A Midwifery Community Profile Health And Social Care Essay

This community profile is based on an area in the outskirts of Glasgow and the objective is to identify the current provisions of maternity care and other health care services, which cater for the needs of the local population in the physical, emotional, intellectual and social needs for groups in the community, additionally, commenting on any deficits in care. Health promotions have been identified as resources that will enhance the health of this specific community’s health and are included in the profile. Also, the role and contribution of the midwifery services is explored, along with other primary healthcare providers and how they use teamwork to deliver healthcare to the community. Professional and ethical issues have been discussed throughout the profile and as all aspects of health are unrelated and interdependent, (Ewles & Simnett, 1992: Ch1 p7), a holistic and professional view has been taken to evaluate the needs, and health services of this community.

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The RCM believes that truly woman-centered care must encompass midwifery-led care of normal pregnancy, birth and the postnatal period and services that are planned and delivered close to women and the communities in which they live or work, (NHS Evidence, 2008). This statement shows the importance of a community midwife, as their role is to not only provide the clinical skills, but also be accessible for support and advice at the time of much adjustment for a woman. If the midwife can become a part of the woman’s community, getting to know the woman and her family more personally, learning to understand their lives and the nature of the life around them, she will be able to be more responsive and understanding to them as individuals, and move away from the depersonalization of the institution. Individual societies each have their own specific needs and characteristics, and it is vital for a midwife to know her area well in order to respond appropriately, along with poverty levels and racial mixes (Fraser and Cooper 2009, p. 43). Community-based care can be in the home or in community hospitals and centers, but is a process that emphasizes consultation, collaboration, and referral to the professionals who are most appropriately prepared to meet the women¹s needs (Walsh, 2001). It is also vital that women are educated and “women should be given appropriate, accurate and unbiased information based on research that would allow and encourage them to make informed choices in relation to their care” (Baston & Green, 2002). Women from different backgrounds, and areas can often have very contrasting education levels and as a midwife, it is essential to know your neighborhood well in order to take these into consideration when communicating with a woman.
The area chosen for this community profile is in the south west of Glasgow, which will now be referred to as area X, with a population of 10,024 (RDC – Registrar General’s Census, 2001).
Table 1: Age Distribution – Area X
Population aged 0-15
Population ages 16-64
Population aged 65+
The majority of the population is in the age range 16-64 years and the relevant health care services in the community for this group are the antenatal clinics, family planning and screening clinics.
Graph 1: Hospital admissions for heart disease – Area X
With respect to the social and economical characteristics of the area, this graph shows the volume of people admitted to hospital for heart disease in Area X. Heart disease is more accurately described now as a disease “of social and economical disadvantage and poverty” (Blackburn, 1991:Ch2 p36) and the major risk factors contributing to heart disease are smoking and diet. These lifestyle factors also may echo a life associated with lower social class (Bond &Bond, 1994: Ch 4 p 70).
Nearly half of the houses in Area X are owner occupied, and that amount can be split into two; ex-council houses and private housing estates. The other half are tenanted homes, renting either from the council or private renting. Almost a quarter of all homes in the area suffer from overcrowding. These statistics indicate there are many occupants of tenement flats and these tend to be low-income families who have little or no choice about the type or standard of accommodation they live in (Blackburn, 1991). Higher income groups tend to live in the private housing sector, and have choices in the location and type of heating which are important influences affecting the health of families (Lowry, 1991).
Table 2: Housing – Area X
Owner Occupiers
(RDC – Registrar General’s Census, 2001).
Glasgow is home to the most workless households in the UK, according to the Office for National Statistics, (ONS). Figures measured in 2007 indicate 29% of households in the Glasgow City council area had members of working age who were unemployed (BBC, 2009). Area X also has a high percentage of people unemployed according to Scotland’s Census from 2001, with both those who are unemployed and claiming and those who are economically inactive. Long-term unemployment can be a self-perpetuating cycle that leads to low morale and poor health (NHS: Greater Glasgow, 2005). Other effects of unemployment are the increased rates of depression, particularly in the young-who form most of the group who have never worked (BMJ, 2009). It is obvious from this that unemployment can alter both our mental and physical state, and in Area X almost 40% of the population of children live in a workless household, which would also have an influence on these children’s quality of life.
Table 3: Unemployment – Area X
Unemployed Claimants
Economically inactive
Children in workless households
(RDC – Registrar General’s Census, 2001).
The role and contribution of midwifery services in Area X are vital in supporting childbearing women and their families, through a holistic approach. It is very important that midwives had a good understanding of social, cultural and context differences so that they can respond to the women’s needs in a variety of care settings This is attained by an integrated midwifery service being part of an expert multidisciplinary team, allowing midwives to draw on other organizations to meet the holistic needs of individual women and providing a complete range of services. (Fraser & Cooper 2009, p. 7).
Midwives in Area X use the local hospital, and local health centers for antenatal and postnatal clinics, as well as parentcraft classes, working along side hospital doctors and GPs. The GP usually confirms the pregnancy and thereafter, an appointment is given to the woman to be introduced to the community midwife for a ‘Booking visit’, as these midwives often better understand social situations through working in the area. The women are generally referred, by the GP, to either the local hospital or a nearby health clinic to meet one of the midwives who work in Area X. These midwives work in teams of around 5, covering 2 or 3 certain postcodes in Glasgow each, and each team named after a colour to make it simple for women and their families to understand which group of community midwives they will be receiving care from, e.g. The Blue Team. This system also works well as it allows a certain degree of continuity as each woman will only be seen by the community midwives in her allocated team. Continuity of carer and care has been a key policy principle since the early 1990s. Research evidence demonstrates that women value continuity of carer in the antenatal and postnatal period (Waldenstrom & Turnbull 1998, Homer et al 2000, Page 2009). Working in Area X requires a high level of continuity in care as it has a lower social class and experiences problems related to pregnancy such as 49.9% of the population of Area X are smokers. Other statistics for Area X include 38.6% of women smoking during pregnancy, a total of 160 women over a 3 year total.
It is well known by midwives and obstetricians that smoking in pregnancy is associated with well recognized health problems and as midwives usually have the most professional contact with pregnant women, they have an important role in providing this advice and support (Buckley, 2000). Glasgow has a very well-organised network of smoke-free pharmacy services who provide NRT for smoking cessation services. They monitor carbon monoxide levels on a weekly basis and only dispense NRT if the breath test is negative (Mcgowan et al, 2008). Smoking cessation services are provided for Area X by specialist midwives, allowing continuity during pregnancy. These midwives speak to the woman and let them know what is available, without pushing them into quitting, and find out what their thoughts and feelings are, focusing on how good it is when women want to stop smoking. The chief executive of ASH Scotland, Sheila Duffy, stated in 2010 “life expectancy, health problems, smoking rates, and deaths from smoking are all markedly different between Scotland’s richest and poorest communities. Research in Scotland has found that smoking is a greater source of health inequality than social class.” This shows clearly that deprived areas such as Area X are at the greatest risk of being affected by smoking issues. 43% of adults who live in deprived areas smoke, compared with 9% in the least deprived areas and this is shown in the prevalence of tobacco related diseases and deaths. 32% of deaths in Scotland’s most deprived areas are due to smoking compared to 15% in the most affluent (Duffy, 2010). This is also reflected in the rates of newborn deaths as the death rate for newborn babies is more than twice as high in deprived towns compared with affluent areas and the high rate of deaths in poor areas was linked to premature delivery or birth defects (BBC, 2010). This leads on to why so many pregnant women smoke in deprived areas, such as Area X. Smokers typically report that cigarettes calm them down when they are stressed and help them to concentrate and work more effectively (Jarvis, 2004), and this prospect could be highly desirable to those suffering from stress and anxiety due to financial problems and other socio-economic factors such as low employment, high crime rates, poor housing and poor health care.
Graph 2: Nicotine intake and social deprivation. Data from health survey for England (1993, 1994, 1996)
As reported in the recent Midwifery Practice Audit 1996-1997 (END, 1997), midwives are the lead professionals in providing care for childbearing women. However, midwives need to acknowledge that other health-care professionals also contribute to each woman’s experience. Midwives work together with other professionals within the primary health-care team, providing integrated approaches to care delivery. Midwives have to use their own skills and expertise with the knowledge of how to access the expertise of other practitioners when required, allowing the women to receive holistic care (Houston S M, 1998). In the recent programme of work Midwifery 2020, a statement was made that women should be cared for in a multi-agency and multi-professional environment and NHS providers should have a collaborative working relationship with all other agencies based on mutual trust and respect to ensure that women and families receive optimum support. They should also ensure clear understanding of roles and facilitate effective communication between professionals and other agencies (Midwifery 2020, 2010). The first booking visit for antenatal care is important and a successful visit “lays the foundation for building that special relationship between mother and the midwifery services on which so much depends” (Cronk & Flint, 1989:ch2 p9). The visit enables the midwife to establish any physical, psychological or social needs that will form the basis of the woman’s plan of care. In area X, the booking visit also allows midwives to inform the woman about the Healthy Start programme. Healthy Start is the Department of Health Welfare Food Scheme that helps pregnant women and eligible families, with children under 5, buy milk, fresh fruit and vegetables, infant feeding formula milk, and receive free vitamin supplements (NHSGCC, 2010). This is a clear example of how health services have integrated to allow women all the benefits they are entitled to, helping them achieve the best possible experience throughout their pregnancy.
As the pregnancy progresses, parentcraft education classes are offered to prepare women for the birth experience (Jamieson, 1993) and raise awareness to the advantages of breastfeeding, giving support to mothers who choose to breastfeed. Area X presents midwives with many teenage pregnancies and antenatal services should be flexible enough to meet the needs of all women, bearing in mind the needs of those from the most disadvantaged, vulnerable and less articulate groups in society are of equal if not more importance (Lewis, 2001). As Area X is a deprived area, this contributes greatly to the teenage pregnancy statistics and throughout the developed world, teenage pregnancy is more common among young people who have been disadvantaged in childhood and have poor expectations of education or the job market. Teenagers seem to be more likely to have sexual intercourse if they come from the lower social classes or unhappy home backgrounds. Another explanation may be that many young people lack accurate knowledge about contraception, STIs, what to expect in relationships and what it will mean to be a parent (Allen, 2002). There are also serious psychological concerns related to teenage pregnancy, which the midwives in Area X must address while working with these girls. The teenage years are a time of much change and difficulty without the added stress and anxiety of a pregnancy, birth and finally motherhood. It is a midwife’s duty to give the necessary advice and proper holistic care, hopefully improving the service provision and having a good obstetric outcome. Comprehensive holistic antenatal care programmes specifically for pregnant teenagers have been found to be effective in reducing poor maternal outcomes (Fullerton, 1997). For teenage pregnancies in Area X, there is a specific midwife who will be contacted at the booking visit and will be a support network for girls 18 and under, available at all times for advice, encouraging continuity and individualized, specific care for young mums.
To conclude, through writing this community profile on Area X, I have discovered how difficult it is to work as a midwife in the community, especially in a deprived area such as Area X. From reading a large variety of articles on the psychological and social effects of poverty on pregnancy, there is much evidence that poverty has a significant effect on midwifery practice, and these women need the best care plan possible to ensure a positive experience. By having an awareness of the restrictions poverty can inflict on pregnancy and childbirth, the midwife can adapt her skills and provide care accordingly, keeping in mind aspects such as smoking during pregnancy and teenage pregnancies (Salmon et al, 1998). There is a reoccurring trend throughout this community profile confirming the link between lower socio-economic status and adverse pregnancy outcomes, such as prematurity, and the midwife is ideally placed to help identify and manage stresses, as it has been a very important consequence for the health and wellbeing of both mother and infant (Alderdice & Lynn, 2009). Working in Area X on clinical placement has given me an insight into the importance of individualized care, as every woman is in a different situation and therefore has different needs, socially and psychologically. Some women may need more specialized care and support than others, however they are all of equal importance. Investigating the role of the midwifery service in Glasgow has opened my eyes to how both the midwives and the primary health care team deals with problems, and how without integrating health services, it would not be possible to give women the best possible care. Only by working as an integrated team with users will health inequalities be reduced, social exclusion be limited and public health become relevant and cost-effective (Henderson, 2002). The importance of involving women in decisions about their care has long been part of the everyday practice of midwives (Proctor, 1998), and the importance of communication has been highlighted to me clearly throughout this community study, and through my placement, forcing me to realize how important it is for a midwife to fulfill her role.
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The Social Implications Of The Bhagavad Gita Religion Essay

Throughout history, religious texts have been widely influential in shaping how society is run. From egalitarian societies to strict social classes, religious texts have driven societies in a great variety of directions. A fundamental example of the social impact of religious texts is the Bhagavad Gita. The Bhagavad Gita has had a tremendous impact on the mindset of people in India. It has provided a standard basis for beliefs and morals, which influenced not only individuals, but Indian society as a whole. This religious text has been an integral part of common beliefs and morals. Because it is such a significant text in India’s history, we want to know what the social implications of the Bhagavad Gita were. By analyzing the text, we are able to gain a greater understanding of what kind of society it promotes. The Gita encourages social stratification, and promotes a strict hierarchy in the form of a caste system.

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The Bhagavad Gita’s idea of duty, or dharma, calls for a stratified society. With different castes each having their own duty, society is separated into distinct groups of people who are taught to act differently based on the status they are born into. The Sanskrit word dharma, is translated to “sacred duty,” which is a key idea of The Gita. Members of different castes have different sacred duties. We can see the importance of this idea through the warnings not to violate the laws of duty and caste. An example of this is when the text states, “When the family is ruined, / the timeless laws of family duty / perish; and when duty is lost, / chaos overwhelms the family” (The Bhagavad Gita 28). This verse warns the people not to go against the laws of family duty, or dharma. It introduces the idea that if people do not follow their own duty and act according to their caste, chaos will ensue. Through this, the importance of separate duties for each family is clear. This encourages people of all castes to act according to their own specific duty. Because it tells each caste to act in a different way, The Gita causes deeper divisions between people born into different families. By dividing up the people into different classes and giving them each separate duties, The Gita asks for a strict hierarchy.
The Bhagavad Gita uses fear of chaos and disorder to further divide society into the different castes. The warnings against breaking the laws of duty are elaborated on as the text continues. The fear that The Gita is trying to instill can be seen when the text says, “The sins of men who violate / the family create disorder in society / that undermines the constant laws / of caste and family duty” (The Gita 29). This passage pairs the word “sin” with not following the caste system. In telling people that undermining the laws is a sin, the text warns the reader not to disobey their duty. Those who violate the system are violating the family and cause disorder, making them severely looked down upon. To prevent disorder, all one has to do is follow his or her duty. This makes the individual feel as though they are in control of whether or not society falls into chaos. The society as a whole can avoid disorder as long as each individual follows the duty of his or her caste. This shapes the guidelines for the different castes and introduces the idea that everyone must follow these set rules. With this passage, we see how The Gita influences society’s structure, in separating people by their family duties.
Some may argue that the Bhagavad Gita encourages an egalitarian society, where everyone is equal. They interpret the text to contradict the ideas of the caste system and social stratification. For example, the text says that, “Learned men see with an equal eye / a scholarly and dignified priest, / a cow, an elephant, a dog, / and even an outcaste scavenger” (The Gita 61). This statement encourages the reader to see everything equally, which may seem to promote an egalitarian society. However, although The Gita touches on themes of equality, these ideas clearly do not mean that society should be egalitarian. Although all beings are considered equal, it is certainly not saying that everyone should have equal wealth or that everyone should be able to pursue any endeavor they choose. The structure of this verse is an immediate indicator of The Gita’s reinforcement of the caste system. In saying “and even an outcaste scavenger,” the text puts outcaste scavengers lower than priests and animals. This in itself hints to a hierarchal order of people in society. It is also important to note that viewing things with an “equal eye” does not refer to equal rank in society, but instead it focuses on the being’s core essence. All beings are capable of improving themselves. The commonality is that they all have to act on their respective duties to succeed. This means that the ideas of equality in The Gita do not have any grounding in societal structure, but instead, are meant to transcend worldly status.
While The Gita may be suggesting that all beings have equal value on a higher level, each being has a defined place in the hierarchal order, indicating social stratification. This can be seen as the text states that, “The actions of priests, warriors, / commoners, and servants / are apportioned by the qualities / born of their intrinsic being” (The Gita 141). This passage separates people into different classes and states that they each have separate actions. This idea is the outline for the caste system, as different people are meant to act a certain way based on the caste they are born into. In defining the distinct groups of people and creating a further divide between them with the idea of different necessary actions for different people, The Gita clearly supports social stratification.
The text goes on to say that, “Each one achieves success / by focusing on his own action; / hear how one finds success / by focusing on his own action” (The Gita 141). This passage tells us that each being has an intrinsic function, and all beings can “achieve success” by focusing on that. All beings are equal and equally capable of achieving that success, but they have separate ways of achieving that success. Everyone has the same end goal, which is moksha, the release from the cycle of rebirth of samsara. The different path they must take towards success is what stratifies them in the social order. People are divided into different classes are encouraged to act differently according to these divisions. This means that The Gita’s mentioning of viewing all things as equal does not encourage an egalitarian society. Instead, it further supports the caste system, as members of the lower castes feel that they are equal to members of higher castes, even though it is not reflected in societal structure. Through its definition of the castes and different necessary actions, The Bhagavad Gita encourages social stratification and a hierarchal order.
The idea of moksha as the ultimate goal for everyone further demands the people to follow the social order of society, supporting the caste system. This promotes people to do as The Gita says and follow one’s own duty. This is shown when the text says, “Look to your own duty; / do not tremble before it; / nothing is better for a warrior / than a battle of sacred duty” (The Gita 36). This clearly defines the path that one must take to reach moksha. It is referring to Arjuna’s path as a warrior and his duty to fight in battle. This outline of one individual’s caste and duty not only tells us about how people in his caste should act, but also how everyone should. This link between caste and duty tells people to follow the caste system in order to achieve the common goal of moksha. Uniting the people under a universal purpose, The Gita cleverly divides the people into separate paths to attain the ultimate release from rebirth. This division is the basis for the hierarchy in Indian society.
The Bhagavad Gita gives a sense of hope to members of lower castes, which gathers their support and cooperation within the hierarchal social structure. We have seen that in history, it is often the lower class that rises up and rebels against the system when they feel they are mistreated or underrepresented. The Bhagavad Gita takes care of this threat to the caste system by providing reason and hope for those in lower castes. The text tells that for those who are committed to achieving moksha, “Fallen in discipline, he reaches / worlds made by his virtue, wherin he dwells / for endless years, until he is reborn / in a house of upright and noble men” (The Gita 71). This passage gives those in lower castes optimism in that if they according to their caste’s duty, they have the ability to be reborn in a higher caste. This also justifies the position of those in higher castes, in that they deserve their spots. According to this passage, those who are born into higher castes earned it through their discipline and determination to follow their dharma. This passage explains to the reader why people are born into different castes, and strengthens the hierarchal ranking system.
The justification of the caste system is further discussed in The Bhagavad Gita, as the idea of duty of castes is emphasized. The Gita stresses ideas that promote hierarchy within society. This is shown once again when the text states, “The actions of priests, warriors, / commoners, and servants / are apportioned by the qualities / born of their intrinsic being” (The Gita 141). This passage gives a greater sense of necessary action. It says that all the different castes of people have different actions that they are designated. This justifies the caste system by implying that one’s duty remains the same for their entire life. Without the ability to move out of a caste within one’s lifetime, members of different castes solely focus on how they can act upon their sacred duty and following the guidelines for their caste. This shows that The Gita wants people to only focus on their own task, without worrying about anyone else’s. While there is hope to have a better life after one is reborn, the idea that one is set in their caste for their lifetime forces people to learn to endure any suffering that goes along with being in the caste. The inevitability of this suffering allows for people to deal with it more easily. With this passage, we are able to see how The Gita justifies the different castes and the actions they must make.
The Gita finalizes the ideas of the caste system through its reinforcement of the ideas of the different paths of different castes to reach a common goal. Each caste has a different duty that its members must follow and act upon to achieve moksha. The text states that it is “[b]etter to do one’s own duty imperfectly / than to do another man’s well; / doing action intrinsic to his being, / a man avoids guilt” (The Gita 142). This passage tells the reader that people should do their caste’s duty, even if they are unable to do it well. The key point in this passage is that doing another caste’s duty, no matter how well it is done, is never as good as doing one’s own duty. This clearly defines the importance of one’s caste in determining how people should act. It solidifies the hierarchal caste system by creating strict order. Through this, we can see how The Bhagavad Gita strongly promotes social stratification and the caste system.
The continuous reinforcements of the ideas of duty, moksha, and the separate castes in The Bhagavad Gita strongly show the intent of the text to stratify Indian society. While the text does hint at equality, it does not apply to an egalitarian society. Instead, it further justifies the caste system by giving a higher sense of equality, even though there are clear differences between people in this world with the caste system. The common goal of moksha unites the people and encourages them to act upon their respective duties. The different duties of the separate castes define the hierarchal structure of society that The Gita promotes. This influential text has played a key role in shaping Indian society. Through it we are able to see how the hierarchal caste system is justified. The Bhagavad Gita is without a doubt a highly influential religious text and its social implications have echoed in India’s culture.

Natural And Conventional Medicine Health And Social Care Essay

This paper discusses and compares the two main medical traditions – natural and conventional medicine. Both conventional and natural medicine have been practiced and found proven to hold many advantages but conventional medicine is regarded as the universal, hence, more popular method of healing illness. Conventional medicine relies on science and technology to contribute to the preservation and longevity of people’s lives and the leaps that this tradition has made has surpassed expectation. Nevertheless, with the rising cost of medicines, procedures, and hospitalization, and the preference for more holistic and non-invasive methods in the treatment of illness, naturopathy or natural medicine has grown in popularity. In its comparison with conventional medicine, this paper highlights the advantages of naturopathy including its effectiveness, safety, a good patient-healer relationship, the sense of being in control over illness, and its non-invasive nature. Naturopathy’s congruence with the culture and psychological belief systems of diverse peoples also contributes to growing preference of it. Moreover, conventional treatment has slowly incorporated natural methods such as the use of herbs, crossing over with acupuncture and other alternative practices, proving that the next best step for medicine is to maximize knowledge from both conventional and natural methods toward a better quality of life for mankind.
In the current world, medical practice is dichotomized. Medical practice may either be classified as “conventional” or “alternative.” Sometimes, classifications go by “conventional” versus “natural” or “traditional.” These medical traditions and their respective practitioners are often pitted against one another. Yet, a closer look reveals that these classifications are arbitrary and are not actually in blanket opposition. Conventional medicine also has a long history of utilizing natural resources in the past. Meanwhile, various natural methods of healing are now using technologies too.

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The real nature of these categories are hegemonic. Conventional medicine which was developed by more dominant societies and cultures arose as the dominant and in this respect, the most “scientific” way of healing. Meanwhile, indigenous, natural and traditional forms of healing that have long histories of local practices were simply lumped together in opposition to the conventional. This is similar to how various forms of traditional music have been clustered together under the banner of “world music” despite obvious aesthetic variations. Sadly, the burden of proof was pushed more to the side of the alternative or natural medical traditions.
This paper intends to give a brief discussion and comparison of conventional and natural medicine. Being the less dominant one, this paper will put stress on the strengths and positive attributes of natural medicine. Although the historical importance and contributions of conventional medicine are recognized, this paper asserts the need for a greater recognition, utilization, and further improvement in the realm of natural medicine.
Conventional Medicine
Conventional medicine, sometimes called “allopathic medicine” or even “Western medicine,” is the most widely used medical system in the world today, particularly in the Western hemisphere. It is largely based on the physical and biological sciences. Its universality lies in its materialist and standardized approaches and to its positivist and experimental tradition. The materialism of this medical school enables the easy translation of the discipline to different countries and cultures. This enables its practitioners to speak the “same language” and to have a unified view of medical problems.
Advances in the field of conventional medicine owe to its strong research tradition. Conventional treatments are all supposed to subscribe to proven treatments based on evidence. Of course, many researches are now being done by multi-national pharmaceutical corporations owing to conventional medicine’s strong commercial nature. Thus, the price to pay for getting oneself cured can be very high due to the commercialized and increasingly privatized treatment facilities, medicines and other diagnostic procedures.
Indeed, it is undeniable that conventional medicine has gone through great leaps and bounds in preserving the quality and longevity of lives of people around the world. This owes very much to advances in diagnostic and treatment procedures and preventive measures. The use of X-rays, CT scans and magnetic resonance imaging (MRI) technologies now give more accurate diagnoses over a shorter period of time. Vaccinations are now preventing the spread of diseases over large populations. Advances in the pharmaceutical industries are now presenting greater potential in curing some of the world’s deadliest diseases.
Even medical doctors (M.D.) who recognize and advocate and use alternative medicine, like Weil (1998), still point out the greater ability and efficacy of conventional medicine in treating particular diseases as compared to alternative medical systems. Particularly, they mention the management and cure of viral infections; allergies; chronic degenerative diseases; autoimmune problems such as AIDS; bacterial infection; trauma; many of the serious forms of cancer; mental illnesses, which require medication; other “functional” illnesses; and medical and surgical emergencies.
However, there are still many imperfections in conventional treatments. For example, there are drugs that are effective in treating particular problems but may bring about ugly side effects. For instance, thalidomide, a morning sickness drug is known to produce severe birth defects. The taking of malarial prophylaxis, such as doxycyclin, can damage the liver over long use, thus deemed inadvisable for usage of people living in malaria-infested areas. A recent online news report told how Americans get the most radiation from medical radiology. Viruses also evolve every day which presents continuous new challenges to the medical world.
Natural Medicine
The term “natural medicine” for the purpose of this paper refers to alternative medical systems that lean towards the usage of more natural means of healing, especially in comparison to conventional medicine. This adoption of a more simplified definition is due to the existence of several yet still similar and related definitions. The term is oftentimes almost equated to “alternative medicine” which was defined by Brannon and Feist (2007) as “a group of diverse medical and health care systems, practices and products that are not currently considered part of conventional medicine” (p. 190). In actuality, the term “alternative medicine” covers a wide array of medical systems which evolved more or less independently from different cultures. Examples are the Chinese traditional medicine, from which acupuncture and acupressure arose; Ayurvedic medicine from India, Naturopathy from Europe; macrobiotics; chiropractic and other various massage treatments from all over the world. When these methods are incorporated by conventional doctors to their practice, the treatments are termed “complementary medicine.” The clustering of these diverse medical systems and traditions, some of which from great civilizations, either under the term “alternative medicine” or “complementary medicine,” implies how the former is deemed only secondary to conventional medicine.
On the other hand, natural medicine is also treated as synonymous to “naturopathy.” Naturopathy is a cure system which targets the prevention and cure of diseases with the use of safe and efficient natural remedies (Muetzell, 2008). The practitioners’ central belief is that the human being in his normal state is healthy and that disobedience to natural laws results to illnesses (Brown, 1988). It then follows that nature has the power and resources to heal and that the human body has the ability to maintain, nurse and heal itself back to health. It is said that the movement became sufficiently coherent in Europe in the 19th century. A man named Benedict Lust, a German patient who was treated for tuberculosis through hydrotheraphy and other natural means, migrated to the United States and popularized the movement. The naturopathy movement was popular in Germany and in Britain during those days and was later popularized in the United States (Brannon & Feist, 2007).
In spite of the varying definitions of natural medicine, the various alternative medical systems named early in the paper have significant similarities in their principles, which like naturopathy leans towards the healing power of nature. The seeking of natural balance is quite universal to various traditional and indigenous medical systems. In reverse, naturopathy employs various healing practices from various cultures.
Increasing Popularity in Conventional Medicine-Dominated Countries
More and more, natural medicine has been enjoying increasing popularity and patronage in countries with advanced levels of conventional medical practice. Eisenberg et al. (1993) reported that the unconventional medicine usage frequency of the United States adult population had been way higher than stated in previous reports. Particularly, they estimated that one in three persons in the U.S. adult population had been utilizing unconventional medicine in 1990. This figure also implied a greater number of patient visits to unconventional medicine practitioners as compared to visits to conventional medical practitioners. They added that the amount spent by these adults on unconventional treatment was also comparable to the amount spent by Americans for all hospitalizations. A telephone survey in Britain revealed a 20% usage of alternative medicine, most popular of which is the use of herbs, aroma therapy, acupuncture, massage and reflexology (Ernst, 2000).
This increasing patronage of natural and other alternative medicine may also be attributed to the increasing number of physicians who practice or recommend alternative therapies to their patients. Astin (1998) mentioned how a 1994 survey showed that more than 60% of the surveyed variably specialized physicians in Washington State, New Mexico and Israel recommended alternative therapies to their patients in the previous year while 38% had done so in the previous month. Meanwhile, 47% of these physicians use alternative therapies on themselves and 23% of the physicians have incorporated alternative therapies to their practices.
The practice of naturopathy as a discipline is also becoming more and more regulated and consolidated with the creation of professional associations such as the American Naturopathic Association. More so, various schools have been accredited to teach naturopathy such as the Bastyr University, National College of Natural Medicine and the Broucher Institute of Naturopathic Medicine. More mainstream medical schools are now tackling or offering alternative medicine. Examples of such schools are Harvard, Columbia, Georgetown and Duke (Barney, 1998).
Many conventional medical practitioners critique the usage of natural medicine. According to Ernst (2003), alternative medicine is largely opinion-based. Practitioners tend to give inconsistent and different prescriptions for the same diseases or medical conditions. For example, he cites how “100 different complementary therapies were recommended for asthma, while systemic reviews failed to back up a single treatment for this indication” (p. 1134). Ernst was also disappointed at the scarcity of systematically gathered evidence. Yet, he is not against alternative medicine per se. He advocated for a more objective and scientific usage of alternative medicine.
Why the Shift towards Natural Medicine?
Overly-commercialized Conventional Medicine
Weil (1998) tells how the commercialization of orthodox medicine is discouraging patients to continue seeking conventional treatments. He characterizes how mainstream medicine continues to become more expensive and technology-reliant. He tells how the popularity of health maintenance organizations (HMOs) has gravely affected the health care system. HMOs, he claims, want doctors to see as many patients as possible for the purpose of profit. Sadly, doctors spend less time with their patients which translate to less detailed medical and family histories, thus affecting the quality of diagnosis and treatment. In contrast, naturopathic consultations involves long and thorough interview with patients. Interviews look at medical and family histories, patient lifestyle, emotional health, and other physical features.
Ernst (2000) points to various motivating factors for trying complementary and alternative medicine, which he divides into two – positive and negative motivations. Positive motivations consist of the attributes of alternative medicine itself while negative motivations refer to negative attributes of conventional medicine which pushes patients to try alternative medicine. Examples of those enlisted as positive motivation are the following: 1) perceptions of effectiveness; 2) perception of safety; 3) control over treatment; 4) good patient-healer relationship; and 5) non-invasive nature. Meanwhile, enumerated as negative motivations are: 1) dissatisfaction of- and case-to-case ineffectiveness of conventional medicine; 2) rejection of science and technology; 3) rejection of the establishment; and 4) desperation.
Education, Poorer Health Status and Congruence to Patient Beliefs and Principles
The national study of Astin (1998) revealed that the most significant factors leading to the use of alternative medicine are the attainment of a higher level of education, having a poorer health status and the greater congruence of alternative medicine to the patients’ values, beliefs and philosophies. Patrons, he said, tend to hold a philosophical orientation towards health and holism. He also found out that dissatisfaction with the conventional medical system is not as significant as the earlier mentioned factors.
Key Principles of Natural Medicine and their Implication to Treatment in Comparison to Conventional Medicine
As mentioned in Astin’s study (1998), the principles of natural medicine appeals significantly to patients. The key principles of naturologists can be summed up into six guidelines, which are: 1) Promote the healing power of nature; 2) First do no harm; 3) Treat the whole person; 4) Treat the cause rather than the symptom; 5) Prevention is the best cure; 6) The physician is a teacher, teaching patients to take care of themselves (Brannon & Feist, 2007).
Holistic (system-oriented vis-a-vis disease oriented)
The most common word to describe naturalistic treatment is “holistic.” This owes to natural medicine’s strong faith and reliance on the natural balance of nature. Particularly, the body was said to have a stable state that when bothered can lead to illnesses. Natural medicine also believes that excretion of wastes is a valuable part of this system and a stoppage to this normal functions lead to an unhealthy state. To illustrate, Chinese traditional medicine believes in the concept of “Chi,” a local concept which closely translates to vital energy. Chi, the Chinese believe, flows throughout the body. In line with this, illnesses are attributed to the blockage of this energy flow. Acupuncture for instance targets to solve this blockage.
Natural medicine practitioners look at patients in their wholeness as individuals. Practitioners usually look at factors that may be disrupting the body’s natural balance. They are not only focused on the physical body but also looks at the mind and spirit. It is common for natural medicine practitioners to look at the lifestyles of patients and tries to being out the natural healing capacity of the body. They advise and help patients incorporate stress reduction methods and healthy eating into their lifestyles.
This was in contrast to the treatment of conventional medicine which commonly isolates the physical body from the exclusion of mind and spirit (Weil, 1998). Barney (1998) a medical doctor who subscribes to medical complementation, criticizes the rigidity of conventional medicine in its approach to diseases. Particularly, he describes conventional treatments as disease-oriented. For instance, to address an infection, doctors may prescribe antibiotics that can weaken the kidneys. This shows a disregard to the body as a system only comprised of body parts. He said that treatment options must be expanded to fit the specific needs of each patient.
Regard for particularities
While natural medicine practitioners look at the “whole” in everyone, they also do not forget to look at the particular attributes of the individual. For instance, Ayurvedic medicine subscribes to the belief that there are different types of human bodies and that each body type must be given customized medical treatment. People who are fat or thin are also not automatically considered unhealthy in Ayurvedic medicine. Whereas in conventional medicine, normal body mass is calculated based on the height and weight of a person compared to universal standards. Also, some of the healthiest food prescribed by conventional medicine for a healthy person can be classified as unhealthy in Chinese medicine based on individual conditions. In this tradition, the definition of “healthy food” varies from person to person, even to those who may be classified by conventional medicine as being in a state of good health.
Bias towards the Natural
Natural medicine also attributes illnesses to actions and activities which veer away from natural laws of the body. For example, in macrobiotics, it is viewed that meat and poultry products being sold nowadays are very characteristically “un-natural” due to the hormones and chemicals being fed to the animals to facilitate speedy growth. Thus, natural medicine avoids or minimizes the usage of synthetic drugs such as antibiotics, radiation technologies, biomedical technologies such as vaccines and major surgery. Furthermore, it uses more natural substances and medicines found in the body and in the natural environment such as water in hydrotherapy. It has a far greater respect for herbal medicines which was used by a great number of people around the world. In contrast, conventional medical treatments can sometimes suppress the body’s efforts and capability to self-heal.
The fact that natural medicine is enjoying widening and growing support especially in the Western world gives credence to its claims of efficacy in relieving problems of the mind, body and soul. It also reflects particular weaknesses in the current conventional medical practice, which translates as negative motivations for usage of natural medicine. This validates the importance of the key characteristics of natural medicine which are: 1) holism; 2) bias towards the natural; and 3) attention to the particular. Outside the efficacy in dealing with physical problems, I think that the greatest trait espoused by natural medicine that conventional medicine lacks is in the former’s attention to the mind and body. This translates to patients’ feelings of peace, control over their bodies and feelings of being valued and respected by their healers.
Like Ernst, I believe that natural medicine and other alternative medical systems can benefit from addressing the critiques of conventional medical practitioners. In particular, it would be beneficial if natural medicine practitioners from various traditions can take steps in systematically documenting and gathering our- and other unexplored healing practices and their results. This is a positive step towards a maximization of knowledge from all over the world and the integration of various know-hows and towards more informed choices among patients.

Essay On Corporate Social Responsibility Accounting Essay

The term stakeholders means a party that can effect or be effected by the actions of the business as a whole and they are the group of members without whose support the organisation cannot exist or they are the interested parties who is keen to know what the business is doing. In this situation the stakeholder is Steve Morgan who is the controller of the Newton Industries and is interested in production cost reports.
What are the ethical issues involved in this situation?
Steve Morgan is involved in the ethical issue as he did not inform the management that the advertising cost is expensed in the current period the net income wouldn’t be overstated and this would help the financial managers to make decisions and maintain effective control over resources.
What would you do if you were Steve Morgan ?
Managerial Accounting or management accounting is a set of practices and techniques aimed at the providing managers with financial information to help them make decisions and maintain effective control over corporate resources.
So, if I was in Steve Morgan’s position I would had recorded the advertising cost as expense in the current period , so as to not to overstate net income.
BYP 3-6
Who are the potential stakeholders involved in this situation?
The term stakeholders means a party that can effect or be effected by the actions of the business as a whole and they are the group of members without whose support the organisation cannot exist or they are the interested parties who is keen to know what the business is doing. In this case the potential stakeholders are Jan Wooten who is department head in the Moulding Dept. And Tony Ferneti who is quality control inspector of moulding department and are interested in saving the company’s money.
What alternatives does Tony have in this situation? What might the company do to prevent this situation from occurring?
Tony has two alternatives in this situation, first alternative is that pass through the inspection and on to the Assembly Department all the units that had defects non-detectable to the human eye. The second alternative is that Tony can reject all the units that had defects.
The company can lower the wages of the employees so that the employees will be extra vigilant and will be careful. Also the company could use the extra money after lowering the wages in providing the employees a better training and could avoid such situation in the future.
Part B: Essay on corporate social responsibility
Corporate social responsibility (CSR) in business is related to the obligation of companies and other business organizations to increase their positive influence and reduce their negative activity toward society. In that sense, while ethics is a matter for each individual in the business field, social responsibility is related to the influence of an organization’s business decisions on society. One of the most significant principles on which modern business is based is that of an organization based on responsibility. Organizations must take responsibility for their role in society.
Corporate Social Responsibility is becoming an increasingly important activity to businesses nationally and internationally. As globalization accelerates and large corporations serve as global providers, these corporations have progressively recognised the benefits of providing CSR programs in their various locations. CSR activities are now being undertaken throughout the globe.
The rationale for CSR has been articulated in a number of ways. In essence it is about building sustainable businesses, which need healthy economies, markets and communities.(megatrend)
The key drivers for CSR are:
Enlightened self-interest – creating a synergy of ethics, a cohesive society and a Sustainable global economy where markets, labour and communities are able function well together.
Social investment – contributing to physical infrastructure and social capital is increasingly seen as a necessary part of doing business.
Transparency and trust – business has low ratings of trust in public perception. There is increasing expectation that companies will be more open, more accountable and be prepared to report publicly on their performance in social and environmental.
Increased public expectations of business – globally companies are expected to-do more than merely provide jobs and contribute to the economy through taxes and employment.”
The concept of corporate social responsibility has been standardized and today represents an integral part of integrated management systems. The principles connected with existing definitions of corporate social responsibility consist of the following: taking part in community life, accountability, sustainability, transparency, ethical behaviour (without corruption), honesty and inclusion. Socially responsible companies adhere to the “triple result” approach, keeping in mind the social, economic and environmental influence of their business operations. (Weygand, kimmel & kieso. 6th Ed, p 21)

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Framework of CSR
CSR is important, as it’s a starting point towards building CSR into management control systems. The different phases are also named steps. This is done because the framework works as a continuum where different steps follow one another and a step cannot be skipped when heading to a system working in day-to-day work and helping to reach set goals. In step three the management control system is shaped and it represent the processes, systems and tools by which the management guides the organization’s and its employees’ behaviour to fulfil the set strategy and targets. To facilitate management actions management should get proper reporting of the step three. After attaining CSR outcomes these outcomes can be reported to the stakeholders via CSR reporting. The steps will be used to analyze the empirical results of the study. The stage of alignment of CSR into management control systems in the case companies will be analyzed according to this framework. In this internal control the role of accounting plays a very important concept.
Corporate social responsibility and important of accounting –
• CSR is a concept whereby companies integrate social and environmental concerns into their business operations and in their interaction with their stakeholders on a voluntary basis.
• CSR is “the process by which managers within an organization think about and discuss relationships with stakeholders as well as their roles in relation to the common good, along with their behavioural disposition with respect to the fulfilment and achievement of these roles and relationships”
Several concepts related to CSR, which apply to the accounting areas:
Environmental Management Accounting,
Social Environmental Accounting and
Environmental Reporting or Social Responsibility Accounting.
These concepts link CSR to the accounting system, arguing for the importance of such aspects in the work of accountants.
Very well informed businesses and non-profit organizations environment seems aware of the importance of good CSR practices. CSR developed a portal presenting and advertising very well the experience of CSR and international organizations in this area. Such companies in our country have initiated several projects and initiatives.
CSR-related concepts influence significantly the accountancy profession for example, Environmental Management Accounting is the management of environmental and economic performance via management accounting systems and practices that focus on both physical information on the flow of energy, water, materials, and wastes, as well as monetary information on related costs, earnings and savings. (tkf.org.in)
Managerial accounting is reflected by both physical information on the use, flows and destinies of energy, water and materials, and monetary information on environment-related costs, earnings and savings sides. It has such application fields as: assessment of annual environmental costs/expenditure, product pricing, budgeting, investment appraisal, calculating costs, savings and benefits of environmental systems, environmental performance evaluation, indicators and benchmarking, external disclosure on environmental expenditures, investments and liabilities. As this shows, and we will further develop, it is then imperative that all parties involved in the accounting domain consider fostering such competencies in accountants, for the overall good of the society.
Managerial Accountability is an international standard for social responsibility, created by Council on Economic Priority Accreditation Agency with the goal of securing an ethical source of products and services. This standard is of a voluntary character and can be applied to any company, regardless of size and branch of operations. Also, the standard can either replace or be a supplement to companies or industries with a specific code of social responsibility.(amfiteatur.economic)
Part C: Essay on budgeting
“Is a formal written statement of management’s plan for a specified future time period, expressed in financial terms. It represents the primary method of communicating agreed-upon objectives throughout the organization. Once adopted, a budget becomes an important basis for evaluating performance. It promotes efficiency and serves as a deterrent to waste and inefficiency”. (Weygandt, Kimmel & Kieso, 6th Ed, p 384)
Some employees will question the need for a budget. The procedure of budget preparation is at times seen as difficult, and it is not constantly clear how the attempt that is required leads to any fruitful production. Furthermore, budgets can be seen as imposing constraint that is hard to live with and establish goals that are difficult to meet.
Despite these dismal remarks, it is very important that organizations carefully plan their financial affairs to attain financial achievement. These plans are normally expressed as “budgets.” A budget is detailed financial plans that quantify future expectations and actions relative to acquiring and using resources. (Principles of Accounting)
In small organization, formal budgets are an unusual object. The individual management/owners likely manage only by reference to a common mental budget. The person has a good sense of estimated sales, costs, financing, and asset needs. Each operation is under direct oversight of this person and confidently she or he has the capacity to keep things on a logical course. When things don’t go well, the management/owners can normally take up the slack by not taking a pay check or engage in some other form of financial requirement. Of course, much small business eventually is unsuccessful anyway. Explanation for unsuccessful are several and varied, but are often pinned on “undercapitalization” or “insufficient resources to sustain operations.” Many of these post-mortem assessments reflect a failure to adequately plan! Even in a small company, a reliable business budget/plan can often result in anticipate and avoiding terrible outcomes.
Medium and big organization consistently relies on budgets. This is likewise true in business, government, and non-profit organization. The budget provides a formal quantitative phrase of opportunity. It is an essential aspect of the planning and control process. Without a budget, an business will be highly unproductive and ineffective. (Principles of Accounting)
Advantages of Detailed Budgeting:
There are several advantages of detailed budgeting for business which are.
First of all creating a budget is a long term perspective so it enables to think in a long term and moves away from making short term goals. It also allows thinking long term financial position and profitability of a business no matter if the planned budget doesn’t successes. (Accounting Tools)
Making a detailed business budget allows to pin point where the company generates it most of the revenue as in many cases it is easy that the management looses the most profitable aspect. It forces management to consider to whether it should let go non productive part of business and which new one to invest in. (Accounting Tools)
Budgeting allows business to think what the key purpose of the business is and to forecast environmental factors that may affect the performance of the business. This forecasting enables to develop strategy to overcome different environmental pressure. (Accounting Tools)
A detailed budgeting allows business to look forward what future cash flows will be required for the expansion of the business and from where to generate funds in order to meet the future growth needs. (Beyond)
Formulating a budget also allows you to evaluate the performance of the business. Where the business is now and where to be and how to get there. It provides step by step information which is helpful in reaching where the business wants to be. Without budget it is very difficult to evaluate the current performance of business. It measures the planned performance with actual which gives a complete and true picture of the business. (Weygandt, Kimmel & Kieso, 6th Ed, p 385)
Budgeting enables managers to decide where to allocate funds as cash are always limited. Whether to invest in fixed assets to increase production for matching future demands or to invest in working capital. It also enables business to decide which asset is worth investing. (Beyond)
A realistic established budget enhances the probability that the business will successes because it contains all the essentials and targets that have to be accomplished and also enables the business owner to according to the planned activities. (Accounting Tools)
In addition detailed budgeting also helps to formulate different department goals and different functional goals. The functionality of all the departments are necessary to run the business mechanism. Basically budget creates a harmony among the entire department prevailing in a particular business. (Principles of Accounting)
A budget is not only useful for owner or managers of business but it is also useful for the investors. Budgets helps investors to check if the business have enough potential and if the business if worth investing. Investors see the budget to find out what are the goals of business and investing in that particular business will maximize the probability of better return in terms of interest. (Accounting Tools)
Budgets are not just useful in comparing your own performance with the planned one but it is also useful in comparing the performance of your business with the overall industry, like what are the labor rate prevailing in the market, what price to charge from customer, what volume to sell in order to get maximum revenue. (Accounting Tools)
A strong budgeting system serves as an effective planning and control tool that allows a business to plan its short term and long term strategy towards achievement of its short term and long term goals, by:
Setting up targets for individual departments of the Company,
Checking and ensuring the availability of necessary resources for the achievement of the said targets,
Streamlining the goals of different departments with that of the organization,
Monitoring the actual performance against the budget,
Adjusting the performance deficiencies by referring back to the budget
Adjusting the budget where required by incorporating the changes in the working environment, and
Continuously planning for effective and better performance.
All in all a budget is a system of governance that enables the management to build up the business by adequately planning its each move in the market and maintain a pro-active approach in its business that serves as a plus point in a competitive business environment if managed effectively and intelligently. (Weygandt, Kimmel & Kieso, 6th Ed, p 385 & 386)

Factors Of Increased Life Expectancy Health And Social Care Essay

People around the world are now living longer. According to the government information life expectancy in the UK has increased (Office For National Statistics 2004). Their data showing that life expectancy for women increased from 49 years in 1901 to 81 by 2002, and for men it increased from 45 to 76 years. This paper examine the factors that contribute to increased life expectancy in the UK and in the World.

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Firstly medical changes have allowed life expectancy to increase because as Tallis (2005) state better health information, medicine can prevent many diseases and special medical care available. In the UK many improvements in the health care “have made a significant contribution to the major and sustained increases in life expectancy” (Gray et al, 2006, 107). In particular, the Centers for Disease Control and Prevention (2009) point to ten health advances that increased life expectancy in the last 100 years. For example immunisations, control of infections, safer food and reducing heart illnesses. Marmot (2003) point to research that show the level of death from heart disease is lower in countries where there is higher supply of fruit and vegetables.
Another factor is the effect of healthcare in the area pregnancy an infant caring. The United Nations Population Fund (UNFPA 2010a) state that the increase in life expectancy of the World’s population is because of improvements that has been including “lowered infant and child mortality; better nutrition, education, health care and access to family planning;” (UNFPA 2010a, np). The UNFPA (2010a) emphasise how health in the early years is increasing life expectancy because for example young children are eating better The UNFPA also indicate the importance of healthcare and family planning and for women mean less pregnancy and infant health problems. An example of a health factor that is reducing death at birth and pregnancy issues is the increase in skilled health staff (UNFPA 2009). According to Wilkinson and Marmot (2003) this increases life expectancy because this means when young children grow up they will have less illness connected to infant ill health.
Additionally, the UNFPA (2009) state that education is also another important factor to increasing life expectancy. They say this is so especially for women that finish secondary school education because it means that girls are stronger physically and emotionally and this lead to fewer infant deaths. This make sense because education across all countries give people more knowledge and they are able to make better decisions, choices and live healthier life (Marmot 2009).
Meanwhile a report by the World Health Organisation show that there are also many social factors affecting the life expectancy (Marmot 2009). In richer developed countries life expectancy has increased because the social conditions are better because the people that are living longer are not suffering from issues relating to poverty such as not eating well, access to medical care and clean water (Marmot 2009). More of the world now has access to cleaner water (UNFPA 2010b). So over the past 100 years in richer countries there have been improvements to health, water and nutrition which is helping to increase life expectancy.
Improvements in economic situation of people has led to increases in life expectancy around the world (Wilkinson and Marmot 2003). According to Wilkinson and Marmot (2003) diseases are less common if the social position of the person is better because these people can pay for better food and better medicine and better care. However at same time they say not only about rich or poor because as stated by Wilkinson and Marmot (2003) the social factors increasing life expectancy can affect all level of society. For example they state that “even among middle-class office workers, lower ranking staff suffer much more disease and earlier death than higher ranking staff” (Wilkinson and Marmot 2003, p10). This is because social factors that can effect life expectancy can happen at any level. The people that are living longer have good social factors such good family relations and support, good education in the youth years, secure employement, job satisfaction and good housing. All these factors find the World Health Organisation can improve life expectancy (Wilkinson and Marmot 2003).
Furthermore reduced stress is example of social factor that is helping people live longer. The World Health Organisation say that “continuing anxiety, insecurity, low self-esteem, social isolation and lack of control over work and home life, have powerful effects on health” (Wilkinson and Marmot 2003, p12). Consequently life expectancy is increasing around the world for people who are experiencing these problems less and less.
Stress can also include stress at work which can have affect in life expectancy. According to Wilkinson and Marmot 2003 the “psychosocial environment at work is an important determinant of health “(p18). Other employment factors that increase life expectancy are high job security and high job satisfaction (Wilkinson and Marmot 2003).
Social isolation is another factor that affect life expectancy. “Life is short where quality is poor. By causing hardship and resentment, poverty, social exclusion and discrimination cost lives” (Wilkinson and Marmot 2003, p16). Therefore society where people are not isolated is helping to increase life expectancy. So then in countries around the world factor is helping to increase life expectancy where people experience less isolation and there is more community and relationship. Wilkinson and Marmot (2003) say however that this factor can also include for example discrimination, racism and unemployment. In the UK there is higher life expectancy in areas where there is less social isolation and unemployment. Rich areas such as Chelsea and Kensington in London say the BBC (2009) have highest life expectancy in the UK, which is 84 for men and 89 for women. But in Glasgow which has many social problems (BBC 2006) the life expectancy is only 70 years for man and 77 years for women.
The evidence it seems that people are living longer for many reasons. Either for health, better medicine, better support and social connection or increase in wealth. People not only living longer in rich countries but also in poor countries where the country is maybe still poor but there improvement in health and education. As long these factors increase for people then more people will live longer.

The Types Of Disabilities Health And Social Care Essay

The basic aim in this chapter is to describe about disability of a special person, mentioning its nature of irregularities, types of difficulties faced by them and its remedy, kinds of disabilities and category model wise disabilities.
The term disability when it is explained with respect to humans refers to any condition that impedes the completion of daily tasks using traditional methods. A disability is a condition or function judged to be significantly impaired relative to the usual standard of an individual or group. The term is used to refer to individual functioning including physical impairment, sensory impairment, cognitive impairment, intellectual impairment mental illness, and various types of chronic disease.
Some disabilities are not obvious to outside observers; these are termed invisible disabilities.[2]
According to the Americans with Disabilities Act of 1990, a person with a disability is defined as
A person that has a physical or mental impairment that substantially limits one or more major life activities,has a record of such impairment, or is regarded as having such an impairment.
Under the Disability Discrimination Act 1995 (DDA), a disability is a physical or mental impairment that has a long-term or substantial effect on a person’s ability to carry out day to day tasks.
Some disabilities are not obvious to outside observers; these are termed invisible disabilities.
Types of disabilities include various physical and mental impairments that can hamper or reduce a person’s ability to carry out his day to day activities. These impairments can be termed as disability of the person to do his or her day to day activities.
These impairments can be termed as disability of the person to do his day to day activities as previously. Disability can be broken down into a number of broad sub-categories, which include the following
This includes people with no vision, or some functional vision. For example, screen readers are used by the blind to read web pages, and someone with poor vision may use screen magnification or adjust their browser settings to make reading more comfortable. This group also includes people with color blindness and those with eyesight problems related to ageing.
Disability in mobility can be either an in-born or acquired with age problem. It could also be the effect of a disease. People who have a broken bone also fall into this category of disability. [3]
Spinal cord injuries (SCI) can sometimes lead to lifelong disabilities. This kind of injury mostly occurs due to severe accidents. The injury can be either complete or incomplete. In an incomplete injury, the message conveyed by the spinal cord is not completely lost. Where as a complete injury results in a total dis functioning of the sensory organs. In rarest of cases spinal cord disability can be a birth defect.
Brain Disability
A disability in the brain occurs due to a brain injury. The magnitude of the brain injury can range from mild, moderate and severe. There are two types of brain injuries:
Acquired Brain Injury (ABI)
Traumatic Brain Injury (TBI)
ABI is not a hereditary type defect but is the degeneration that occurs after birth.
The causes of such cases of injury are many and are mainly because of external forces applied to the body parts. TBI results in emotional dysfunctioning and behavioral disturbance.
Vision Disability
There are hundreds of thousands of people that suffer from minor to various serious vision injuries or impairments. These injuries can also result into some serious problems or diseases like blindness and ocular trauma, to name a few. Some of the common vision impairment includes scratched cornea, scratches on the sclera, diabetes related eye conditions, dry eyes and corneal graft.
Hearing disability
This category includes people that are completely or partially deaf. People who are partially deaf can often use hearing aids to assist their hearing. Hearing impairments can be evident at birth or occur later in life from several biologic causes, for example Meningitis can damage the auditory nerve or the cochlea.
Cognitive disability
Is a kind of impairment present in people who are suffering from dyslexia and various other learning difficulties. People having dyslexia face difficulties in reading, writing and speaking.
Invisible Disabilities
Invisible Disabilities are disabilities that are not immediately apparent to others. It is estimated that 10% of people in the U.S. have a medical condition considered a type of invisible disability.
1.3 Anomaly Of Special Persons
It is likely that different people could have different responses to the question of whether any of the above-listed characteristics would result in disability, and some might say, It depends. This illustrates the differences in the terms disability and handicap, as used by the U.N. Any of the above traits could become a handicap if the individual were considered disabled and also received disparate treatment as a result.
figure 1.1: Anomalies of a special person
1.4 Comparison Of Normal & Special Person
For a normal person major life activities means functions such as caring for one’s self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, working and receiving education or vocational training.
Special people are those who lack in any of the following abilities as compared to the normal person
Visionary problem [Blinds]
2. Hearing and speech problem [Deaf & Dump]
3. Physical disabilities [Missing any part of body]
4. Mental disability [Mentally Abnormal]
1.5 Categorization
The categorization of a special person with respect to their disability can be of the following nature.
1.5.1 Blind Person
As it is very evident from the name that blind cannot see anything from their eyes .This type of disability in any special person may be present by birth, or he can suffer through any accident or by any other mean.This category can further be described as:
figure 1.2: Categorization of a blind person
1.5.2 Deaf And Dump
The Special persons having this disability lack in them the problem of either hearing or speaking and sometimes both. This category can further be described as:
figure 1.3: Categorization of a deaf and dump person
1.6 Model For Disabilities
Any sort of disability in a special person which includes blind, deaf and dump, handicapped, etc is directly connected to brain from where it is sensed and controlled.
figure 1.4: The brain model [4]
Brief descriptions of disability models are explain as follows:
1.6.1 The Moral Model
This is historically the oldest and is less prevalent today. However, there are many cultures that associate disability with sin and shame, and disability is often associated with feelings of guilt, even if such feelings are not overtly based in religious doctrine. For the individual with a disability, this model is particularly burdensome. This model has been associated with shame on the entire family with a member with a disability. Families have hidden away the disabled family member, keeping them out of school and excluded from any chance at having a meaningful role in society. Even in less extreme circumstances, this model has resulted in general social ostracism and self-hatred. [4]
The Medical Model
The medical Model came about as modern medicine began to develop in the 19th Century, along with the enhanced role of the physician in society. Since many disabilities have medical origins, people with disabilities were expected to benefit from coming under the direction of the medical profession. Under this model, the problems that are associated with disability are deemed to reside within the individual. In other words, if the individual is cured then these problems will not exist. Society has no underlying responsibility to make a place for persons with disabilities, since they live in an outsider role waiting to be cured.

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The individual with a disability is in the sick role under the medical model. When people are sick, they are excused from the normal obligations of society: going to school, getting a job, taking on family responsibilities, etc. They are also expected to come under the authority of the medical profession in order to get better. Thus, until recently, most disability policy issues have been regarded as health issues, and physicians have been regarded as the primary authorities in this policy area. [5]
One can see the influence of the medical model in disability public policy today, most notably in the Social Security system, in which disability is defined as the inability to work. This is consistent with the role of the person with a disability as sick. It is also the source of enormous problems for persons with disabilities who want to work but who would risk losing all related public benefits, such as health care coverage or access to Personal Assistance Services (for in-home chores and personal functioning), since a person loses one’s disability status by going to work.
Rehablitation Model
The rehabilitation model is similar to the medical model; it regards the person with a disability as in need of services from a rehabilitation professional who can provide training, therapy, counseling or other services to make up for the deficiency caused by the disability. Historically, it gained acceptance after World War II when many disabled veterans needed to be re-introduced into society. The current Vocational Rehabilitation system is designed according to this model.
Persons with disabilities have been very critical of both the medical model and the rehabilitation model. While medical intervention can be required by the individual at times, it is naive and simplistic to regard the medical system as the appropriate locus for disability related policy matters. Many disabilities and chronic medical conditions will never be cured. Persons with disabilities are quite capable of participating in society, and the practices of confinement and institutionalization that accompany the sick role are simply not acceptable.
Disability Model
This model regards disability as a normal aspect of life, not as a deviance and rejects the notion that persons with disabilities are in some inherent way defective.
As Professor David Pfeiffer said:
…paralyzed limbs may not particularly limit a person’s mobility as much as attitudinal and physical barriers. The question centers on ‘normality’. What, it is asked, is the normal way to be mobile over a distance of a mile? Is it to walk, drive one’s own car, take a taxicab, ride a bicycle, use a wheelchair, roller skate, or use a skate board, or some other means? What is the normal way to earn a living?”
Most people will experience some form of disability, either permanent or temporary, over the course of their lives. Given this reality, if disability were more commonly recognized and expected in the way that we design our environments or our systems, it would not seem so abnormal.
The cultural habit of regarding the condition of the person, not the built environment or the social organization of activities, as the source of the problem, runs deep. The disability model recognizes social discrimination as the most significant problem experienced by persons with disabilities and as the cause of many of the problems that are regarded as intrinsic to the disability under the other models.
1.7 Identify Disability
Another important issue related to the topic of the definition of disability has to do with disability identity. There are many persons who unarguably fit within the first prong of the ADA definition who do not consider themselves disabled. …there are many reasons for not identifying yourself as disabled, even when other people consider you disabled. First, disability carries a stigma that many people want to avoid, if at all possible. For newly disabled people, and for children with disabilities who have been shielded from knowledge of how most non-disabled people regard people with disabilities, it takes time to absorb the idea that they are members of a stigmatized group. Newly disabled adults may still have the stereotypes of disability that are common among non-disabled people. They may be in the habit of thinking of disability as total, believing that people who are disabled are disabled in all respects. …They may fear, with good reason, that if they identify themselves as disabled others will see them as wholly disabled and fail to recognize their remaining abilities, or perhaps worse, see their every ability and achievement as ‘extraordinary’ or ‘courageous’.
The reason that so many people reject the label disabled is that they seek to avoid the harsh social reality that is still so strong today. Having a disability, even though the ADA has been in place for almost a decade, still carries with it a great deal of stigmatization and stereotyping. It is ironic that those who could benefit from the law choose not to do so because they wish to avoid the very social forces that this law seeks to redress and eradicate.
People who may fall under the coverage of the ADA because of the presence of a genetic marker are certainly not likely to think of themselves as disabled. While there may be discomfort at the thought of coming under this label, it is worthwhile to recognize that no one with a disability, visible or otherwise, wants to experience the stigma and discrimination that is still all too common for those who society considers disabled. There are many others who do not consider themselves to be disabled but who do experience discrimination.
1.8 Remedy
From a policy point of view, there are two possible options that could be pursued to avoid coming under the coverage of the ADA: (1) an amendment to the ADA to explicitly state that persons with genetic markers are excluded from coverage under the definition; and/or (2) separate legislation to redress discrimination based on genetic characteristics.
The first option would operate like the proverbial phrase, cutting off one’s nose to spite one’s face. The possibility of genetic discrimination is quite real, and it would be a poor bargain to lose one’s civil rights in exchange for avoiding disability based stigma. It could also cause significant problems with legal interpretation of the ADA definition; the risk is that courts could use any exclusion to deny ADA coverage to others.
The second option is also politically and legally fraught with risk. Politically, people with genetic markers are a much smaller group than the very large confederation of disability organizations and individuals who came together to work towards passage of the ADA. Thus, the chances of gaining the strong legal protections that are now available in the ADA are not very high. It could also be expected that well-financed corporate interests would oppose such legislation. Enactment of any new legislation would be a tough, uphill battle that would probably result in a compromised version of the original proposal. In addition, the existence of two overlapping pieces of legislation could result in unfavorable judicial interpretation.
On December 13, 2006, the United Nations formally agreed on the Convention on the Rights of Persons with Disabilities, the first human rights treaty of the 21st century, to protect and enhance the rights and opportunities of the world’s estimated 650 million disabled people. Countries that sign up to the convention will be required to adopt national laws, and remove old ones, so that persons with disabilities would, for example, have equal rights to education, employment, and cultural life; the right to own and inherit property; not be discriminated against in marriage, children, etc; not be unwilling subjects in medical experiments.
The ADA provides a legal remedy when this occurs. Since the ADA definition recognizes the social construction of disability, whether it can apply to a person is a function of the social treatment that the individual receives. In other words, the question of whether a person with a genetic marker is covered by the definition does not arise in the abstract. If the individual has experienced discrimination based on the individual’s physical or mental characteristics, then that individual may take advantage of the ADA to redress that discrimination.
1.9 Conclusion
The disability rights movement is working towards a society in which physical and mental differences among people are accepted as normal and expected, not abnormal or unusual. We have plenty of methods and tools at our disposal to accommodate human differences. Paradoxically, the growth of technology in our lives provides us with both the ability to detect more human differences than ever before, as well as the ability to make those differences less meaningful in practical terms. How we react to human differences is a social and a policy choice. We prefer to advocate for a social structure that focuses on including all people in the social fabric, rather than drawing an artificial line that separates disabled people from others.

Developing Social Support for Mental Health Patients

Social support plays a vital role in every individual’s life. Through comforting relationships and interactions, people are able to express their feelings and share their experiences. These relationships are essential for purposeful and meaningful life. People with mental disorders often experience difficulty in maintaining and initiating relationships with family members, friends, society and even with health care providers. ` For human beings, families are the most obvious of social systems (relationships)` (Charles & Laurel., 2013). Their limited social network keeps them secluded from their environment. In contrast, a good and non threating social networks help pateints in coping with their problems. An intact social network is a precursor for the executive of social support. Person with serious mental illness not only need to overcome the symptoms of disorder but societal and family misconceptions as well. (Batastini, Bolanos & Morgan, 2014)

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I encountered a client in AKUH Psychatric ward for last 2 months with the disgnosis of schizophrenia. Presenting complains were aggresiveness, low mood, low motivation and depression. On exploring patient’s histroy and by observing I came to know that patient is living within his boundries and remains isolated where he doesn’t interact with other patients, nor they interact with him, doesnot participate in any activities and no body came to visit him no relatives no family members . When he was at his house his neighbours used to make fun of him and even family members were misbehaving and giving him no respect. From furthur interviewing and considering above scenerio, I identified that the patient is suffering from social isolation because of lack of social support.
To analyze the varying aspects of this issue, which is of great concern to mental health nurses because they have to deal with such patients who encountered many problems because of low social support and by increasing social support their mental health can be promotes and they can cope with many problems.
Social support is the key to reduce social isolation by promoting interaction within society. It helps in adaptive process of adjustments and helps in sharing of feelings (Schuler, Zaider & Kissane, 2012) People with mental illness often feel lonely, scared and avoided by society. Such people consider themselves as inferior and worthless. `Social relationships both quantity and quality affect mental health, health behavior, physical health, and mortality risk` (Umberson & montez, 2010). Social support promotes mental health by enhancing patient’s self esteem, confidence and empowerment. It aids in the course of illness from acute phase to recovery phase. It fosters prompt recovery and compliance to medical treatment. (Finfgeld-Connett, 2005).
In Pakistani context, our society is bound by social ties in which people share their feelings with loved ones which indeed promotes mental wellbeing and provides person with sense of security, love and affection. Considering literature `mental health problems in Pakistan, a developing
country, have in the last few decades reached an appalling level linked to both the current violence in Pakistani society and disruption in social structure ` (Khalily, 2011). In Pakistani society mentally ill are perceived as abnormal, be mocked by people and often misbehaved by younger’s. As discussed in my scenario, the family members misbehaved with him. The families are ashamed to have mentally challenged family members and they are sent to mental health care institutions giving staff the entire responsibility (Todor, 2013, pg 210). Sufferers of mental illness are often seen as most disadvantaged group whose rights are violated by the members of their own society. A study conducted in Pakistan (Lahore) where medical students and doctors were surveyed to assess their attitude towards mental illness. It came out that half of the health care professionals poses negative attitude towards mental disorders such as schizophrenia, depression and substance abuse regarding their dangerousness, unpredictability and fear of communicating with patients. (Naeem, Ayub, Javed, Irfan, Haral & Kingdon, 2006).
Researchers have proposed several theories which describe the causes of isolation and low social support of mentally ill by society. One of them is labeling theory by Scheff in 1984. This theory proposed that public rejection is due to label such as “mentally ill” which leads to provoke negative emotions such as fear and exclusion that person labeled with mentally ill should be alarm and, therefore, be set aside from communities. (Abdullah and Brown, 2011, pp 935-948).
While reviewing literature I came across several strategies to reduce social isolation in patients at an individual, group and institutional level . All these strategies are meant to encourage positive sense of self, increased confidence and self esteem. On individual level therapeutic use of self, enhancing spirituality and rebuilding family networks are considered valuable tools for patients. The professional relationship shared between a patient and nurse can decrease patient’s isolation and feelings of loneliness through therapeutic communication and active listening. (Abate, 2011). Client should also be given love and affection from family by rebuilding existing family relationships, promoting family meetings and help patients recall pleasant experiences. This will aid in increasing family bounding and augmenting sense of hope and comfort. In group level, various interventions can be done to increase patient’s coping. Referral to support groups should be incorporated in care plans. ’ The primary goal of support group is to increase member’s coping ability in face of stress, to strengthen the central core of individuals` (Perese & Wolf, 2005). This will help cliet to express their feelings and desires with person going through same situation. It will increase their interpersonal relationships and coping skills and enhance feeling of togetherness and decrease uniqueness. Family education should be done to make them equal part of treatment. Mass media can be involved to convey our messages to population. Institutions should arrange semi structured sessions for the health care providers so as to increase their knowledge and make them competent enough to teach patient an their family members.
During my clinical rotation, I identified and addressed the issue of social isolation at an individual and group level through nursing care process. The planning phase starts with assessment and purpose to promote social interaction. Firstly, I used therapeutic communication as a measure to build rapport with patient and gave him room for expressing and ventilation feelings through active listening. Secondly, I identified teaching needs of patients and delivered ongoing teaching on relaxation technique to make him feel comfortable since physical helath also plays a vital role in maintenance of functional health pattern I involved patient in different leisure activities such as playing indoor games and drawing to increase self esteem.
While evaluating my patient I noticed that he started to participate in small activities with other patients . More over, becoming more sociable, interactive and willing to participate in different activities.
This was the first time I dealt with mental illness patient with decreased social support. Initially I was resistant and scared in caring for these patients. However my perception changed when I came across different strategies to deal with such patients. I tried to remain non judgmental, sensitive and empathetic towards them and applied theoretical knowledge to clinical settings.
In conclusion, decreased social support is the most challenging yet interesting domain which has many solutions. We should inculcate multidimensional approach to address this issue. Health care professionals should take a step forward to confront biased social attitudes In order to increase social support. Nurses should recognize the unmet needs of patients and pay them attentions that are often ignored by society. Increased efforts are needed to incorporate the practice of social support in mental health settings.

Public Health Reflective Journal Health And Social Care Essay

Our discussion last Thursday and Friday focused on the Impact of Disease on Health Care Delivery System and Health & Social Care. During that time our tutor Kate gave us an activity which we will cite examples have disease affected those areas of health.
Things like Financial Issues, Supply and Demands, Lack of Awareness and Knowledge, Skills Shortage and Poor compliance are the cited problems in all groups that occur in a community who are affected with any kinds of disease. We come up this idea of some reasons. Why Financial Issues? Because medicines and manpower are not free which means it needs funding to cope this problem especially when a large portion of individuals who are needed to be rendered with health services. Supply and Demands, still related to financial issues. Lack of Awareness and Knowledge, this contributes the problem because if a community is lack of awareness or knowledge about it health they are very vulnerable to illnesses or diseases. Skills Shortage this pertains to the members of health care system, it talks about how effective are they in rendering their services, are they professional and skilled to give services in an efficient and effective way??
Another topic we also considered last week was about case study of Philip, that study is very meaningful to us because its talks about Philips health and family problem. That case study gives us information that Health awareness is vital to a human life and we should take care of ourselves. It also
gives ideas to health practitioner on how to manage a case that has crucial situation and needs immediate attention.
Has this new knowledge changed my understanding? ( have I developed a whole new way of seeing things):
Knowing about the topic we tackled last week enlightened my mind on the importance of caring ourselves and a community as a health practitioner. Hearing those facts make me think that we should take care ourselves in many ways like having enough knowledge in health promotion and disease prevention, regular check up to assess our health status whether we are having illness or not, having healthy habit, diet and lifestyle.

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On the other hand also as a health care provider it is our responsibility to provide health teaching on those individuals we know that needs it or even not because doing this promotes health and gives knowledge to them on avoiding any disease problems. In addition, we should be a role model of health to them because this is one of the effective way were they will believe our health teachings and apply it to their selves.
How will I apply this knowledge and understanding in my work situation?
In my situation, there are many cases where I can apply this facts and knowledge I gathered in our last week’s discussion. As we know, we can encounter different case of diseases in care homes both communicable and non-communicable disease and we are aware that we’re susceptible to have that diseases if we are not aware of it. Due to this point, precautions necessary to prevent getting and spread of one disease to another and we can do it by applying the things we discussed about public health in our workplace. In order to avoid ourselves and others from getting any disease we must maintain doing the basic things like hand washing after toileting/diapering, before preparing or eating food, after covering a sneeze or cough, after blowing the nose, before and after treating a sore or wound. Using of proper protective clothing as a first line of defence.
2.) Submitted: 28th of Jan. 2010
Learning a new topic leads to changes in our knowledge and understanding and should also lead to changes in ways of working.
Identify any new knowledge, facts or theories that I have learnt from this week’s teaching:
Last week, We discussed all the things that are related about public health and itself. I found out that public health is a very broad topic and correlates many components such as health sector, health organisations, etc.
I learned that Public Health is vital in helping people to be aware about their health because it promotes good health, prolongs life and prevents society in getting any kind of diseases. It is also a gathered deed for the health of the certain population.
In dissemination of all the information related to health, there are agencies that are responsible in data distribution. This agencies and sectors are the one who takes the promotion, prevention, planning, action, and implementation of all the goals in regarding health information dissemination.
One of the most common agencies here in United Kingdom is the National Health Service or commonly called NHS. This agency acts as a framework of local organisations responsible for the healthcare of the community and to work with the local community to improve our populations health and well being. There are more agencies that acts or has a role like the NHS in relation to Public Health.
On the other hand Health Organisation has a big role in terms of promoting people in health awareness of the community because they are the one who distribute the health information globally such as World Health Organisation. WHO is the organisation that coordinates and directs for health within the United Nations. WHO leads in providing information about global health matters. Every time there is a new case of disease they are the one that conducts the studies on it and share the information all over the globe. For example, last week we had disserted the topic about the different infectious disease ( Swine Flu, Salmonella, HIV/AIDS, Measles, Meningitis, Tuberculosis , and MRSA ) and Non-infectious Disease ( Cancer, Coronary Heart Disease, Cerebro-Vascular Accident, Obesity, Asthma ) which are the products of the studios of WHO. Without WHO we cant gain access or unknowledgeable about these diseases.
Has this new knowledge changed my understanding? (have I
developed a whole new way of seeing things)
The topic we discussed doesn’t change my understanding about Public Health. The lesson we take up last week adds information about what I know in public health and it makes me understand that it is very important in building healthy community not only in a certain place but globally.
It also reminds me that as a health practitioner, we have also the responsibility to share what we have learned about promoting health and preventing diseases. Through this way we can help achieved one of the Public Health goal, which is the Health Awareness.
How will I apply this new knowledge and understanding in my work situation?
Like what I have said before, we can apply this knowledge by sharing the information about public health and telling them how to prevent diseases.
In my situation as an Health Care Assistant in a Care Home, I can share what I have learned by telling to all my colleague’s the importance of using protective clothes whilst giving care to a service user and explaining them how to make care a service user who has infectious and non-infectious disease.
In this assignment, for Part 1, I am going to cite two agencies and named their roles in Public Health in terms of identifying level of health and disease in communities. I will name also epidemiology of two diseases and investigate a chart or graphical form of its incident rate. On other hand I will show the Statistical Data of the two diseases and interpret it base on facts and my understanding.
In every agency I will choose two different approaches and strategies in controlling disease and investigate its effectiveness and after that I will make surveillance on how it improves Public Health. In this activity too I need to inspect current priorities to the provision of one disease and gives example on how it relates between prevalence rate, its causes and the requirements for health and social care services. Explore
In Part 2, I will do a case study on a given data or on a workplace experience. Analyse its critical factors that affects individual’s health then after I am going to put its priorities and evaluate its effectiveness to individuals well being. I will proposed as well changes that can improve its health and set it in action like having implementing campaigns to encourage maximize their health.
In this part, I will explain the role of 2 different agencies in identifying levels of health and disease in communities
It is improving and safeguarding well-being. Public Health is in charge for health safety, health enhancement and health inequalities issues in England. It is responsible moreover for shaping policy, allocating resources, co-ordinating actions and supervising progress. Diagnose and investigate health hazards and health problems in the society. Assess accessibility, effectiveness, and quality of personal and population-based health services. In addition they are the one organised community efforts in aiming prevention of disease and promotion of health. In relation of this, I select two agencies that will partake the goals of public health.
There are many agencies that have important roles in the society. I chose two agencies which helps contribute health awareness and protection for any kind of diseases; it is the Department of Health (DOH) and National Health Services (NHS).
I will precisely relate this two agency to the two diseases I chose which is the Meningitis and Cerebrovascular Accident.
Department of Health has many roles for the society. This agency focuses on issues related to the general health of the citizenry. It also compiles statistics about health issues of their area. It assesses and assures risk management to human health from the environment properly. Promote and protect the health and wellness of the people within the society and community. Promote and protects the public health to prevent disease and illness. Provides research and information for the detection, reporting, prevention, and control of any diseases or health hazard that the department considers to be dangerous that likely affects the public health. Establish a uniform public health program throughout the community which includes continuous service, employment of qualified employees, and a basic program of disease control, vital and health statistics, sanitation, public health nursing, and other preventive heath programs necessary or desirable for the protection of public health. Gather and disseminate information on causes of injury, sickness, death, and disability and the risk factors that contribute to the causes of injury, sickness, death, and disability within the society for their awareness. Implement programs and campaigns necessary or desirable for the promotion or protection of the public health to reduce and control the disease. DOH develops strategic approaches for current health risks. Establish risk analysis framework and maintenance of risk standards.
National Health Services is a publicly funded healthcare systems in United Kingdom, this agency focus on maintaining people’s health and well-being. This agency is responsible for delivering quality and effective health service to humanity. They also contribute fair access to everyone in relation to people’s need. They are responsible for making payments to independent primary care contractors such as GPs, dentists, opticians and pharmacists in rendering their services to all people who needs it. It provides different caring services such as Emergency Respite Care, where care is provided if an individual; are unable to fulfil your caring responsibilities due to unforeseen circumstances, such as illness. Domiciliary Care, where somebody comes into your home and takes over some of your responsibilities for a few hours. Day care centre, where the person you care for spends time at a centre whilst you have a few spare hours to yourself. There are more services rendered by the NHS which develop societies health
In this part, I will investigate the epidemiology of two diseases in graph format and show my understanding and interpretation of the given data:
Meningitis is an infection of the meninges, protective membranes that surround the brain and spinal cord. Infection can cause the meninges to become inflamed and swell, which can damage the nerves and brain. This can cause symptoms such as a severe headache, vomiting, high fever, stiff neck and sensitivity to light. Many people (but not all) also develop a distinctive skin rash.
Symptoms can differ in young children and babies. See the “symptoms” section for more information.
Meningitis can be caused by:
bacteria, such as streptococcus pneumoniae, the bacteria also responsible for pneumonia, which usually live harmlessly in your mouth and throat, and
viruses, such as the herpes simplex virus.
Viral meningitis
Viral meningitis is the most common and less serious type of meningitis. There are approximately 3,000 cases of viral meningitis reported in England and Wales every year, but experts believe the true number is much higher. This is because in many cases of viral meningitis the symptoms are so mild that they can often be mistaken for flu.
Viral meningitis is most common in young children and babies, especially in babies less than one year old.
Viral meningitis usually gets better by itself within a couple of weeks, without the need for specific treatment.
Bacterial meningitis
Bacterial meningitis is extremely serious and should be treated as a medical emergency.
If the bacterial infection is left untreated, it can cause severe damage to the brain and infect the blood (septicaemia), leading to death.
Treatment requires a transfer to an intensive care unit so the body’s functions can be supported whilst antibiotics are used to fight the infection.
There are approximately 2,000 cases of bacterial meningitis in England and Wales every year. The number of cases has dropped sharply in recent years due to a successful vaccination programme that protects against many of the bacteria that can cause meningitis.
The treatment for bacterial meningitis has improved greatly. Several decades ago, almost all people with bacterial meningitis would die, even if they received prompt treatment. Now deaths occur in one in 10 cases, usually as a result of a delay in treatment.
Bacterial meningitis is most common in children and babies under the age of three, and in teenagers and young people aged 15-24.
The best way to prevent meningitis is to ensure that your family’s vaccinations are up to date.
Stroke (cerebrovascular accident)
A stroke happens when the blood supply to the brain is disturbed in some way. As a result, brain cells are starved of oxygen. This causes some cells to die and leaves other cells damaged.
Types of stroke
Most strokes happen when a blood clot blocks one of the arteries (blood vessels) that carries blood to the brain. This type of stroke is called an ischaemic stroke.
Transient ischemic attack (TIA) or ‘mini-stroke’ is a short-term stroke that lasts for less than 24 hours. The oxygen supply to the brain is quickly restored and symptoms disappear. A transient stroke needs prompt medical attention because it indicates a serious risk of a major stroke.
Cerebral thrombosis is when a blood clot (thrombus) forms in an artery that supplies blood to the brain. Blood vessels that are furred up with fatty deposits (atheroma) make a blockage more likely. The clot prevents blood flowing to the brain and cells are starved of oxygen.
Cerebral embolism is a blood clot that forms elsewhere in the body before travelling through the blood vessels and lodging in the brain. In the brain, it starve cells of oxygen. An irregular heartbeat or recent heart attack may make you prone to forming blood clots.
Cerebral haemorrhage is when a blood vessel bursts inside the brain and bleeds (haemorrhages). With a haemorrhage, blood seeps into the brain tissue and causes extra damage.
(2009) (Meningitis). Available from http://www.nhs.uk/conditions/Meningitis/Pages/Introduction.aspx. [Accessed Feb. 24, 2010]
These are the graphs showing the rates of Meningitis and Cardiovascular Accident here in United Kingdom.
Source: PHLS Meningococcal Reference Unit
Disease Trends
Group B- unvaccinated Meningococcal serogroup C
Group C- vaccinated with Meningococcal serogroup C conjugate vaccine (MCC)
This graph table shows the effectiveness of meningococcal conjugate vaccine from 1998 – 2007. As we have seen in the figure, the case reduces every year especially to those who have taken the vaccine. It also shows the successful phased introduction of the meningococcal serogroup C conjugate vaccine (MCC) in 1999 into the National Immunisation Programme in the UK. This graph tells also that the immunity to Meningitis C has been identified in age groups who have not been vaccinated, as bacterium carriage rates are reduced across the population. We can see also in this table that those who didn’t take meningococcal vaccine were greatly affective by Meningitis.
Source: NOIDS England & Wales Final Midi Report for 2005 (Table 3 – Final totals for 2005 by sex and age-group)
Prevalence of Bacterial Meningitis and Septicaemia by Age Group
In this table, we could conclude that ages under 1-4 years old was greatly affected by meningitis as we have seen in the peaks of the graph and 0-11 months was greatly affected by the Pneumococcal and Meningococcal disease. And the same ‘peaks’ in the number of notifications for the ‘under 4 years’ and ’15-24′ age groups can also be seen with meningococcal septicaemia.
Source: NOIDS England & Wales Final Midi Report for 2005 (Table 3 – Final totals for 2005 by sex and age-group)
Prevalence of Bacterial Meningitis (without Septicaemia) by Age Group
This graph shows the high number of notifications of meningococcal and pneumococcal meningitis (without septicaemia) in England and Wales. Observing this graph will note us that the cases in 2005, age group that is 1 year of age are greatly affected with Meningococcal Meningitis and Pneumococcal Meningitis and 15 to 24 years of age were averagely affected with the certain disease. It also illustrates us that among the group cases ‘under 1 year of age’ gets the highest peak in having Pneumococcal disease. It is also interesting to note that the pneumococcal meningitis peaks again in the older age groups (45-64 and 65+).
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This graph shows all the percentages of all six categories are experiencing stroke. Figures for males are in dark gray bars and data for females are in light gray bars, with the number of patients in each age category shown above each bar. All data are patients who are experiencing stroke or CVA. As we observed in the graph the age group from 30 to

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This illustration shows the Incidence Rate of stroke in United States and United Kingdom. Details are articulated as person per year having stroke in 7 age categories. Individual experiencing strokes, person-years of follow-up was defined as the number of years from birth to the date for first recorded stroke. For individual without strokes, person-years of follow-up were defined as the last available follow-up date during the natural history period. Stroke incidence rates are revealed in data chart beneath the graph. As you see the data it’s very clear that a UK male has the highest incidence rates. UK Females, US Males and US Females are mostly like has the same incidence rate in occurrence of CVA.
In this part, I will choose at least two approaches and strategies that control the incidence of one disease and analyse its effectiveness:
As prevention of these diseases and to decrease its rate Department of Health and National Health Services make strategies and campaign to attain their goals. Department of Health formulate the ” Meningitis C Campaign ” the purpose of the this campaign was to immunise as many as possible of the country’s 15 million young people and children aged under the age of 18 years in as short a time as possible, immunising those most at risk of disease first.
Carrying out of the programme was made according to the risk of disease-those at utmost risk being immunised first. In November 1999, National Childhood Programme introduces the routine immunisation of vaccine at the ages of two, three and four months – alongside the DTP, Hib and polio vaccines and in December 1999 adolescent that ages 15 and 17 was also immunised.
As a result of the campaign there are around 13 million children have immunised during the first year through the help of general practitioners, nurses, immunisation coordinators and many other health professional.
This was pursuing by a widespread draw alongside programme to immunise all other children and adolescents up to the age of 18 years in 2000/2001.  After that the vaccine was made accessible to anyone up to 25 years.
National Health Services contributed also a meningitis prevention program here in United Kingdom. The ” Campaign to promote new Vaccine against Meningitis”, this program encouraged all parents to immunised their children against pneumococcal disease which is the causative agent of meningitis. General Practitioners has the big role of this campaign because they are the who will catch-up the campaign for the children ages 0 – 2 years who is starting their immunisations. This program was imposed by Health Minister Dr. Brian Gibbons. He states that: “Immunisation is the best way to protect children from serious disease and the routine childhood programme has been extremely effective in achieving this. The changes will further improve the programme and benefit children. This new vaccine will help save lives and prevent hundreds more cases of serious illness such as meningitis and pneumonia.”
To maximise the defence against Meningitis C and Hib disease NHS made two changes in the routine program. The present three doses of Meningitis C vaccine will be respaced at three and four months of age with a booster shot at 12 months.
Most up-to-date proof shows that the protection offered by this vaccine declines one year after vaccination. To maximise the protection in the first two years of life when the risk of infection is high, we will recommend doses at three and four months of age and a booster dose at 12 months. A booster shot of Hib vaccine will be given at 12 months.
In 1992 Hib vaccine was introduced and is presently given to children at two, three and four months of age. Since 1999, there was a small but slow increase in the number of cases in older children being reported. Again, because of this Meningitis prevention program, the disease declined over time. There was a Hib booster campaign happened in 2003. This dose was given to older children to maximise their immunity. This upturned the small increase in infections that had started to occur. A booster dose of Hib vaccine is being added to the childhood immunisation programme as a routine at 12 months to extend protection against Hib disease.
The new routine vaccination schedule is as follows:
2 months DTaP/IPV/Hib + pneumococcal vaccine
3 months DTaP/IPV/Hib + MenC vaccine
4 months DTaP/IPV/Hib + MenC + pneumococcal vaccine
12 months Hib/Men C
13 months MMR + pneumococcal vaccine
DTaP/IPV/Hib is a single injection that protects against diphtheria, tetanus, pertussis, polio and Hib.
MenC protects against meningitis C
Hib/ MenC is a combined vaccine protecting against Hib and Meningitis C
(2009)( Campaign to promote new Vaccine against Meningitis ) available from www.immunisation.nhs.uk. [Accessed at February 24, 2010]
Due to this campaign the rate of meningococcal infection has fallen every year since, and the cases of laboratory-confirmed group C meningococcal disease across all age groups immunised has go down by 90% since the vaccine was implemented. In 2003/04, there were only 65 cases reported and 8 deaths.
There was even a good effect in those who were not immunised with a reduction of about 70%, recommending that the vaccine has had a community protection effect.
In fact the campaign has been so successful that meningitis C disease now accounts for less than 10% of meningococcal meningitis cases. Even though the campaign made a great success still the health officials and medical professionals need to remain cautious.
(2010) ( Meningitis C Campaign) available from http://webarchive.nationalarchives.gov.uk. [Accessed at February 24, 2010]
. For Cardiovascular Accident prevention, Department of Health formulated new strategies to fall its rate. They formulated the Stroke: Act F.A.S.T. awareness campaign; F.A.S.T means Face, Arm, Speech, and Time.
The Stroke: Act F.A.S.T. awareness campaign aims to teach all health related professionals and the community on the signs of stroke and that prompt emergency treatment can reduce the risk of death and disability.
The campaign will notify the community about F.A.S.T. to call 999. F.A.S.T is a simple examination to help people to identify the signs of stroke and be aware of the importance of fast emergency management.
Campaign adverts, on Television, radio, internet and flyers, illustrate stroke ‘spreading like fire in the brain’ to demonstrate that fast emergency action can limit damage and radically raise a person’s probability of surviving and of avoiding long-term disability.
(2010)( Stroke: Act F.A.S.T. awareness campaign ) available from http://www.dh.gov.uk/en/Publicationsandstatistics. [Accessed at February 24, 2010]
If Department of Health has its campaign towards CVA, National Health Services provide also a program to lessen its incidence rate; The National Stroke Awareness Campaign. This campaign is related to F.A.S.T were NHS implemented that all paramedics should know how to assess a person using F.A.S.T before sending them to hospital.
They also made a Stroke Association who will support this campaign. This kind of charity is exclusively concerned with fighting stroke towards people in all ages. The charity resources research into prevention, treatment, better methods of rehabilitation and facilitates stroke patients and their families directly through its Rehabilitation and Support Services which include Communication Support, Family and Carer Support, information services, welfare grants, publications and leaflets.
In this part, I will investigate current priorities and approaches to the provision of heath services for people with one disease:
Treating Meningitis is not easy thing to do because this disease has various types, viral and bacterial meningitis. There is no treatment for Viral Meningitis. The immune system, will create antibodies to annihilate the virus. Until it is known that a child has viral, not bacterial meningitis, he or she will be admitted to the hospital. But once the finding of viral meningitis is complete, antibiotics are stopped, and a child who is recuperating satisfactorily will be sent home.
Simply acetaminophen must be given to lessen fevers. Clear fluids and a bland diet including preferred foods should be offered. During recovery, a child desires rest in a gloomy, quiet room. Bright lights, noise and guests may irritate a child with meningitis. Increased anxiety on the brain from build-up of fluid in the meninges is a severe problem.
(2010)(Viral Meningitis) available from: http://www.healthscout.com. [Accessed at February 24, 2010)
For Bacterial Meningitis may prove fatal within hours. Patients with suspected acute bacterial meningitis should be immediately admitted to the hospital and assessed for whether LP (lichen planus) is clinically safe. Antimicrobials should be given quickly. If LP is late because a CT scan is essential, antibiotic action should be started before the scan and after blood samples have been attained for culture. When the exact organism is recognized and results of susceptibilities are known, treatment can be customized accordingly. After the diagnosis has been confirmed (generally within 12-48 hours of admission to the hospital), the patient’s antimicrobial therapy can be modified according to the causative organism and its susceptibilities. Supportive therapy, such as fluid replacement, should be continued. Dexamethasone should be continued for Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitides.
S pneumoniae (duration of therapy 10-14 days)
Penicillin susceptible (minimum inhibitory concentration [MIC] Penicillin intermediate (MIC = 0.1-1.0 microgram/mL): cefotaxime or ceftriaxone
Penicillin resistant (MIC ≥2.0 microgram/mL) or cephalosporin-resistant (MIC ≥1.0 microgram/mL): vancomycin AND cefotaxime or ceftriaxone.
H influenzae (duration of therapy 10-14 days)
Beta-lactamase-negative: ampicillin
Beta-lactamase-positive: cefotaxime or ceftriaxone.
Streptococcus agalactiae (group B streptococci) (duration of therapy 14-21 days)
Gentamicin AND ampicillin or benzylpenicillin.
Escherichia coli and other gram-negative Enterobacteriaceae: (duration of therapy 21-28 days)
Gentamicin AND cefotaxime or ceftriaxone.
Listeria monocytogenes (duration of therapy 21-28 days)
Gentamicin AND ampicillin or benzylpenicillin.
Staphylococcus aureus (duration of therapy depends on microbiological response of CSF and underlying illness of the patient)
Methicillin susceptible: nafcillin or oxacillin
Methicillin resistant: vancomycin.
Staphylococcus epidermidis (duration of therapy depends on microbiological response of CSF and underlying illness of the patient)
Pseudomonas aeruginosa (duration of therapy 21 days)
Ceftazidime and gentamicin.
Enterococcus species (duration of therapy 21 days)
Ampicillin and gentamicin.
Acinetobacter species (duration of therapy 21 days)
Gentamicin and meropenem.
N meningitides (duration of therapy 5-7 days)
Penicillin susceptible (MIC Penicillin intermediate (MIC = 0.1-1.0 microgram/mL): cefotaxime or ceftriaxone.
(2010) (Bacterial Meningitis) available from: http://bestpractice.bmj.com. [Accessed February 24, 2010]
In this part, I will explain by giving examples, the relationship between the prevalence of one disease, its causes and the requirements for health and social care services:
Nowadays United Kingdom is still cautious about Meningitis even though the incidence rate is already decreasing radically. To be safe, health organisation are prioritising women and children’s health. They develop a guideline which suggest about ma

Diagnosed With Acute Bronchiolitis Health And Social Care Essay

Acute bronchiolitis is the inflammation of the small airway tubes of the lungs that is known as the bronchioles. It’s an acute episode of obstructive lower airway disease that is caused by a viral infection in infants younger than 2 years of age (Nino, 2011). There are different types of viruses that cause the illness, such as adenovirus, influenza, parainfluenza, and the most common type of virus that is usually being the culprit is respiratory syncytial virus or commonly known by its abbreviation RSV. When the virus gets to the bronchioles, it will infect the respiratory epithelial cells of the bronchioles causing it to necrose, get inflamed and produces mucous and secretions. The mucous plug that is formed obstructs proper air flow, hence causing air trapped inside the lungs. As air exits the lungs, wheezing sounds can be heard. The disease is infectious, as it can spread through physical contact from one individual to another. Bronchiolitis are more common in those who are not been breastfed and who live in crowded areas (Nino, 2011), and in the case of Baby A, she stopped being given breastfeeding at the age of 4 months old.
Bronchiolitis is inflammation of the bronchioles, the smallest air passages of the lungs. It usually occurs in children less than two years of age and presents with coughing, wheezing, and shortness of breath. This inflammation is usually caused by respiratory syncytial virus. Treatment is typically supportive and may involve the use of nebulized epinephrine or hypertonic saline.
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Not to be confused with bronchitis.
Classification and external resources
An x ray of a child with RSV showing the typical bilateral perihilar fullness of bronchiolitis.
Bronchiolitis is inflammation of the bronchioles, the smallest air passages of the lungs. It usually occurs in children less than two years of age and presents with coughing, wheezing, and shortness of breath. This inflammation is usually caused by respiratory syncytial virus. Treatment is typically supportive and may involve the use of nebulized epinephrine or hypertonic saline.
1 Signs and symptoms
2 Causes
3 Diagnosis
4 Prevention
5 Management
5.1 Inhaled epinephrine
5.2 Inhaled hypertonic saline
5.3 Other medications
5.4 Non-effective treatments
6 Epidemiology
7 References
8 External links
Signs and symptoms
In a typical case, an infant under two years of age develops cough, wheeze, and shortness of breath over one or two days. The infant may be breathless for several days. After the acute illness, it is common for the airways to remain sensitive for several weeks, leading to recurrent cough and wheeze.
The term usually refers to acute viral bronchiolitis, a common disease in infancy. This is most commonly caused by respiratory syncytial virus[1] (RSV, also known as human pneumovirus). Other viruses which may cause this illness include metapneumovirus, influenza, parainfluenza, coronavirus, adenovirus, and rhinovirus.
Studies have shown there is a link between voluntary caesarean birth and an increased prevalence of bronchiolitis. A recent study by Perth’s Telethon Institute for Child Health Research has shown an 11% increase in hospital admissions for children delivered this way.[2]
The diagnosis is typically made by clinical examination. Chest X-ray is sometimes useful to exclude pneumonia, but not indicated in routine cases.[3]
Testing for the specific viral cause can be done but has little effect on management and thus is not routinely recommended.[3] RSV testing by direct immunofluorescence testing on nasopharyngeal aspirate had a sensitivity of 61% and specificity of 89%.[4] Identification of those who are RSV-positive can help for: disease surveillance, grouping (“cohorting”) people together in hospital wards to prevent cross infection, predicting whether the disease course has peaked yet, reducing the need for other diagnostic procedures (by providing confidence that a cause has been identified).
Infant with bronchiolitis between the age of two and three months have a second infection by bacteria (usually a urinary tract infection) less than 6% of the time.[5]
Prevention of bronchiolitis relies strongly on measures to reduce the spread of the viruses that cause respiratory infections (that is, handwashing, and avoiding exposure to those symptomatic with respiratory infections). In addition to good hygiene an improved immune system is a great tool for prevention. One way to improve the immune system is to feed the infant with breast milk, especially during the first month of life[6]. Immunizations are available for premature infants who meet certain criteria (some cardiac and respiratory disorders) such as Palivizumab (a monoclonal antibody against RSV). Passive immunization therapy requires monthly injections every winter.
Treatment and management of bronchiolitis is usually focused on the symptoms instead of the infection itself (supportive therapies) since the infection will run its course and complications are typically from the symptoms themselves.[7]
Inhaled epinephrine
Nebulized and inhaled epinephrine (both racemic and levo(1)-epinephrine) has been shown to decrease hospitalization rates[8][9]. Sometimes inhaled hypertonic saline is used.
Inhaled hypertonic saline
Inhaled hypertonic saline (3%) appears to be effective in improving clinical outcomes and shortening the duration of hospital stay[3].
Other medications
Currently other medications do not yet have evidence to support their use[9].
Non-effective treatments
Ribavirin is an antiviral drug which does not appear to be effective for bronchiolitis.[10] Antibiotics are often given in case of a bacterial infection complicating bronchiolitis, but have no effect on the underlying viral infection.[10] Corticosteroids have no proven benefit in bronchiolitis treatment and are not advised.[10] DNAse has not been found to be effective.[11]
90% of the patients are aged between 1 and 9 months old. Bronchiolitis is the most common cause of hospitalization up to the first year of life. It is epidemic in winters.
^ Smyth RL, Openshaw PJ (July 2006). “Bronchiolitis”. Lancet 368 (9532): 312-22. doi:10.1016/S0140-6736(06)69077-6. PMID 16860701.
^ http://www.abc.net.au/news/2011-10-31/elective-caesarean-heightens-respiratory-risk/3611358
^ a b c Zorc, JJ; Hall, CB (2010 Feb). “Bronchiolitis: recent evidence on diagnosis and management”. Pediatrics 125 (2): 342-9. doi:10.1542/peds.2009-2092. PMID 20100768.
^ Bordley WC, Viswanathan M, King VJ, Sutton SF, Jackman AM, Sterling L et al. (2004). “Diagnosis and testing in bronchiolitis: a systematic review”. Arch Pediatr Adolesc Med 158 (2): 119-26. doi:10.1001/archpedi.158.2.119. PMID 14757603.
^ Ralston, S; Hill, V, Waters, A (2011 Oct). “Occult serious bacterial infection in infants younger than 60 to 90 days with bronchiolitis: a systematic review.”. Archives of pediatrics & adolescent medicine 165 (10): 951-6. doi:10.1001/archpediatrics.2011.155. PMID 21969396.
^ Belderbos ME, Houben ML, van Bleek GM, et al. (February 2012). “Breastfeeding modulates neonatal innate immune responses: a prospective birth cohort study”. Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology 23 (1): 65-74. doi:10.1111/j.1399-3038.2011.01230.x. PMID 22103307.
^ Wright, M; Mullett CJ, Piedimonte G et al. (October 2008). “Pharmacological management of acute bronchiolitis”. Veterinary Research 4 (5): 895-903. PMC 2621418. PMID 19209271.
^ Hartling L, Bialy LM, Vandermeer B, Tjosvold L, Johnson DW, Plint AC et al. (2011). “Epinephrine for bronchiolitis.”. Cochrane Database Syst Rev (6): CD003123. doi:10.1002/14651858.CD003123.pub3. PMID 21678340.
^ a b Hartling, L; Fernandes, RM, Bialy, L, Milne, A, Johnson, D, Plint, A, Klassen, TP, Vandermeer, B (2011 Apr 6). “Steroids and bronchodilators for acute bronchiolitis in the first two years of life: systematic review and meta-analysis”. BMJ (Clinical research ed.) 342: d1714. doi:10.1136/bmj.d1714. PMC 3071611. PMID 21471175.
^ a b c Bourke, T; Shields, M (2011 Apr 11). “Bronchiolitis”. Clinical evidence 2011. PMID 21486501.
^ “BestBets: Do recombinant DNAse improve clinical outcome in an infant with RSV positive bronchiolitis?”.
External links
Bronchiolitis. Patient information from NHS Direct
Bronchiolitis in children – A national clinical guideline PDF (1.74 MB) from the Scottish Intercollegiate Guidelines Network
Diagnosis and Management of Bronchiolitis from the AAP
Look up bronchiolitis in Wiktionary, the free dictionary.
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Nursing Assessment
The patient was Baby A, a female Malay patient who was 9 months and 29 days of age on admission. On admission, her weight was 8.6kg and her height was 73cm. She had a blood pressure of 105/ 73 mmHg, a pulse rate of 156/ min, a respiratory rate of 32 breaths/ min, and her oxygen saturation level was 96% under room air. Initially she started to having a fever and coughing,
Nursing Diagnosis #1: Ineffective breathing pattern
Nursing Goals #1:
Nursing Interventions #1:
Nursing Evaluation #1:
Nursing Diagnosis #2:
Nursing Goals #2:
Nursing Interventions #2:
Nursing Evaluation #2:
Nursing Diagnosis #3:
Nursing Goals #3:
Nursing Interventions #3:
Nursing Evaluation #3:
Pharmacological aspect of nursing care
Respiratory Virus DFA Test:
NPA for Virus +
Adenovirus –
Influenzae A –
Influenzae B –
Parainfluenzae 1 –
Parainfluenzae 2 –
Parainfluenzae 3 –
Test Methodology: NPM
Nursing Implementation
Discharge Summary
Patient Education

The Use Of Ergonomics Health And Social Care Essay

The practice of safety in workplace has seen incredible advances as time has gone, due to advancement in technology, although there is still considerable amount of challenges that comes in form of injuries and illnesses (Hopwood and Thompson, 2006). This is where ergonomics comes to play a role in making the workplace safe for activities that would be carried out by the employee. Ergonomics draws on many disciplines in its study of humans and their environments, including anthropometry, biomechanics, mechanical engineering, industrial engineering, industrial design, kinesiology, physiology and psychology (Wikipedia, 2010).

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Unsafe, unhealthy, uncomfortable or inefficient situations at work or in everyday life are avoided by taking account of the physical and physiological capabilities and limitations of humans (Dul and Weerdmeester, 1993). Human health and safety is at optimum range when the workplace environmental parameters are suitable for the employee (Story, 2010). Each year, poorly designed products and workplaces account for thousands of injuries and skyrocketing costs. That is why ergonomics the human factor in product and workplace design is fast becoming a major concern of manufacturers (Gross, 1995).
This report is about how is about applying and proper training on the use of ergonomics to everyday workplace can prevent life threatening illnesses, discomfort, accidents, and how employers can save money by reducing costs related to issues like workers’ compensation, absenteeism and turn over, as it makes operations more efficient by creating work place designs with fewer errors and improve on workplace user friendliness (MacLeod, 1995), with the goal of reducing musculoskeletal discomfort, increase work productivity, efficiency and comfort, as an employee who is more comfortable is more productive (Meriano and Latella, 2008).
The aim of this report is to know what ergonomics is all about and how it can be incorporated into the health and safety sector.
The objectives of this report are;
Reduce risks factors associated with poorly designed work stations and,
To design a workplace that is suitable for the human body rather than the human body adapting to workplace.
To be able to identify, measure, control and monitor the occupational health hazards/agents in the workplace which may cause ill-health to employees.
Ergonomics is the science of fitting workplace conditions and job demands to the capabilities of the working population, it tends to look into work related problems that poses a risk of musculoskeletal disorders and ways of alleviating them (Cohen et al, 1997). It is also the applied science that is devoted to provide comfort, efficiency and safety into the design of items in the work place (Shelly and Vermaat, 2010), ergonomic intervention can benefit both employer and employee (Meriano and Latella, 2008).
The International Ergonomics Association defines ergonomics as follows:
Ergonomics (or human factors) is the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data and methods to design in order to optimize human well-being and overall system performance.
A large number of factors play a role in ergonomics; these include body posture and movement, environmental factors, information and operation as well as work organization. Ergonomics differs from other fields by its interdisciplinary approach and applied nature (Dul and Weerdmeester, 1993).
The benefits of ergonomics include job satisfaction and enhanced worker motivation, added problem-solving capabilities, and greater acceptance of change. Involving staffs can help to identify job hazards, suggest ways to control these hazards and working with management in deciding how to put this control in place.
An Ergonomist is one who has adequate knowledge of the relation between humans’ health and humans’ performance (Schlick, 2009) taking into consideration the job, equipment used and information used (http://en.wikipedia.org/wiki/Ergonomics). According to Dul and Weerdmeester, 1993, the professional ergonomists can work for the authorities (legislation), training institutions (universities and colleges), research establishments, the service industry (consultancy) and production sector (occupational health services, personnel departments, design departments, research departments, etc.), they also wrote that the ergonomist highlights the areas where ergonomic knowledge is essential, provides ergonomic guidelines and advises designers, purchasers, management and employees, on which are more acceptable systems.
Science of Ergonomics dates back to 1717, when Bernadino Ramazzini, father of occupational medicine, speculated on factors within the work environment that contributed to his patients’ illnesses, he described violent and irregular motions, bent posture and tonic strain on the muscle as factors that contributed to musculoskeletal pains in his patients (Meriano and Latella, 2008).
However, in the United Kingdom, ergonomics started in 1917 in World War I when the Department of Scientific and Industrial Research and the Medical Research Council were asked to investigate industrial conditions, particularly of munitions workers, this led to the establishment of Industrial Fatigue Research Board who performed research on above topic in 1929 because of the expanded scope of work (hours of work, training, accidents, lighting and ventilation, and design of the machinery. In 1949, the Ergonomics Research Society was established at a meeting held by a small group of research workers at the Admiralty; this made the society the earliest to be formed in the world (Meister, 1999).
The law serves as a vital function in complex social setting as it provides standards or guidelines that define unacceptable and acceptable human behaviour. A breach in this law can be considered violation of the law and the transgressor could face civil or criminal penalties the legal system of every governmental jurisdiction and at every level of organised society must constantly adapt to changing demands, so there has and will be a continuing effusion of controlling laws. It is for this reason that the legal system is based on concepts of human faults. Liability prevention or mitigation is the avoidance of fault by investigation, analysis, evaluation, risk assessment, corrective action, and preventive remedies. The probability of a scientist or engineer having contact with law is high, it is wise to become familiar with the area of entanglement (Marras and Karwowski, 2006), as there are a myriad of roles that can be played in state or federal common law actions, workers’ compensation cases, allegations of statutory violations, arbitrations or mediations, government agency hearings, or citations involving Occupational Safety and Health Administration (OSHA), Environmental Protection Agency (EPA) (Vinal, 1999). According to Health and Safety at Work (HASAW) Act 1974, which is legislation, it states that; it is the duty of the employer to carry out a risk assessment in the work place. Failure to this is regarded as a breach in the law and has its consequences.
The fundamental goal of human-centred engineering is to match human characteristics such as body size, strengths and weaknesses, and capabilities and preferences with the relevant attributes of equipment, tasks, and procedure (Kroemer, 2006).
The different methods used in the assessment of ergonomics include;
I Physical methods
II Psycho physiological methods
III Behavioural and Cognitive Methods
IV Team methods
V Environmental methods
VI Macroergonomics methods
(Stanton et al., 2005)
All these methods make use of the following techniques listed below;
Measurement teams
Anthropometric techniques
Assessing energetic capabilities
Assessing muscle strength
Assessing mental workload
Assessing vision capabilities
Systematic gathering of information
The ideal field assessment tools used should possess the following attributes;
Predictive: the tool should provide predictive measure of risk of musculoskeletal injury,
Robust: can be used in any work situation,
Inexpensive: tool can be available at minimal monetary cost,
Non-invasive: should not affect when worker performs or process work flow,
Quick: assessment could be performed quickly,
Easy to use: tool could be used with minimal training,
(Marras and Karwowski, 2006).
For the purpose of this assessment to be done, several protocols would have to be met. The first thing that would be done is to get a work station that can be used to carry out an ergonomics assessment, and the Help Desk in the Learning Resource Centre (LRC) has been selected. A proposed meeting was set up with the Manager of the LRC to get permission to carry out the assessment, the manager approved of this and forwarded necessary messages to the supervisors in the LRC who helped in completing the task. A confidentiality questionnaire was handed to one of the supervisors, which was filled and returned and would be used as a point of reference in the results. Using anthropometric method of ergonomic risk assessment, measurement of the work station would be taken using a measuring tape and pictures snapped for further evidence of the work station for ergonomics assessment. Ergonomics assessment on the work station would be done on the basis of the task carried out. The task carried out in the Help Desk in the LRC involves helping students use the computer systems to locate books in the library and helping to arrange books in shelves. For this reason, there is the need to alternate between sitting down and standing. Below is a chart that shows a plan on how the work would be carried out.
Hazard Identification
Ergonomics Assessment Evaluation
Risk Validation
Control and monitor
Chart 1: Flow Plan on the methodology of the ergonomic assessment.
The particular work station selected for this ergonomics was carefully observed for the different task carried out to see if there is any problem associated with the work place. Anthropometric technique was used to carry out this work by getting measurements of the work place.
4.1 OBSERVATION: The help desk offered assistance in carrying out this work after permission was granted by the Manager of the LRC. Looking carefully at the way work was done and asking questions from the staff being monitored were put into consideration, also photographs were taken to also get a clear picture of how the employee carries out the task.
Fig 1: A Staff carrying out her duties on a Visual Display Unit.
4.2 HAZARD IDENTIFICATION: hazard identification was obtained mainly by asking questions from the employee on the work station, making use of a questionnaire and viewing the work station for possible activities that may cause health disorder(s) and affect the employee. Health and Safety at Work (HASAW) Act 1974 demands that the employer should make sure that employers carry out a risk assessment in the work environment to ensure safety of staffs. See result in table 1 below.
Table 1: Hazard Identification on the help desk.
Hazard aspect
Impact/ Effect
Stooped posture (resulting from fatigue and long hours of working)
Stiffness of the back, neck, and wrist from working too long on the Visual Display Unit
Variety of health problems, like caved shoulders, muscular imbalances, rounding of the upper back and a tendency to lean forward while walking.
Incidence of lower back disorders.
Twisting of the waist, neck, stretching the hand and holding in that position for a long time (straining muscles in the hand)
Pain and strain on neck muscles and waist.
Stress on muscles of the arms while stretching causes fatigue of the arm muscle.
Visual Display Unit (VDU), keyboard and mouse.
Fixed position of the neck when staring at the VDU, and stress on fingers from too much typing, twisting and flexing of the wrist when handling the mouse.
Makes the employee aware of some eye defects that he/she was not aware of. Straining of the arms to reach the mouse and twisting of the wrist to get to the keyboard and grabbing the mouse.
Ergonomics assessment on the work station showed that the design of the station has a moderate score as it accommodates the employee and has a low risk level. Below is a table of the total ergonomic risk factor and how it was derived.
Table 2: Ergonomic Work Position Evaluation.
Assessed by: Igho Date:14/12/2010
Ergonomic Evaluation Risk Factor Static Points Comments/Action
Work Positions (Sitting)
0 pts 2 pts 4 pts
√ if 20 secs +
X 3 if static
Neck (Flexion) bending head forward

Shoulders (Raising elbows)


Back (flexion) bending forward at the hips

Hiking Shoulders

Twisting (incorrectly with feet stationary)

Table 3: Task factor Evaluation
Task Factors
Points Awarded
Muscle force
Low √ Moderate High
Low √ Moderate High
Good √ Fair Poor
Workplace Temperature
Comfortable √ Warm/Cool Hot/Cold
Table 4: Risk Factor total on the work station.
Risk Factor total Risk Factor Points Total Comments/Action
0 pts 2 pts 4pts
Work Positions
0 – 7 8 – 15 16 pts+
= 4
High (8-12)
Task factors
0 – 8 9 – 15 16 pts+
= 0
= 4
Moderate (4 – 7)
0 – 7 8 – 13 14 pts+
= 0
Low (0 – 3)
Table 5: Key Descriptor
Little or no complaints of muscle aches and pains
Taking of short time breaks
Stress and fatigue on muscles which is tolerable
Selection of an employee to monitor how tasks are being carried out
Work Musculoskeletal disorder, static load on muscles leads to painful fatigue on muscles
Reduction of work that can cause musculoskeletal disorder and training of staffs to become more aware of ergonomic risk factors related to musculoskeletal disorders.
Below is a sketch on the work station used in the LRC, measured in cm.
48cm 24cm
96cm 48cm 72cm
Fig 1: Sketch and measurement of the work station.
The sketch above can be compared to the British standard dimension to know if the measured work station meets up with the standard.
Table 6: Work place measurement compared with British Standard Dimension
Measured Work Station
British Standard Dimension (5th – 95th Percentile (mixed Population 19 – 65 yrs)
Popliteal height
Thigh Clearance
Table Height (Popliteal height + Sitting Elbow height)
Sitting Shoulder Height Position
Back rest
Based on the production of a well ergonomically equipped work station, a good control and review of the work station, and everything put in order, information and training of employees there may still be a problem that can pose as a threat to the work place. This can be seen in workers habit; sitting forward on the chair, sitting in the middle of the chair, leaning on arm rest and back rest, arms resting on the table are some examples of employees habit, and this can result in intervertebral disc injuries and back problems as the muscles of the back are easily stressed.
To control occupational health and safety risks, improvement of performance and benefits in work places in order to eliminate or minimize risk to employees and other interested parties exposed to risks associated with its activities, it is necessary to implement, maintain and continually improve occupational health and safety in the work place.
The following can be used to control and monitor on-going activities and tasks in the work place;
Avoid Unnatural Posture: bending the trunk/head sideways is more harmful than bending forward
The working area should be located so that it is at the best distance from the eyes of the operator.
Hand grip, materials and tools should be arranged in such a way that the most frequent movements are carried out with the elbows bent and near to the body.
Manipulations can be made easier by using supports under the elbows, forearms or hands. Padded/soft warm materials that can be adjustable to suite people of different sizes.
It is essential that the workplace should be suited to the body size and mobility of the operator/employee, since neutral/natural postures and movements are a necessary part of efficient work.
Neck and head posture: head and neck should not be bent forward by more than thirty degrees when the trunk is erect, else fatigue and troubles may occur.
Having seen that ergonomically, the work station is tolerable, and staffs have been informed on how to position themselves whilst working, there is need to review work practice every three months to ensure and enforce that the mode of working is still in place to avoid injuries that may have built up with time.
After measuring the work station and comparing with the British standard measurement, it is recommended that the chair (adjustable) should be adjusted to fit the user so as to get the comfortability needed in order not to stress and strain muscles in the back and feet. The mouse and Visual display unit should be ergonomically put in place to the comfort of the operator, to reduce tension and strain to the eyes, hands and wrist
The purpose of this policy is to endeavour staffs to adhere to guidelines in the work place with the aim of ensuring a safe working environment as well as to bring health hazard to a minimum. It is the management’s responsibility to carry out duties under the Health and Safety at work Act 1974 and other legislation including amendments to ensure safe working practices and work environment. For this reason, the help desk shall abide to the following guidelines;
Ergonomics efforts shall be embedded, maintained and preserved on the help desk in Learning Resource Centre (LRC) to ensure a safe and healthy work place environment for employees.
Cooperation of work force in making sure that ergonomic improvement is realised. (Joint effort of managers, supervisors, employees and other supporting staffs)
Designation of post to a responsible employee to check that workers are well positioned, to prevent Work-related Musculoskeletal Disorders in the work station.
Training of staffs to be more aware of ergonomic risk factors related to Work-related Musculoskeletal Disorders.
Informing staffs about ergonomics and its risk factors can help to reduce cost of treatment of Work-related Musculoskeletal Disorders, as the budgeted cost can be used as employees’ benefits.
This policy would be implemented and reviewed three times a year to ensure that the health conditions of the employees are in order, to reduce money spent on treating employees for work related musculoskeletal disorders. This policy would be handed to each staff through information and trainings and in written form.
After a thorough ergonomic examination of the help desk in the LRC, and assessing the working environment, proper ergonomics evaluation was done and control measures put in Place as well as a policy for the safety and health of the employees so as to reduce chances of the risk of having a staff complain about a work related musculoskeletal disorder. Control measures used after ergonomic assessment and risk validation was carried
out is to help in reducing the chances of getting a work related musculoskeletal disorder and cost of treatment from injuries sustained (if any at all, considering the tolerable amount derived from the evaluation and chances of any injury sustained, this is as a result of proper training of the staffs).