommend a minimal overnight admission to allow for comprehensive assessment and proper implementation of on psychology, appropriate treatment. Admission must be in a suitable ward or unit and should ensure support and safety at all times. The treatment options are vast and could range from medical, surgical or pharmacological management to psychosocial and psychological interventions. Larger studies would be beneficial to gain a more accurate insight into how to a good essay, the reliability and generalisability of these interventions in this group of patients. There appears to be more research and information in the literature for psychological and psychosocial interventions such as problem-solving, cognitive behavioural therapy, dialectical behaviour therapy and essay on psychology group therapy, than for pharmacological management e.g. the use of anti-depressants or anti-psychotics following self-harm in young people.
Ultimately, the choice of treatment depends on introducing the individual patient and his/ her inherent risk factors. Assessment of needs and essay on psychology disorders risks (psychosocial assessment) must be carried out placing in the essay before discharge to ascertain the patients’ ability to cope and the extent of their suicidal ideation. The outcomes of such assessment would further determine suitable treatment path and the necessary agencies and services to employ. For a comprehensive child and mental health service to efficiently respond to on psychology the rising incidents of self-harm among young people, there is need to appreciate the importance of last, inter-professional collaboration within the essay on psychology hospital setting. Integration of people and skills will improve the quality of care provided, and enhance the services understanding of self-harm in young people. In addition to this the importance of external multi-agency involvement is noted, as the full range of interventions required by write academic, these highly susceptible patient group necessitates the input of a wide range of agencies and sectors of care. Thus collaboration with other health and non-health services is crucial and essay disorders should involve professionals such as the police, school workers, social workers and child protection agencies, as necessary. It is (u.s. version) answers important to note that the mental and physical health of the adolescent is essay disorders not isolated, and could be an indicator of other family or social problems. A child and for teaching positions adolescent mental health agency can keep its services comprehensive and effective by keeping up-to-date with new and proven treatment options that could be applied to its young patients.
Also, suitable training is essential for all staff that will have any form of contact with these patients to adequately cater for essay on psychology disorders them. The views of the targeted young people should be considered, when making local health policies. Essay! In a qualitative study investigating young people’s perceptions about helpful contacts (Mental Health Foundation, 2006), it was found that young people found voluntary local organisations, friends and health visitors most helpful in their distressful times. Furthermore, investigating what sort of help they would like on offer, most people thought that one on one support and/ or counselling would be helpful. Other popular interventions were group support, facilitated self-help groups and creative initiatives and multimedia/ Internet access. In reality adolescents were more likely to seek help from friends and their general practitioners. As sources of information, these contact points are not trained to provide such specialist help. Young people should be made aware of services provided by child and adolescents mental health agencies to educate them on essay disorders the available benefits of reaching out to them in time of need.
The limited literature available on this topic is a potential setback to effective resolution of the current problem. Nevertheless, the interventions and assessment made in patient care should remain evidence-based as much as possible. It must be understood that the treatment of young people who self-harm should not be just solely psychiatric, and cover for teaching should adopt the essay on psychology recommended multi agency approach in order to effectively target all latent aspects of the problem. Young people’s opinions should not be ignored, and findings on interventions they consider helpful must be applied within reason to achieve patient satisfaction and encourage them to seek help from the appropriate sources. Anderson, M., Woodward, L., Armstrong, M. (2004) Self-harm in placing surveillance cameras essay, young people: a perspective for mental health nursing care. International Nursing Review 51, 222-228. Ayton, A., Rasool, H., Cottrell, D. Essay! (2003) Deliberate self-harm in children and adolescents: association with social deprivation.
European Child and Adolescent Psychiatry 12, 303-307. Beautrais, A. (2000) Risk factors for suicide and cameras essay attempted suicide among young people. On Psychology Disorders! Australian and New Zealand Journal of Psychiatry 34, 420. Broadbent, M., Jarman, H., Berk, M. (2004) Emergency department mental health triage scales improve outcomes. Journal of how to a good, Evaluation in Clinical Practice 10, 57-62.
Burns, J., Michael, D., Hazell, P., Patton, G. On Psychology Disorders! (2005) Clinical management of araby, deliberate self-harm in young people: the need for evidence-based approaches to reduce repetition. Australian and New Zealand Journal of Psychiatry 39, 121-128. Bywaters, P. and Rolfe, A. (2002) Look beyond the scars: Understanding and essay on psychology responding to positions self-harm and self-injury. Disorders! [WWW] http://nch.org.uk/uploads/documents/selfharm.pdf (December7th 2006). Cooper, J., Kapur, N., Webb, R., Lawlor, M., Guthrie, E., Mackway-Jones, K., Appleby, L. (2005) Suicide after deliberate self-harm; a 4-year cohort study. Essay Introducing! The American Journal of Psychiatry 162, 297-303. Fortune, S., Sinclair, J., Hawton, K. (2005) Adolescents views on on psychology prevention of self-harm, barriers to help-seeking for self-harm and how quality of placing surveillance in the, life might be improved: A qualitative and quantitative study. Oxford: Centre for suicide research, University of Oxford. Fox, C. and disorders Hawton, K. (2004) Deliberate self-harm in adolescence. Jessica Kingsley Publishers, London. Harrington, R., Kerfoot, M., Dyer, E., McNiven, F., Gill, J., Harrington, V., Woodham, A. (1998) Randomised trial of a home-based family intervention for streets children who have deliberately poisoned themselves.
Journal of American Academy of Child and essay on psychology disorders Adolescent Psychiatry 37, 512-518. Hawton, K., Fagg, J., Simkin, S., Bale, E., Bond, A. (2000) Deliberate self-harm in - non-fiction, adolescents in Oxford, 1985-1995. Journal of Adolescence 23, 47-55. Hawton, K., Hall, S., Simkin, S., Bale, L., Bond, A., Codd, S., (2003) Deliberate self-harm in adolescents; a study of characteristics and trends in Oxford, 1990-2000. Journal of Child Psychology and Psychiatry 44, 1191-1198. Hawton, K., Harriss, L., Hodder, K., Simkin, S., Gunnell, D. (2001) The influence of the economic and social environment on essay on psychology disorders deliberate self-harm and suicide: an ecological and person-based study. Psychological Medicine 31, 827-836. Hawton, K. and James, A. (2005) ABC of how to a good academic, adolescence: Suicide and deliberate self-harm in young people.
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Katz, L., Cox, B., Gunasekara, S., Miller, A. (2004) Feasibility of dialectical behaviour therapy for suicidal adolescent in-patients. Journal of American Academy of Child and Adolescent Psychiatry 43, 276-282. Linehan, M., Armstrong, H., Suarez, A., Allmon, D., Heard, H. (1991) Cognitive behavioural treatment of chronically parasuicidal borderline patients. Disorders! Archives of General Psychiatry 48, 1069-1064. Sentence Of Essay! March, J., Silva, S., Petrycki, S. The Treatment for disorders Adolescents Depression Study (TADS) team (2004) Fluoxetine, cognitive behavioural therapy, and araby analytical essay their combination for adolescents with depression: Treatment for Adolescents With Depression Study. A randomised controlled study. Journal Of American Medical Association 292, 807-820. Mental Health Foundation (2006) Truth Hurts: Report of the national inquiry into essay disorders, self-harm among young people. [WWW] http://www.selfharmuk.org/docs/selfharmreportlowres.pdf (December7th 2006) Montgomery, S., Montgomery, D., Jayanthi-Rani, S., Roy, D., Shaw, P., McAuley, R. Write Academic! (1979) Maintenance therapy in repeat suicidal behaviour: A placebo-controlled trial. Essay On Psychology! Proceedings of 10th International Congress for Suicide Prevention And Crisis Intervention, Ottawa, 227-229. Montgomery, S., Roy, D., Montgomery, D. (1983) The prevention of recurrent suicidal acts. British Journal of Clinical Pharmacology 15, 183-188.
Morley, D. and Wilson, P. (2001) Child and adolescents mental health: its importance and how to write a good academic commission a comprehensive service. Guidance for primary care trusts. Essay! [WWW] http://www.youngminds.org.uk/pctguidance/YM_PCT_Guidelines.pdf (December7th 2006) Neeleman, J., Wilson-Jones, C., Wessely, S. (2001) Ethnic density and deliberate self-harm: a small area study in how to write a good academic essay, southeast London. Essay On Psychology Disorders! Journal of Epidemiology and Community Health 55, 85-90. National Health Service, Health Advisory Service (1995) Together we stand, a thematic review of child and adolescent mental health service. National Institute for Health and Clinical Excellence (2004) Self-harm: The short-term physical and psychological management and secondary prevention of self-harm in essay, primary and secondary care. [WWW] http://www.nice.org.uk/guidance/CG16/guidance/cfm/English (December7th 2006) Office of National Statistics (1999) Children and adolescents who try to harm, hurt or kill themselves. [WWW] http://www.statistics.gov.uk/downloads/theme_health/Childselfabuse_v1.pdf (December7th 2006).
Rathus, J., and Miller, A. (2002) Dialectical behaviour therapy adapted for suicidal adolescents. Disorders! Suicide Life Threat Behaviour 32, 146-157. Skegg, K. (2005) Self-harm. The Lancet 366, 1471-1483. The Royal College of Psychiatry (2006) Managing deliberate self-harm in young people. [WWW] http://www.rcpsych.ac.uk/publications/collegereports/cr/cr64.aspx (December7th 2006). Townsend, E., Hawton, K., Altman, D., Arensman, E., Gunnell, D., Hazell, P., House, A., Van Heeringen, K. Letters Positions! (2001) The efficacy of problem-solving treatments after deliberate self-harm: a meta-analysis of randomised controlled trials with respect to essay on psychology depression, hopelessness and improvement in essay introducing malaysia, problems. Psychological Medicine 31, 979-988. Waterhouse, J. and Platt, S. On Psychology Disorders! (1990) General hospital admission in the management of creative writing, parasuicide. A randomised controlled trial. The British Journal of Psychiatry 156, 236-242.
Webb, L. (2002) Deliberate self-harm in adolescence: a systematic review of psychological and psychosocial factors. Journal of Advanced Nursing 38, 235-244. Wong, I., Besag, F., Santosh, P., Murray, M. (2004) Use of selective serotonin reuptake inhibitors in children and adolescents. Drug Safety 27, 991-1000. Wood, A., Trainor, G., Rothwell, J., Moore, A., Harrington, R. (2001) Randomised trial of group therapy for repeated deliberate self-harm in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 40, 1246-1253. Wynaden, D., O’Connell, B., McGowan, S., Popescu, A. (2000) The educational needs of nurses’ in the area of mental health. The Australian Electronic Journal of Nursing Education 6, No.1.
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open source essay This article has been superseded by essay disorders a major rewrite, “Open Source” misses the point of Free Software, which is last much better. We keep this version for historical reasons. While free software by any other name would give you the same freedom, it makes a big difference which name we use: different words convey different ideas . In 1998, some of the people in essay, the free software community began using the term “open source software” instead of essay introducing malaysia “free software” to describe what they do. The term “open source” quickly became associated with a different approach, a different philosophy, different values, and even a different criterion for which licenses are acceptable. Essay. The Free Software movement and the Open Source movement are today separate movements with different views and sentence of essay goals, although we can and do work together on essay disorders, some practical projects. The fundamental difference between the two movements is in analytical, their values, their ways of looking at the world.
For the Open Source movement, the issue of whether software should be open source is a practical question, not an ethical one. On Psychology. As one person put it, “Open source is essay a development methodology; free software is a social movement.” For the Open Source movement, non-free software is essay on psychology a suboptimal solution. For the Free Software movement, non-free software is a social problem and free software is the solution. Relationship between the Free Software movement and Open Source movement. The Free Software movement and the Open Source movement are like two political camps within the last sentence of essay free software community. Radical groups in the 1960s developed a reputation for factionalism: organizations split because of disagreements on essay on psychology, details of strategy, and then treated each other as enemies. How To Write. Or at least, such is the image people have of them, whether or not it was true.
The relationship between the Free Software movement and the Open Source movement is just the opposite of that picture. We disagree on the basic principles, but agree more or less on disorders, the practical recommendations. So we can and do work together on many specific projects. We don't think of the Open Source movement as an araby essay enemy. The enemy is proprietary software. We are not against the Open Source movement, but we don't want to be lumped in with them. We acknowledge that they have contributed to our community, but we created this community, and we want people to know this. Essay On Psychology. We want people to essay introducing malaysia, associate our achievements with our values and our philosophy, not with theirs. We want to be heard, not obscured behind a group with different views. To prevent people from thinking we are part of them, we take pains to on psychology disorders, avoid using the word “open” to describe free software, or its contrary, “closed”, in talking about non-free software.
So please mention the Free Software movement when you talk about the work we have done, and creative version) the software we have developedsuch as the GNU/Linux operating system. This rest of this article compares the two terms “free software” and essay disorders “open source”. It shows why the term “open source” does not solve any problems, and in fact creates some. The term “free software” has an ambiguity problem: an unintended meaning, “Software you can get for zero price,” fits the term just as well as the intended meaning, “software which gives the user certain freedoms.” We address this problem by publishing a more precise definition of free software, but this is not a perfect solution; it cannot completely eliminate the problem. An unambiguously correct term would be better, if it didn't have other problems. Unfortunately, all the alternatives in English have problems of their own. We've looked at many alternatives that people have suggested, but none is essay introducing so clearly “right” that switching to it would be a good idea.
Every proposed replacement for “free software” has a similar kind of semantic problem, or worseand this includes “open source software.” The official definition of “open source software,” as published by on psychology the Open Source Initiative, is very close to our definition of free software; however, it is how to write a good essay a little looser in some respects, and they have accepted a few licenses that we consider unacceptably restrictive of the essay disorders users. However, the araby essay obvious meaning for the expression “open source software” is “You can look at the source code.” This is a much weaker criterion than free software; it includes free software, but also some proprietary programs, including Xv, and Qt under its original license (before the QPL). That obvious meaning for “open source” is essay on psychology not the meaning that its advocates intend. The result is that most people misunderstand what those advocates are advocating. Here is how writer Neal Stephenson defined “open source”: Linux is how to a good academic “open source” software meaning, simply, that anyone can get copies of its source code files.
I don't think he deliberately sought to reject or dispute the “official” definition. I think he simply applied the conventions of the English language to come up with a meaning for the term. The state of Kansas published a similar definition: Make use of open-source software (OSS). OSS is software for which the source code is freely and publicly available, though the specific licensing agreements vary as to what one is allowed to do with that code. Of course, the open source people have tried to deal with this by publishing a precise definition for the term, just as we have done for essay on psychology disorders, “free software.” But the explanation for “free software” is simplea person who has grasped the idea of letters positions “free speech, not free beer” will not get it wrong again. Essay. There is how to write a good academic no such succinct way to explain the official meaning of “open source” and on psychology show clearly why the malaysia natural definition is the wrong one. The main argument for the term “open source software” is that “free software” makes some people uneasy. That's true: talking about freedom, about ethical issues, about responsibilities as well as convenience, is asking people to essay disorders, think about things they might rather ignore.
This can trigger discomfort, and answers some people may reject the idea for that. It does not follow that society would be better off if we stop talking about essay on psychology disorders these things. Years ago, free software developers noticed this discomfort reaction, and some started exploring an araby essay approach for avoiding it. Essay On Psychology Disorders. They figured that by writing test - non-fiction keeping quiet about ethics and freedom, and talking only essay on psychology disorders, about the creative writing immediate practical benefits of certain free software, they might be able to “sell” the software more effectively to certain users, especially business. The term “open source” is offered as a way of doing more of essay on psychology disorders thisa way to be “more acceptable to business.” The views and values of the Open Source movement stem from this decision. This approach has proved effective, in its own terms. Today many people are switching to free software for purely practical reasons. That is good, as far as it goes, but that isn't all we need to do! Attracting users to free software is not the whole job, just the - non-fiction (u.s. version) answers first step. Sooner or later these users will be invited to switch back to on psychology, proprietary software for some practical advantage. Cover Letters Positions. Countless companies seek to offer such temptation, and why would users decline?
Only if they have learned to value the freedom free software gives them, for its own sake. It is up to us to disorders, spread this ideaand in order to do that, we have to talk about introducing malaysia freedom. A certain amount of the “keep quiet” approach to essay on psychology disorders, business can be useful for the community, but we must have plenty of freedom talk too. At present, we have plenty of “keep quiet”, but not enough freedom talk. Most people involved with free software say little about freedomusually because they seek to be “more acceptable to business.” Software distributors especially show this pattern. Some GNU/Linux operating system distributions add proprietary packages to the basic free system, and last sentence they invite users to consider this an advantage, rather than a step backwards from essay freedom. We are failing to keep up with the influx of free software users, failing to teach people about freedom and letters positions our community as fast as they enter it. Essay. This is why non-free software (which Qt was when it first became popular), and partially non-free operating system distributions, find such fertile ground. To stop using the word “free” now would be a mistake; we need more, not less, talk about how to freedom. If those using the term “open source” draw more users into our community, that is on psychology a contribution, but the rest of creative test - non-fiction (u.s. answers us will have to work even harder to essay on psychology disorders, bring the issue of freedom to those users' attention.
We have to surveillance cameras in the streets, say, “It's free software and essay on psychology disorders it gives you freedom!”more and placing surveillance cameras streets louder than ever before. The advocates of “open source software” tried to on psychology, make it a trademark, saying this would enable them to prevent misuse. This initiative was later dropped, the term being too descriptive to in the streets essay, qualify as a trademark; thus, the legal status of “open source” is the same as that of “free software”: there is no legal constraint on using it. I have heard reports of a number of companies' calling software packages “open source” even though they did not fit the on psychology disorders official definition; I have observed some instances myself. But would it have made a big difference to use a term that is a trademark?
Not necessarily. Companies also made announcements that give the impression that a program is essay malaysia “open source software” without explicitly saying so. Essay. For example, one IBM announcement, about a program that did not fit the official definition, said this: As is common in last sentence of essay, the open source community, users of the . technology will also be able to essay on psychology disorders, collaborate with IBM . This did not actually say that the placing cameras in the streets program was “open source”, but many readers did not notice that detail. (I should note that IBM was sincerely trying to on psychology, make this program free software, and later adopted a new license which does make it free software and “open source”; but when that announcement was made, the program did not qualify as either one.) And here is how Cygnus Solutions, which was formed to be a free software company and subsequently branched out essay, (so to speak) into proprietary software, advertised some proprietary software products: Cygnus Solutions is a leader in the open source market and has just launched two products into the [GNU/]Linux marketplace. Unlike IBM, Cygnus was not trying to make these packages free software, and disorders the packages did not come close to qualifying. But Cygnus didn't actually say that these are “open source software”, they just made use of the term to give careless readers that impression. These observations suggest that a trademark would not have truly prevented the placing cameras confusion that comes with the term “open source”. The Open Source Definition is clear enough, and it is quite clear that the typical non-free program does not qualify. So you would think that “Open Source company” would mean one whose products are free software (or close to it), right?
Alas, many companies are trying to give it a different meaning. At the “Open Source Developers Day” meeting in August 1998, several of the commercial developers invited said they intend to make only a part of their work free software (or “open source”). The focus of their business is on essay disorders, developing proprietary add-ons (software or manuals) to sentence of essay, sell to the users of this free software. They ask us to regard this as legitimate, as part of our community, because some of the essay money is write essay donated to free software development. In effect, these companies seek to gain the favorable cachet of “open source” for their proprietary software productseven though those are not “open source software”because they have some relationship to free software or because the same company also maintains some free software. (One company founder said quite explicitly that they would put, into the free package they support, as little of their work as the community would stand for.) Over the on psychology years, many companies have contributed to araby analytical essay, free software development. Disorders. Some of these companies primarily developed non-free software, but the two activities were separate; thus, we could ignore their non-free products, and work with them on essay, free software projects. Then we could honestly thank them afterward for essay disorders, their free software contributions, without talking about the rest of what they did.
We cannot do the same with these new companies, because they won't let us. Last Sentence. These companies actively invite the public to lump all their activities together; they want us to regard their non-free software as favorably as we would regard a real contribution, although it is not one. They present themselves as “open source companies,” hoping that we will get a warm fuzzy feeling about them, and that we will be fuzzy-minded in applying it. This manipulative practice would be no less harmful if it were done using the essay on psychology disorders term “free software.” But companies do not seem to use the term “free software” that way; perhaps its association with idealism makes it seem unsuitable. The term “open source” opened the door for this.
At a trade show in late 1998, dedicated to the operating system often referred to as “Linux”, the featured speaker was an executive from araby analytical a prominent software company. He was probably invited on account of his company's decision to “support” that system. Unfortunately, their form of “support” consists of releasing non-free software that works with the on psychology disorders systemin other words, using our community as a market but not contributing to it. He said, “There is no way we will make our product open source, but perhaps we will make it ‘internal’ open source. If we allow our customer support staff to have access to the source code, they could fix bugs for the customers, and we could provide a better product and better service.” (This is not an exact quote, as I did not write his words down, but it gets the creative writing - non-fiction version) answers gist.) People in the audience afterward told me, “He just doesn't get the essay point.” But is for teaching that so? Which point did he not get? He did not miss the on psychology disorders point of the Open Source movement. Cover For Teaching. That movement does not say users should have freedom, only that allowing more people to essay disorders, look at the source code and help improve it makes for faster and better development. Analytical. The executive grasped that point completely; unwilling to carry out that approach in full, users included, he was considering implementing it partially, within the on psychology disorders company.
The point that he missed is the point that “open source” was designed not to raise: the point that users deserve freedom. Spreading the test (u.s. version) idea of freedom is a big jobit needs your help. That's why we stick to the term “free software” in the GNU Project, so we can help do that job. On Psychology Disorders. If you feel that freedom and community are important for their own sakenot just for the convenience they bringplease join us in using the letters for teaching positions term “free software”. Lakhani and Wolf's paper on the motivation of essay on psychology disorders free software developers says that a considerable fraction are motivated by the view that software should be free. This was despite the fact that they surveyed the developers on SourceForge, a site that does not support the sentence view that this is an ethical issue. “Our mission is to preserve, protect and promote the freedom to use, study, copy, modify, and on psychology disorders redistribute computer software, and to how to write academic essay, defend the rights of Free Software users.” The Free Software Foundation is the principal organizational sponsor of the GNU Operating System. Support GNU and the FSF by buying manuals and gear, joining the FSF as an essay on psychology associate member, or making a donation , either directly to the FSF or via Flattr. Please send general FSF GNU inquiries to email@example.com.
There are also other ways to contact the FSF. Broken links and other corrections or suggestions can be sent to firstname.lastname@example.org. Please see the - non-fiction version) answers Translations README for information on coordinating and submitting translations of essay disorders this article. Copyright 1998, 1999, 2000, 2001, 2007, 2016 Free Software Foundation, Inc.
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Developing Ethical Skills: From Sensitivity to disorders, Action. Acute and critical care nurses routinely encounter ethical “quandaries” such as providing perceived futile care. Other everyday ethically important occurrences may go unrecognized, however, thus diminishing their importance to moral nursing practice. This column presents a framework that may assist in developing specific skills to recognize and engage in both critical and everyday ethical situations with confidence. Cover Letters. James Rest’s Four Component Model addresses the role of the moral practitioner from initial recognition that an ethical situation exists to implementation of a justifiable action. Patient/provider scenarios are used to illustrate components of Rest’s model followed by an approach to distinguish ethical from nonethical situations. Practical strategies to enhance ethical skills such as development of nursing ethics groups and providing continuing ethics education also are presented.
A cute and critical care nurses regularly encounter situations fraught with conflict and tension, ethical “quandaries” such as disagreements about withdrawal of essay on psychology disorders life support, allocation of resources, and analytical the adequacy of informed consent. Events commonly thought of essay on psychology disorders as ethical situations include disputes among nurses, physicians, patients, and patients’ family members about the benefit or futility of treatment options or who knows best or has the most power. But many other instances are also ethically important. These instances may involve recognition of the situation and last sentence of essay the development of the skills of sensitivity and interpretation in essay on psychology, addition to ethical reasoning and how to academic the ability to implement a chosen action. 1 Such situations may also be the essay, ordinary, everyday ethical occurrences that go unrecognized, and thus their importance to araby, moral nursing practice is diminished. 2. An example of such an occurrence (C.R., unpublished data, 2007) is provided in disorders, the following scenario shared by a nurse when asked to talk about streets essay her experiences with end-of-life care in a pediatric intensive care unit (PICU). An 8-year-old boy was basically brain dead because of essay on psychology disorders a gunshot wound. The doctors were trying to talk with his mother, but she did not want to hear anything. She was distraught, crying and screaming and sitting in the corner just rocking herself. So I said to her, “Do you want to hold him and just be with him?” And she stopped crying and said, “Yes!” And so we moved all the equipment over and put her in bed with him and introducing she held him.
We just worked around her and tried to on psychology disorders, keep the catheters and things straight and she stayed in the bed with him the whole day. Does this scene reflect an ethical situation? What, if any, is the ethical content? Possible disputes about essay life support and organ donation could be anticipated, but what about the mother’s immediate state or circumstances and the nurse’s interpretation and essay disorders action? In this column, I present a framework that may provide a useful approach to the development of ethical skills for acute and critical care nurses. The Four Component Model (FCM) of James Rest, 3 an educational psychologist, addresses the placing streets, role of the ethical practitioner from initial recognition that a morally important situation exists to implementation of a justifiable action. In the essay on psychology disorders, model, Rest integrates the cognitive and how to academic affective processes that underlie a holistic understanding of ethical practice: sensitivity, judgment, motivation, and action. I illustrate several components of the essay on psychology disorders, Rest model via reference to the preceding scenario in the introduction and to additional scenarios. After discussing the FCM, I present an approach to distinguishing ethical from nonethical situations. Cover Letters. Finally, I suggest strategies to essay, enhance the development of ethical skills. I use the terms ethical and moral interchangeably.
The first component of the FCM, ethical sensitivity, involves the skill or ability to interpret the reactions and feelings of letters for teaching positions others. More than that, ethical sensitivity is also the essay, capacity to last sentence, feel and be moved by others, to identify with their distress, to be aware of how one’s action or inaction may affect them, and to assume a sense of responsibility or obligation. 4,5 Before reasoning or action can occur, a nurse must recognize that an ethical situation exists. This first step can be particularly challenging in the current health care environment, particularly in the intensive care unit (ICU), where attention is often focused on essay on psychology, the efficient, the economical, and how to a good academic essay the procedural. Evidence 5 suggests that professional socialization and organizational structures may diminish or limit the abilities of health care providers to be sensitive to the moral content of everyday practice. Lack of time and support to provide the care that patients need and perceived inability to live up to expectations of oneself and essay those of peers and supervisors, have been associated with diminished ethical sensitivity and dulling of moral conscience. 6. Development of ethical sensitivity includes an awareness of alternative courses of action and how each course of action could affect all those involved, including patients, patients’ family members, health care colleagues, members of the administration, and others.
5 Recognition of and respect for alternative perspectives are essential if constructive ethical dialogue is to occur and may contribute to maintaining a healthy workplace. 7 Empathy and role-taking skills contribute to ethical sensitivity because they allow imaginative construction of possible scenarios and consideration of potential immediate and long-term consequences. The demands of writing test - non-fiction (u.s. version) a particular situation may also be compared with external standards and guides such as professional codes, ethical theories, and academic knowledge. Feelings of uncertainty and tension among competing loyalties to disorders, patients, patients’ family members, nurses, and oneself can characterize this process. 5. Emotion, an element often downplayed or marginalized in traditional ethical theories, may further affect the ethics response. Educated emotion, that is, emotion tempered by insight and experience, may help nurses avoid inappropriate reaction and also provide access to how to, the moral domain of a situation. To discriminate and essay respond appropriately, nurses must be in araby essay, a relationship with the patient involved, identify with the patient, and essay put themselves in the patient’s position. Although affective responses such as emotion enable engagement, they are subject to placing cameras in the streets essay, personal motives and misunderstandings.
Thus, increasing self-knowledge, critical reflection, and awareness of essay on psychology disorders individual biases and araby analytical essay assumptions also become important aspects of the development of ethical sensitivity. 8. Sensitivity—that is, accurate perception of, exquisite attention to, and assessment of the needs of patients’ and patients’ families—is an essay on psychology essential precursor to creative test answers, clinically competent reasoning and essay nursing practice. This same attention and sensitivity are essential to analytical essay, the development of ethically competent reasoning and nursing practice. 9 Benner 10 (p16) also suggests that clinical judgment cannot be separated from ethical sensitivity and reasoning because such judgment determines what good is at stake and what to do in each particular situation: If nurses do not have a good grasp . . . of pathophysiology and medical and nursing interventions, then they can make neither good ethical or good clinical decisions, because they cannot know what it is good to do in the particular situation. The nurse in the PICU scenario competently cared for the child while assessing and responding to the mother’s overwhelming distress. Although the nurse could have displayed a number of emotional reactions, including frustration, experience and reflection may have tempered her response.
She showed an understanding of the physicians’ perspectives and essay on psychology may have felt uncertainty or conflict about her obligations to colleagues and adherence to unit standards. The skill of ethical sensitivity enabled the nurse to consider what was good or ethical nursing practice in the situation and how to best meet the needs of the for teaching, child and the child’s mother. After a nurse determines that an disorders ethical situation exists and requires action, he or she must decide which course of action is the most justifiable in the situation. 11 This second component in the FCM, ethical judgment, has been widely studied in nursing and other disciplines. 11 The thoughtful, deliberative nature of last of essay ethical reasoning has been compared to the research process, because judgment should reflect knowledge of ethical principles, theories, and professional codes. Unlike in the scientific process, however, the goal is not to on psychology, achieve certainty but to cover letters for teaching, make a choice that is reasonable and prudent and integrates emotional responses. 9. Many judgment or decision-making frameworks have been described.
Several key elements span all frameworks that define or outline a process for reaching a judgment. Essay Disorders. These various processes, like the nursing process, help identify and writing (u.s. answers organize the facts so that one can reflect on the ethical issues. Although some models for decision making are step-by-step or linear, others allow for an evolving perspective and are spiral, with each step revisited as necessary. 9 Table 1 lists some elements and clarifying questions identified in several frameworks 9,12 used to achieve an ethical judgment or decision. Elements and questions in ethical decision making a. Ethical situations that arise during the course of on psychology daily practice, such as the situation depicted in the PICU scenario, might not require consideration of all the elements or questions listed in the table. The complexity of the ethical issue, the environment in last, which the issue occurs, and essay on psychology disorders the availability of and essay necessity for facilitators, such as ethicists, may affect the choice of the method used for deliberation. Essay Disorders. 13 The following scenario from creative writing test - non-fiction answers, a neonatal ICU (NICU) and adapted from disorders, a published case study 14 provides an example: I was caring for a full-term infant who had severe cortical damage and was blind from essay, a long period of on psychology disorders anoxia during birth. The doctors wanted to put in a feeding tube even though they thought the prognosis was bad. The parents weren’t really sure and thought the baby was suffering too much already.
Some of the other nurses thought that not putting the tube in sentence, was denying basic care. They (the parents) had 2 other kids and had a hard time visiting the infant and keeping up with caring for the other children. The parents didn’t speak much English and were very religious. I took care of essay on psychology him (the infant) a lot, so then they asked me what would I do. Placing Cameras In The. We had a few family conferences, but I felt that, coming from on psychology disorders, a different culture, maybe they weren’t being heard, so I decided to for teaching positions, call the ethics committee. This NICU scenario is a complex ethical situation in which the nurse carefully considered several elements and questions outlined in Table 1 before deciding to call the ethics committee. On Psychology. The nurse identified value conflicts among providers and value or cultural conflicts between the parents and last sentence of essay providers. Essay Disorders. She also recognized that a possible power imbalance existed between the parents, whose knowledge of English was limited, and those physicians and nurses who thought that a feeding tube was indicated.
Participants in how to academic, the situation also had different views of the on psychology, consequences of an acceptable outcome. The parents did not want to cause additional suffering for their child, whereas several providers considered that withholding nutrition and malaysia fluids violated basic human care. Although the nurse’s decision to call the ethics committee did not provide the essay on psychology disorders, final resolution for the situation, it was an ethical judgment, nonetheless. As the third element in creative writing test (u.s. version) answers, the FCM, ethical motivation is the link between ethical judgment and action. On Psychology. Conceptualizing situations in which nurses may recognize an ethical issue and determine a justifiable course of action but decide not to placing cameras streets, act is not difficult. A nurse may give priority to competing personal values such as protecting his or her position or reputation, or the essay on psychology, nurse may place a low priority on how to a good, ethical considerations in general.
5 Additional personal obstacles to ethical motivation may include lack of knowledge of professional obligations and essay on psychology disorders deficient ethical sensitivity. 8. Ethical motivation is the desire to essay, be ethical and to act and live in a manner consistent with one’s moral values. When morality is central to a nurse’s sense of self or identity, it may heighten the nurse’s feelings of obligation and responsibility to practice in an ethical manner. 15 This understanding of obligation and responsibility may provide the bridge between knowing the right thing to do and actually doing it. Situations occur in which an acute or critical care nurse may have the ethical skills of sensitivity, judgment, and motivation but cannot act on a justified moral choice because of institutional obstacles. Fear of reprisal and lack of administrative support are some impediments evident in an ethical climate that does not sustain patient-family advocacy and professional integrity. 1 The moral distress that may ensue because of this inability to act may be countered by cultivating moral courage.
16. Although moral courage was not addressed in the initial FCM framework, Bebeau et al 17 included the notion in an expanded discussion of the FCM that incorporates the attributes of moral character or those personal elements that influence ethical motivation and action. Lachman 16 (p131) defines moral courage as “the individual’s capacity to overcome fear and to essay on psychology, stand up for his or her core values . . . the willingness to write a good, speak out and do what is right in essay, the face of forces that would lead a person to essay, act in some other way.” Although motivated to do what they believed to be ethically correct, the nurses in both of the preceding scenarios may have considered several potential personal and essay disorders institutional obstacles. The PICU nurse may have thought that her decision to allow the distraught mother to hold the dying child could be criticized by peers and thus harm the araby analytical, nurse’s role as a preceptor.
In addition, the action might be perceived as interfering with the physicians’ communication with the mother, resulting in possible supervisory reprimand. The NICU nurse may have decided to call the ethics committee but was then dissuaded by nursing peers who cited instances of reprisal when doing so. Essay. Overcoming such perceived obstacles required moral courage and a commitment to prioritizing ethical values. Similar to all skills in the FCM, ethical motivation and moral courage can be developed and sustained through strategies suggested in creative writing test - non-fiction, the section on developing ethical skills and summarized in Table 2. Strategies to develop ethical skills.
The final component in the FCM, ethical action, involves determining the best way to implement the chosen decision and having the ability and confidence to persist to completion. The complexity of the on psychology disorders, ethical issue may require a strategic action plan that carefully considers the who, where, and when regarding implementation of the decision. 1 In the PICU scenario, a decision to inform the mother or a designated family member of a recommendation to withdraw life support could be enhanced by identifying a person who has the best relationship with the patient’s family. In addition, an important consideration is who might address potential staff concerns and questions about implementation of the decision to avoid causing additional distress and future reproach. 1 The environment and timing of the ethical action should also be determined. Although a family conference room might be an appropriate setting to write academic, present the recommendation to withdraw life support, many parents express a strong desire to be physically close to their child at all times during hospitalization and especially at the end of life. 18. As indicated in Table 1, implementation of the ethical action requires consideration of possible resistance or objections that might arise. Resistance to the decision does not mean that the decision is wrong. However, being able to clearly explain and disorders justify the placing surveillance essay, reasons for the decision and the thoroughness of the process used to reach the ethical judgment is important.
Ethics consultants, if available, may assist in on psychology disorders, communicating and facilitating implementation of the decision, because they can articulate the issue and judgment in an ethically grounded manner. 1 For acute and critical care nurses, training in conflict resolution and assertiveness skills may enhance their confidence and (u.s. version) answers ability to on psychology disorders, overcome resistance. 16. Distinguishing Ethical From Nonethical Situations. How can acute and critical care nurses distinguish ethical situations or conflicts from streets essay, those that are nonethical or nonmoral, what Burkhardt and Nathaniel 12 refer to as “practical dilemmas” and Kopala and Burkhart 19 term “decisional conflicts”? A given situation has ethical content when an action freely performed or not performed has the potential to harm or benefit others.
What is meant by harm? Broadly speaking, basic harms include death, pain (physical, emotional, spiritual), disability, loss of freedom or opportunity, and loss of on psychology disorders dignity or self-esteem. 20. Practical or decisional conflicts can be identified as claims of self-interest or choices based on personal values. In these situations, a person’s action (or lack or action) may not harm others. 12 Decisional conflicts may arise from uncertainty about one plan of action versus another plan.
Although uncertainty about the consequences of a chosen plan may cause conflict and tension, the uncertainty does not make the conflict an ethical one unless the potential decision may result in harm or considerably less benefit to another. 20. This interpretation of situations that contain ethical content may help nurses avoid erroneously identifying some situations as strictly administrative or clinical. 21 As examples, mandatory overtime and resultant nurse fatigue have been associated with a higher incidence of nurses’ errors in medication, 22 and mortality rates of surgical patients have increased in hospitals with lower numbers of essay malaysia registered nurses on staff. 23 Lateral hostility or bullying is pervasive in nursing. These antagonistic behaviors may result in nurses leaving their positions and, ultimately, the essay, profession, in addition to increasing the potential for decreased quality of patient care. 24 An example of the FCM applied to a lateral hostility scenario is presented in the sidebar.
Although considered administrative or clinical issues, the situations just described contain ethical content when understood in the context of avoiding or causing harm. Araby Analytical Essay. Similarly, the PICU and NICU scenarios are considered ethical situations because the nurses’ actions or inactions had the on psychology, potential to result in harm or considerably less benefit for malaysia, others. Although certain ethical skills such as sensitivity may be innate to a certain extent, 27 they cannot be developed in a moral vacuum and must be cultivated and maintained in a supportive environment. 1 Health care institutions can create administrative systems that either facilitate or undermine nurses’ ethical skills or moral competency. The same is true of nursing units, which can be thought of as individual moral communities. A sensitive and essay disorders morally competent nurse must be receptive to the vulnerabilities of write a good academic those for whom he or she provides care yet not be overwhelmed by their pain and suffering. Interventions to prevent and address the moral distress that can develop from such situations have been developed by the American Association of Critical-Care Nurses. 28 Although the 4 A ’s (ask, affirm, assess, and act) described in the association’s method are designed to ameliorate moral distress, they can also be viewed as ways to enhance the ethical skills of acute and critical care nurses. Similar to clinical skills, ethical skills can be experientially learned and can improve over time through appropriate role modeling 29 and use of several strategies suggested by Scanlon 30 and Clark and Taxis. 31 These strategies include continuing ethics education, development of a nursing ethics group and/or committee, and interdisciplinary and/or nursing ethics rounds.
Although interdisciplinary ethics rounds are the ideal strategy, they may not be available or conducted in every institution. The inclusion of ethics in nursing education and continuing professional education has always been important but is now recognized as essential to professional practice. Many nurses receive instruction in ethics as part of their basic educational preparation program. However, the findings of a recent study by Grady et al 32 suggest that continuing education or in-house training is necessary to improve and maintain ethical skills. Although the specific content was not specified, the nurses in on psychology disorders, the study 32 reported that receiving such training increased their self-confidence in their ethical skills and ability to take moral action. Although controversy exists about the essay introducing malaysia, structure and content of essay on psychology ethics education in general, Wocial 33 suggests that it is araby essay necessary to on psychology disorders, move beyond the debate and provide continuing education. Essay Introducing. An example of such education is the Unit-Based Ethics Conversations (UBEC) used in the Clarian Health System (Indiana University Health System) in Indianapolis, Indiana. 34 The purpose of UBEC is to provide staff nurses with opportunities to on psychology disorders, develop confidence and skills in managing ethically difficult situations. Formal evaluation of the UBEC is ongoing; the objective is to develop a program for trainers so that the educational strategy can be exported and implemented by others. 34.
Jurchak and Pennington 35 provide another example of a continuing education intervention. A nurse ethicist and a critical care program manager, respectively, they developed a program to foster the creative (u.s. version) answers, moral agency of new ICU nurses. On Psychology. Moral agency is defined as the ability to last sentence of essay, act on an ethical judgment about what is right or good for a patient, similar to the components of essay on psychology disorders ethical motivation and action in the FCM. The 3 objectives of the creative test - non-fiction version), program 35 are to provide a safe space for nurses to talk about ethical dilemmas, introduce and apply an ethical framework for analysis of ethical problems, and allow nurses to be able to identify supportive institutional resources. An initial evaluation of the program was positive; the new nurses reported that they especially valued the opportunity to share the ethical problem and receive constructive feedback. 35. As a periodic part of nursing practice in acute and critical care units, interdisciplinary and/or nursing ethics rounds may provide opportunities to identify, distinguish, and clarify issues with ethical or nonethical content.
Because nurses are often the first ones to essay on psychology disorders, become aware of ethical issues, such rounds may also prevent the surveillance cameras streets, occurrence of more serious dilemmas. Similar to essay on psychology, consciousness raising, ethics rounds may help nurses develop and refine ethical skills as different perspectives are shared. Nursing ethics rounds in creative writing test (u.s., particular may enable nurses to articulate the important, unidentified moral dimension of their practice. In a more formal strategy, nursing ethics groups or committees may meet periodically to further develop ethical knowledge, skills, and problem-solving abilities. Although nurses may be members of an interdisciplinary ethics committee, the nursing ethics group or committee provides a forum for expression of essay on psychology disorders perspectives and last concerns that may be unique to nurses in a particular institution. For example, as a member of such a group, I participated in a discussion of various forms of essay on psychology disorders lateral hostility or bullying and other forms of workplace violence experienced by nurses in different types of cover letters for teaching units and the effect on ethical practice.
Group members also reviewed relevant literature on the issue and on psychology disorders discussed possible interventions. As ethics liaisons or representatives for their individual units, members of the group were then able to share the knowledge and skills gained with their peers. 30,31. The development of last of essay ethics rounds, groups, and/or committees often begins with a single motivated individual and takes time and patience. Many academic medical centers have such entities in place and essay on psychology disorders can perhaps provide models and how to write a good academic essay direction. Seeking guidance and support from essay on psychology disorders, faculty members at nearby nursing and/or medical schools may be helpful. Cover Letters Positions. Institutions that have received Magnet designation or are seeking Magnet status may also be able to offer insight, because nurses’ participation in the overall ethical structure of the facility is a vital component of essay initial and continuing accreditation. As Benner 36 (p335) has stated, “It is in the streets essay not an exaggeration to say that in every clinical encounter, there may be ethical issues at the personal, provider, and social levels.” Use of the FCM may help in developing the essay on psychology disorders, skills needed to recognize and actively address these ethical issues.
The author acknowledges the constructive comments and insights provided by the reviewers.